Effect of Age of Onset of Psoriasis on Clinical Outcomes with Systemic Treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

AbstractAutoimmune retinopathy (AIR) is a rare immune-mediated inflammation of the retina. The autoantibodies against retinal proteins and glycolytic enzymes were reported to be involved in the pathogenesis. This retrospective cohort study assessed the antiretinal autoantibody profiles and their association with clinical outcomes of AIR patients in Thailand. We included 44 patients, 75% were females, with the overall median age of onset of 48 (17–74, IQR 40–55.5) years. Common clinical presentations were nyctalopia (65.9%), blurred vision (52.3%), constricted visual field (43.2%), and nonrecordable electroretinography (65.9%). Underlying malignancy and autoimmune diseases were found in 2 and 12 female patients, respectively. We found 41 autoantibodies, with anti-α-enolase (65.9%) showing the highest prevalence, followed by anti-CAII (43.2%), anti-aldolase (40.9%), and anti-GAPDH (36.4%). Anti-aldolase was associated with male gender (P = 0.012, OR 7.11, 95% CI 1.54–32.91). Anti-CAII showed significant association with age of onset (P = 0.025, 95% CI − 17.28 to − 1.24), while anti-α-enolase (P = 0.002, OR 4.37, 95% CI 1.83–10.37) and anti-GAPDH (P = 0.001, OR 1.87, 95% CI 1.32–2.64) were significantly associated with nonrecordable electroretinography. Association between the antibody profiles and clinical outcomes may be used to direct and adjust the treatment plans and provide insights in the pathogenesis of AIR.

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The Association Between Age of Onset of Type 2 Diabetes with Long-term Risk of End Stage Kidney Disease: A National Registry Study

10.2337/figshare.12273110.v1 ◽

2020 ◽

Author(s):

Jedidiah I Morton ◽

Danny Liew ◽

Stephen P McDonald ◽

Jonathan E Shaw ◽

Dianna J Magliano

Keyword(s):

Type 2 Diabetes ◽

Kidney Disease ◽

Cumulative Incidence ◽

Age Of Onset ◽

End Stage Kidney Disease ◽

Onset Of Diabetes ◽

End Stage ◽

Effect Of Age

Objective: The long-term risk of end-stage kidney disease (ESKD) in type 2 diabetes is poorly described, as is the effect that younger age of diabetes onset has on this risk. Therefore, we aimed to estimate the effect of age of onset on the cumulative incidence of ESKD from onset of type 2 diabetes. Research Design and Methods: This study included 1,113,201 people with type 2 diabetes registered on the Australian National Diabetes Services Scheme (NDSS) followed from 2002 until 2013. The NDSS was linked to the Australia and New Zealand Dialysis and Transplant Registry and the Australian National Death Index. Results: Between 2002 and 2013, there were 7,592 incident cases of ESKD during 7,839,075 person-years of follow up. In the first 10-15 years following onset of diabetes, the incidence of ESKD was highest in those with an older age of onset of diabetes, whereas over longer durations of diabetes the incidence of ESKD became higher in those with younger-onset diabetes. After 40 years of diabetes, the cumulative incidence of ESKD was 11.8% and 9.3% in those diagnosed with diabetes aged 10-29 and 30-39 years, respectively. When death from ESKD without renal replacement therapy was included, incidence of ESKD remained higher in older onset diabetes for the initial 20 years, with no clear effect of age thereafter. Conclusions: The long-term risk of ESKD in type 2 diabetes is high, which disproportionately affects those with younger-onset of diabetes as they are more likely to survive to longer diabetes durations.

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Classifying Crohn’s disease into colon-involving versus non-colon-involving groups is a better predictor of clinical outcomes than the Montreal classification

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820968732 ◽

2020 ◽

Vol 13 ◽

pp. 175628482096873

Author(s):

Si-Nan Lin ◽

Dan-Ping Zheng ◽

Yun Qiu ◽

Sheng-Hong Zhang ◽

Yao He ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Abdominal Surgery ◽

Clinical Outcomes ◽

Protective Factor ◽

Age Of Onset ◽

Disease Classification ◽

Major Abdominal Surgery ◽

Montreal Classification

Background: A suitable disease classification is essential for individualized therapy in patients with Crohn’s disease (CD). Although a potential mechanistic classification of colon-involving and non-colon-involving disease was suggested by recent genetic and microbiota studies, the clinical implication has seldom been investigated. We aimed to explore the association of this colonic-based classification with clinical outcomes in patients with CD compared with the Montreal classification. Methods: This was a retrospective study of CD patients from a tertiary referral center. Patients were categorized into colon-involving and non-colon-involving disease, and according to the Montreal classification. Clinico-demographic data, medications, and surgeries were compared between the two classifications. The primary outcome was the need for major abdominal surgery. Results: Of 934 patients, those with colonic involvement had an earlier median (interquartile range) age of onset [23.0 (17.0–30.0) versus 26.0 (19.0–35.0) years, p = 0.001], higher frequency of perianal lesions (31.2% versus 14.5%, p < 0.001) and extraintestinal manifestations (21.8% versus 14.5%, p = 0.010), but lower frequency of stricture (B2) (16.3% versus 24.0%, p = 0.005), than those with non-colon-involving disease. Colon-involving disease was a protective factor against major abdominal surgery [hazard ratio, 0.689; 95% confidence interval (CI), 0.481–0.985; p = 0.041]. However, patients with colon-involving CD were more prone to steroids [odds ratio (OR), 1.793; 95% CI, 1.206–2.666; p = 0.004] and azathioprine/6-mercaptopurine (AZA/6-MP) treatment (OR, 1.732; 95% CI, 1.103–2.719; p = 0.017) than were patients with non-colon-involving disease. The Montreal classification was not predictive of surgery or steroids and AZA/6-MP treatment. Conclusion: This study supports the rationale for disease classification based on the involvement of colon. This new classification of CD is a better predictor of clinical outcomes than the Montreal classification.

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Effect of age and baseline ASPECTS on outcomes in large-vessel occlusion stroke: results from the HERMES collaboration

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-016621 ◽

2020 ◽

pp. neurintsurg-2020-016621

Author(s):

Johanna Maria Ospel ◽

Manon Kappelhof ◽

Nima Kashani ◽

Bijoy K Menon ◽

Bruce C V Campbell ◽

...

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Effect Size ◽

Point Estimate ◽

Stroke Patients ◽

Multiplicative Interaction ◽

Size Estimates ◽

Effect Of Age

BackgroundPatient age and baseline Alberta Stroke Program Early CT score (ASPECTS) are both independent predictors of outcome in acute ischemic stroke patients treated with endovascular therapy (EVT). We assessed the combined effect of age and ASEPCTS on clinical outcome in acute ischemic stroke patients with LVO with and without EVT, and EVT treatment effect in different age/ASPECTS subgroups.MethodsThe HERMES collaboration pooled data of seven randomized controlled trials that tested the efficacy of EVT. Adjusted logistic regression was performed to test for multiplicative interaction of age and ASPECTS with the primary outcome (ordinal mRS) and secondary outcomes (mRS 0–2/0–1/0–3) in the EVT and control arms. Patients were then stratified by age (<75 vs ≥75 years) and ASPECTS (0–5/6–7/8–10), and adjusted effect-size estimates for the association of EVT were derived for the six age/ASPECTS subgroups.Results1735 patients were included in the analysis. There was no multiplicative interaction between age and ASPECTS on clinical outcomes. In the exploratory subgroup analysis, we found a nominally negative point estimate for the association of EVT with clinical outcome in the ASPECTS 0–5/age ≥75, subgroup (acOR 0.36, 95% CI 0.07 to 1.89). The point estimate for moderate outcome (mRS0-3) nominally favored EVT (aOR 1.24, 95% CI 0.16 to 9.84). In all other subgroups, effect size-estimates consistently favored EVT.ConclusionThere was no multiplicative interaction of age and ASPECTS on clinical outcomes in EVT or control arm patients. Outcomes in patients ≥75 years with ASPECTS 0–5 were poor, irrespective of treatment. Further investigation to define the role of EVT and range of acceptable outcomes in this subgroup is warranted.

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The Effect of Age of Onset on Depression in the Elderly

Topics in geriatrics ◽

10.1177/089198878900200403 ◽

1989 ◽

Vol 2 (4) ◽

pp. 182-187 ◽

Cited By ~ 5

Author(s):

Nathan Herrmann ◽

Susan Lieff ◽

Michel Silberfeld

Keyword(s):

Age Of Onset ◽

The Elderly ◽

Effect Of Age

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The Effect of Age on Clinical Outcomes and Health Status

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2011.05.020 ◽

2011 ◽

Vol 58 (8) ◽

pp. 810-819 ◽

Cited By ~ 24

Author(s):

Sheng-Chia Chung ◽

Mark A. Hlatky ◽

David Faxon ◽

Kodangudi Ramanathan ◽

Dale Adler ◽

...

Keyword(s):

Health Status ◽

Clinical Outcomes ◽

Effect Of Age

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The effect of age of onset of PD on risk of dementia

Journal of Neurology ◽

10.1007/s00415-006-0234-8 ◽

2007 ◽

Vol 254 (1) ◽

pp. 38-45 ◽

Cited By ~ 84

Author(s):

D. Aarsland ◽

J.T. Kvaløy ◽

K. Andersen ◽

J.P. Larsen ◽

M.X. Tang ◽

...

Keyword(s):

Age Of Onset ◽

Effect Of Age

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Treatment patterns and clinical outcomes of patients with metastatic gastroenteropancreatic neuroendocrine tumors (mGEP-NETs).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.331 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 331-331

Author(s):

Xiaolong Jiao ◽

Sonia J. Pulgar ◽

Marley Boyd ◽

Fadi S. Braiteh ◽

Susan Pitman Lowenthal ◽

...

Keyword(s):

Targeted Therapy ◽

Small Bowel ◽

Clinical Outcomes ◽

Systemic Treatment ◽

Somatostatin Analogs ◽

Community Setting ◽

Tumor Grade ◽

Treatment Patterns ◽

Gastroenteropancreatic Neuroendocrine Tumors ◽

Primary Tumor Site

331 Background: mGEP-NETs are rare and heterogeneous tumors. Limited data has been published on real world clinical management of these tumors. This study was conducted to understand the treatment patterns and clinical outcomes of patients with mGEP-NETs treated in the community oncology setting. Methods: A retrospective study was conducted using US Oncology’s (USON) iKnowMed electronic health record (EHR) database with supplemental chart review. The first diagnostic record of mGEP-NET in the EHR system was defined as the date of diagnosis of mGEP-NET. Inclusion criteria: ≥ 18 years of age at diagnosis; diagnosis of mGEP-NET between 1/1/2008 to 12/31/2012. Patients in clinical trials or with poorly differentiated tumors were excluded. Results: 229 patients were included with a median age of 64.0 years. Primary tumor site included small bowel (47.6%), pancreas (31.4%), and other (21.0%). Tumor grade was available for 134/229 (58.5%) patients, and the majority was reported as well-differentiated (52.8%). Chromogranin A (CgA) and urinary 5-HIAA were reported for 34.9%, and 32.8% of patients respectively. 37 (16.2%) of patients were under observation only. For those receiving systemic treatment, median time to first systemic treatment after diagnosis was 2.7 weeks, with 75% of patients starting therapy by 9.4 weeks. 120 (52.4%) patients received only somatostatin analogs (SSAs) during the study period, and 72 (31.4%) patients received chemotherapy, and/or targeted therapy. In the 1st line setting (n = 192), 148 (77%) patients received SSAs, 23 (12%) chemotherapy, and 21 (10.9%) targeted therapy. The most common AEs for SSAs were diarrhea (18.2%), abdominal pain (16.9%), and fatigue (13.5%). The median OS from diagnosis was 84.2 months [95%CI 70.9, 108.0 months] for the overall cohort. OS was longer in small bowel NETs than in pancreatic or other NETs (median OS 108.0 vs 69.9 vs 84.2 months, p = 0.017). Conclusions: Most of the patients with mGEP-NETs received systemic treatment soon after diagnosis and referral to USON. The OS and AEs were consistent with other studies. Low reporting of CgA, 5-HIAA, and tumor grade reflected variability of clinical practice in the community setting.

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