Impact of dermatologic adverse events induced by targeted therapies on quality of life

e12533 Background: Endocrine therapies are known to cause adverse events including hot flashes, arthralgias, and dyspareunia. Dermatologic adverse events (dAE), including alopecia are infrequently reported, despite their potential impact on quality of life (QoL). This study aims to characterize endocrine therapy-related dAE including alopecia, acne, xerosis, and onychodystrophy. Methods: A retrospective chart review (2005-2015) of patients referred to the dermatology service for dermatologic conditions developing during endocrine therapies was performed. Relevant data was abstracted from each patient’s medical record including demographics, primary cancer diagnosis, and dAEs by grade (CTCAE v4.03). The psychosocial impact of alopecia was assessed in a subset of patients using a QoL questionnaire (Hairdex), which includes the following domains: ‘emotions’, ‘functioning’, ‘symptoms’, ‘stigmatization’ and ‘self-confidence’. Results: A total of 74 breast cancer patients treated with endocrine therapies were included (median age 62yrs. [range, 34-85]). Alopecia was the reason for a dermatologic consultation in all patients, and was attributable to aromatase inhibitors (AI) in 49 patients (66.2%) and tamoxifen in 22 (29.3%). The mean duration of treatment at the time of alopecia diagnosis was 24 months (SD ±14.3). In 93.2% of the patients, alopecia was grade 1 in severity, and in 6.8% it was grade 2 (the latter was attributable to AIs only). All grade xerosis was identified in 34 (45.9%), onychodystrophy in 21 (28.4%) and acne in 9 patients (12.2%). In patients who completed the Hairdex questionnaire (n = 44), a high ‘emotions’ (52.6, p < 0.05) and ‘stigmatization’ (46, p < 0.05) domains score were found, while ‘symptoms’ (22.1, p < 0.05) and ‘functioning’ (24.5, p < 0.05) domains score were lower. Conclusions: Endocrine therapies are associated with alopecia and dAEs, with a greater severity with AIs. A psychosocial impact on emotions was seen in patients with alopecia. Moreover, xerosis, acne, and onychodystrophy were also observed. These findings underscore the need for increased attention to dAE in breast cancer patients receiving endocrine agents, in order to maintain quality of life and adherence to therapies.

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Improvements in multiple domains of quality of life with alemtuzumab as assessed by the functional assessment of multiple sclerosis questionnaire over 6 years regardless of presence of thyroid adverse events

10.26226/morressier.5b7578655aff7400151f35ff ◽

2018 ◽

Author(s):

Aaron Boster

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Adverse Events ◽

Functional Assessment ◽

Multiple Domains

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Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

Foregut: The Journal of the American Foregut Society ◽

10.1177/26345161211021766 ◽

2021 ◽

pp. 263451612110217

Author(s):

Joshua A. Sloan ◽

Philip O. Katz

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Adverse Events ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Drug Class ◽

Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

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Patient-reported quality-of-life outcomes in relation to provider-assessed adverse events during head and neck radiotherapy

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-020-00227-4 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Joshua R. Niska ◽

Cameron S. Thorpe ◽

Michele Y. Halyard ◽

Angelina D. Tan ◽

Pamela J. Atherton ◽

...

Keyword(s):

Quality Of Life ◽

Adverse Events ◽

Head And Neck ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Patient Reported ◽

Head And Neck Radiotherapy

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A systematic review of the clinical effectiveness of donepezil, rivastigmine and galantamine on cognition, quality of life and adverse events in Alzheimer's disease

International Journal of Geriatric Psychiatry ◽

10.1002/gps.1402 ◽

2005 ◽

Vol 21 (1) ◽

pp. 17-28 ◽

Cited By ~ 124

Author(s):

A. Takeda ◽

E. Loveman ◽

A. Clegg ◽

J. Kirby ◽

J. Picot ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Adverse Events ◽

Clinical Effectiveness

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Sunitinib achieved fast and sustained control of VIPoma symptoms

Acta Endocrinologica ◽

10.1530/eje-14-0682 ◽

2015 ◽

Vol 172 (1) ◽

pp. K1-K3 ◽

Cited By ~ 16

Author(s):

Louis de Mestier ◽

Thomas Walter ◽

Hedia Brixi ◽

Catherine Lombard-Bohas ◽

Guillaume Cadiot

Keyword(s):

Quality Of Life ◽

Tyrosine Kinase ◽

Targeted Therapies ◽

Therapeutic Option ◽

Somatostatin Analogs ◽

Watery Diarrhea ◽

Tyrosine Kinase Receptors ◽

Secretory Pathways ◽

Discharge From Hospital

VIPomas are rare-functioning neuroendocrine tumors (NETs). Overproduction of vasointestinal peptide (VIP) leads to the Verner–Morrison syndrome, whose management is challenging when refractory to somatostatin analogs. Two patients with progressive metastatic pancreatic NETs and refractory VIPoma symptoms were treated with sunitinib. This led to fast and sustained total relief of VIPoma symptoms, enabling earlier discharge from hospital and improvement in their quality of life. In both cases, sunitinib discontinuation led to the quick recurrence of watery diarrhea, which resolved within a few days after reintroducing sunitinib. The anti-secretory effect of sunitinib on VIPoma syndrome was probably not related to any anti-tumor effect. These observations agree with the rare reported cases of anti-secretory effects with targeted therapies. The sunitinib-driven inhibition of multiple-tyrosine kinase receptors might act on secretory pathways and describe sunitinib's ability to improve VIPoma symptoms. Sunitinib could be a therapeutic option to control refractory VIPoma symptoms in patients with NETs.

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The Impact of Adverse Events on Functional Capacity and Quality of Life After HeartWare Ventricular Assist Device Implantation

ASAIO Journal ◽

10.1097/mat.0000000000001378 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Marc D. Samsky ◽

Carmelo A. Milano ◽

Salpy Pamboukian ◽

Mark S. Slaughter ◽

Emma Birks ◽

...

Keyword(s):

Quality Of Life ◽

Adverse Events ◽

Functional Capacity ◽

Ventricular Assist Device ◽

Assist Device ◽

Ventricular Assist ◽

Device Implantation ◽

The Impact

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Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea

European Respiratory Journal ◽

10.1183/13993003.01320-2019 ◽

2019 ◽

Vol 55 (1) ◽

pp. 1901320 ◽

Cited By ~ 21

Author(s):

Peter R. Eastwood ◽

Maree Barnes ◽

Stuart G. MacKay ◽

John R. Wheatley ◽

David R. Hillman ◽

...

Keyword(s):

Quality Of Life ◽

Adverse Events ◽

Nerve Stimulation ◽

Hypoglossal Nerve ◽

Sleep Apnoea ◽

Serious Adverse Events ◽

Obstructive Sleep ◽

Device Use ◽

Post Implantation

Background and aimHypoglossal nerve stimulation (HNS) decreases obstructive sleep apnoea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.MethodsThis prospective, open-label, non-randomised, single-arm treatment study was conducted at eight centres in three countries (Australia, France and the UK). Primary outcomes were incidence of device-related serious adverse events and change in the apnoea–hypopnoea index (AHI). The secondary outcome was the change in the 4% oxygen desaturation index (ODI). Additional outcomes included measures of sleepiness, quality of life, snoring and device use. This trial was registered with ClinicalTrials.gov, number NCT03048604.Results22 out of 27 implanted participants (63% male, aged 55.9±12.0 years, body mass index (BMI) 27.4±3.0 kg·m−2) completed the protocol. At 6 months BMI was unchanged (p=0.85); AHI decreased from 23.7±12.2 to 12.9±10.1 events·h−1, a mean change of 10.8 events·h−1 (p<0.001); and ODI decreased from 19.1±11.2 to 9.8±6.9 events·h−1, a mean change of 9.3 events·h−1 (p<0.001). Daytime sleepiness (Epworth Sleepiness Scale; p=0.01) and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire-10; p=0.02) both improved significantly. The number of bed partners reporting loud, very intense snoring, or leaving the bedroom due to participant snoring decreased from 96% to 35%. 91% of participants reported device use >5 days per week, and 77% reported use for >5 h per night. No device-related serious adverse events occurred during the 6-month post-implantation period.ConclusionsBilateral HNS using the Genio™ system reduces OSA severity and improves quality of life without device-related complications. The results are comparable with previously published HNS systems despite minimal implanted components and a simple stimulation algorithm.

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