510 OUTCOMES OF ENTECAVIR (ETV) AND TENOFOVIR (TDF) COMBINATION THERAPY IN CHRONIC HEP-B PATIENTS WITH PREVIOUS TREATMENT FAILURE

2012 ◽  
Vol 56 ◽  
pp. S201
Author(s):  
M. Gill ◽  
U. Gill ◽  
N. Anwar ◽  
F. Salman
Keyword(s):  
Combination Therapy ◽  
Treatment Failure ◽  
Previous Treatment ◽  
Hep B

scholarly journals Recurrent or New Symptomatic Cerebral Aneurysm after Previous Treatment

2005 ◽  
Vol 11 (4) ◽  
pp. 341-348 ◽  
Author(s):  
S. Rothemeyer ◽  
D. Lefeuvre ◽  
A. Taylor
Keyword(s):  
Treatment Failure ◽  
Cerebral Aneurysm ◽  
Nerve Palsy ◽  
Cerebral Aneurysms ◽  
Previous Treatment ◽  
Primary Treatment ◽  
The Other ◽  
Endovascular Coiling ◽  
Previously Treated ◽  
Third Cranial Nerve Palsy

With the establishment of endovascular coiling as a successful treatment for symptomatic cerebral aneurysms, attention is now being directed at the durability of this treatment. If this is to be accurately done it will be important to understand the causes of symptomatic aneurysm presentation after previous treatment. In order to assess this we undertook a retrospective review, covering the four year period from 2000 to 2004, of all patients re-presenting with a symptomatic saccular aneurysm after previous treatment. Seven patients were identified, six presenting with subarachnoid haemorrhage (SAH) and one with a third cranial nerve palsy. Three patients had incomplete clipping of their aneurysms and all presented within months of their initial treatment. The other four patients presented between five and 20 years after primary treatment and all were felt to have new cerebral aneurysms. Two of these patients had aneurysms develop at the same location as their previously treated lesions, however these were still felt to be new aneurysms rather than re-growth or recurrence because of their morphology. Based on our findings it would appear that development of a new cerebral aneurysm after clipping is more of a risk than aneurysm recurrence from treatment failure. This will need to be considered when evaluating re-presentation after treatment by either coiling or clipping and more importantly, perhaps we should be directing more attention to preventing disease progression rather than treatment failure.

High Rate of Complete Viral Suppression With Combination Therapy in Patients With Chronic Hepatitis B and Prior Treatment Failure

2011 ◽  
Vol 45 (10) ◽  
pp. 900-905 ◽  
Author(s):  
Carrie R. Wong ◽  
Huy N. Trinh ◽  
Benjamin Yip ◽  
Huy A. Nguyen ◽  
Ruel T. Garcia ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Combination Therapy ◽  
Treatment Failure ◽  
Chronic Hepatitis B ◽  
Viral Suppression ◽  
Prior Treatment ◽  
High Rate

scholarly journals Combined Biologic and Immunomodulatory Therapy is Superior to Monotherapy for Decreasing the Risk of Inflammatory Bowel Disease-Related Complications

2020 ◽  
Vol 14 (10) ◽  
pp. 1354-1363 ◽  
Author(s):  
Laura E Targownik ◽  
Eric I Benchimol ◽  
Charles N Bernstein ◽  
Harminder Singh ◽  
Aruni Tennakoon ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Combination Therapy ◽  
Treatment Failure ◽  
Real World ◽  
Bowel Disease ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background and Aims The combination of infliximab and azathioprine is more efficacious than either therapy alone for Crohn’s disease [CD] and ulcerative colitis [UC]. However, it is uncertain whether these benefits extend to real-world clinical practice and to other combinations of biologics and immunomodulators. Methods We collected health administrative data from four Canadian provinces representing 78 413 patients with inflammatory bowel disease [IBD] of whom 11 244 were prescribed anti-tumour necrosis factor [anti-TNF] agents. The outcome of interest was the first occurrence of treatment failure: an unplanned IBD-related hospitalization, IBD-related resective surgery, new/recurrent corticosteroid use or anti-TNF switch. Multivariable Cox proportional hazards modelling was used to assess the association between the outcome of interest and receiving combination therapy vs anti-TNF monotherapy. Multivariable regression models were used to assess the impact of choice of immunomodulator or biologic on reaching the composite outcome, and random effects generic inverse variance meta-analysis of deterministically linked data was used to pool the results from the four provinces to obtain aggregate estimates of effect. Results In comparison with anti-TNF monotherapy, combination therapy was associated with a significant decrease in treatment ineffectiveness for both CD and UC (CD: adjusted hazard ratio [aHR] 0.77, 95% confidence interval [CI] 0.66–0.90; UC: aHR 0.72, 95% CI 0.62–0.84). Combination therapy was equally effective for adalimumab and infliximab in CD. In UC azathioprine was superior to methotrexate as the immunomodulatory agent (aHR = 1.52 [95% CI 1.02–2.28]) but not CD (aHR = 1.22 [95% CI 0.96–1.54]). Conclusion In an analysis of a database of real-world patients with IBD, combination therapy decreased the likelihood of treatment failure in both CD and UC.

Raltitrexed in the management of metastatic colorectal cancer: The COMET study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 677-677
Author(s):  
Jérôme Desramé ◽  
Louis-Marie Dourthe ◽  
Philippe Debourdeau ◽  
Dominique Mille ◽  
Pascal Artru ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Combination Therapy ◽  
Treatment Failure ◽  
Folinic Acid ◽  
Disease Progression ◽  
Cardiac Toxicity ◽  
Tumour Progression ◽  
Single Agent ◽  
Patient Consent

677 Background: Raltitrexed, indicated for palliative treatment of advanced colorectal cancer (CRC), may be useful for patients (pts) with cardiovascular (CV) risk factors, or cardiotoxicity/disease progression with prior chemotherapy (CT). The COMET study, conducted in France, described the characteristics of pts with metastatic CRC (mCRC) treated with raltitrexed, focusing on pts with cardiotoxicity or disease progression with prior 5-fluorouracil (5FU)/folinic acid. Methods: A national, multicentred, cross-sectional, non-interventional study to describe the profiles of pts with mCRC treated with raltitrexed. Pts (≥18 years) with mCRC, treated with raltitrexed as a single agent or in combination therapy, were included. Following patient consent, retrospective data were recorded during a single inclusion visit based on pt medical files; during the study, data were recorded prospectively. Results: 414 pts with mCRC were analysed; 84.8% had ≥1 prior CT, 60.9% had CV risk factors and 35.2% had CV history (angina: 11.8%; myocardial infarction: 11.8%). Overall, 79.5% of pts had received a prior 5FU-based CT. Reasons for switching to raltitrexed included short 15-min infusion duration (34.8%), treatment failure (49.8%) and acute cardiotoxicity with 5FU (8.9%). After switching, 57.2% of pts received raltitrexed as combination therapy. Mean initial dosage of raltitrexed was 2.6±0.6 mg/m2. Of those who had CV risk factors (n=73) or CV history (n=67), 69.0% and 72.7% received raltitrexed after CV toxicity, respectively. Of the pts treated with second-line raltitrexed and assessed with prior acute CV events (45/414), 88.9% (40/45) had no cardiac toxicity during treatment with raltitrexed. Of those (n=206) receiving raltitrexed due to treatment failure, 62.7% had received 5FU/folinic acid during their last CT. Of the pts assessed for tumour response (183/206), tumour progression was controlled with raltitrexed in 25.7% of cases (stable disease: 18.0%; partial response: 7.7%; progressive disease: 56.3%). Conclusions: Raltitrexed appears to be effective in heavily pretreated pts with mCRC and tumour progression after 5FU therapy and could be a safe therapeutic alternative to 5FU for pts with mCRC and prior cardiac toxicity.

Entecavir plus tenofovir combination therapy for chronic hepatitis B in patients with previous nucleos(t)ide treatment failure

2016 ◽  
Vol 10 (5) ◽  
pp. 779-788 ◽  
Author(s):  
Fabien Zoulim ◽  
Jolanta Białkowska-Warzecha ◽  
Mircea Mihai Diculescu ◽  
Adrian Eugen Goldis ◽  
Renate Heyne ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Combination Therapy ◽  
Treatment Failure ◽  
Chronic Hepatitis B

Comparative Efficacy of Beta-Lactams and Macrolides in the Treatment of Pediatric Pneumonia: a Systematic Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Dalia Al Saeedy ◽  
Syed Wasif Gillani ◽  
Jumana Al-Salloum ◽  
Arzu Moosvi ◽  
Mohamed Eissa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Treatment Failure ◽  
Hospital Stay ◽  
Pediatric Population ◽  
Community Acquired Pneumonia ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Comparative Efficacy ◽  
Pediatric Pneumonia

Background: Pneumonia is an acute infection of the lung parenchyma that is differentiated among three main diagnoses: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and healthcare-associated pneumonia (HCAP). Though CAP is initially presented as a mild infection, it contributes to childhood mortality rates globally. A vast number of pathogens are the cause of CAP, but the two main causative organisms include Streptococcus pneumoniae and Haemophilus influenzae, with the former causing up to 50% of all childhood cases. Current treatment guidelines from the Infectious Diseases Society of America (IDSA), amoxicillin is the recommended treatment choice for mild-to-moderate CAP while ampicillin is recommended for cases of severe CAP. Previous studies compared treatment between macrolides and beta-lactams to provide more information on the effectiveness in the pediatric population. Objective: The objective of this article is to systematically review literature on comparative efficacy of beta-lactams and macrolides in the treatment of community-acquired pneumonia among children and to evaluate the outcomes that are used to determine drug efficacy in order to provide medication recommendations. Methods: A systematic literature search was conducted in PubMed, TRIP, Cochrane and SCOPUS. Cohort studies and randomized controlled trials between the years 2000 and 2020 that compared the efficacy of amoxicillin and macrolides in treating pediatric pneumonia are included in the systematic review Eligible patients included patients who were 17 years and younger, diagnosed with community-acquired pneumonia, and were given beta-lactams or macrolides, either as monotherapy or combination. Two reviewers were involved in the appraisal process to assess the quality of the methods used in the selected studies. Results: A total of six articles were eligible according to the inclusion criteria and quality assessment. Four articles compared beta-lactam monotherapy with beta-lactam and macrolide combination therapy, while Kogan R, et al. compared macrolide therapy monotherapy with beta-lactam and macrolide combination therapy and Leyenaar JK et al. compared ceftriaxone monotherapy to ceftriaxone plus macrolide combination therapy. The studies defined treatment failure as either a change in antibiotic therapy or hospital admission within 14 days of CAP diagnosis. Three studies used length of hospital stay as their primary outcome for comparison of treatment efficacy. Four studies showed that the use of macrolides provided better treatment outcomes by reducing hospital stay and treatment failure rates. Beta-lactam and macrolide combination therapy did not show a significant effect on treatment failure compared to beta-lactam monotherapy regimens and it did not affect mortality compared to placebo or diet alone. Within the macrolide class, azithromycin was more clinically significant compared to erythromycin. Conclusion: The use of macrolidesas monotherapy or add-on therapy to beta-lactams is more effective in the treatment of community acquired pneumonia in the pediatric population.

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