37 Analysis of the Utility of CO2 and Pulse-Dye Lasers in the Treatment of Hypertrophic Burn Scars

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S28-S29
Author(s):  
Laura E Cooper ◽  
Phillip Kemp Bohan ◽  
Victoria D Hatem ◽  
Anders H Carlsson ◽  
Leopoldo C Cancio ◽  
...  
Keyword(s):  
Dye Lasers ◽  
Final Visit ◽  
Treatment Area ◽  
Treatment Groups ◽  
Burn Care ◽  
Scar Assessment ◽  
Laser Treatments ◽  
Ultrasound Assessment ◽  
The Difference

Abstract Introduction Despite advances in burn care, hypertrophic burn scars (HTBS) remain a significant source of morbidity. Treatment often involves use of CO2 lasers to reduce thickness and pulse-dye lasers (PDL) to reduce erythema. Despite frequent utilization, little quantitative data exists. This study seeks to objectively determine the effects of these laser treatments on burn scars. Methods Patients found to have HTBS undergoing laser treatments were approached for enrollment. Following enrollment, an area of HTBS outside of the treatment area was divided into 4 equal 3x3cm squares which were randomized to receive either CO2, PDL, CO2+PDL, or no treatment. Patients underwent a total of 3 treatments, 4–6 weeks apart, and were seen for follow-up over 3–6 months. Scar assessments occurred at each visit prior to treatment and consisted of digital photographs, ultrasound assessment for scar thickness, colorimetry, and the Patient and Observer Scar Assessment Score (POSAS). Results Twenty-five patients were enrolled at our institution. To date, 12 (48%) have completed all 3 treatments and the remainder are still in their follow-up period. Median initial scar thickness (ST) was 0.3cm. Mean time since injury was 9 months. Overall, there was a significant decrease in ST over time (p=0.0246) but not between treatment groups. There were no significant changes seen in melanin, erythema, or POSAS scores (p=0.9030, 0.6470, and 0.1495, respectively). When separated by ST before initiation of treatment, thin scars (< 3cm) appeared to be overall less erythematous in groups treated with PDL and CO2+PDL and untreated groups (p=0.0358, 0.0027. 0.0118, respectively) as compared to thick scars (≥3cm). Thin scars treated with PDL and CO2+PDL were also less pigmented than thick scars (p=0.0127, 0.0213, respectively). Erythema significantly decreased between the last treatment and the final visit for PDL and CO2+PDL groups (p< 0.0001). Older scars (≥9 months prior to treatment) tended to have a greater reduction in thickness as compared to newer scars but the difference was not significant to date. Conclusions Laser therapy is often employed in the treatment of HTBS. However, few studies have determined their objective benefits. Based on a preliminary analysis of our data, we have shown an overall decrease in scar thickness, less pigmentation, and less erythema in thin scars treated with PDL or CO2+PDL. Further analysis will be performed after additional follow-up information is collected.

Fractional CO2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars

2019 ◽  
Vol 40 (4) ◽  
pp. 386-391 ◽  
Author(s):  
Sagar P Patel ◽  
Ha Vi Nguyen ◽  
Diana Mannschreck ◽  
Richard J Redett ◽  
Katherine B Puttgen ◽  
...  
Keyword(s):  
Laser Treatment ◽  
Pediatric Patients ◽  
Assessment Tool ◽  
Tertiary Care ◽  
Convincing Evidence ◽  
Clinical Role ◽  
Treatment Protocols ◽  
Burn Care ◽  
Scar Assessment ◽  
Laser Treatments

Abstract Carbon dioxide ablative fractional laser (CO2-AFL) therapy has not been widely adopted in pediatric burn care given limited outcomes literature and no established guidelines on laser treatment protocols. We present our experience to further elucidate the clinical role of CO2-AFL therapy for pediatric hypertrophic burn scars. We conducted a prospective cohort study of pediatric burn patients undergoing CO2-AFL treatment of hypertrophic, symptomatic burn scars at a tertiary care regional burn center during a 2-year period. Scars were assessed before each treatment using the Patient and Observer Scar Assessment Scale (POSAS), a validated, subjective, comprehensive scar assessment tool. We treated 49 pediatric patients for a total of 180 laser sessions. Burn severity was full thickness (63.6%) or deep partial thickness (47.7%). Observer-rated POSAS scores revealed statistically significant improvements in pigment, thickness, relief, pliability, and surface area after one treatment with continued improvement until the last laser session. Patient-rated POSAS revealed statistically significant improvements in color, stiffness, thickness, and irregularity after laser treatments. Total POSAS improved from 89.6 ± 17.5 to 76.6 ± 16.8 (P < .0001) after one treatment with further improvement to 69.2 ± 14.9 (P < .0001) at the final laser session. We found convincing evidence that CO2-AFL therapy improves hypertrophic burn scars on both patient- and observer-rated scales confirming statistical and clinical significance to both providers and families. These findings demonstrate that CO2-AFL can improve hypertrophic burn scars in pediatric patients providing a lower risk alternative to invasive therapies and a more immediate, efficacious alternative to more conservative scar treatments.

Efficacy and safety of endostar in the treatment of advanced lung squamous cell carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20574-e20574
Author(s):  
Weiheng Hu ◽  
Jian Fang ◽  
Jun Nie ◽  
Ling Dai ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Group Versus ◽  
Lung Squamous Cell Carcinoma ◽  
Progression Free Survival ◽  
Control Group ◽  
Efficacy And Safety ◽  
Free Survival ◽  
Treatment Groups ◽  
The Difference ◽  
Nsclc Patients

e20574 Background: From the early 2000s, many advances in non-small cell lung cancer (NSCLC) have been made with the emergence of targeted therapies. However, because of safety concerns and a lower prevalence of relevant therapeutic targets, patients with squamous NSCLC have been excluded from many of these breakthroughs. Endostar is a novel inhibitor of tumor angiogenesis that acts specifically on neovascular endothelial cells. This study is to explore the clinical efficacy and safety of endostar in advanced squamous NSCLC patients. Methods: We performed a retrospective analysis of 259 newly diagnosed advanced squamous NSCLC patients who had received platinum-based doublet chemotherapy (PBDC) between September 2009 and March 2016. Of these patients, 116 received Endostar combined with PBDC, and 143 received PBDC only. Clinical tumor responses, progression-free survival (PFS), overall survival (OS), and toxicity profiles were recorded and analyzed. Results: After a median follow-up of 13.5 months, a improvement in PFS was observed in the Endostar group, the median PFS was7.7 months compared with 5.4 months in the control group (HR, 0.745; P= 0.034). The median OS was 19.0 months in the Endostar group versus 14.3 months in the control group, but the difference was not significant (HR, 0.780; P= 0.094). Multivariate analysis demonstrated that in patients with advanced squamous NSCLC, anti-angiogenesis therapy with Endostar, radiotherapy of primary tumor and Ⅲb stage were significant and independent predictors of improved PFS ( P< 0.05). For both arms, hematologic and gastrointestinal toxicities were the most common adverse events. Patients treated with Endostar had slightly higher rates of cardiac disorder and thromboembolic event, as compared with the control patients, but there were no statistically significant differences in toxicities overall between the 2 treatment groups. Conclusions: The current study indicates that Endostar as an anti-angiogenesis therapy combined with PBDC is able to provide further survival benefits with satisfactory toxicity in previously untreated squamous NSCLC patients, which merits further evaluation in randomized trials.

Abstract 7: Outcomes at Six Months of a Randomized Trial of Home Blood Pressure Telemonitoring with Pharmacist Case Management

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Karen L Margolis ◽  
Anna R Bergdall ◽  
Stephen E Asche ◽  
Joann M Sperl-Hillen ◽  
Michael V Maciosek ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Management ◽  
Usual Care ◽  
Randomized Trial ◽  
Uncontrolled Hypertension ◽  
Satisfaction With Care ◽  
Hypertensive Patients ◽  
Treatment Groups ◽  
The Difference

Background: Patients with high blood pressure (BP) visit a physician on average 4 times per year, though fewer than half achieve BP control. Practical, effective, and sustainable models are needed to improve BP management. Aims: Hyperlink is a clinic-randomized trial testing an intervention that combines home BP telemonitoring with pharmacist case management in patients with uncontrolled hypertension. Methods: We enrolled 450 patients with uncontrolled BP from 16 primary care clinics. Eight clinics (222 patients) were randomized to usual care and 8 clinics (228 patients) to intervention. Intervention patients received home telemonitors that transmit BP data to a secure database. Pharmacists consult with patients by phone and adjust antihypertensive therapy based on home BP data. The intervention lasts 12 months with follow-up to 18 months to observe durability. The primary outcome is BP control at 6 and 12 months, defined as BP ≤140/90 mm Hg (or ≤130/80 mm Hg in patients with chronic kidney disease or diabetes). Data on demographics, medication use and adherence, and satisfaction with care were also gathered. Here we report 6-month BP outcomes. General and generalized linear mixed models are used to accommodate the cluster-randomization. Results: Enrollees were 45% female, 83% white, and 13% black, with mean age of 61 years. Mean BP at baseline was 148/85 mm Hg in both treatment groups. Of the 403 attending the 6-month visit (197 usual care, 206 intervention), 45.2% in usual care and 71.8% in intervention achieved BP control (p<0.0001). In usual care, mean systolic BP decreased by 10.3 mm Hg and diastolic decreased by 3.4 mm Hg. In intervention, mean systolic BP decreased by 21.6 mm Hg and diastolic decreased by 9.3 mm Hg. The difference in change between groups was 11.3 mm Hg systolic (p<0.0001) and 5.8 mm Hg diastolic (p=0.003). Self-reported satisfaction with care in the six months following baseline was higher for intervention (mean=4.6) than usual care (mean=4.4, p<0.01), on a 5 point scale (1=worst care possible, 5=best care possible). Between baseline and 6 months mean number of antihypertensive drugs used per participant increased from 1.4 to 1.6 in usual care and from 1.5 to 2.3 in intervention. The difference between treatment groups in increased drug use from a particular class was largest among thiazide diuretics (4.6% increase usual care, 27.6% intervention) and ACE inhibitors (1.6% increase usual care, 13.6% intervention). Calcium channel blocker and beta blocker use also increased more among intervention patients, while loop diuretic use decreased. Self-reported adherence to BP medications indicated better adherence for intervention (mean=0.7) than usual care (0.3, p<0.01) measured on the Morisky scale (0-4, lower scores indicating better adherence) during the 6 months following the baseline visit. Conclusions: Home telemonitoring with pharmacist case management was effective at reducing BP for hypertensive patients over 6 months. This intervention may be cost-effective for managing hypertensive patients with uncontrolled BP, especially if results are sustained during the maintenance and post-intervention phases of follow-up.

scholarly journals Comparison of aflibercept and bevacizumab in the treatment of type 1 retinopathy of prematurity

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hamid Riazi-esfahani ◽  
Alireza Mahmoudi ◽  
Mehdi Sanatkar ◽  
Afsar Dastjani Farahani ◽  
Fatemeh Bazvand
Keyword(s):  
Retinopathy Of Prematurity ◽  
Initial Treatment ◽  
Vitreous Body ◽  
Intravitreal Bevacizumab ◽  
Complete Regression ◽  
Recurrence Rates ◽  
Treatment Groups ◽  
The Difference

Abstract Background To evaluate the outcome of intravitreal bevacizumab (IVB) and aflibercept (IVA) injection for patients with retinopathy of prematurity (ROP). Methods In this single-center retrospective cohort, the recorded medical data of the infants who had been undergone intravitreal injection with either bevacizumab or aflibercept for type 1 ROP were reviewed. The infants were allocated into two groups. IVB group included patients who were treated with bevacizumab as initial treatment and the IVA group included patients who were treated with aflibercept as initial treatment. The rate and time of complete regression, as well as the recurrence rates, were compared between the groups. Results A total of 889 eyes of 453 infants were enrolled in the study. There were 865 eyes of 441 infants in the IVB group and 24 eyes of 12 infants in the IVA group. Follow-up time was 289 ± 257 days in the IVB group and 143 ± 25 days in the IVA group (p < 0.001). The difference in the ROP zone was not statistically significant between the 2 treatment groups (p = 0.328). All eyes in the IVA group showed initial regression of ROP after the intravitreal injections. These regressions were achieved in 830 (96.0%) eyes that were injected with IVB (p = 0.023). The median observed regression time was 10 days and 16 days in eyes treated with bevacizumab and aflibercept respectively. Recurrence was noted in 3.9% of eyes (34/865) in the IVB group and 58.3% of eyes (14/24) in the IVA group (p < 0.001). Conclusion While the regression rate in the IVA group was significantly higher than in the IVB group, the recurrence rate was significantly more in the IVA group, which may be attributed to differences in the pharmacokinetics of these drugs in the vitreous body.

Re-Increased Male Suicide Rates in the Recovery Phase Following the Great East Japan Earthquake

Crisis ◽  
2020 ◽  
Vol 41 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Masatsugu Orui
Keyword(s):  
Social Connectedness ◽  
Recovery Phase ◽  
Great East Japan Earthquake ◽  
Temporary Housing ◽  
Period Analysis ◽  
Suicide Rates ◽  
Male Suicide ◽  
The Social ◽  
The Difference

Abstract. Background: Monitoring of suicide rates in the recovery phase following a devastating disaster has been limited. Aim: We report on a 7-year follow-up of the suicide rates in the area affected by the Great East Japan Earthquake, which occurred in March 2011. Method: This descriptive study covered the period from March 2009 to February 2018. Period analysis was used to divide the 108-month study period into nine segments, in which suicide rates were compared with national averages using Poisson distribution. Results: Male suicide rates in the affected area from March 2013 to February 2014 increased to a level higher than the national average. After subsequently dropping, the male rates from March 2016 to February 2018 re-increased and showed a greater difference compared with the national averages. The difference became significant in the period from March 2017 to February 2018 ( p = .047). Limitations: Specific reasons for increasing the rates in the recovery phase were not determined. Conclusion: The termination of the provision of free temporary housing might be influential in this context. Provision of temporary housing was terminated from 2016, which increased economic hardship among needy evacuees. Furthermore, disruption of the social connectedness in the temporary housing may have had an influence. Our findings suggest the necessity of suicide rate monitoring even in the recovery phase.

Effects of an Antihypertensive Combination in Japanese Hypertensive Outpatients Based on the Long-Acting Calcium Channel Blocker Benidipine on Vascular and Renal Events: A Sub-Analysis of the COPE Trial

2020 ◽  
Vol 16 ◽  
Author(s):  
Seiji Umemoto ◽  
Toshio Ogihara ◽  
Masunori Matsuzaki ◽  
Hiromi Rakugi ◽  
Kazuyuki Shimada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Rank Test ◽  
Vascular Events ◽  
Treatment Groups ◽  
Β Blocker ◽  
The Difference ◽  
Long Acting

Background: In the trial known as COPE (Combination Therapy of Hypertension to Prevent Cardiovascular Events) three benidipine (a calcium channel blocker; CCB) regimens were compared. Hypertensive Japanese outpatients aged 40–85 years (n=3,293) who did not achieve the target blood pressure of <140/90 mmHg with benidipine 4 mg/day were treated with the diuretic thiazide (n=1,094) or a β-blocker (n=1,089) or an additional angiotensin receptor blocker (ARB; n=1,110). A significantly higher incidence of hard cardiovascular composite endpoints and of fatal or non-fatal strokes was observed in the benidipine-β-blocker group compared to the benidipine-thiazide group. Objective and Methods: We further evaluated the treatment effects of the three benidipine-based regimens on vascular and renal events in a sub-analysis of the COPE patients. Results: A total of 10 vascular events (0.8 per 1,000 person-years) including one aortic dissection (0.1 per 1,000 person-years) and nine cases of peripheral artery disease (0.8 per 1,000 person-years) were documented, as was a total of seven renal events (0.6 per 1,000 person-years). No significant differences in vascular and renal events were revealed among the three treatment groups: vascular events p=0.92 renal events p=0.16 log-rank test. Conclusions: Blood pressure-lowering therapy with benidipine combined with an ARB, β-blocker, or thiazide was similarly effective in the prevention of vascular and renal events in hypertensive outpatients, although there is no enough these events to compare the difference in the three treatment groups.

scholarly journals Differences in the Effectiveness of Long-Acting Injection and Orally Administered Antipsychotics in Reducing Rehospitalization among Patients with Schizophrenia Receiving Home Care Services

2019 ◽  
Vol 8 (6) ◽  
pp. 823
Author(s):  
Hsiao-Fen Hsu ◽  
Chia-Chan Kao ◽  
Ti Lu ◽  
Jeremy C. Ying ◽  
Sheng-Yu Lee
Keyword(s):  
Treatment Group ◽  
Home Care ◽  
Second Generation ◽  
Home Care Services ◽  
Rehospitalization Rate ◽  
Treatment Groups ◽  
Psychiatric Rehospitalization ◽  
Care Services ◽  
Long Acting

The current study explored the differences in the effectiveness of first and second generation long-acting injections and orally administered antipsychotics in reducing the rehospitalization rate among patients with schizophrenia receiving home care services in a medical center in Southern Taiwan. Longitudinal data between 1 January 2006, and 31 December 2015, were collected retrospectively. Patients were classified into three treatment groups: First generation antipsychotic (FGA) long-acting injection (LAI), second generation antipsychotic long-acting injection (SGA) (LAI), and oral antipsychotics. The primary outcomes were the rehospitalization rate and the follow-up time (duration of receiving home care services) until psychiatric rehospitalization. A total of 78 patients with schizophrenia were recruited. The average observation time was about 40 months. The oral treatment group tended to be older with a higher number of female patients and a lower level of education. The FGA treatment group tended to have a higher frequency and duration of hospitalization before receiving home care services. We found no significant differences in the follow-up time or psychiatric rehospitalization rate after receiving home care services among the three treatment groups. We propose that oral and LAI antipsychotics were equally effective when patients received home care services. Our results can serve as a reference for the choice of treatment for patients with schizophrenia in a home care program.

The rein-type arthroscopic capsular suture for triangular fibrocartilage complex foveal tears: midterm results for 90 patients

2021 ◽  
pp. 175319342110241
Author(s):  
I-Ning Lo ◽  
Kuan-Jung Chen ◽  
Tung-Fu Huang ◽  
Yi-Chao Huang
Keyword(s):  
Simple Procedure ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Joint Stability ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
High Satisfaction ◽  
Ultrasound Assessment ◽  
Triangular Fibrocartilage

We describe an arthroscopic rein-type capsular suture that approximates the triangular fibrocartilage complex to the anatomical footprint, and report the results at a minimum 12 month follow-up. The procedure involves two 3-0 polydioxanone horizontal mattress sutures inserted 1.5 cm proximal to the 6-R and 6-U portals to obtain purchase on the dorsal and anterior radioulnar ligaments, respectively. The two sutures work as a rein to approximate the triangular fibrocartilage complex to the fovea. Ninety patients with Type IB triangular fibrocartilage complex injuries were included retrospectively. The 12-month postoperative Modified Mayo Wrist scores, Disabilities of Arm, Shoulder and Hand scores and visual analogue scale for pain showed significant improvements on preoperative values. Postoperative range of wrist motion, grip strength and ultrasound assessment of the distal radioulnar joint stability were comparable with the normal wrist. The patients had high satisfaction scores for surgery. There were minor complications of knot irritation. No revision surgery for distal radioulnar joint instability was required. It is an effective and technically simple procedure that provides a foveal footprint contact for the triangular fibrocartilage complex. Level of evidence: IV

scholarly journals Association of biological antirheumatic therapy with risk for type 2 diabetes: a retrospective cohort study in incident rheumatoid arthritis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042246
Author(s):  
Sanjoy K Paul ◽  
Olga Montvida ◽  
Jennie H Best ◽  
Sara Gale ◽  
Attila Pethö-Schramm ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Type 2 Diabetes ◽  
T Cell ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Therapy ◽  
Treatment Groups ◽  
Significant Difference ◽  
Necrosis Factor

ObjectiveTo explore possible associations of treatment with biological disease-modifying antirheumatic drugs (bDMARDs), including T-cell-based and interleukin-6 inhibition (IL-6i)-based therapies, and the risk for type 2 diabetes mellitus (T2DM) in patients with rheumatoid arthritis (RA).Study design, setting and participantsFive treatment groups were selected from a United States Electronic Medical Records database of 283 756 patients with RA (mean follow-up, 5 years): never received bDMARD (No bDMARD, n=125 337), tumour necrosis factor inhibitors (TNFi, n=34 873), IL-6i (n=1884), T-cell inhibitors (n=5935) and IL-6i+T cell inhibitor abatacept (n=1213). Probability and risk for T2DM were estimated with adjustment for relevant confounders.ResultsIn the cohort of 169 242 patients with a mean 4.5 years of follow-up and a mean 641 200 person years of follow-up, the adjusted probability of developing T2DM was significantly lower in the IL-6i (probability, 1%; 95% CI 0.6 to 2.0), T-cell inhibitor (probability, 3%; 95% CI 2.3 to 3.3) and IL-6i+T cell inhibitor (probability, 2%; 95% CI 0.1 to 2.9) groups than in the No bDMARD (probability, 5%; 95% CI 4.6 to 4.9) and TNFi (probability, 4%; 95% CI 3.7 to 4.7) groups. Compared with No bDMARD, the IL-6i and IL-6i+T cell inhibitor groups had 37% (95% CI of HR 0.42 to 0.96) and 34% (95% CI of HR 0.46 to 0.93) significantly lower risk for T2DM, respectively; there was no significant difference in risk in the TNFi (HR 0.99; 95% CI 0.93 to 1.06) and T-cell inhibitor (HR 0.96; 95% CI 0.82 to 1.12) groups.ConclusionsTreatment with IL-6i, with or without T-cell inhibitors, was associated with reduced risk for T2DM compared with TNFi or No bDMARDs; a less pronounced association was observed for the T-cell inhibitor abatacept.

scholarly journals POS0208 GENDER DIFFERENCES IN RESPONSE TO BIOLOGICALS. WOMEN FARE WORSE ACROSS INFLAMMATORY ARTHRITIS DISEASES - DATA FROM THE BIOREG

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 320.1-321
Author(s):  
E. Loibner ◽  
V. Ritschl ◽  
B. Leeb ◽  
P. Spellitz ◽  
G. Eichbauer-Sturm ◽  
...  
Keyword(s):  
Gender Differences ◽  
Psoriatic Arthritis ◽  
Gender Difference ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Tnf Inhibitors ◽  
Significant Difference ◽  
The Difference ◽  
All Diseases

Background:Gender differences in prevalence and disease course are known in various rheumatic diseases; however, investigations of gender difference concerning therapeutical response have yielded variable results.Objectives:The aim of this retrospective study was to investigate, whether a gender difference in response rate to biological disease-modifying antirheumatic drugs (bDMARDs) and apremilast in bDMARD-naïve patients could be observed across the three most prevalent inflammatory arthritis diseases: rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA). Additionally, a response to individual TNF blockers was investigated in this respect.Methods:Data from bDMARD-naïve RA-, SpA- and PsA-patients from Bioreg, the Austrian registry for biological DMARDs in rheumatic diseases, were used. Patients with a baseline (Visit 1=V1) and follow-up visits at 6 months (Visit 2=V2) and 12 months (Visit 3=V3) were included and response to therapy with TNF-inhibitors (TNFi), furthermore to therapy with rituximab, tocilizumab and apremilast was analyzed according to gender. The remaining bDMARDs were not analyzed due to small numbers. Key response-parameter for RA was disease activity score (DAS28), whereas for PsoA the Stockerau Activity Score for Psoriatic Arthritis (SASPA) and for SpA the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were employed; in addition, the Health assessment Questionnaire (HAQ) was used. Data were analyzed in R Statistic stratified by gender using Kruskal-Wallis and Wilcoxon tests.Results:354 women and 123 men with RA (n=477), 81 women and 69 men with PsA (n=150), 121 women and 191 men with SpA (n=312) were included. No significant differences in biometrics was seen between female and male patients at baseline in all diseases.In RA patients overall DAS28 decreased from baseline (V1) to V2 and V3 (DAS28: V1: male: 4.38 [3.66, 5.11], female: 4.30 [3.68, 5.03], p(m/f) = 0.905; V2: male: 2.66 [1.73, 3.63], female: 3.10 [2.17, 3.98], p(m/f) = 0.015; V3: male: 2.25 [1.39, 3.36], female: 3.01 [1.87, 3.87], p(m/f) = 0.002). For TNF inhibitors (n=311), there was a significant difference between genders at V2 (Fig.1a). Patients receiving Rituximab (n=41) displayed a significantly higher DAS28 at baseline in females, which diminished in the follow up: V1: (p(m/f) p=0.002; V2: p=0.019; V3: p=0.13); response to tocilizumab (n=63) did not show any gender differences.In PsA patients overall SASPA decreased from baseline (V1) to V2 and V3 (SASPA: V1: male: 4.00 [2.80, 5.20], female: 4.40 [2.80, 5.80], p(m/f) = 0.399; V2: male: 2.20 [1.20, 3.50], female: 3.40 [2.00, 5.00], p(m/f) = 0.071; V3: male: 1.80 [0.80, 2.70], female: 3.01 [2.35, 4.80], p(m/f) = 0.001). For TNF inhibitors (n=79), there was a significant difference between genders at V3 (Fig 1a). For Apremilast (n=39), there was a significant difference between genders at V2 (Fig.1c).In SpA patients overall BASDAI decreased from baseline (V1) to V2 and V3 (BASDAI: V1: male: 4.70 [2.88, 6.18], female: 4.80 [3.30, 6.20], p(m/f) = 0.463; V2: male: 3.05 [2.00, 4.60], female: 3.64 [2.62, 5.41], p(m/f) = 0.039; V3: male: 3.02 [1.67, 4.20], female: 3.65 [2.18, 5.47], p(m/f) = 0.016). In V3 a differential BASDAI in response to TNFi (n=299) was observed (Fig.1a).Possible differences of response to individual TNFi (etanercept, infliximab, other TNFi) measured by HAQ were investigated in all diseases together. The difference between male and females was significant at baseline for all 3 TNFi; whereas with the use of ETA the significant difference was carried through to V2 and V3, it was lost with the use of IFX and was variable with the other TNFi (Fig.1b)Figure 1.Conclusion:Female patients showed a statistically lower response to TNFi in all three disease entities (RA, SpA and PsoA) to a variable degree in our homogenous central european population. Interestingly, the difference was not uniform across individual TNFi when measured by HAQ. Gender differences were also seen in response to Apremilast.Disclosure of Interests:Elisabeth Loibner: None declared, Valentin Ritschl: None declared, Burkhard Leeb Speakers bureau: AbbVie, Roche, MSD, Pfizer, Actiopharm, Boehringer-Ingelheim, Kwizda, Celgene, Sandoz, Grünenthal, Eli-Lilly, Grant/research support from: TRB, Roche, Consultancies: AbbVie, Amgen, Roche, MSD, Pfizer, Celgene, Grünenthal, Kwizda, Eli-Lilly, Novartis, Sandoz;, Peter Spellitz: None declared, Gabriela Eichbauer-Sturm: None declared, Jochen Zwerina: None declared, Manfred Herold: None declared, Miriam Stetter: None declared, Rudolf Puchner Speakers bureau: AbbVie, BMS, Janssen, Kwizda, MSD, Pfizer, Celgene, Grünenthal, Eli-Lilly, Consultant of: AbbVie, Amgen, Pfizer, Celgene, Grünenthal, Eli-Lilly, Franz Singer: None declared, Ruth Fritsch-Stork: None declared

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