scholarly journals Hydroxychloroquine and the risk of respiratory infections among RA patients

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001389
Author(s):  
Joel M Kremer ◽  
George Reed ◽  
Dimitrios A Pappas ◽  
LR Harold ◽  
Kevin Kane ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Smoking Status ◽  
Secondary Analysis ◽  
Time Varying ◽  
Biologic Dmards ◽  
Cox Models ◽  
Serious Infections ◽  
History Of ◽  
Upper Respiratory ◽  
Time Varying Covariates

ObjectivesTo determine the effect of hydroxychloroquine on the incidence of new respiratory infections in a large registry of rheumatoid arthritis (RA) patients compared with a matched cohort receiving other conventional disease-modifying antirheumatic drugs (csDMARDs).MethodsWe reviewed physician-reported infections including upper respiratory infections (URI), bronchitis and pneumonia in the Corrona RA registry from June 2008 to February 2020 with the goal of comparing infections in biologic/targeted synthetic (b/ts) DMARDs naive HCQ starts compared with starts of other csDMARDs and no HCQ. Patients on different interventions were compared using time-varying adjusted Cox models adjusting for age, sex, duration of RA, BMI, disease activity, smoking status, concurrent medications, season of the year, year of onset and history of serious infections, diabetes or cardiovascular disease (CVD). A secondary analysis in a set of propensity-matched starts were also compared adjusting for time-varying covariates. The analysis was repeated including URI and bronchitis only and also for serious respiratory infections only.ResultsNo evidence of differences was found in the incidence of any respiratory infection (URI, bronchitis, pneumonia) in patients receiving HCQ compared with other csDMARDs: HR=0.87 (0.70 to1.07) in adjusted analyses and HR=0.90 (0.70 to 1.17) in adjusted matched analysis. Similar results were found in the analysis of URI and bronchitis only and for serious respiratory infections only.ConclusionsIn patients with RA, the risk for respiratory infections was similar among patients using HCQ as compared to other non-biologic DMARDs.

scholarly journals A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers

2001 ◽  
Vol 119 (4) ◽  
pp. 142-145 ◽  
Author(s):  
Páris Ali Ramadan ◽  
Francisco Barreto de Araújo ◽  
Mario Ferreira Junior
Keyword(s):  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Vaccination Campaign ◽  
Influenza Like Illness ◽  
Upper Respiratory Infections ◽  
Medical Consultations ◽  
History Of ◽  
Upper Respiratory ◽  
Upper Respiratory Symptoms

CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.

Bilateral Cavitary Disease with a History of Recurrent Upper Respiratory Infections

CHEST Journal ◽  
1981 ◽  
Vol 80 (5) ◽  
pp. 629-630
Author(s):  
Robert A. Boedecker ◽  
Henry J. Bradley ◽  
John R. Sty
Keyword(s):  
Respiratory Infections ◽  
Upper Respiratory Infections ◽  
Cavitary Disease ◽  
History Of ◽  
Upper Respiratory

Association of changes in circulating cell-free plasma DNA (cfDNA) and circulating tumor cells (CTC) during treatment with clinical outcome from olaparib in castration-resistant prostate cancer (CRPC): Exploratory analyses from the TOPARP-A trial.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 141-141 ◽  
Author(s):  
Joaquin Mateo ◽  
Helen Mossop ◽  
Jane Goodall ◽  
David Lorente ◽  
Nuria Porta ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
P Value ◽  
Time Varying ◽  
Castration Resistant Prostate Cancer ◽  
Plasma Dna ◽  
Cox Models ◽  
Castration Resistant ◽  
Treatment Switch ◽  
Response Biomarkers ◽  
Time Varying Covariates

141 Background: Response biomarkers are needed to optimize treatment switch decisions in CRPC patients. CTC and cfDNA may have clinical utility as response biomarkers; we studied them during olaparib treatment in a phase II trial in CRCP (Mateo et al NEJM 2015). Methods: CTC were enumerated using CellSearch (Jannsen Diagnostics) and cfDNA was extracted with the QIASymphony circulating DNA kit (Qiagen) from blood samples taken at baseline, 4- and 8-weeks (wk) of therapy. Radiological progression-free survival (rPFS) was defined as time from starting treatment to progression by RECIST 1.1, bone scan (PCWG2) or death. Overall survival (OS) was defined as time from starting treatment to death. CTC changes were categorized based on conversion from ≥ 5 to < 5 CTC/7.5ml blood and on ≥ 30% decline (Lorente et al Eur Urol 2016). cfDNA changes were evaluated as percentage change from baseline (continuous and binary). The prognostic value of CTC and cfDNA changes were assessed by Landmark analysis and Cox models with time-varying covariates; p-value < 0.01 were considered significant to account for multiple tests. Results: Overall, 13/47 (28%) and 16/42 (38%) evaluable patients had a CTC conversion at 4- and 8-wk respectively. A CTC conversion after 4-wk of olaparib associated with longer rPFS (median 8.9 vs 2.7 months [m], p = 0.001); a similar association was found at 8-wk. A 30% CTC decline at 4-wk also associated with longer rPFS (median 4.4 vs 2.6 m, p = 0.004). CTC conversion as a time-varying covariate associated with longer OS (HR 0.26, 95%CI 0.14-0.50, p < 0.001). Median baseline cfDNA was 31.6 ng/ml (IQR 19.4-57.1); 46 and 42 patients were evaluable for cfDNA changes at 4- and 8-wk. Percentage changes in cfDNA at 4- and 8- wk associated with rPFS (HR 1.01 and 1.005; p = 0.005 and 0.002 respectively) but association with OS was not significant. cfDNA declines ≥ 50% at 8- wk associated with longer rPFS (median 8.9 vs 2.7 m, p = 0.007) and OS (17.0 vs 10.1 m, p = 0.004). Conclusions: Decreases in CTC counts and cfDNA concentration associate with improved outcome from olaparib (rPFS, OS) in the TOPARP-A trial. Clinical trial information: NCT01682772.

Exponential decay for binary time-varying covariates in Cox models

2017 ◽  
Vol 37 (5) ◽  
pp. 776-788
Author(s):  
Charles Donald George Keown-Stoneman ◽  
Julie Horrocks ◽  
Gerarda Darlington
Keyword(s):  
Exponential Decay ◽  
Time Varying ◽  
Cox Models ◽  
Time Varying Covariates

scholarly journals Efficacy and Safety of CVT-E002, a Proprietary Extract of Panax quinquefolius in the Prevention of Respiratory Infections in Influenza-Vaccinated Community-Dwelling Adults: A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Janet E. McElhaney ◽  
Andrew E. Simor ◽  
Shelly McNeil ◽  
Gerald N. Predy
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Primary Analysis ◽  
Double Blind ◽  
Upper Respiratory ◽  
To Receive ◽  
Larger Sample

CVT-E002 (a proprietary extract) was found to be effective in the prevention of upper respiratory infections (URIs) in healthy adults, and institutionalized and community-dwelling seniors. A multicenter, randomized, double-blind, placebo-controlled trial was carried out to determine effects of CVT-E002 in the prevention of URIs in influenza-vaccinated community-dwelling adults. 783 community-dwelling adults were randomized to receive placebo, 400 mg or 800 mg treatment/d (1 : 1 : 1) for 6 months. Primary analysis on the incidence of laboratory-confirmed-clinical URIs (LCCUs), including influenza A and B, was performed on those receiving at least one dose. Secondary analysis was performed on study completers and included incidence, severity, and duration of URIs meeting a Jackson-based criteria and safety of CVT-E002. The incidence of LCCUs in the ITT group was 5.5%, 5.2%, and 4.6% in the placebo, 400 mg and 800 mg groups, respectively (P=0.89). Jackson-confirmed URIs were significantly lower in the treated groups (P<0.04). CVT-E002 supplementation reduced the severity and duration of Jackson-confirmed URIs. The results indicate that CVT-E002 can be safely used by similar groups and may prevent symptoms of URIs; larger sample size is warranted.

scholarly journals Acute respiratory infections in children from an ENT perspective

2015 ◽  
Vol 10 (2) ◽  
pp. 172-175
Author(s):  
A. ZAMFIR-CHIRU-ANTON ◽  
◽  
N. MANEA ◽  
D.C. GHEORGHE ◽  
◽  
...  
Keyword(s):  
Soft Palate ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Case Series ◽  
Pulmonary Complications ◽  
Upper Respiratory Tract ◽  
Retrospective Case ◽  
History Of ◽  
Upper Respiratory ◽  
Tract Infections

Background. Adenoidectomy remains a frequent surgical approach for recurrent upper respiratory tract infections (URTI) in children. We research if only age and collectivity are responsible for recurrences, or other anatomic conditions can account for the history of the patient. Design. Retrospective case series review. Material and method. Questionnaire about respiratory symptoms and correlations observed between the history of the patient and the presence or absence of short soft palate. Results. 102 children could provide enough data to be included in the study. Frequent URTI were observed in 30% of the affected children and only 16% of their normal peers. 41% of URTIs each persisted longer than 10 days in short soft palate children vs. 17% in normal patients. Broncho-pulmonary complications were encountered in 44% of children with short palate as opposed to 27% in others. Conclusions. Short velli palatini can disturb normal swallowing process and allow rhinopharyngeal chronic inflammation. That can lead to persistent recurrent URTIs, more probable chronic obstruction through the adenoids and other diseases in pediatric ENT practice.

Natural History of Viral Upper Respiratory Infections (vURIs) in Children

2009 ◽  
Vol 123 (2) ◽  
pp. S76-S76
Author(s):  
H. Barth ◽  
D. Gentile ◽  
J. Koehrsen ◽  
A. Patel ◽  
D. Skoner
Keyword(s):  
Natural History ◽  
Respiratory Infections ◽  
Upper Respiratory Infections ◽  
History Of ◽  
Upper Respiratory

ITI with high-dose FIX and combined immunosuppressive therapy in a patient with severe haemophilia B and inhibitor

2009 ◽  
Vol 29 (02) ◽  
pp. 155-157 ◽  
Author(s):  
H. Hauch ◽  
J. Rischewski ◽  
U. Kordes ◽  
J. Schneppenheim ◽  
R. Schneppenheim ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Immunosuppressive Agents ◽  
Tolerance Induction ◽  
Intravenous Immunoglobulins ◽  
Factor Ix ◽  
High Dose ◽  
Allergic Reactions ◽  
Success Rates ◽  
Serious Infections ◽  
History Of

SummaryInhibitor development is a rare but serious event in hemophilia B patients. Management is hampered by the frequent occurrence of allergic reactions to factor IX, low success rates of current inhibitor elimination protocols and the risk of development of nephrotic syndrome. Single cases of immune tolerance induction (ITI) including immunosuppressive agents like mycophenolat mofetil (MMF) or rituximab have been reported. We present a case of successful inhibitor elimination with a combined immune-modulating therapy and high-dose factor IX (FIX). This boy had developed a FIX inhibitor at the age of 5 years and had a history of allergic reactions to FIX and to FEIBA→. Under on-demand treatment with recombinant activated FVII the inhibitor became undetectable but the boy suffered from multiple joint and muscle bleeds. At the age of 11.5 years ITI was attempted with a combination of rituximab, MMF, dexamethasone, intravenous immunoglobulins and high-dose FIX. The inhibitor did not reappear and FIX half-life normalized. No allergic reaction, no signs of nephrotic syndrome and no serious infections were observed.

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