Percent Change of Perfusion Skewness and Kurtosis: A Potential Imaging Biomarker for Early Treatment Response in Patients with Newly Diagnosed Glioblastomas

Background We sought to identify immunoglobin G autoantibodies predictive of early treatment response to methotrexate, the recommended first-line therapy for patients with newly diagnosed rheumatoid arthritis, and to the interleukin-6 receptor inhibitor biologic tocilizumab, initiated as the first disease-modifying anti-rheumatic drug. Materials and methods In baseline sera of a subset of patients with newly diagnosed rheumatoid arthritis in the U-Act-Early study, selected based on specific responder/non-responder criteria using the Disease Activity Score assessing 28 joints (DAS28) within the first 20 weeks, we measured immunoglobin G antibody reactivity against 463 protein antigens and performed supervised cluster analysis to identify predictive autoantibodies for treatment response. The analysis subset comprised 56 patients in the methotrexate arm (22 responders, 34 non-responders) and 50 patients in the tocilizumab arm (34 responders, 16 non-responders). For comparison, these analyses were also performed in 50 age- and gender-matched healthy controls. Results Increased reactivity in responders versus non-responders was found in the methotrexate arm against two antigens—DOT1-like histone lysine methyltransferase (p = 0.009) and tropomyosin (p = 0.003)—and in the tocilizumab arm against one antigen—neuro-oncological ventral antigen 2 (p = 0.039). Decreased reactivity was detected against two antigens in the methotrexate arm—G1 to S phase transition 2 (p = 0.023) and the zinc finger protein ZPR1 (p = 0.021). Reactivity against the identified antigens was not statistically significant in either treatment arm for patients with rheumatoid factor–positive versus–negative or anti-cyclic citrullinated test–positive versus test–negative rheumatoid arthritis (p ≥ 0.06). Conclusions Comprehensive profiling of baseline sera revealed several novel immunoglobin G autoantibodies associated with early treatment response to methotrexate and to tocilizumab in disease-modifying anti-rheumatic drug-naive patients with rheumatoid arthritis. These findings could eventually yield clinically relevant predictive markers, if corroborated in different patient cohorts, and may facilitate future benefit in personalised healthcare.

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[68Ga]Ga-PSMA-HBED-CC PET/CT demonstrates to be superior to ceCT in detecting early treatment response in metastatic clear cell renal cell carcinoma

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05250-1 ◽

2021 ◽

Author(s):

Priscilla Guglielmo ◽

Donatello Gasparro ◽

Maura Scarlattei ◽

Giorgio Baldari ◽

Stefano Bola ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Treatment Response ◽

Early Treatment ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Early Treatment Response ◽

Pet Ct

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Early Treatment Outcomes for Bloodstream Infections Caused by Potential AmpC Beta-lactamase-producing Enterobacterales with Focus on Piperacillin/Tazobactam: A Retrospective Cohort Study

Antibiotics ◽

10.3390/antibiotics10060665 ◽

2021 ◽

Vol 10 (6) ◽

pp. 665

Author(s):

Lena Herrmann ◽

Aurelia Kimmig ◽

Jürgen Rödel ◽

Stefan Hagel ◽

Norman Rose ◽

...

Keyword(s):

Cohort Study ◽

Treatment Outcomes ◽

Treatment Response ◽

Sofa Score ◽

Early Treatment ◽

Primary Outcome ◽

Bloodstream Infections ◽

Beta Lactamase ◽

Early Treatment Response

The Gram-negative bacilli Serratia spp., Providencia spp., Morganella morganii, Citrobacter freundii complex, Enterobacter spp. and Klebsiella aerogenes are common Enterobacterales that may harbor inducible chromosomal AmpC beta-lactamase genes. The purpose of the present study was to evaluate treatment outcomes and identify predictors of early treatment response in patients with bloodstream infection caused by potential AmpC beta-lactamase-producing Enterobacterales (SPICE-BSI). This cohort study included adult patients with SPICE-BSI hospitalized between 01/2011 and 02/2019. The primary outcome was early treatment response 72 h after the start of active treatment, defined as survival, hemodynamic stability, improved or stable SOFA score, resolution of fever and leukocytosis and microbiologic resolution. Among 295 included patients, the most common focus was the lower respiratory tract (27.8%), and Enterobacter spp. (n = 155) was the main pathogen. The early treatment response rate was significantly lower (p = 0.006) in the piperacillin/tazobactam group (17/81 patients, 21.0%) than in the carbapenem group (40/82 patients, 48.8%). Independent negative predictors of early treatment response (p < 0.02) included initial SOFA score, liver comorbidity and empiric piperacillin/tazobactam treatment. In vitro piperacillin/tazobactam resistance was detected in three patients with relapsed Enterobacter-BSI and initial treatment with piperacillin/tazobactam. In conclusion, our findings show that piperacillin/tazobactam might be associated with early treatment failure in patients with SPICE-BSI.

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