Real-World Experience With Apremilast in Treating Psoriasis

2016 ◽  
Vol 21 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Julia N. Mayba ◽  
Melinda J. Gooderham
Keyword(s):  
Real World ◽  
Chart Review ◽  
Community Setting ◽  
Clinical Trial Data ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Serious Adverse Events ◽  
Phosphodiesterase 4 ◽  
Discontinuation Of Treatment ◽  
Significant Clinical Improvement

Background: Clinical trial data have shown apremilast, an oral phosphodiesterase-4 inhibitor, to be efficacious and safe for the treatment of psoriasis. However, little real-world experience using apremilast in the community setting has been documented. Objectives: Many patients with psoriasis are often unresponsive to various treatment modalities, including topical, systemic, and biologic medications. The aim of this chart review was to assess the overall patient experience while using apremilast to treat psoriasis. Methods: A retrospective chart review of electronic medical records was conducted of all patients prescribed apremilast in a community dermatology practice. Results: Of 99 patients who were prescribed apremilast, 81 patients took at least 1 dose. In 63 patients, apremilast improved clinical disease severity, with 37% of patients achieving a body surface area <1%. As a treatment, it was generally well tolerated and caused no serious adverse events. The most commonly reported side effect resulting in discontinuation of treatment of apremilast was nausea and vomiting. Conclusions: Overall, apremilast was a safe and well-tolerated treatment with significant clinical improvement in our patient population.

Real-World Experience with Alitretinoin in a Community Dermatology Practice Setting in Patients with Chronic Hand Dermatitis

2014 ◽  
Vol 18 (5) ◽  
pp. 332-336 ◽  
Author(s):  
Kaiya Ham ◽  
Priya Maini ◽  
Melinda J. Gooderham
Keyword(s):  
Real World ◽  
Patient Population ◽  
Chart Review ◽  
Clinical Trial Data ◽  
Retrospective Chart Review ◽  
Disease Symptoms ◽  
Hand Dermatitis ◽  
Significant Clinical Improvement ◽  
Review Study ◽  
Clinically Significant

Background: The treatment of moderate to severe chronic hand dermatitis (CHD) has been advanced with the introduction of alitretinoin (9- cis-retinoic acid). Although clinical trial data demonstrated the efficacy and safety of alitretinoin, real-world experience is lacking in a more generalized patient population. Objective: Patients with CHD often, and unsuccessfully, attempt several therapeutic options before seeing a dermatologist. This chart review study aimed to examine the experience of using alitretinoin for CHD in a dermatology office setting. Methods: A retrospective chart review of electronic medical records was conducted of all patients prescribed alitretinoin in a community dermatology practice. Results: Alitretinoin was well tolerated in this patient population of 53 patients and showed a clinically significant reduction in disease symptoms. Conclusion: Alitretinoin was a safe and well-tolerated treatment with significant clinical improvement in our patient population. Few clinically significant laboratory abnormalities were identified, and only one patient discontinued therapy due to adverse events.

Long-Term Single Center Experience in Treating Plaque Psoriasis With Guselkumab

2020 ◽  
Vol 24 (6) ◽  
pp. 588-595 ◽  
Author(s):  
Khalad Maliyar ◽  
Ashley O’Toole ◽  
Melinda J. Gooderham
Keyword(s):  
Real Life ◽  
Community Setting ◽  
Clinical Trial Data ◽  
Retrospective Chart Review ◽  
Severe Psoriasis ◽  
Upper Respiratory Tract ◽  
Serious Adverse Events ◽  
Single Center Experience ◽  
Interleukin 23 ◽  
Tract Infections

Background Clinical trial data have shown guselkumab, an interleukin-23 inhibitor, to be efficacious and safe for the treatment of psoriasis. However, there is very little real-world experience using guselkumab in the community setting that has been documented. Objectives The goal of this study was to determine real-life outcomes of guselkumab use in patients with moderate-to-severe psoriasis in a community dermatology practice. Methods A retrospective chart review of electronic medical records was conducted in patients with moderate-to-severe psoriasis who were prescribed guselkumab at a community dermatology office in Ontario, Canada. Results Of the 89 patients who received at least 1 dose of guselkumab, 79 had follow-up information at the time of review, with 71 patients receiving ongoing treatment. In our cohort of patients, 73.3% achieved clinically significant clearance of psoriasis with a global assessment of clear or almost clear defined as a body surface area involvement of <1%. Guselkumab was generally well tolerated and caused no serious adverse events. The most common reported side effects were nasopharyngitis, headaches, upper respiratory tract infections, gastrointestinal upset, and arthralgia. Conclusion Overall, guselkumab was a safe and well-tolerated treatment with significant clinical improvement in our patient population.

Perspectives from the community setting: A retrospective chart review of nivolumab for previously treated non-small cell lung cancer.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 86-86
Author(s):  
Brian Richard Nhan ◽  
Swati Kulkarni
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Small Cell Lung Cancer ◽  
Chart Review ◽  
Community Setting ◽  
Retrospective Chart Review ◽  
Small Cell ◽  
Small Cell Lung ◽  
Discontinuation Of Treatment ◽  
Previously Treated

86 Background: Lung cancer is among the most commonly diagnosed cancers in Canada and is the leading cause of cancer deaths. Non-small cell lung cancer (NSCLC) is one of the most common types representing 85-90% of cases. Compared to other cancers, the five-year survival rate for lung cancer in Canada is among the lowest at 17%. Nivolumab has been in use in the setting of progression of previously treated NSCLC at the Windsor Regional Cancer Center since June 2015. This retrospective chart review abstracts data from 26 patients at WRCC with NSCLC who were treated with nivolumab. Methods: A retrospective chart review of 26 patients treated with nivolumab in the setting of progressive NSCLC. Results: 26 patients were reviewed (1 stage 2a, 2 stage 3a, 3 stage 3b, 20 stage 4 with 12 M1b and 8 M1a). Grade 1-2 side effects were documented in 4 patients treated with monitoring and no discontinuation or dose modification of nivolumab. A grade 3 side effect was documented in 1 patient leading to discontinuation of treatment. 3 living patients discontinued treatment due to progression. 6 patients died while on treatment secondary to disease progression. The remaining patients are on nivolumab with no side effects documented. Conclusions: As the use of immuno-oncology agents use expand in community clinics, opportunities arise from community data to further learn which patients benefit from these treatments, what side effects can occur and how to manage them, and how response to treatment may look. Out of the 26 patients receiving nivolumab, 5 patients had documented side effects resulting in discontinuation of treatment in 1 patient. Overall nivolumab has been well tolerated in patients with NSCLC in this community setting.

scholarly journals The Clinical Spectrum of Primary Cutaneous CD4+ Small/Medium-Sized Pleomorphic T-Cell Lymphoproliferative Disorder: An Updated Systematic Literature Review and Case Series

Dermatology ◽  
2020 ◽  
Vol 237 (4) ◽  
pp. 618-628
Author(s):  
Philip Surmanowicz ◽  
Sean Doherty ◽  
Arunima Sivanand ◽  
Nikoo Parvinnejad ◽  
Jean Deschenes ◽  
...  
Keyword(s):  
T Cell ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Lymphoproliferative Disorder ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Cutaneous Lymphoma ◽  
World Health ◽  
Treatment Modalities ◽  
Systemic Treatments

<b><i>Background:</i></b> Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoproliferative disorder (SMPLPD) is a provisional entity within the 2016 World Health Organization classification of primary cutaneous lymphomas. The condition is currently classified as a lymphoproliferative disorder to emphasize its benign course and discourage aggressive, systemic treatment modalities. <b><i>Objective:</i></b> To provide a relevant synthesis for the dermatological practitioner on the prevalence, presentation, and treatment of SMPLPD. <b><i>Methods:</i></b> We conducted an updated systematic literature review and a retrospective chart review of diagnosed cases of SMPLPD from 2 Canadian academic cutaneous lymphoma centers. <b><i>Results:</i></b> A total of 23 studies with 136 cases were extracted from the systematic review and 24 patients from our retrospective chart review. SMPLPD proved relatively common accounting for 12.5% of all cutaneous T-cell lymphomas encountered in our cutaneous lymphoma clinics, second in frequency only to mycosis fungoides. The typical clinical presentation was that of an older individual (median age 59 years) with an asymptomatic solitary lesion on their upper extremity. The most common clinical differentials were cutaneous lymphoid hyperplasia, basal cell carcinoma, and lymphoma unspecified. T follicular helper markers were reliably detected. The main treatment modalities were surgical excision, local radiation therapy, and topical or intralesional steroids. Cure was achieved in the vast majority of cases. <b><i>Conclusions:</i></b> SMPLPD is an underdiagnosed T-cell lymphoma with an overtly benign clinical course. The condition has an excellent prognosis and responds well to skin-directed therapies. Practitioners should be aware of this condition to avoid aggressive systemic treatments.

Treatment response among patients with multiple myeloma initiating daratumumab across different lines of therapy: A real-world chart review study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18737-e18737
Author(s):  
Shebli Atrash ◽  
Philippe Thompson-Leduc ◽  
Ming-Hui Tai ◽  
Shuchita Kaila ◽  
Kathleen Gray ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Response ◽  
Real World ◽  
Chart Review ◽  
Response Rate ◽  
Retrospective Chart Review ◽  
Case Report Form ◽  
Combination Regimen ◽  
Cell Transplant ◽  
Effective Treatment Option

e18737 Background: Daratumumab (DARA), a CD38 monoclonal antibody, has been approved for the treatment of multiple myeloma (MM) among previously-treated patients since 2015, and among newly-diagnosed patients since 2018. This study aimed to describe real-world treatment response among patients initiating DARA across different lines of therapy since 2018. Methods: A retrospective chart review of adult patients with MM initiating DARA (monotherapy or as part of a combination regimen) between 1/2018 and 5/2020 was conducted at two clinical sites in the US (Levine Cancer Institute & Weill Cornell Medical College). De-identified patient-level data were abstracted in an electronic case report form. Treatment patterns, overall response rate (ORR) and proportion of patients with very good partial response (VGPR) or better were reported using descriptive statistics and stratified by line of therapy (first line [1L], second line [2L] or third line or later [3L+]). Results: A total of 202 patient charts were extracted. Patients were, on average, 65.3 years old at MM diagnosis and 68.1 years old at DARA initiation; 109 (54.0%) were male; 104 (51.5%) were White and 65 (32.2%) were Black or African American; 64 (31.7%) received a stem cell transplant (SCT) prior to the line of DARA initiation. Twenty-one (10.4%), 53 (26.2%) and 128 (63.4%) patients initiated DARA in 1L, 2L and 3L+, respectively. Median follow-up time was 6.2 months for 1L patients and 13.8 months for 2L+ patients. The most common 1L regimen was DARA with bortezomib, lenalidomide ± dexamethasone (DVRd; n=10, 47.6%) followed by DARA with lenalidomide ± dexamethasone (DRd; n=8, 38.1%). The most common 2L regimen was DRd (n=15, 28.3%) followed by DARA with pomalidomide ± dexamethasone (DPd, n=13, 24.5%) and DARA with bortezomib ± dexamethasone (DVd, n=13, 24.5%). The most common regimen in 3L+ was DPd (n=62, 48.4%). Among patients initiating DARA in 1L, 2L or 3L+ the ORR was 100.0%, 81.6% and 76.0%, and the proportion of patients achieving VGPR or better was 73.3%, 65.8% and 51.0%, respectively (Table 1). Median time to treatment response ranged between 2.6 and 2.8 months post-initiation. Conclusions: In this study, patients initiated on DARA had high ORR and rates of VGPR or better, including an ORR of 100% among 1L DARA users. These findings suggest that DARA-based regimens are an effective treatment option across all lines of therapy, with highest response rate in 1L. [Table: see text]

scholarly journals Impact of standard care on elderly glioblastoma patients

2016 ◽  
Vol 4 (1) ◽  
pp. 4-14
Author(s):  
Sarah Lapointe ◽  
Marie Florescu ◽  
David Simonyan ◽  
Karine Michaud
Keyword(s):  
Chart Review ◽  
Median Overall Survival ◽  
Performance Status ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Significant Prognostic Factor ◽  
Resection Status ◽  
Newly Diagnosed Glioblastoma ◽  
Similar Survival ◽  
Stupp Protocol

Abstract Background. Uncertainty persists about the survival advantage of concomitant and adjuvant temozolomide (TMZ) plus radiotherapy (RT) in elderly patients with newly diagnosed glioblastoma (GBM). We compared the clinical outcome of unselected elderly GBM patients treated with 4 adjuvant treatment modalities, including the Stupp protocol. Methods. From 2010 to 2014, retrospective chart review was performed on 171 GBM patients aged ≥55 who received either concurrent chemoradiation therapy (CCRT) with standard 60 Gy/30 (SRT); CCRT with hypofractionated 40 Gy/15 (HRT); HRT alone; or TMZ alone. Stratification is by age (55–69, ≥70), KPS (<70, ≥70), and resection status (biopsy, resection). Results. Out of 171 patients identified, 128(75%) had surgical resection, median age was 66(55–83), and median overall survival (mOS) 11.4mo. Majority (109/171) were treated according to the Stupp protocol (CCRT-SRT), and 106/171 received post-CCRT adjuvant TMZ (median of 3 cycles). In our population, age <70yo was a significant prognostic factor (mOS of patients aged 55–69 vs ≥70 yo = 13.3 vs 6.6 mo; P = .001). However, among the population receiving the Stupp regimen, there was no difference in survival between patients aged 55–69 and those ≥70 (respectively, 14.4 vs 13.2 mo; P = .798). Patients ≥70 yo had similar survival when treated with CCRT-HRT and CCRT-SRT (P = .248), although numbers were small. Conclusions. Our data suggests that, despite having a worse global prognostic than their younger counterparts, GBM patients ≥70yo with a good performance status could be treated according to the Stupp protocol with similar survival. Theses results need prospective confirmation.

scholarly journals Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Feras Sendy ◽  
Eman AlShehri ◽  
Amani AlAjmi ◽  
Elham Bamanie ◽  
Surekha Appani ◽  
...  
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Treatment Modalities ◽  
Pregnancy Failure ◽  
Dose Methotrexate ◽  
Mass Size ◽  
Primary Management

Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure.Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate.Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound.Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

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