Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia

Abstract Purpose To evaluate the factors associated with the development of ocular candidiasis (OC) and ocular prognosis with echinocandin therapy for candidemia. Methods The medical records of 56 consecutive patients with a positive blood culture for Candida species between November 2016 and October 2019 were retrospectively reviewed. Information on patient characteristics, isolated Candida species, treatment details for candidemia, and ocular findings were extracted to identify factors associated with OC development. Results The leading pathogen of candidemia was Candida albicans (C.albicans) (41.1%). Of 56 patients, 18 (32.1%) were diagnosed with chorioretinitis, categorized as either probable (8 patients) or possible OC (10 patients). There was no case of endophthalmitis with vitritis. The incidence of probable OC was not significantly different between the groups treated with echinocandins and other antifungal drugs (15.2% vs. 11.1%, p = 1.00). In all probable OC cases, systemic antifungal therapy was switched from echinocandins to azoles, and no case progressed to endophthalmitis. A multivariate logistic analysis revealed that female sex (adjusted odds ratio [aOR], 8.93; 95% confidence interval [CI], 1.09–72.9) and C. albicans (aOR, 23.6; 95% CI, 1.8–281) were independent factors associated with the development of probable OC. Conclusion One-seventh of patients with candidemia developed probable OC. Given the evidence of female and C. albicans as the factors associated with OC development, careful ophthalmologic management is required with these factors, especially in candidemia. Although echinocandins had no correlation with OC development and did not lead to the deterioration of ocular prognosis, further investigation is required.

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Association between Near Work Time and Depression among Workers in South Korea

Korean Journal of Family Medicine ◽

10.4082/kjfm.20.0217 ◽

2021 ◽

Vol 42 (5) ◽

pp. 390-394

Author(s):

Na Rae Jeong ◽

Seung Hun Lee ◽

Yun Jin Kim ◽

Jeong Gyu Lee ◽

Yu Hyeon Yi ◽

...

Keyword(s):

Odds Ratio ◽

Adjusted Odds Ratio ◽

Reference Group ◽

Nutrition Examination Survey ◽

Work Time ◽

Logistic Analysis ◽

Health And Nutrition ◽

Patient Health ◽

Near Work ◽

Multivariate Logistic Analysis

Background: The aim of this study was to evaluate the association between near work time and depression. Methods: Data of 1,551 workers aged 19–49 years from the sixth Korea National Health and Nutrition Examination Survey were examined. The Patient Health Questionaire-9 scores were used to screen for depression. Participants who scored a total of 10 or above, which is suggestive of the presence of depression, were classified as the depression group; the rest were classified as normal. The correlation between daily near work time and depression was analyzed using multivariate logistic analysis after adjusting for other sociodemographic and health behavior-related variables. Results: Multivariate logistic analysis found that workers with 3 or more hours of near work were more likely to report depression compared to the reference group who had 2 or fewer hours per day of near work (adjusted odds ratio, 2.471; 95% confidence interval, 1.062–5.747). Conclusion: Longer near work time was associated with depression among South Korea’s workers. Therefore, it is necessary to reduce near work time to prevent depression.

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Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312120978008 ◽

2020 ◽

Vol 8 ◽

pp. 205031212097800

Author(s):

Damtew Asrat ◽

Atsede Alle ◽

Bekalu Kebede ◽

Bekalu Dessie

Keyword(s):

Confidence Interval ◽

Traditional Medicine ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medicine Use ◽

Community Based ◽

Cross Sectional ◽

Traditional Medicines ◽

Factors Associated

Background: Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda. Method: Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables. Results: Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children. Conclusions: Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.

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Analysis models for variables associated with breastfeeding duration

Revista Paulista de Pediatria ◽

10.1590/s0103-05822013000300006 ◽

2013 ◽

Vol 31 (3) ◽

pp. 306-314 ◽

Cited By ~ 3

Author(s):

Edson Theodoro dos S. Neto ◽

Eliana Zandonade ◽

Adauto Oliveira Emmerich

Keyword(s):

Logistic Regression ◽

Protective Factors ◽

Regression Model ◽

Odds Ratio ◽

Regression Models ◽

Adjusted Odds Ratio ◽

Cox Regression ◽

Bottle Feeding ◽

Breastfeeding Duration ◽

Factors Associated

OBJECTIVE To analyze the factors associated with breastfeeding duration by two statistical models. METHODS A population-based cohort study was conducted with 86 mothers and newborns from two areas primary covered by the National Health System, with high rates of infant mortality in Vitória, Espírito Santo, Brazil. During 30 months, 67 (78%) children and mothers were visited seven times at home by trained interviewers, who filled out survey forms. Data on food and sucking habits, socioeconomic and maternal characteristics were collected. Variables were analyzed by Cox regression models, considering duration of breastfeeding as the dependent variable, and logistic regression (dependent variables, was the presence of a breastfeeding child in different post-natal ages). RESULTS In the logistic regression model, the pacifier sucking (adjusted Odds Ratio: 3.4; 95%CI 1.2-9.55) and bottle feeding (adjusted Odds Ratio: 4.4; 95%CI 1.6-12.1) increased the chance of weaning a child before one year of age. Variables associated to breastfeeding duration in the Cox regression model were: pacifier sucking (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.3) and bottle feeding (adjusted Hazard Ratio 2.0; 95%CI 1.2-3.5). However, protective factors (maternal age and family income) differed between both models. CONCLUSIONS Risk and protective factors associated with cessation of breastfeeding may be analyzed by different models of statistical regression. Cox Regression Models are adequate to analyze such factors in longitudinal studies.

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Stunting at birth and associated factors among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital

PLoS ONE ◽

10.1371/journal.pone.0245528 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245528

Author(s):

Almaz Tefera Gonete ◽

Bogale Kassahun ◽

Eskedar Getie Mekonnen ◽

Wubet Worku Takele

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

Low Birth Weight ◽

Short Stature ◽

Odds Ratio ◽

Associated Factors ◽

Adjusted Odds Ratio ◽

Referral Hospital ◽

Factors Associated ◽

The University

Background Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia. Methods An institution-based cross-sectional study was conducted from February 26th to April 25th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association. Results About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted. Conclusion Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.

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Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw254 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 2

Author(s):

Ikwo K. Oboho ◽

Anna Bramley ◽

Lyn Finelli ◽

Alicia Fry ◽

Krow Ampofo ◽

...

Keyword(s):

Intensive Care Unit ◽

Differential Diagnosis ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Influenza Season ◽

Community Acquired Pneumonia ◽

Severe Illness ◽

Factors Associated ◽

Icu Admission ◽

Clinician Education

Abstract Background Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited. Methods Patients hospitalized with CAP at 6 hospitals during the 2010−2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression. Results Oseltamivir treatment was provided to 89 of 1627 (5%) children (<18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36−4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47−5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27−3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16−1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64−15.12), hospitals D and E (aOR, 3.46−5.11; 95% CI, 1.75−11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18−3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34−3.13). Conclusions Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.

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Adverse Events and Factors Associated with Potentially Avoidable Use of General Anesthesia in Cesarean Deliveries

Anesthesiology ◽

10.1097/aln.0000000000002629 ◽

2019 ◽

Vol 130 (6) ◽

pp. 912-922 ◽

Cited By ~ 20

Author(s):

Jean Guglielminotti ◽

Ruth Landau ◽

Guohua Li

Keyword(s):

Adverse Events ◽

General Anesthesia ◽

Cesarean Delivery ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Neuraxial Anesthesia ◽

General Anesthetics ◽

Factors Associated ◽

Increased Risk ◽

Anesthesia Complications

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. Methods This retrospective study analyzed cesarean delivery cases without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia in New York State hospitals, 2003 to 2014. Adverse events included anesthesia complications (systemic, neuraxial-related, and drug-related), surgical site infection, venous thromboembolism, and the composite of death or cardiac arrest. Anesthesia complications were defined as severe if associated with death, organ failure, or prolonged hospital stay. Results During the study period, 466,014 cesarean deliveries without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia were analyzed; 26,431 were completed with general anesthesia (5.7%). The proportion of avoidable general anesthetics decreased from 5.6% in 2003 to 2004 to 4.8% in 2013 to 2014 (14% reduction; P < 0.001). Avoidable general anesthetics were associated with significantly increased risk of anesthesia complications (adjusted odds ratio, 1.6; 95% CI, 1.4 to 1.9), severe complications (adjusted odds ratio, 2.9; 95% CI, 1.6 to 5.2), surgical site infection (adjusted odds ratio, 1.7; 95% CI, 1.5 to 2.1), and venous thromboembolism (adjusted odds ratio, 1.9; 95% CI, 1.3 to 3.0), but not of death or cardiac arrest. Labor neuraxial analgesia rate was one of the most actionable hospital-level factors associated with avoidable general anesthetics. Relative to hospitals with a rate greater than or equal to 75%, the adjusted odds ratio of avoidable general anesthetics increased to 1.3 (95% CI, 1.2 to 1.4), 1.6 (95% CI, 1.5 to 1.7), and 3.2 (95% CI, 3.0 to 3.5) as the rate decreased to 50 to 74.9%, 25 to 49.9%, and less than 25%, respectively. Conclusions Compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.

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Epidemiology of Methicillin-ResistantStaphylococcus aureusBloodstream Coinfection Among Adults With Candidemia in Atlanta, GA, 2008–2012

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.185 ◽

2015 ◽

Vol 36 (11) ◽

pp. 1298-1304 ◽

Cited By ~ 5

Author(s):

Jessica Reno ◽

Saumil Doshi ◽

Amy K. Tunali ◽

Betsy Stein ◽

Monica M. Farley ◽

...

Keyword(s):

Nursing Home ◽

Medical Records ◽

Odds Ratio ◽

Nursing Home Residents ◽

Population Based ◽

Emerging Infections ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Active Population ◽

Invasive Infections

BACKGROUNDPatients with candidemia are at risk for other invasive infections, such as methicillin-resistantStaphylococcus aureus(MRSA) bloodstream infection (BSI).OBJECTIVETo identify the risk factors for, and outcomes of, BSI in adults withCandidaspp. and MRSA at the same time or nearly the same time.DESIGNPopulation-based cohort study.SETTINGMetropolitan Atlanta, March 1, 2008, through November 30, 2012.PATIENTSAll residents withCandidaspp. or MRSA isolated from blood.METHODSThe Georgia Emerging Infections Program conducts active, population-based surveillance for candidemia and invasive MRSA. Medical records for patients with incident candidemia were reviewed to identify cases of MRSA coinfection, defined as incident MRSA BSI 30 days before or after candidemia. Multivariate logistic regression was performed to identify factors associated with coinfection in patients with candidemia.RESULTSAmong 2,070 adult candidemia cases, 110 (5.3%) had coinfection within 30 days. Among these 110 coinfections, MRSA BSI usually preceded candidemia (60.9%; n=67) or occurred on the same day (20.0%; n=22). The incidence of coinfection per 100,000 population decreased from 1.12 to 0.53 between 2009 and 2012, paralleling the decreased incidence of all MRSA BSIs and candidemia. Thirty-day mortality was similarly high between coinfection cases and candidemia alone (45.2% vs 36.0%,P=.10). Only nursing home residence (odds ratio, 1.72 [95% CI, 1.03–2.86]) predicted coinfection.CONCLUSIONSA small but important proportion of patients with candidemia have MRSA coinfection, suggesting that heightened awareness is warranted after 1 major BSI pathogen is identified. Nursing home residents should be targeted in BSI prevention efforts.Infect. Control Hosp. Epidemiol.2015;36(11):1298–1304

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Trends and predictors of recent HIV testing over 22 years among a clinic sample of men who have sex with men in South Australia

Sexual Health ◽

10.1071/sh16091 ◽

2017 ◽

Vol 14 (2) ◽

pp. 164 ◽

Cited By ~ 1

Author(s):

Bin Li ◽

Peng Bi ◽

Alison Ward ◽

Charlotte Bell ◽

Christopher K. Fairley

Keyword(s):

Hiv Testing ◽

Medical Records ◽

Odds Ratio ◽

South Australia ◽

Injecting Drug Use ◽

Sex Partners ◽

Factors Associated ◽

Multiple Sex Partners ◽

The Past ◽

Sex With Men

Background Increasing the frequency of HIV testing is crucial for effective HIV prevention and care. The aim of the present study was to determine whether there has been a change in HIV testing among men who have sex with men (MSM) at the South Australia Specialist Sexual Health (SASSH) clinic over the past two decades. Methods: Computerised medical records of MSM who attended the SASSH at their first visit between 1994 and 2015 were used to determine whether HIV testing had changed among MSM. First HIV tests in each calendar year and return tests within 12 months were analysed. Factors associated with recent HIV testing were also examined. Results: There were 24 036 HIV tests conducted among 8163 individual MSM over the study period. The proportion of newly registered MSM who reported ever being tested for HIV declined (Ptrend = 0.030), the proportion who reported recent HIV testing did not change (Ptrend = 0.955) and the proportion who have had current HIV testing increased (Ptrend = 0.008). The proportion of MSM who returned to the clinic for HIV testing within 12 months did not change (Ptrend >0.05), with less than 40% of MSM returning for HIV testing. Factors independently associated with recent HIV testing included MSM aged ≥20 years, (odds ratio (OR) 1.79; 95% confidence interval (CI) 1.53–2.10), higher education (OR 1.28; 95% CI 1.12–1.45), non-Caucasian (African OR 1.68; 95% CI 1.30–2.17), having multiple sex partners (OR 1.47; 95% CI 1.29–1.69), having had sex interstate (OR 1.61; 95% CI 1.42–1.82) or overseas (OR 1.53; 95% CI 1.33–1.76) and injecting drug use (OR 1.56; 95% CI 1.29–1.88). Conclusions: HIV testing rate among MSM attending SASSH was suboptimal. New approaches are needed to increase the uptake and early detection of HIV infection among the high-priority MSM population.

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VULVOVAGINAL CANDIDIASIS: PREVALENCE, SPECIES DISTRIBUTION AND RISK FACTORS AMONG NON-PREGNANT WOMEN, IN SANA'A, YEMEN

Universal Journal of Pharmaceutical Research ◽

10.22270/ujpr.v6i3.613 ◽

2021 ◽

Author(s):

Sameera Mohammad Mahdi Al-Hatami ◽

Khaled Abdulkareem A Al-Moyed ◽

Hassan Abdulwahab Al-Shamahy ◽

Ahmed Mohammed Al-Haddad ◽

Azhar Azher Mohammed Al-Ankoshy

Keyword(s):

Risk Factors ◽

Candida Albicans ◽

Pregnant Women ◽

Peer Review ◽

Species Distribution ◽

Candida Species ◽

Odds Ratio ◽

Vulvovaginal Candidiasis ◽

Age Group ◽

Factors Associated

Background and objectives: Vulvovaginal candidiasis is known to be a global issue of concern due to its association with economic costs, sexually transmitted diseases, and the escalation of genital tract infections. This study aimed to determine the prevalence, species distribution and risk factors associated with Candida species causing vulvovaginal candidiasis. Subjects and Methods: Non-pregnant women attending routine antenatal visits at Al-Olaifi-Family Center in Sana'a were enrolled in a cross-sectional study conducted from June 2018 to March 2019. Laboratory work was carried out at the National Center of Public Laboratories (NCPHL). Vaginal swabs were sampled from participants after oral consent was obtained. The swabs were inoculated in Sabouraud glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48 h under aerobic conditions in order to perform a fungal culture. Candida species were determined by culturing on HiCrome Candida differential Agar at 35°C for 48 h to produce species-specific colours. Data on demographic, clinical, and risk factors were collected in a pre-designed questionnaire. Results: A total of 190 non-pregnant women were included. The prevalence of VVC was 22.1%. Candida albicans accounted for 16.3% and non-Candida albicans accounted for 5.8% of the isolates, mainly C. glabrata (3.2%), C. rugosa (1.05%), C. lipolytica (1.05%), and C. dubliniensis (0.53%). When VVC risk factors were considered, there were significant risk factors with age group 30-34 years (33.3%, odds ratio=2.1) and age group ≥35 years (62.5%, odds ratio=10.3), residence in a rural area (39.5 %, OR=3.3), negative emotions (30.2%, OR=2.3), underwear replacement over 1 day (29.3%, OR=4.2), impure cotton underwear (29.4%, OR=4.9), while Condom use and vulvar cleaning before or after sexual life were found to be highly significant protective factors against VVC (p=0.008, 0.03, respectively). Conclusions: Guidelines for the management of VVC syndrome in Yemen should be revised to include a protocol specifically for women over 30 years of age. VVC undoubtedly poses a significant threat to women's reproductive health. Risk factors for VVC are varied, and include ages, health habits, history of the disease, and other aspects. It is necessary to take appropriate measures to avoid risk factors and to help reduce the prevalence of VVC among women of childbearing age. Peer Review History: Received: 3 May 2021; Revised: 23 June; Accepted: 30 June, Available online: 15 July 2021 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Dr. Michael Otakhor Erhunmwunse, St. Philomena Catholic Hospital, Nigeria,[email protected] Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, [email protected] Similar Articles: VULVOVAGINAL CANDIDIASIS PREVALENCE AMONG PREGNANT WOMEN IN DIFFERENT HOSPITALS IN IBB, YEMEN PREVALENCE AND RISK FACTORS ASSOCIATED WITH VULVOVAGINAL CANDIDIASIS DURING PREGNANCY IN SANA'A, YEMEN

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Common Immune-Related Adverse Events of Immune Checkpoint Inhibitors in the Gastrointestinal System: A Study Based on the US Food and Drug Administration Adverse Event Reporting System

Frontiers in Pharmacology ◽

10.3389/fphar.2021.720776 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xiaoyin Bai ◽

Shiyu Jiang ◽

Yangzhong Zhou ◽

Hongnan Zhen ◽

Junyi Ji ◽

...

Keyword(s):

Adverse Events ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Reporting System ◽

Checkpoint Inhibitors ◽

Adverse Event Reporting System ◽

Adverse Event Reporting ◽

Event Reporting ◽

Logistic Analysis ◽

The Us

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, immune-related adverse events (irAEs) in the gastrointestinal (GI) system commonly occur. In this study, data were obtained from the US Food and Drug Administration adverse event reporting system between July 2014 and December 2020. Colitis, hepatobiliary disorders, and pancreatitis were identified as irAEs in our study. Reporting odds ratio (ROR) with information components (IC) was adopted for disproportionate analysis. A total of 70,330 adverse events were reported during the selected period, 4,075 records of which were associated with ICIs. GI toxicities have been reportedly increased with ICI, with ROR025 of 17.2, 6.7, and 2.3 for colitis, hepatobiliary disorders, and pancreatitis, respectively. The risks of colitis, hepatobiliary disorders, and pancreatitis were higher with anti-CTLA-4 treatment than that with anti-PD-1 (ROR025 2.6, 1.3, and 1.1, respectively) or anti-PD-L1 treatment (ROR025 4.8, 1.3, and 1.3, respectively). Logistic analysis indicated that hepatobiliary disorders and pancreatitis more frequently occurred in female patients (adjusted odds ratio, 1.16 and 1.52; both p < 0.05). Consistently, polytherapy was a strong risk factor for colitis (adjusted odds ratio 2.52, p < 0.001), hepatobiliary disorders (adjusted odds ratio 2.50, p < 0.001), and pancreatitis (adjusted odds ratio 2.29, p < 0.001) according to multivariate logistic analysis. This pharmacovigilance analysis demonstrated an increased risk of all three GI irAEs associated with ICI therapies. The comparative analysis offered supportive insights on selecting GI irAEs for patients treated with ICIs.

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