scholarly journals Intravenous tacrolimus is a superior induction therapy for acute severe ulcerative colitis compared to oral tacrolimus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiromichi Shimizu ◽  
Toshimitsu Fujii ◽  
Kenji Kinoshita ◽  
Ami Kawamoto ◽  
Shuji Hibiya ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cohort Study ◽  
Primary Outcome ◽  
Remission Rate ◽  
Survival Rates ◽  
Efficacy And Safety ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Severe Ulcerative Colitis ◽  
Intravenous Corticosteroid

Abstract Background Intravenous corticosteroid is the mainstay for managing acute severe ulcerative colitis, but one-third of patients do not respond to intravenous corticosteroid. Tacrolimus, a salvage therapy before colectomy, is usually orally administered, though its bioavailability is low compared intravenous administration. The efficacy of intravenous tacrolimus has not been widely studied. Aim To determine the efficacy and safety of intravenous tacrolimus for the treatment of acute severe ulcerative colitis. Methods Eighty-seven hospitalized acute severe ulcerative colitis patients were enrolled for a prospective cohort study between 2009 and 2017. Sixty-five patients received intravenous tacrolimus and 22 received oral tacrolimus. The primary outcome was the achievement of clinical remission within 2 weeks. Relapse and colectomy incidence and adverse events were assessed at 24 weeks. Results Response rates of both treatments exceeded 50% but were not significantly different. The remission rate was higher in intravenous tacrolimus compared with oral tacrolimus. At 24 weeks, oral and intravenous tacrolimus showed similar relapse-free survival rates; however, colectomy-free survival rates were higher in intravenous tacrolimus compared with oral tacrolimus. Conclusions Patients receiving intravenous tacrolimus achieved superior remission and colectomy-free survival rates compared with patients receiving oral tacrolimus. Safety was similar between the two treatments.

P627 Acute severe ulcerative colitis in pregnancy: A retrospective cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S518-S519
Author(s):  
J Ollech ◽  
I Avni-Biron ◽  
S Dalal ◽  
L Glick ◽  
S Schafer ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gestational Age ◽  
Survival Rates ◽  
Incidence Rates ◽  
Low Birth Weight Infants ◽  
Free Survival ◽  
Severe Ulcerative Colitis ◽  
Chronic Inflammatory Condition ◽  
Adverse Pregnancy ◽  
Intravenous Steroids

Abstract Background Ulcerative colitis is a chronic inflammatory condition of the colon with peak incidence rates between the ages of 15 and 35 years. Consequently, women with ulcerative colitis are often diagnosed during childbearing years, which makes the effect of the disease on pregnant patients an important clinical question. Acute severe ulcerative colitis will affect up to 25% of patients. There are limited studies that describe the medical treatment, colectomy rates, and birth outcomes of women hospitalised with acute severe ulcerative colitis during pregnancy. Methods We performed a retrospective observational study of pregnant ulcerative colitis patients hospitalised at two large tertiary medical centres between January 2003 and December 2018. The primary endpoint was colectomy-free survival. Secondary endpoints included details of disease management and fetal outcomes. Results Twenty patients met the inclusion criteria. At admission, the median age was 30.3 years (IQR 23.4–32), and the median gestational age was 21 weeks (IQR 14–28). All patients met Truelove and Witts criteria for acute severe ulcerative colitis. The median follow-up time was 48 months (IQR 20.7–80). Colectomy free survival rates from admission were 90% at six months, 84% at one year, and 64% at four years (Figure 1). Only one patient (5%) underwent colectomy at her index admission. All patients were treated with intravenous steroids, and half received anti-tumour necrosis factor agents as inpatients (7 received infliximab and 3 received adalimumab). Following discharge, seven (35%) patients were maintained on infliximab, four (20%) were maintained on adalimumab, vedolizumab and azathioprine were used as the maintenance drug in one patient each, and another seven (35%) patients were transitioned to mesalamine preparations. Live birth occurred in 18 patients (90%), and the median gestational age at birth was 37 weeks (IQR 34.5–38). Adverse pregnancy outcomes included two spontaneous abortions (10%), six premature births (30%), and four low birth weight infants (20%). There were no stillbirths, and no major congenital abnormalities were noted. Conclusion We report on the largest cohort of pregnant patients hospitalised for acute severe ulcerative colitis and have shown that these patients have good response rates to standard treatments and comparable colectomy rates to studies of non-pregnant patients. In our cohort, there were relatively high rates of preterm and low weight births.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

scholarly journals Efficacy of perioperative chemotherapy for synovial sarcoma: a retrospective analysis of a Nationwide database in Japan

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gang Xu ◽  
Hisaki Aiba ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Synovial Sarcoma ◽  
Survival Rates ◽  
Surgical Margin ◽  
Oncologic Outcomes ◽  
Wide Resection ◽  
Perioperative Chemotherapy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Relapse

Abstract Background Synovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of perioperative chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan. Methods This study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. Moreover, the effects of perioperative chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive chemotherapy were compared (cx + and cx-). Results Multivariate analysis revealed significant correlations of age (over 40, hazard ratio [HR] = 0.61, p = 0.043), margin status (marginal resection, HR = 0.18, p < 0.001 and intralesional resection, HR = 0.30, p = 0.013 versus wide resection) with overall survival; surgical margin type (marginal resection, HR = 0.14, p = 0.001 and intralesional resection, HR = 0.09, p = 0.035 versus wide resection) with local recurrence; and postoperative local recurrence (HR = 0.30, p = 0.027) and surgical margin (marginal resection, HR = 0.31, p = 0.023 versus wide resection) with distant relapse-free survival. Before propensity score matching, perioperative chemotherapy was mainly administered for young patients and patients with deeper tumor locations, larger tumors, more advanced-stage disease, and trunk location. The 3-year overall survival, local control, and distant relapse-free survival rates were 79.8%/89.3% (HR = 0.64, p = 0.114), 89.6%/93.0% (HR = 0.37, p = 0.171) and 71.4%/84.5% (HR = 0.60, p = 0.089) in the cx+/cx- groups, respectively. After propensity score matching, 152 patients were selected such that the patient demographics were nearly identical in both groups. The 3-year overall survival, local control, and distant relapse-free survival rates were 71.5%/86.0% (HR = 0.48, p = 0.055), 92.5%/93.3% (HR = 0.51, p = 0.436) and 68.4%/83.9% (HR = 0.47, p = 0.046) in the cx+/cx- groups, respectively. Conclusion This large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of perioperative chemotherapy for survival outcomes in synovial sarcoma patients was not proven in this Japanese database analysis.

scholarly journals Tofacitinib: An Option for Acute Severe Ulcerative Colitis?

2021 ◽  
pp. 1-3
Author(s):  
Sara Santos ◽  
Verónica Gamelas ◽  
Rita Saraiva ◽  
Guilherme Simões ◽  
Joana Saiote ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Improvement ◽  
Rescue Therapy ◽  
New Drugs ◽  
Multiple Drug ◽  
Disease Course ◽  
Efficacy And Safety ◽  
Severe Ulcerative Colitis ◽  
Rapid Absorption

Tofacitinib has emerged as a new option for ulcerative colitis. Its rapid absorption, metabolism, and clinical improvement make it an interesting option for rescue therapy in acute severe ulcerative colitis (ASUC), a situation with limited therapeutic options in patients with a long-term disease course and multiple drug failure. The management of ASUC in this setting becomes challenging, underlying the need for new drugs and data on their efficacy and safety. We describe 2 cases of acute episodes in which tofacitinib was used as a rescue therapy.

592 Histological Normalization Is Associated With Superior Relapse Free Survival Compared to Histological Activity and Histological Quiescence in Ulcerative Colitis

2015 ◽  
Vol 148 (4) ◽  
pp. S-115 ◽  
Author(s):  
Britt Christensen ◽  
Olufemi Kassim ◽  
Jonathan Erlich ◽  
Stephen B. Hanauer ◽  
David T. Rubin
Keyword(s):  
Ulcerative Colitis ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Histological Activity

scholarly journals Experimental, Clinical, and Morphological Analysis of H-Ras Oncoproteins for Locally Advanced Breast Cancer

2020 ◽  
Vol 8 (B) ◽  
pp. 1077-1082
Author(s):  
Ainura Maratovna Zhumakayeva ◽  
K. D. Rakhimov ◽  
I. M. Omarova ◽  
S. M. Adekenov ◽  
S. S. Zhumakayeva
Keyword(s):  
Breast Cancer ◽  
Comparative Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Positive Expression ◽  
Egfr Expression

BACKGROUND: Activated forms of RAS increase both in breast cancer and in cell lines in the presence of estimated glomerular filtration rate (EGFR) or HER2 expression. HRAS oncoproteins play an important role in enhancing the proliferation and resistance of breast cancer tumor cells to apoptosis. A number of studies have shown a significant decrease in EGFR expression after neoadjuvant chemotherapy, which has been clinical, manifested by an improvement in immediate efficacy and an increase in overall and relapse-free breast cancer survival rates. AIM: The aim of the study was to study relapse-free survival depending on the expression of the H-RAS oncoprotein in patients with breast cancer who received different treatment regimens for the farnesyltransferase inhibitor. METHODS: H-RAS status was assessed by immunohistochemistry. RESULTS: A comparative analysis of patients with negative expression of H-RAS oncoproteins showed a statistically significant increase in relapse-free survival in the subgroups who received neoadjuvant chemotherapy according to the AC regimen (adriablastin + cyclophosphamide) and AC + arglabin, compared with monotherapy by arglabin: Kruskal–Wallis= 12.56, where p = 0.001. A comparative analysis of patients with positive expression of H-RAS showed that in the subgroups treated with arglabin and AC+arglabin, there was a statistically significant increase in relapse-free survival compared with the AC subgroup: Kruskal–Wallis = 10.96, where p = 0.004. It was established that the positive expression of H-RAS negatively affects not only the direct effectiveness of neoadjuvant therapy but also worsens the rates of relapse-free survival. However, in patients with positive H-RAS expression who received arglabin in monotherapy, there was a statistically significant increase in relapse-free survival up to 16.5 ± 1.1 months compared with the standard AC regimen (13.5 ± 1.1 months) (р ˂ 0.05), the addition of arglabin to the standard AC regime also increased this indicator to 16.4 ± 1.2 months (р ˂ 0.05). CONCLUSION: These results may indicate the clinical applicability of determining H-RAS as a prognostic factor for relapse-free survival in breast cancer.

scholarly journals Laparoscopic Versus Open Distal Gastrectomy With D2 Lymph Node Dissection for cT2 Gastric Cancer: A Retrospective Cohort Study of Short- and Long-Term Outcomes

2015 ◽  
Vol 100 (9-10) ◽  
pp. 1315-1322 ◽  
Author(s):  
Kei Hosoda ◽  
Shinichi Sakuramoto ◽  
Natsuya Katada ◽  
Keishi Yamashita ◽  
Hiromitsu Moriya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Survival Rates ◽  
Controlled Study ◽  
D2 Lymphadenectomy ◽  
Open Distal Gastrectomy ◽  
Long Term Outcomes ◽  
Relapse Free Survival ◽  
Free Survival

The purpose of this study was to determine whether laparoscopy-assisted distal gastrectomy (LDG) with D2 lymphadenectomy could be a standard treatment for cT2N0-1 gastric cancer. There have been few reports regarding the long-term outcomes of patients with advanced gastric cancer who underwent LDG with D2 lymphadenectomy. The study included 32 patients who underwent LDG with D2 lymphadenectomy and 44 patients who underwent open distal gastrectomy (ODG) with D2 lymphadenectomy. There was no clinicopathologic difference in patient background between the groups. Operative duration was significantly longer in the LDG group than in the ODG group (297 ± 12 minutes versus 226 ± 10 minutes; P &lt; 0.001). However, blood loss was significantly less (90 ± 27 mL versus 314 ± 23 mL; P &lt; 0.001) and the number of days to assisted ambulation significantly shorter (1.1 ± 0.1 days versus 1.5 ± 0.1 days; P = 0.010) in the LDG group than in the ODG group. Median follow-up period was 60 months. The 5-year overall survival rates for the LDG group and the ODG group were 89.5% and 97.1%, respectively. The 5-year relapse-free survival rates for the LDG group and the ODG group were 88.0% and 97.7%, respectively. There were no significant differences in overall and relapse-free survival rates between the groups. LDG with D2 lymphadenectomy for cT2N0-1 gastric cancer is oncologically and technically safe and feasible, and is an option in the surgeon's arsenal. Randomized controlled study including the investigation of cost-effectiveness should be conducted.

Sign in / Sign up

Export Citation Format

Share Document