Albendazole alone vs. albendazole and diethylcarbamazine combination therapy for trichuriasis

Background Trichuris trichiura is one of the most commonsoil-transmitted helminths, estimated to infect l billion peopleworldwide. Several studies have compared the efficacies ofalbendazole and diethylcarbamazine, but the efficacy of acombination of these two drugs has been inconclusive.Objective To assess the effectiveness of a single dose ofalbendazole compared to a combination of albendazole anddiethylcarbamazine for trichuriasis treatment.Methods A randomized, clinical open trial was conducted fromJune to September 2009 on elementary school children withtrichuriasis from two villages in the North Sumatera Province.Stool specimens were collected at baseline and at days 7, 14,21, and 28 after treatment, and examined by the Kato Katzmethod. Subjects were randomized into two groups. Group Ireceived a single dose of albendazole (400 mg) and group IIreceived albendazole (400 mg) plus diethylcarbamazine (6 mg!kg). Statistical analyses used were Chi square test for cure ratesand Wilcoxon rank test for egg reduction rates.Results One hundred eight children were enrolled andrandomized into group l (53 children) and group II (55children). The prevalence of T. trichiura infection was 54.7%.There were no significant differences (P=0.52) in the curerate between groups I and II (66% and 60%, respectively) or inegg reduction rates at day 28 (54.5% and 60.07%, respectively,P= 0.10).Conclusion Albendazole alone and abendazole combinedwith diethylcarbamazine have similar efficacies for trichuriasistreatment, in terms of cure rates and egg reduction rates.

Download Full-text

The efficacy of single-dose albendazole for the treatment of ascariasis

Paediatrica Indonesiana ◽

10.14238/pi45.3.2005.118-22 ◽

2016 ◽

Vol 45 (3) ◽

pp. 118

Author(s):

Deddy S Putra ◽

W Dalimunthe ◽

M Lubis ◽

S Pasaribu ◽

Chairuddin Lubis

Keyword(s):

Single Dose ◽

School Children ◽

Reduction Rate ◽

Chi Square ◽

Treat Ment ◽

Significant Difference ◽

Chi Square Test ◽

Stool Specimens ◽

Cure Rates ◽

Egg Reduction Rate

Objective This study aims to assess the efficacy of single-dosealbendazole in treating mild, moderate, and severe ascariasis.Methods Stool specimens were collected from randomly selectedelementary school children in Suka village, Sumatera Utara, fromMarch to April 2002. Based on the number of eggs per gram feces(NEPG), samples were categorized as mild (NEPG < 7000), mod-erate (NEPG 7000-35,000), or severe (NEPG > 35,000) ascari-asis. All subjects then received 400 mg albendazole orally. NEPGcount was repeated on the 7 th , 14 th , 21 st and 28 th day after treat-ment. The chi-square test was used to compare cure rates be-tween subjects with mild, moderate, and severe ascariasis. TheANOVA and Kruskal-Wallis tests were employed to analyze quan-titative data.Results From the 134 specimens collected, we found mild ascari-asis in 57 (42.5%), moderate ascariasis in 57 (42.5%), and severeascariasis in 20 (15%). There was no significant difference be-tween the three groups in NEPG after treatment (P>0.05). Thecure rate and egg reduction rate on day 28 after treatment was 100%.Conclusion A single dose of 400 mg albendazole is effective forthe treatment of mild, moderate, and severe ascariasis.

Download Full-text

Hubungan Kecacingan dengan Kejadian Anemia pada Anak Sekolah Dasar di Kecamatan Tanjung Senang Bandar Lampung

MAHESA : Malahayati Health Student Journal ◽

10.33024/mahesa.v1i4.3987 ◽

2021 ◽

Vol 1 (4) ◽

pp. 445-452

Author(s):

Rita Agustina ◽

Tusy Triwahyuni ◽

Devita Febriani Putri ◽

Nindi Destiani

Keyword(s):

Elementary School ◽

School Children ◽

Elementary School Children ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Chi Square Test ◽

Quota Sampling ◽

Prevalence Of Anemia

ABSTRACT: RELATIONSHIP WITH ANEMIA IN ELEMENTARY CHILDREN IN TANJUNG SENANG REGENCY, BANDAR LAMPUNG Background: Anemia is a condition in which the number of red blood cells or the hemoglobin concentration in them is less than normal. WHO in the World Wide Prevalence of Anemia reports that the total population of the world who suffer from anemia is 1.62 billion people with a prevalence in primary school children (25.4%) and 305 million school children worldwide suffer from anemia. In general, the cause of anemia is nutritional deficiencies, especially iron deficiency and parasitic infections such as worms. Worms is an infectious disease caused by parasites in the form of worms. Objective: Knowing the Relation between Worms and Anemia in Elementary School Children in In Tanjung Senang District Bandar Lampung in 2020. Method: This type of research is quantitative research and analytical observational research methods with a cross sectional approach with the Chi Square test. Sampling was done using Quota Sampling. The sample in this study were 63 people. Results: The results of the Chi Square test showed p-value = 0.000, which is less than the significance value of 5% (0.05), this shows that there is a significant relationship between worms and anemia in elementary school children in Tanjung Senang, Bandar Lampung, in 2020. Conclusion: There is a significant relationship between helminths and the incidence of anemia in elementary school children in Tanjung Senang, Bandar Lampung, in 2020. Keywords: Worms, Anemia Incidence ABSTRAK: HUBUNGAN KECACINGAN DENGAN KEJADIAN ANEMIA PADA ANAK SEKOLAH DASAR DI KECAMATAN TANJUNG SENANG BANDAR LAMPUNG Pendahuluan: Anemia merupakan suatu kondisi dimana jumlah sel darah merah atau konsentrasi hemoglobin di dalamnya kurang dari biasanya. WHO dalam World wide Prevalence of Anemia melaporkan bahwa total dari keseluruhan penduduk dunia yang menderita anemia adalah 1,62 miliar orang dengan prevalensi pada anak sekolah dasar (25,4%) dan 305 juta anak sekolah di seluruh dunia menderita anemia. Pada umumnya penyebab anemia adalah kekurangan nutrisi, terutama kekurangan zat besi dan infeksi parasit seperti kecacingan. Kecacingan merupakan penyakit infeksi yang disebabkan oleh parasit berupa cacing.Tujuan: Penelitian ini bertujuan untuk mengetahui Hubungan Kecacingan Dengan Kejadian Anemia Pada Anak Sekolah Dasar di Di Kecamatan Tanjung Senang Bandar Lampung Tahun 2020. Jenis penelitian yang digunakan adalah penelitian kuantitatif dan metode penelitian analitik observasional dengan pendekatan cross sectional dengan uji Chi Square. Pengambilan sampel dilakukan dengan menggunakan Quota Sampling. Sampel pada penelitian ini sebanyak 63 orang.Hasil: Hasil uji Chi Square menunjukkan p-value = 0.000 dimana kurang dari nilai kemaknaan yaitu 5% (0.05), hal tersebut menunjukkan terdapat hubungan yang signifikan antara kecacingan dengan kejadian anemia pada anak Sekolah Dasar di Kecamatan Tanjung Senang Bandar Lampung Tahun 2020.Kesimpulan: Kesimpulannya terdapat hubungan yang signifikan antara kecacingan dengan kejadian anemia pada anak Sekolah Dasar di Kecamatan Tanjung Senang Bandar Lampung Tahun 2020. Kata Kunci Kecacingan, Kejadian Anemia

Download Full-text

Brain-Derived Neurotrophic Factor (BDNF) Serum And Intelligence Levels of Elementary School Children in Rural Areas, Seluma Regency

Jurnal Ilmu Kesehatan Masyarakat ◽

10.26553/jikm.2021.12.1.60-68 ◽

2021 ◽

Vol 12 (1) ◽

pp. 60-68

Author(s):

Rostika Flora ◽

Ena Juhaina ◽

Ahmad Fickry Faisya ◽

Nur Alam Fajar ◽

Yeni Anna Appulembang ◽

...

Keyword(s):

Elementary School ◽

School Children ◽

Rural Areas ◽

Neurotrophic Factor ◽

Elementary School Children ◽

Brain Derived Neurotrophic Factor ◽

Average Risk ◽

Chi Square ◽

Intelligence Level ◽

Chi Square Test

Children living in rural areas are prone to nutritional deficiencies. Low-income levels impact people’s purchasing power so that the intake of most nutrients comes from plant-based foods and consumes less animal food. Nutritional intake greatly affects the development of children’s cognitive function. Brain-derived neurotrophic factor (BDNF) is a group of neurotrophins that contribute greatly to the learning process and memory. This study aims to analyze the relationship between levels of BDNF with the level of intelligence in elementary school children in rural areas of Seluma Regency. This was a cross-sectional study involving 70 elementary school children aged 9-12 years were taken by multi-stage random sampling, who came from 5 districts of Seluma Regency. Blood was collected for measurement of BDNF levels, and stool samples were examined to detect intestinal parasites. The data on respondent characteristics were derived from questionnaires. Data analysis were done by using the chi-square test. The results of BDNF measurements found 31 children (44.3%) had BDNF levels below the average (<3342.95ng / mL). The results of measuring intelligence level found that 54 children (77.1%) had a level of intelligence below the average. Chi-Square test results obtained p = 0.012 with a PR value of 7.538. There was a significant association between the BDNF level and intelligence level in elementary school students in the rural area. Elementary school children in rural areas with BDNF levels below the average risk of 7.538 times have below-average intelligence levels.

Download Full-text

The Relationship between History of Breastfeeding and Obesity on Elementary School Children

SCRIPTA SCORE Scientific Medical Journal ◽

10.32734/scripta.v1i2.1239 ◽

2020 ◽

Vol 1 (2) ◽

pp. 7

Author(s):

David Jhon Ricardo Pakpahan ◽

Ika Citra Dewi Tanjung ◽

Haflin Soraya Hutagalung

Keyword(s):

Elementary School ◽

School Children ◽

Elementary School Children ◽

Health Concern ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

History Of ◽

Cross Sectional Design ◽

The Relationship

ABSTRACT Obesity is a public health concern that its prevalence and intensity on children have been increasing with alarming status. Breastfeeding has been considered as one of protective factors that can prevent childhood obesity. The aim of this study is to discover the relationship between history of breastfeeding and obesity on elementary school children. This is an analytical study with cross sectional design. All children in first and second grade of Namira Islamic Elementary School and their mothers were included as population. Ninety samples were recruited randomly. Data on breastfeeding history were collected by using questionnaire guided interview from the mothers. The BMI-for-age curve CDC 2000 was used to determine obesity status of the children (≥ 95th percentile). Data were analyzed using chi-square test. This study found percentage of children with and without history of breastfeeding consecutively is 92.2% and 7.8%. Prevalence of children with obesity is 12.2% and without obesity is 87.8%. Eight of 83 children with history of breastfeeding (72.7%) were obese, and 3 of 7 children without history of breastfeeding (27.3%) were obese (PR=0.2; 95% CI=0.27-0.752;p<0.05). Based on the study, there is a relationship between history of breastfeeding and obesity in elementary school children. Keywords: Breastfeeding, Elementary School Children, Obesity ABSTRAK Obesitas merupakan masalah kesehatan yang prevalensi dan intensitas kejadiannya pada anak terus meningkat serta telah mencapai status yang mengkhawatirkan. Pemberian ASI telah dipertimbangkan sebagai salah satu faktor yang dapat mencegah terjadinya obesitas pada anak. Tujuan dari penelitian ini adalah untuk mengetahui adanya hubungan antara riwayat pemberian ASI dengan kejadian obesitas pada anak sekolah dasar. Penelitian ini dilakukan melalui pendekatan analitik dengan desain cross sectional. Populasi penelitian ini adalah anak Sekolah Dasar Swasta Islam Namira yang berada di kelas satu dan dua dan Ibu nya. Jumlah sampel dalam peneltian ini adalah 90 orang yang dipilih secara acak. Data mengenai riwayat pemberian ASI didapatkan melalui wawancara dengan kuesioner dari Ibu. Kriteria obesitas pada anak ditentukan dengan menggunakan kurva indeks massa tubuh menurut usia dari CDC 2000 (persentil ≥95). Data yang didapat dianalisis dengan uji kai kuadrat. Pada penelitian ini ditemukan 92.2% anak mendapat ASI dan 7.8% anak tidak mendapat ASI saat bayi. Anak yang mengalami obesitas adalah 12.2% sedangkan anak yang tidak mengalami obesitas adalah 87.8%. Anak yang mendapat ASI dan mengalami obesitas adalah 72.7% sedangkan anak yang tidak diberi ASI dan mengalami obesitas adalah 27.3%. Berdasarkan hasil uji hipotesis didapatkan (RP=0.2; 95% CI=0.27-0.752: p<0.05). Berdasarkan hasil penelitian didapatkan bahwa terdapat hubungan antara riwayat pemberian ASI dengan kejadian obesitas pada anak sekolah dasar. Kata Kunci: Anak Sekolah Dasar, ASI, Obesitas

Download Full-text

Hubungan kekerasan dengan depresi pada anak sekolah dasar di Kecamatan Malalayang Kota Manado

e-CliniC ◽

10.35790/ecl.4.2.2016.14485 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Christin Y. Hutasoit ◽

Herdy Munayang ◽

Bernabas H.R. Kairupan

Keyword(s):

Elementary School ◽

School Children ◽

Elementary School Children ◽

Psychological Impact ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Alternative Test ◽

Relationship Of

Abstract: Child abuse is all forms of violence and neglect that occurred against children under the age of 18 years old. One of the psychological impact of violence is depression. Depression is a mood disorder that can happen to anyone, including a child. The purpose of this study is to determine whether there is a relationship of violence with depression in elementary school children in the district Malalayang city of Manado. Design of the study is quantitative analytical research with cross sectional approach. Samples were 4th, 5th, and 6th grade elementary schools students in the district of the city of Manado Malalayang aged 9 to 12 years old. The respondents who followed the study are 316 children consisting of 169 female and 147 male. Screening instrument used for children depression in this study was Children Depression Inventory (CDI). Statistic analysis chi-square test with alternative test fisher. The results showed that of 316 respondents, 315 experience abuse but only 31 respondents become depressed. The result (p value) of the analysis of relationship between violence and depression in children using Fisher test is 1.000 (p> 0.05). Conclusion: Violence is not associated with depression in children, but does not guarantee children who are abused in childhood will not experience depression as they grow up.Keywords: violence, depression, elementary school children, CDI Abstrak: Kekerasan pada anak adalah segala bentuk tindakan kekerasan dan penelantaran yang terjadi terhadap anak di bawah usia 18 tahun. Salah satu dampak psikologis dari kekerasan adalah depresi. Depresi adalah gangguan mood yang dapat terjadi pada siapapun, termasuk seorang anak. Tujuan dari penelitian ini untuk mengetahui apakah ada hubungan kekerasan dengan depresi pada anak sekolah dasar di kecamatan Malalayang kota Manado. Desain Penelitian yang digunakan adalah penelitian analitik kuantitatif dengan pendekatan potong lintang. Sampel penelitian ini adalah siswa-siswi kelas 4, 5, dan 6 sekolah dasar di kecamatan Malalayang kota Manado yang berusia 9 sampai 12 tahun.Responden yang mengikuti penelitian adalah 316 anak yang terdiri dari 169 perempuan dan 147 laki-laki.Intrumen yang digunakan untuk skrining depresi pada anak dalam penelitian ini adalah kuesioner Children Depression Inventory (CDI).Uji analisis yang digunakan adalah chi-square dengan uji alternatif uji fisher. Hasil penelitian menunjukkan bahwa dari 316 responden, 315 yang mengalami kekerasan tetapi hanya 31 responden yang depresi. Hasil analisis hubungan kekerasan dengan depresi pada anak menggunakan uji fisher didapatkan nilai p sebesar 1,000 (p > 0,05). Simpulan: kekerasan tidak berhubungan dengan depresi pada anak, tetapi tidak menjamin anak yang mengalami kekerasan pada masa kecil tidak akan mengalami depresi saat dewasa. Kata kunci: kekerasan, depresi, anak sekolah dasar, CDI

Download Full-text

Efficacy of Albendazole and Albendazole-Mebendazole against Trichuris trichiura Infections

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5329 ◽

2020 ◽

Vol 8 (B) ◽

pp. 1162-1166

Author(s):

Erwin Suteno ◽

Ayodhia Pitaloka Pasaribu ◽

Nirmalia Husin ◽

Willhans Wijaya ◽

Syahril Pasaribu

Keyword(s):

Single Dose ◽

School Children ◽

Trichuris Trichiura ◽

Primary School Children ◽

Research Subjects ◽

Cure Rate ◽

Chi Square ◽

Infection Treatment ◽

Significant Difference ◽

Chi Square Test

BACKGROUND: Trichuris trichiura infections treatment using albendazole or mebendazole as a single dose is rated unsatisfactory. The combination of albendazole-mebendazole is viewed to have better efficacy against T. trichiura infections due to the nature of each drug. AIM: This study compared the efficacy of albendazole and albendazole-mebendazole for T. trichiura infection treatment in Talawi, Batu Bara, North Sumatra, among primary school children. METHODS: An open randomized clinical trial was carried out in Talawi, Batu Bara. The efficacy of albendazole as a single dose and albendazole-mebendazole as a single dose was compared. Research subjects were school children aged 6–12 years old with T. trichiura infections. Chi-square test was performed to compare the cure rate and unpaired t-test was done to compare the number of eggs per gram (epg) in both groups. RESULTS: From a total of 463 children, 235 of them suffered from T. trichiura infections. The cure rate of the group with 400 mg albendazole as a single dose was 52.5%, while the other group with albendazole 400 mg – mebendazole 500 mg as a single dose was at 71.1% cure rate. The cure rate of the two groups showed a significant difference with p = 0.011. Both groups were observed to have a significant reduction in the number worm eggs with p = 0.04. CONCLUSION: Albendazole 400 mg – mebendazole 500 mg combination as a single dose treatment has better efficacy than albendazole 400 mg alone, where the drug combination gave a higher cure rate and greater reduction in the number of T. trichiura eggs.

Download Full-text

Berat Badan, Panjang Badan dan Faktor Genetik sebagai Prediktor Terjadinya Stunted pada Anak Sekolah

JURNAL NUTRISIA ◽

10.29238/jnutri.v19i2.257 ◽

2017 ◽

Vol 19 (2) ◽

pp. 95

Author(s):

Hetriana Leksananingsih ◽

Slamet Iskandar ◽

Tri Siswati

Keyword(s):

Birth Weight ◽

Nutritional Status ◽

School Children ◽

Genetic Factors ◽

Control Group ◽

Case Group ◽

Normal Birth Weight ◽

Chi Square ◽

Normal Birth ◽

Chi Square Test

Background: Riskesdas in 2013 showed that Yogyakarta (DIY) had a prevalence of stunted new kid in school is less than the national average, which is 14.9% (MOH, 2013). Stunted or short, is a linear growth retardation has been widely used as an indicator to measure the nutritional status of individuals and community groups. Stunted can be influenced by several factors: birth weight, birth length match and genetic factors. Objective: To determine the weight, length of low birth weight and genetic factors as predictors of the occurrence of stunted on elementary school children. Methods: The study was a case control analytic. Research sites in SD Muhammadiyah Ngijon 1 Subdistrict Moyudan. The study was conducted in May and June 2015. The subjects were school children grade 1 to grade 5 the number of cases as many as 47 children and 94 control children. With the inclusion criteria of research subjects willing to become respondents, was present at the time of the study, they have a father and mother, and exclusion criteria have no data BB and PB birth, can not stand upright. The research variables are BBL, PBL, genetic factors and TB / U at this time. Data were analyzed by chi-square test and Odd Ratio (OR) calculation. Results: In case group as much as 91.5% of normal birth weight and length of 80.9% of normal birth weight, most of the height of a normal mother and father as many as 85.1%. In the control group as much as 78.7% of normal birth weight and 61.7% were born normal body length, height mostly normal mom and dad that 96.7% of women and 90.4% normal normal father. Statistical test result is no significant correlation between height mothers with stunted incidence in school children, and the results of chi-square test P = 0.026 with value Odd Ratio (OR) of 3.9 and a range of values from 1.091 to 14.214 Cl95%. Conclusion: High maternal body of mothers can be used as predictors of the occurrence of stunted school children and mothers with stunted nutritional status have 3.9 times the risk of having children with stunted nutritional status.

Download Full-text

Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles

Medicina ◽

10.3390/medicina57020178 ◽

2021 ◽

Vol 57 (2) ◽

pp. 178

Author(s):

Alessandro Nota ◽

Silvia Caruso ◽

Shideh Ehsani ◽

Gianmaria Fabrizio Ferrazzano ◽

Roberto Gatto ◽

...

Keyword(s):

Surface Electromyography ◽

Orthodontic Treatment ◽

Masticatory Muscles ◽

Rank Test ◽

Nominal Data ◽

Chi Square ◽

Initial Reduction ◽

Signed Rank Test ◽

Chi Square Test ◽

Semg Activity

Background and objectives: The aim of this study is to evaluate mandibular elevator muscles activity and pain on palpation in the early stages of orthodontic treatment with clear aligners using surface electromyography (sEMG). Materials and methods: Surface electromyography (sEMG) activity and pain level on muscle palpation of masseter and anterior temporalis muscles were recorded in a sample of 16 adult subjects (aged 18–32 years; mean 22.5 +/− 3.5 SD) undergoing orthodontic treatment with clear aligners before the treatment (T0), after 1 month of treatment (two clear aligners) (T1), and after 3 months of treatment (T2) (six clear aligners). A chi-square test for nominal data, a Friedman test, and a Wilcoxon-signed rank test as post hoc analysis were applied. Results: No statistically significant differences in muscular pain were observed. At T1, the sEMG activity of masseter muscles at mandibular rest position showed a statistically significant reduction, but after 3 months (T2), the data appeared similar to T0 (p = 0.03 and p = 0.02). Conclusions: During the treatment with clear aligners, subjects could experience an initial reduction in the masseter basal activity after 1 month of treatment. This effect tends to decrease to baseline levels after 3 months of therapy.

Download Full-text

LED vs Halogen Light-Curing of Adhesive-Precoated Brackets

The Angle Orthodontist ◽

10.2319/042707-211.1 ◽

2008 ◽

Vol 78 (5) ◽

pp. 935-940 ◽

Cited By ~ 10

Author(s):

Davide Mirabella ◽

Raffaele Spena ◽

Giovanni Scognamiglio ◽

Lombardo Luca ◽

Antonio Gracco ◽

...

Keyword(s):

Failure Rate ◽

Rank Test ◽

Fisher Exact Test ◽

Halogen Lamp ◽

Chi Square ◽

Halogen Light ◽

Significant Difference ◽

Chi Square Test ◽

Light Curing ◽

Bracket Failure

Abstract Objective: To test the hypothesis that bonding with a blue light-emitting diode (LED) curing unit produces no more failures in adhesive-precoated (APC) orthodontic brackets than bonding carried out by a conventional halogen lamp. Materials and Methods: Sixty-five patients were selected for this randomized clinical trial, in which a total of 1152 stainless steel APC brackets were employed. In order to carry out a valid comparison of the bracket failure rate following use of each type of curing unit, each patient's mouth was divided into four quadrants. In 34 of the randomly selected patients, designated group A, the APC brackets of the right maxillary and left mandibular quadrants were bonded using a halogen light, while the remaining quadrants were treated with an LED curing unit. In the other 31 patients, designated group B, halogen light was used to cure the left maxillary and right mandibular quadrants, whereas the APC brackets in the remaining quadrants were bonded using an LED dental curing light. The bonding date, the type of light used for curing, and the date of any bracket failures over a mean period of 8.9 months were recorded for each bracket and, subsequently, the chi-square test, the Yates-corrected chi-square test, the Fisher exact test, Kaplan-Meier survival estimates, and the log-rank test were employed in statistical analyses of the results. Results: No statistically significant difference in bond failure rate was found between APC brackets bonded with the halogen light-curing unit and those cured with LED light. However, significantly fewer bonding failures were noted in the maxillary arch (1.67%) than in the mandibular arch (4.35%) after each light-curing technique. Conclusions: The hypothesis cannot be rejected since use of an LED curing unit produces similar APC bracket failure rates to use of conventional halogen light, with the advantage of a far shorter curing time (10 seconds).

Download Full-text

Sequence decision making for cabazitaxel (Cbz) versus abiraterone (Abt) or enzalutamide (Enz) post-docetaxel (Dtx) in a publicly funded health care system.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.57 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 57-57

Author(s):

Alexander Watson ◽

Richard Gagnon ◽

Eugene Batuyong ◽

Nimira S. Alimohamed ◽

Richard M. Lee-Ying

Keyword(s):

Real World ◽

Performance Status ◽

Patient Choice ◽

Rank Test ◽

First Line ◽

Chi Square ◽

The Real ◽

Therapeutic Decisions ◽

Chi Square Test ◽

Castrate Resistant

57 Background: The TROPIC trial demonstrated an overall survival (OS) benefit of Cbz after Dtx in metastatic castrate-resistant prostate cancer (mCRPC). However, the novel anti-androgens (NAA) Abi and Enz have demonstrated similar improvements post-Dtx. The recent CARD trial suggests Cbz may provide the greatest OS benefit in selected patients who were rapid progressors ( < 12 months, RP) on first NAA, however Cbz use and efficacy in the real-world is uncertain. We sought to quantify the real-world use of Cbz and evaluate outcomes post-Dtx. Methods: mCRPC patients who received Dtx at the two tertiary referral centres in the Canadian province of Alberta from October 2012 (Cbz funding approval) to December 31st 2017 were assessed. We examined Cbz eligibility per TROPIC and CARD trial criteria, tracked therapies received, and documented objective and subjective reasoning for therapeutic decisions. OS was measured using the Kaplan-Meier method and the log-rank test was used to compare outcomes. The Chi-Square test was used to compare relative therapy utilization. Results: 463 mCRPC patients received Dtx over the study period, including 83 (18%) for castrate sensitive disease. At Dtx progression, 262 patients (56%) were eligible for Cbz per TROPIC trial criteria, while only 162 (62%) of those were RP on first NAA. Post-Dtx OS was lower among TROPIC-eligible patients receiving Cbz compared to those receiving Abi or Enz (9.1 vs 14.2 months, p = 0.001). This OS difference was not demonstrated among RP patients (11.2 vs 12 months, p = 0.664). The most common reasons for TROPIC ineligibility were Dtx intolerance (13%), serious comorbidities (12%), unacceptable blood counts (11%), performance status (9%) or, for CARD ineligible patients, no progression within 12 months on first NAA (38%). The most common agent immediately post-Dtx was Abi (n = 180, 39%), followed by Enz (n = 129, 28%). Significantly fewer patients (n = 56, 12%) received Cbz immediately post-Dtx (p = 0.001), and 149 (32%) received Cbz overall. First line post-Dtx, 286 patients (62%) did not have a documented discussion about Cbz, and in 172 cases (38%) consideration of Cbz was never documented. Patient choice against Cbz chemotherapy was recorded in 15% of discussions. Conclusions: In a real-world cohort of mCRPC patients, Cbz was a significantly less common choice than Abi or Enz after progression on Dtx. In a majority of these cases, no first line discussion of Cbz was documented, and in documented discussions, patient choice was the driving factor in a minority. OS post-Dtx in patients who met TROPIC trial criteria was lower for those receiving Cbz, noting that, unlike in TROPIC, these patients also received NAAs. This OS difference was not seen in those who also progressed rapidly on first NAA. These data suggest ongoing hesitation towards Cbz use in mCRPC and support careful selection of patients who may obtain benefit.

Download Full-text