scholarly journals Steroid-sparing effect of mepolizumab in children with severe eosinophilic nonallergic asthma

2021 ◽  
Vol 49 (5) ◽  
pp. 113-116
Author(s):  
Maria Angela Tosca ◽  
Donata Girosi ◽  
Oliviero Sacco ◽  
Roberto Bernardini ◽  
Giorgio Ciprandi
Keyword(s):  
Lung Function ◽  
Therapeutic Option ◽  
Clinical Findings ◽  
Peripheral Eosinophilia ◽  
Interleukin 5 ◽  
Asthma Exacerbations ◽  
Effective Therapeutic Option ◽  
Sparing Effect ◽  
Steroid Sparing

Background: Asthma is characterized by a chronic airway inflammation, usually sustained by type 2 immunity. Bronchial and peripheral eosinophilia are biomarkers for type 2 asthma. Biologicals are the most effective treatment for severe asthma at present. Mepolizumab is an antagonist of interleukin-5 (IL-5), the most relevant cytokine involved in eosinophilia.Objective: This case report evaluated the effectiveness of mepolizumab in two girls with severe eosinophilic non-allergic asthma.Materials and methods: Two female children with severe eosinophilic nonallergic asthma were treated with mepolizumab for two years. Clinical findings, lung function, peripheral eosinophils, asthma control, and bronchial endoscopy were performed.Results: Biologicals reduced the eosinophilia, asthma exacerbations, and improved lung function in both patients. The treatment was also safe and well-tolerated.Conclusion: Mepolizumab represents an effective therapeutic option in the management of severe pediatric asthma.  

scholarly journals Docetaxel/cisplatin therapy in myasthenia gravis with hypertension/diabetes

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 403-408 ◽  
Author(s):  
Guoyan Qi ◽  
Yinping Xue ◽  
Yongzhao Li ◽  
Hongxia Yang ◽  
Xiaojing Zhang
Keyword(s):  
Myasthenia Gravis ◽  
Pulmonary Infection ◽  
Therapeutic Option ◽  
Therapeutic Options ◽  
The Status ◽  
Effective Therapeutic Option ◽  
Grade Ii ◽  
Antibody Levels ◽  
Cisplatin Therapy

AbstractBackgroundTherapeutic options for thymoma-associated myasthenia gravis (MG) patients complicated with hypertension and/or diabetes post thymectomy are often conventional steroids. As the prevalence of diabetes and hypertension globally increases, other therapeutic options for these patients are of great importance.Material/methods9 patients with thymoma-associated MG complicated with hypertension and/or diabetes after thymectomy were administered 75 mg/m2 of docetaxel and 70 mg/m2 of cisplatin on day 1. The treatment could be repeated at 3-week intervals, ranging from 1 to 4 cycles according to the status of the patients. Therapeutic efficacy and side effects were evaluated. Results2 patients were complicated with type 2 diabetes, 6 with hypertension, and 1 with both diabetes and hypertension. After docetaxel/cisplain therapy, the MG symptoms were markedly improved in all patients (2, complete remission; 3, basic remission; 3, marked improvement; 1, improvement). Acetylcholine receptor (AchR) antibody levels were decreased in 8 patients. Minor adverse effects were observed in 2 patients, 1 with Grade II gastrointestinal reaction, and the other with pulmonary infection.ConclusionDocetaxel plus cisplatin might be an effective therapeutic option for thymoma-associated MG patients complicated with hypertension /diabetes post thymectomy without worsening thymoma and hypertension / diabetes.

scholarly journals Use Of Leflunomide In Patients With Hypersensitivity Pneumonitis

2020 ◽  
Author(s):  
Sungryong Noh ◽  
Ruchi Yadav ◽  
Manshi Li ◽  
Xiaofeng Wang ◽  
Debasis Sahoo ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Lung Function ◽  
Adverse Effects ◽  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis ◽  
Second Line ◽  
Significant Fibrosis ◽  
Discontinue Therapy ◽  
Sparing Effect ◽  
Steroid Sparing

Abstract Prednisone has been shown to reverse lung function declines in hypersensitivity pneumonitis patients without established fibrosis. Second line immunosuppressants like azathioprine and mycophenolate mofetil have a steroid sparing effect and improve DLCO. There is no published literature on the use of leflunomide in such patients. We reviewed our experience with leflunomide for treatment of hypersensitivity pneumonitis in 40 patients. We stratified patients according to the presence or absence of significant (>20%) fibrosis. We studied the effect of leflunomide on FVC and DLCO trajectory and reported the changes at 12 months.Treatment with leflunomide tended to improve the estimated FVC slope from 0.18±1.90% (SEM) of predicted per year to 4.62±1.65% of predicted (NS, p=0.118). It significantly improved the FVC at 12 months of treatment by 4.4% of predicted (p=0.02). DLCO continued to increase at 1.45±1.44% (SEM) of predicted per year. Non-fibrotic HP patients had the largest gain in pulmonary function. Their FVC increased by 8.3% (p=0.001) and DLCO by 4.8% (p=0.011). Patients with fibrotic HP did not improve. Leflunomide treatment was associated with significant gastrointestinal and other adverse effects leading 40% of patients to discontinue therapy. It had a significant steroid sparing effect with half the patients weaned off prednisone entirely.Leflunomide appears to be a fairly well tolerated steroid sparing immunosuppressant that improves pulmonary function in HP patients. It is most effective in patients without significant fibrosis.

scholarly journals REAL-WORLD CLINICAL OUTCOMES ASSOCIATED WITH CANAGLIFLOZIN IN PATIENTS AGED 65 YEARS AND OLDER WITH TYPE 2 DIABETES MELLITUS IN SPAIN: THE OLD REAL-WECAN STUDY.

2021 ◽  
Author(s):  
MANUEL GARGALLO-FERNANDEZ ◽  
Alba Galdón Sanz-Pastor ◽  
Teresa Antón-Bravo ◽  
MIGUEL BRITO-SANFIEL ◽  
Jaime Wong-Cruz ◽  
...  
Keyword(s):  
Older Patients ◽  
Primary Outcome ◽  
Therapeutic Option ◽  
Age Groups ◽  
Multiple Linear Regression Model ◽  
Inclusion Criteria ◽  
Effective Therapeutic Option ◽  
The Mean

Abstract Objectives The observational REAL WECAN study showed that canagliflozin 100 mg (CANA100) as add-on therapy, and canagliflozin 300 mg (CANA300), switching from prior SGLT-2i therapy, significantly improved several cardiometabolic parameters in patients with T2DM. The aim of this sub-analysis was to assess the effectiveness and safety of canagliflozin in patients aged >65 years. The primary outcome of the study was the mean change in HbA1c over the follow-up time. Materials and Methods 583 patients met the inclusion criteria (39.5% > 65 years), 279 in the CANA100 cohort (36.9 % > 65 years, mean HbA1c 8.05%) and 304 in the CANA300 cohort (41.8 % > 65 years, mean HbA1c 7.51%). Results In the CANA100 cohort, older patients showed significant reductions in HbA1c (-0.78%) and weight (-4.5 kg). Patients aged >65 years switching to CANA300 experienced a significant decrease in HbA1c (-0.27%) and weight (-2.1 kg). There were no significant differences in HbA1c and weight reductions when the cohorts of patients <65 and >65 years were compared in a multiple linear regression model. The safety profile of canagliflozin was similar in both age groups. Conclusion These findings support canagliflozin as an effective therapeutic option for older adults with T2DM

scholarly journals Real-World Clinical Outcomes Associated with Canagliflozin in Patients Aged 65 Years and Older with Type 2 Diabetes Mellitus in Spain: The Old Real-Wecan Study

Diabetology ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 165-175
Author(s):  
Manuel A. Gargallo-Fernández ◽  
Alba Galdón Sanz-Pastor ◽  
Teresa Antón-Bravo ◽  
Miguel Brito-Sanfiel ◽  
Jaime Wong-Cruz ◽  
...  
Keyword(s):  
Older Patients ◽  
Primary Outcome ◽  
Therapeutic Option ◽  
Age Groups ◽  
Multiple Linear Regression Model ◽  
Inclusion Criteria ◽  
Effective Therapeutic Option ◽  
The Mean

The observational Real-Wecan study showed that canagliflozin 100 mg (CANA100) as an add-on therapy, and canagliflozin 300 (CANA300), switching from prior SGLT-2i therapy, significantly improved several cardiometabolic parameters in patients with T2DM. The aim of this sub-analysis was to assess the effectiveness and safety of canagliflozin in patients aged ≥65 years. The primary outcome of the study was the mean change in HbA1c over the follow-up period. A total of 583 patients met the inclusion criteria (39.5% ≥65 years), 279 in the cohort of CANA100 (36.9% ≥65 years; mean HbA1c 8.05%) and 304 in the cohort of CANA300 (mean age 61.1 years; 41.8% ≥65 years; mean HbA1c 7.51%). In the CANA100 cohort, older patients showed significant reductions in HbA1c (−0.78%) and weight (−4.5 kg). Patients aged ≥65 years switching to CANA300 experienced a significant decrease in HbA1c (−0.27%) and weight (−2.1 kg). There were no significant differences in HbA1c and weight reductions when the cohorts of patients <65 and ≥65 years were compared in a multiple linear regression model. The safety profile of canagliflozin was similar in both age groups. These findings support canagliflozin as an effective therapeutic option for older adults with T2DM.

scholarly journals Convalescent Plasma Therapy: An Effective Therapeutic Option to Treat COVID-19? A Narrative Review

2020 ◽  
Vol Volume 8 ◽  
pp. 7-21
Author(s):  
Ishita Ray ◽  
Diana Fiorela Sánchez ◽  
Chris Andrea Robert ◽  
Mary Phyllis Robert
Keyword(s):  
Therapeutic Option ◽  
Narrative Review ◽  
Plasma Therapy ◽  
Effective Therapeutic Option

Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation

2021 ◽  
Author(s):  
Edgar Delgado-Eckert ◽  
Anna James ◽  
Delphine Meier-Girard ◽  
Maciej Kupczyk ◽  
Lars I. Andersson ◽  
...  
Keyword(s):  
Lung Function ◽  
Type 2 Inflammation ◽  
Function Fluctuation

scholarly journals Patient profiles as an aim to optimize selection in the second line setting: the role of aflibercept

2021 ◽  
Author(s):  
B. González Astorga ◽  
F. Salvà Ballabrera ◽  
E. Aranda Aguilar ◽  
E. Élez Fernández ◽  
P. García-Alfonso ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Therapeutic Option ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Effective Therapeutic Option ◽  
Line Setting ◽  
First Line Treatment

AbstractColorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient’s profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.

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