scholarly journals Persistence and Adherence to Biologic Therapies in Juvenile Idiopathic Arthritis

Author(s):  
Juan Carlos Nieto-González ◽  
Laura Trives ◽  
Alejandra Melgarejo-Ortuño ◽  
Aranzazu Ais ◽  
Belen Serrano-Benavente ◽  
...  

Abstract BackgroundJuvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disease that often requires the use of biological therapies to control disease activity. Persistence and adherence to treatment are important aspects on which we have scarce information.MethodsWe performed a longitudinal, retrospective, and observational study based on daily clinical management of JIA patients. We calculated the clinical remission status at 6 and 12 months. Persistence of biological therapy was evaluated by Kaplan-Meier curves and adherence by the Medication Possession Ratio (MPR).ResultsWe included 68 patients who received biological therapy. Of these, 11 (16.2%) and 5 (7.4%) required a second and third biological, respectively. Persistence rate of biological therapies at 5 years was 64%, with no differences between the first and second biological line. Adherence was high the first year of treatment (MPR80: 96.3%) as well as the second and third years (MPR80: 85.2% and 91.8% respectively).ConclusionsPersistence and adherence to biological therapies were remarkably high in our JIA cohort. Adherence to biological treatments could be related to a higher probability of accomplishing Wallace remission criteria at 6 months, but it was not confirmed at 12 months.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juan Carlos Nieto-González ◽  
Laura Trives-Folguera ◽  
Alejandra Melgarejo-Ortuño ◽  
Aranzazu Ais ◽  
Belén Serrano-Benavente ◽  
...  

AbstractJuvenile idiopathic arthritis (JIA) is a chronic inflammatory disease that often requires biological therapy to control its activity. Medication persistence and adherence are important aspects on which we have scarce information. We performed a longitudinal, retrospective, and observational study based on data from the daily clinical management of JIA patients. We recorded clinical remission at 6 and 12 months. Persistence of biological therapy was evaluated using Kaplan–Meier curves, and adherence was assessed using the medication possession ratio (MPR). We included 68 patients who received biological therapy. Of these, 11 (16.2%) and 5 (7.4%) required a second and third drug, respectively. The persistence rate for biological therapy at 5 years was 64%, with no differences between the first and second lines. Adherence was high during the first year of treatment (MPR80: 96.3%) and also in the second and third years (MPR80: 85.2% and 91.8%, respectively). Persistence and adherence to biological therapy were remarkably high in our JIA cohort. Adherence to biological treatments could be related to a higher probability of fulfilling the Wallace remission criteria at 6 months, although this was not confirmed at 12 months.


2021 ◽  
Vol 7 (1) ◽  
pp. 27
Author(s):  
Resti Yudhawati ◽  
Megawati Rif’atyyah Nozomi Guntur

Asthma is a heterogeneous chronic inflammatory disease in the respiratory tract that leads to recurrent episodic symptoms. Study about the mechanism of pathophysiology and immunology which stimulates chronic inflammation in asthma has been greatly developed. The understanding of inflammation mediator that is predominant on various asthma phenotypes could be useful for development of diagnosis and targeted therapy. Standard asthma therapy administered through the airway has limited effects only in the airway. The knowledge of molecular pathophysiology and immunology of this disease developed interest of the drugs that perform proximally from inflammation process in the airway, in this case is biological therapy. Several biological therapies have been investigated for its efficacy on human, including Anti IgE (Omalizumab), Anti Interleukin-5 (Mepolizumab, Reslizumab, Benralizumab), Anti Interleukin-4/Interleukin-13 (Dupilumab), and Anti Interleukin-17 (Secukinumab and Brodalumab).


2020 ◽  
Vol 17 (3) ◽  
pp. 115-120
Author(s):  
Elena S. Fedenko ◽  
Olga G. Elisyutina ◽  
Natalia I. Il`ina

The outbreak of the SARS-CoV-2-induced Coronavirus Disease 2019 (COVID-19) pandemic started in December 2019 in Wuhan, China, continued to spread across the globe and spanned 188 countries. Under the new circumstances treatment approach for T2 allergic diseases such as asthma, chronic hives, atopic dermatitis, and sinusitis with polyps has been changed. In the past years, new biological therapies monoclonal antibodies for these diseases have been developed targeting different aspects of the type 2 immune response. New knowledge on the COVID-19 disease course raises many issues around the safety of biologicals in patients with active infection, as well as their interactions with antiviral medications. In Russia new biological therapies entered clinical practice but its effectiveness and safety still are not known. This newsletter is based on Considerations on Biologicals for Patients with allergic disease in times of the COVID-19 pandemic: an EAACI Statement and the latest scientific data.


2021 ◽  
Vol 11 (11) ◽  
pp. 4865
Author(s):  
Marta Amigo-Basilio ◽  
Covadonga Álvarez-González ◽  
Carlos Cobo-Vázquez ◽  
Isabel Leco-Berrocal ◽  
Luis Miguel Sáez-Alcaide ◽  
...  

Objective: The aim of this study is to know the biological therapy drugs that are related to adverse events, what dental treatments are associated with the appearance of these events, their severity, and how they are resolved. Study design: Analysis of cases described in the literature on patients undergoing treatment with biological therapies who have developed adverse effects associated with these drugs. Results: Of the 62 articles reviewed, 49 describe 68 cases of MRONJ, most of which appeared in the jaw and received surgical and/or conservative treatment. Conclusions: Biological therapies can potentially develop adverse effects in the oral cavity, so strict monitoring by the dentist is necessary.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Annette Bley ◽  
Jonas Denecke ◽  
Alfried Kohlschütter ◽  
Gerhard Schön ◽  
Sandra Hischke ◽  
...  

Abstract Background Canavan disease (CD, MIM # 271900) is a rare and devastating leukodystrophy of early childhood. To identify clinical features that could serve as endpoints for treatment trials, the clinical course of CD was studied retrospectively and prospectively in 23 CD patients. Results were compared with data of CD patients reported in three prior large series. Kaplan Meier survival analysis including log rank test was performed for pooled data of 82 CD patients (study cohort and literature patients). Results Onset of symptoms was between 0 and 6 months. Psychomotor development of patients was limited to abilities that are usually gained within the first year of life. Macrocephaly became apparent between 4 and 18 months of age. Seizure frequency was highest towards the end of the first decade. Ethnic background was more diverse than in studies previously reported. A CD severity score with assessment of 11 symptoms and abilities was developed. Conclusions Early hallmarks of CD are severe psychomotor disability and macrocephaly that develop within the first 18 months of life. While rare in the first year of life, seizures increase in frequency over time in most patients. CD occurs more frequently outside Ashkenazi Jewish communities than previously reported. Concordance of phenotypes between siblings but not patients with identical ASPA mutations suggest the influence of yet unknown modifiers. A CD severity score may allow for assessment of CD disease severity both retrospectively and prospectively.


2021 ◽  
Vol 19 ◽  
Author(s):  
Shuxiang Yang ◽  
Lu Zhao ◽  
Lulu Pei ◽  
Shuang Cao ◽  
Yuan Gao ◽  
...  

Background and Objective: Patients with transient ischemic attack(TIA)occasionally showed nonfocal symptoms, such as decreased consciousness, amnesia and non-rotatory dizziness. This study intended to evaluate the effect of nonfocal symptoms on the prognosis of patients with TIA. Methods: Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed. The predictive outcome was stroke occurrence at 1 year. Cumulative risks of stroke in patients with and without nonfocal symptoms were estimated with Kaplan-Meier models. Results: We studied 1384 patients with TIA (842 men; mean age, 56±13 years), including 450 (32.5%) with nonfocal symptoms. In the first year after TIA, stroke occurred in 168(12.1%) patients. There was no difference in the risk of stroke between patients with both focal and nonfocal symptoms and patients with focal symptoms alone (11.8% vs 12.4%, log-rank; P=0.691). Conclusions: The occurrence of nonfocal symptoms did not increase the risk of stroke at one-year follow-up compared to the occurrence of focal symptoms alone.


2019 ◽  
pp. 13-17
Author(s):  
J.M. Sevillano Gutierrez ◽  
D. Capelusnik ◽  
E.E. Schneeberger ◽  
G. Citera

Background: Methotrexate (MTX) is the most frequently used medication in patients with Rheumatoid Arthritis (RA). However, several authors have questioned its success due to the presence of adverse events and the lack of adherence. Objectives: to determine cumulative survival of MTX, frequency and type of adverse events and causes of discontinuation in patients with RA. Methods: consecutive patients 18 years and older with a diagnosis of RA (ACR/EULAR 2010 criteria), who had begun treatment with MTX during their disease were included. Sociodemographic, clinical and therapeutic data were collected. Date of initiation and suspension of MTX, route of administration, concomitant treatments, consumption of coffee and tobacco, presence of adverse events (AE) were all consigned. Adherence was evaluated using the Compliance Questionnaire Rheumatology questionnaire 5-item summary version (CQR5). Statistical analysis: descriptive statistics. Chi2 test or Fisher’s exact test; Survival of treatment by Kaplan-Meier and log Rank. Multiple logistic regression. A p value <0.05 was considered significant.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Eric S Weiss ◽  
Nishant D Patel ◽  
Stuart D Russell ◽  
William A Baumgartner ◽  
Ashish S Shah ◽  
...  

Introduction : Single institution series have suggested that donor-recipient gender matching may be an important factor influencing survival following orthotopic heart transplantation (OHT). The United Network for Organ Sharing (UNOS) database provides a unique and novel opportunity to address this issue by examining outcomes based on gender pairing for a large cohort of OHT patients. Methods : We retrospectively reviewed the UNOS dataset to identify 18,240 patients receiving first time OHT between the years 1998 and 2007. Stratification was by both donor and recipient gender so that 4 separate groups were created (male donor with male recipient, female donor with male recipient, male donor with female recipient, and female donor with female recipient). The primary endpoint of all cause mortality was compared between groups using a Cox proportional hazard regression model. Secondary outcomes (thirty day and one year mortality and rejection during the first year) were examined with multiple logistic regression. Post transplant survival was modeled via the Kaplan Meier method. Results : Of 18,240 patients, 12,951 (71%) were matched by gender to their donor (77% for male recipients, n= 10,750 and 51% for female recipients n= 2,201). A total of 4,543 patients died during the study period (25%). Donor-recipient gender matching resulted in a reduction in the risk of adjusted cumulative mortality (Hz ratio 0.86 [0.78–0.95], p= 0.003) and the greatest risk for cumulative mortality occurred when pairing a male donor with a female recipient (Hz ratio 1.2 [1.04–1.37], p= 0.01). Thirty day and one year mortality were also significantly decreased by gender pairing (OR 0.75 [0.61–0.95], p= 0.02 for 30 day mortality, and OR 0.8 [0.68–0.93], p= 0.005 for one year mortality). Gender pairing resulted in a 13% decrease in the risk of graft rejection within the first year (OR 0.87 [0.79–0.98], p= 0.02]. Kaplan Meier survival modeling revealed that the greatest cumulative survival occurred when a male recipient received an organ from a male donor (Figure) Conclusions : The UNOS dataset has provided a large sample examining donor recipient gender pairing in OHT. Recipients who receive organs for same sex donors have significantly improved short and long term survival.


Principles 250 Immunotherapy 252 Monoclonal antibodies 254 Other biological therapies 258 Biological therapies aim to produce an anti-tumour effect, either by activating the patient's immune system, or by administering natural substances present in the immune system as treatments. These treatments cause an immune response in the patient that eliminates or delays tumour growth....


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