scholarly journals Tamoxifen Induced Pachychoroid Pigment Epitheliopathy with Reversible Changes After Drug Discontinuation

2020 ◽  
Vol Volume 13 ◽  
pp. 285-289 ◽  
Author(s):  
Fariba Ghassemi ◽  
Babak Masoomian ◽  
Alireza Khodabandeh ◽  
Elias Khalili Pour ◽  
Fatemeh Bazvand ◽  
...  
Keyword(s):  
Drug Discontinuation ◽  
Pachychoroid Pigment Epitheliopathy

Have we learnt all from IMPROVE-IT? Part II. Subanalyses on the ef- fects of ezetimibe added to statin therapy on selected clinical and laborato- ry outcomes, cost effectiveness, guideline and clinical implications

2020 ◽  
Vol 18 ◽  
Author(s):  
Zlatko Fras ◽  
Dimitri P. Mikhailidis
Keyword(s):  
Statin Therapy ◽  
Artery Bypass ◽  
Low Density Lipoprotein ◽  
Bypass Graft ◽  
Density Lipoprotein ◽  
Drug Discontinuation ◽  
Atherosclerotic Cardiovascular Disease ◽  
History Of ◽  
Risk Cost ◽  
Cardiovascular Biomarkers

: In this second part of a review of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT), we discuss the findings in relation to patients with stroke, the ACS phenotype, history of coronary artery bypass graft surgery, heart failure, concurrent polyvascular atherosclerotic cardiovascular disease (ASCVD) and diabetes mellitus, and different levels of expression of selected cardiovascular biomarkers. The combination therapy was proven safe, and drug discontinuation rates were not increased by adding ezetimibe. Since both statins and ezetimibe are now almost globally generically available, we can conclude that for secondary prevention of ASCVD, adding ezetimibe to high-intensity statin therapy further reduces low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk cost-effectively.

Identifying the underlying factors associated with antidepressant drug discontinuation: Content analysis of patients’ drug reviews (Preprint)

2020 ◽  
Author(s):  
Mohammad Alarifi ◽  
Somaieh Goudarzvand3 ◽  
Abdulrahman Jabour ◽  
Doreen Foy ◽  
Maryam Zolnoori
Keyword(s):  
Machine Learning ◽  
Antidepressant Drug ◽  
Prediction Method ◽  
Analytical Framework ◽  
Structured Data ◽  
Withdrawal Symptoms ◽  
Machine Learning Techniques ◽  
Drug Discontinuation ◽  
Factors Associated ◽  
Learning Techniques

BACKGROUND The rate of antidepressant prescriptions is globally increasing. A large portion of patients stop their medications which could lead to many side effects including relapse, and anxiety. OBJECTIVE The aim of this was to develop a drug-continuity prediction model and identify the factors associated with drug-continuity using online patient forums. METHODS We retrieved 982 antidepressant drug reviews from the online patient’s forum AskaPatient.com. We followed the Analytical Framework Method to extract structured data from unstructured data. Using the structured data, we examined the factors associated with antidepressant discontinuity and developed a predictive model using multiple machine learning techniques. RESULTS We tested multiple machine learning techniques which resulted in different performances ranging from accuracy of 65% to 82%. We found that Radom Forest algorithm provides the highest prediction method with 82% Accuracy, 78% Precision, 88.03% Recall, and 84.2% F1-Score. The factors associated with drug discontinuity the most were; withdrawal symptoms, effectiveness-ineffectiveness, perceived-distress-adverse drug reaction, rating, and perceived-distress related to withdrawal symptoms. CONCLUSIONS Although the nature of data available at online forums differ from data collected through surveys, we found that online patients forum can be a valuable source of data for drug-continuity prediction and understanding patients experience. The factors identified through our techniques were consistent with the findings of prior studies that used surveys.

Predictors for symptom re-exacerbation after targeted stepwise drug discontinuation in first-episode schizophrenia

2016 ◽  
Vol 170 (1) ◽  
pp. 168-176 ◽  
Author(s):  
Wolfgang Gaebel ◽  
Mathias Riesbeck ◽  
Wolfgang Wölwer ◽  
Ansgar Klimke ◽  
Matthias Eickhoff ◽  
...  
Keyword(s):  
First Episode ◽  
Drug Discontinuation ◽  
First Episode Schizophrenia

scholarly journals POS0642 THE IMPACT OF AGE ON DISCONTINUATION OF BIOLOGIC DMARDs IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 559.2-560
Author(s):  
V. Rivera Teran ◽  
S. Sicsik ◽  
D. Vega-Morales ◽  
F. Irazoque-Palazuelos ◽  
D. Miranda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effects ◽  
Adverse Events ◽  
Cox Regression ◽  
Retention Rate ◽  
Drug Discontinuation ◽  
Discontinuation Rate ◽  
Biologic Dmards ◽  
Conventional Dmards ◽  
The Impact

Background:Rheumatoid arthritis (RA) is the most common autoimmune disease. Older patients treated with biologic DMARDs (bDMARDs) are at a significantly greater risk of adverse effects (AEs) [1]. However, the rate of drug discontinuation because of adverse effects caused by bDMARDs has not differed in elderly compared to younger patients in different registries.Objectives:Determine if drug discontinuation of bDMARDs differs by age in patients with rheumatoid arthritis in the Mexican Adverse Events Registry (BIOBADAMEX).Methods:BIOBADAMEX is a Mexican ongoing cohort of patients using bDMARDs since 2016. In this analysis we included all patients with diagnosis of RA with at least two assessments. Survival on bDMARDs was estimated using Kaplan-Meier analysis. Predictors of discontinuation, including age older than median age in the sample were investigated by Cox regression analyses.Results:Among 743 patients in the registry, 497 had RA diagnosis, from which, 214 had at least two assessments. At baseline, patients had a median (IQR) age of 53.4 (45-61) years old, median disease duration of 10.7 (6-17) months and median DAS28 of 4.7 (3-6). Conventional DMARDS were used by 185 (87%) patients and 94 (44%) patients used corticosteroids. Comorbidities were present in 194 (91%). The most common bDMARDs received at baseline were abatacept 59 (27%), tocilizumab 45(21%), adalimumab 31 (15%) and certolizumab 30 (14%). At the time of analysis, the median bDMARDs treatment duration was 21.0(13-34) months, 128 (59%) had discontinued treatment, 66 for inefficacy, 32 for adverse events and 30 for others. Fig 1 shows discontinuation rate curves in patients younger and older than median age. Cox proportional-hazards demonstrated no significant differences regarding age older than median age (HR 1.1, 95% CI 0.8-1.4, p=0.7), female sex (HR 1.2, 95% CI 0.7-1.9, p=0.44), use of corticosteroids (HR 1.2, 95% CI 0.9-1.6, p=0.20), comorbidities (HR 0.9, 95% 0.6-1.5, p=0.78), DAS28 (HR 0.9, 95% 0.9-1.1, p=0.93) or other factors.Figure 1.Discontinuation rate curves in patients younger and older than median age (< 53.4 and >=53.4 years old)Conclusion:This analysis did not show a role of age on discontinuation of bDMARDs in Mexican RA patients. Further longitudinal analyses will be performed including more patients to assess retention rate of bDMARDs and identify predictive variables of discontinuation in Mexican population.References:[1]Akter R, et al. Can Geriatr J. 2020 May 1;23(2):184-189.[2]Ikari Y, et al. Medicine (Baltimore). 2020 Dec 24;99(52):e23861.Disclosure of Interests:None declared

FRI0168 Drug discontinuation in 6,657 patients with ra starting their first tnf inhibitor: Comparison of adalimumab, etanercept & infliximab

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 368.2-368 ◽  
Author(s):  
M. Neovius ◽  
E. Arkema ◽  
H. Olsson ◽  
J. Eriksson ◽  
J. Simard ◽  
...  
Keyword(s):  
Drug Discontinuation ◽  
Tnf Inhibitor

scholarly journals Efficacy and Tolerability after Unusually Low Doses of Dasatinib in Chronic Myeloid Leukemia Patients Intolerant to Standard-Dose Dasatinib Therapy

2010 ◽  
Vol 4 ◽  
pp. CMO.S6413 ◽  
Author(s):  
Mariana Serpa ◽  
Sabri S. Sanabani ◽  
Israel Bendit ◽  
Fernanda Seguro ◽  
Flávia Xavier ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Standard Dose ◽  
Chronic Phase ◽  
Patient Treatment ◽  
Hematological Toxicity ◽  
Drug Discontinuation ◽  
Once Daily ◽  
Starting Dose

We report our experience in 4 patients with chronic myeloid leukemia (CML) who had discontinued imatinib as a result of adverse events and had switched to dasatinib. The chronic phase ( n 2) and accelerated phase ( n 2) CML patients received dasatinib at starting dose of 100 and 140 mg once daily, respectively. Reappearance of hematological toxicity was observed in 3 patients and pancreatitis in one patient. Treatment was given at a lower dose and patients were followed. The median follow-up was 13 months and the median dose of dasatinib until achievement of complete cytogenetic remission (CCyR) was 60 mg daily (range = 20 to 120 mg). All four patients had achieved CCyR at a median of 4 months (range = 3 to 5 months) and among them, three had also achieved major molecular remission. We conclude that low-dose dasatinib therapy in intolerant patients appears safe and efficacious and may be tried before drug discontinuation.

scholarly journals Laryngeal Cancer With Lung Metastases Showing Long-Term Complete Response and Delayed Immune-Related Adverse Event After Nivolumab Discontinuation

2021 ◽  
pp. 014556132110310
Author(s):  
Takahito Kondo ◽  
Munehide Nakatsugawa ◽  
Mitsuru Okubo ◽  
Hironori Nakamura ◽  
Daisuke Yunaiyama ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Laryngeal Cancer ◽  
Lung Metastases ◽  
Complete Response ◽  
Cervical Lymph Node Metastasis ◽  
Anterolateral Thigh Flap ◽  
Drug Discontinuation ◽  
Antibody Testing ◽  
Extranodal Extension ◽  
The Right

We report a case of laryngeal cancer with multiple lung metastases that maintained a complete response (CR) for 18 months after discontinuing nivolumab treatment, with colitis developing 5 months after drug discontinuation. A 65-year-old man was diagnosed with T3N2cM0 stage IVA right supraglottic squamous cell carcinoma that progressed after 1 course of TPF (cisplatin, docetaxel, and 5-fluorouracil) as induction chemotherapy. He underwent total laryngectomy, bilateral neck dissection, pharyngeal reconstruction with anterolateral thigh flap, and creation of a permanent tracheostoma; extranodal extension was detected in the right cervical lymph node metastasis, and the patient underwent adjuvant radiotherapy. Multiple lung metastases occurred during radiotherapy, and the patient was deemed platinum refractory; nivolumab treatment was thus initiated. The tumor proportion score for programmed death-ligand 1—evaluated via antibody testing of the laryngeal tumor—was <1. The patient received 240 mg/body nivolumab every 2 weeks; a computed tomography performed after course 16 of nivolumab treatment confirmed a CR. He exhibited grade 2 thyroid dysfunction, grade 1 interstitial pneumonia, and grade 2 colitis after 6, 7, and 14 months of receiving nivolumab, respectively; treatment was discontinued as despite maintaining a CR, interstitial pneumonia occurred twice. Colitis appeared 5 months after nivolumab discontinuation; nevertheless, a CR was maintained after 18 months.

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