Infectious complications in patients undergoing treatment with biologic disease-modifying anti-rheumatic drugs in real life practice: a 76 cases study

2018 ◽  
Author(s):  
Majda SAMIH
Keyword(s):  
Real Life ◽  
Infectious Complications ◽  
Cases Study ◽  
Disease Modifying

scholarly journals Infectious complications and graft outcome following treatment of acute antibody-mediated rejection after kidney transplantation: A nationwide cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250829
Author(s):  
Nancy Perrottet ◽  
Mario Fernández-Ruiz ◽  
Isabelle Binet ◽  
Michael Dickenmann ◽  
Suzan Dahdal ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Transplantation ◽  
Real Life ◽  
Severe Infection ◽  
Intravenous Immunoglobulins ◽  
Infectious Complications ◽  
Treatment Recommendation ◽  
Accurate Information ◽  
Significant Heterogeneity ◽  
Antibody Mediated Rejection

Acute antibody-mediated rejection (AMR) remains a challenge after kidney transplantation (KT). As there is no clear-cut treatment recommendation, accurate information on current therapeutic strategies in real-life practice is needed. KT recipients from the multicenter Swiss Transplant Cohort Study treated for acute AMR during the first post-transplant year were included retrospectively. We aimed at describing the anti-rejection protocols used routinely, as well as patient and graft outcomes, with focus on infectious complications. Overall, 65/1669 (3.9%) KT recipients were treated for 75 episodes of acute AMR. In addition to corticosteroid boluses, most common therapies included plasmapheresis (56.0%), intravenous immunoglobulins (IVIg) (38.7%), rituximab (25.3%), and antithymocyte globulin (22.7%). At least one infectious complication occurred within 6 months from AMR treatment in 63.6% of patients. Plasmapheresis increased the risk of overall (hazard ratio [HR]: 2.89; P-value = 0.002) and opportunistic infection (HR: 5.32; P-value = 0.033). IVIg exerted a protective effect for bacterial infection (HR: 0.29; P-value = 0.053). The recovery of renal function was complete at 3 months after AMR treatment in 67% of episodes. One-year death-censored graft survival was 90.9%. Four patients (6.2%) died during the first year (two due to severe infection). In this nationwide cohort we found significant heterogeneity in therapeutic approaches for acute AMR. Infectious complications were common, particularly among KT recipients receiving plasmapheresis.

scholarly journals Adverse drug reactions associated with treatment in patients with chronic rheumatic diseases in childhood: a retrospective real life review of a single center cohort

2020 ◽  
Vol 60 (1) ◽  
Author(s):  
Manar Amanouil Said ◽  
Liana Soido Teixeira e Silva ◽  
Aline Maria de Oliveira Rocha ◽  
Gustavo Guimarães Barreto Alves ◽  
Daniela Gerent Petry Piotto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Model ◽  
Children And Adolescents ◽  
Adverse Drug Reactions ◽  
Rheumatic Diseases ◽  
Real Life ◽  
Drug Reactions ◽  
Wide Range ◽  
Disease Modifying ◽  
Chronic Rheumatic Diseases

Abstract Background Adverse drug reactions (ADRs) are the sixth leading causes of death worldwide; monitoring them is fundamental, especially in patients with disorders like chronic rheumatic diseases (CRDs). The study aimed to describe the ADRs investigating their severity and associated factors and resulting interventions in pediatric patients with CRDs. Methods A retrospective, descriptive and analytical study was conducted on a cohort of children and adolescents with juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM). The study evaluated medical records of the patients to determine the causality and the management of ADRs. In order to investigate the risk factors that would increase the risk of ADRs, a logistic regression model was carried out on a group of patients treated with the main used drug. Results We observed 949 ADRs in 547 patients studied. Methotrexate (MTX) was the most frequently used medication and also the cause of the most ADRs, which occurred in 63.3% of patients, followed by glucocorticoids (GCs). Comparing synthetic disease-modifying anti-rheumatic drugs (sDMARDs) vs biologic disease-modifying anti-rheumatic drugs (bDMARDs), the ADRs attributed to the former were by far higher than the latter. In general, the severity of ADRs was moderate and manageable. Drug withdrawal occurred in almost a quarter of the cases. In terms of risk factors, most patients who experienced ADRs due to MTX, were 16 years old or younger and received MTX in doses equal or higher than 0.6 mg/kg/week. Patients with JIA and JDM had a lower risk of ADRs than patients with JSLE. In the multiple regression model, the use of GCs for over 6 months led to an increase of 0.5% in the number of ADRs. Conclusions Although the ADRs highly likely affect a wide range of children and adolescents with CRDs they were considered moderate and manageable cases mostly. However, triggers of ADRs need further investigations.

Unique-Named People Are Perceived More Suitable for Unique Jobs: A Social Perception and Its Real-Life Impact on Name Change

2020 ◽  
Author(s):  
Han-Wu-Shuang Bao ◽  
Huanhua Lu ◽  
Yu L. L. Luo
Keyword(s):  
Social Perception ◽  
Real World ◽  
Personnel Selection ◽  
Real Life ◽  
Social Reality ◽  
Name Change ◽  
Behavioral Tendencies ◽  
Cases Study ◽  
Life Impact

The latest research has revealed that unique-name holders pursue unique jobs in social reality. However, it remains unclear if such an association exists in social perception. We addressed this question with five studies. Through surveys, we showed that people associated “having a unique name” with “choosing a unique job” in general views (Study 1) and in specific cases (Study 2), which were both partly explained by creativity-relevant stereotypes. Then, through experimental manipulations, we examined the causality and extended the investigation to ecologically valid contexts. In personnel selection (Study 3), people would assign unique jobs to applicants with unique (vs. common) names. For a name change (Study 4), people would recommend unique names to workers in unique (vs. common) jobs. Moreover, these behavioral tendencies were subject to people’s general views about the name-job uniqueness association. In Study 5, we collected real-world name-change data from China, U.S., and U.K. and found that, when there was a name change, artists’ (a typically unique job) given names were actually changed to more unique ones. These findings demonstrate a perceived name-job association and enrich our understanding of the name-job relationship in real life.

High Levels of Polypharmacy in Rheumatoid Arthritis—A Challenge Not Covered by Current Management Recommendations: Data From a Large Real-Life Study

2019 ◽  
pp. 089719001986915 ◽  
Author(s):  
Ana Paula M. Gomides ◽  
Cleandro P. Albuquerque ◽  
Ana B.V. Santos ◽  
Rodrigo B. C. Amorim ◽  
Manoel B. Bértolo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Real Life ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Rheumatic Arthritis ◽  
Increased Risk ◽  
Disease Modifying

Background: Rheumatoid arthritis (RA) is associated with high frequency of comorbidities and increased risk of polypharmacy. Although there is a great potential for complications, there is a gap in literature on polypharmacy in patients with rheumatic arthritis. Objective: To evaluate the prevalence and factors associated with polypharmacy in a population in a real-life setting. Methods: A cross-sectional multicenter study was conducted in Brazil. Patients underwent clinical evaluation and medical records analysis. Polypharmacy was considered as a dependent variable. To test independent variables, we used Poisson regression. Results: We evaluated 792 patients (89% female, median age 56.6 years). Median duration of disease was 12.7 years, 78.73% had a positive rheumatoid factor. The median of disease activity score-28 was 3.5 (disease with mild activity), median of the clinical disease activity index score was 9, and median of health assessment questionnaire-disability index was 0.875; 47% used corticosteroids, 9.1% used nonsteroidal anti-inflammatory drugs, 90.9% used synthetic disease-modifying antirheumatic drugs, 35.7% used biologic disease-modifying antirheumatic drugs (DMARDs). In total, 537 (67.9%) patients used 5 or more drugs. Polypharmacy showed a relationship with a number of comorbidities and use of specific drugs (corticosteroids, methotrexate, and biological DMARDs). Conclusion: We found a high prevalence of polypharmacy (67.9%) in RA. Solutions to management this problem should be stimulated.

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