scholarly journals Management of Adverse Events and Supportive Therapy in Relapsed/Refractory Multiple Myeloma

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4978
Author(s):  
Samantha Pozzi ◽  
Alessia Bari ◽  
Martin Pecherstorfer ◽  
Sonia Vallet
Keyword(s):  
Multiple Myeloma ◽  
Drug Exposure ◽  
Supportive Therapy ◽  
Routine Care ◽  
Gastrointestinal Toxicity ◽  
Ocular Toxicity ◽  
Receptor Like Kinase ◽  
Additional Challenge ◽  
Current Standards

Relapsed/refractory (RR) multiple myeloma (MM) patients are a fragile population because of prolonged drug exposure and advanced age. Preserving a good quality of life is of high priority for these patients and the treatment of disease- and treatment-related complications plays a key role in their management. By preventing and limiting MM-induced complications, supportive care improves patients’ outcome. Erythropoietin-stimulating agents and bisphosphonates are well-established supportive strategies, yet novel agents are under investigation, such as anabolic bone agents and activin receptor-like kinase (ALK) inhibitors. The recent dramatic changes in the treatment landscape of MM pose an additional challenge for the routine care of RRMM patients. Multidrug combinations in first and later lines increase the risk for long-lasting toxicities, including adverse cardiovascular and neurological events. Moreover, recently approved first-in-class drugs have unique side-effect profiles, such as ocular toxicity of belantamab mafodotin or gastrointestinal toxicity of selinexor. This review discusses current standards in supportive treatment of RRMM patients, including recommendations in light of the recent SARS-CoV-19 pandemic, and critically looks at the incidence and management of side effects of standard as well as next generation anti-MM agents.

scholarly journals Current approaches to supportive care in multiple myeloma

2011 ◽  
Vol 139 (suppl. 2) ◽  
pp. 123-128
Author(s):  
Nenad Govedarovic ◽  
Tomislav Vukicevic
Keyword(s):  
Multiple Myeloma ◽  
Chronic Condition ◽  
Malignant Disease ◽  
Plasma Cells ◽  
Supportive Therapy ◽  
Bone Destruction ◽  
Monoclonal Protein ◽  
Blood Disease ◽  
Skeletal Disease

Myeloma multiplex is a malignant blood disease in which monoclonal expansion of malignant plasma cells occurs, together with hyperproduction of monoclonal protein,as well as impairment of normal haematopoiesis. Specific features of myeloma include bone destruction, renal failure and immunologic deficiency which decreases the overall quality of the patient?s life. Thus, prevention and supportive therapy of skeletal disease, anaemia, pain, nausea, infection and hypercalcemia, represent the essential part of therapy in myeloma patients. Improvements achieved in the specific haematological treatment, including supportive measures of complications of multiple myeloma, previously defined as incurable malignant disease, results in the improvement of the overall survival and the quality of life of these patients, thus qualifing multiple myeloma into a chronic condition.

Quality of Life Multiple Myeloma Module Questionnaire--Portuguese Version

2019 ◽  
Author(s):  
M. Graça Pereira ◽  
Gabriela Ferreira ◽  
Marta Pereira ◽  
Sara Faria ◽  
Rosário Bacalhau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Portuguese Version

Preliminary Validation of the Severity of Nail Psoriasis Score (SNAPS) for the Assessment of Nail Psoriasis in Patients With Psoriatic Arthritis

2021 ◽  
pp. 247553032110114
Author(s):  
Anna Antony ◽  
Sadaf Saeed ◽  
Darren Hart ◽  
Preeti Nair ◽  
Charlotte Cavill ◽  
...  
Keyword(s):  
Severity Index ◽  
Routine Care ◽  
Measurement Properties ◽  
Strong Correlations ◽  
Nail Dystrophy ◽  
Psoriasis Area Severity Index ◽  
Nail Psoriasis ◽  
Outcome Instrument ◽  
Preliminary Validation

Background: Psoriatic nail dystrophy is infrequently assessed in routine care and observational cohorts due to the lack of a feasible validated outcome measure. Objective: To assess the measurement properties of the “Severity of NAil Psoriasis Score” (SNAPS) in PsA. Methods: Nail photography was performed on prospectively recruited patients at baseline and 6 months. The modified Nail Psoriasis Severity Index (mNAPSI) and Physician Nail Visual Acuity Scale (PhNVAS) were comparator instruments for construct validity. Reliability and feasibility were assessed using intra-class correlations (ICCs) and timed scoring. Responsiveness was assessed by correlating the changes in SNAPS, mNAPSI and PhNVAS. Retrospective data from the Bath PsA database was further utilized to assess responsiveness. Results: 21 patients participated in the prospective validation at baseline. Inter- and intra-rater reliability of SNAPS were 0.94 and 0.93-0.96 (p ≤ 0.005). Mean times required to score SNAPS and mNAPSI were 59 and 136 seconds. There were strong correlations between SNAPS and mNAPSI (r = 0.95, p < 0.001) and PhNVAS (r = 0.77, p < 0.001) at baseline. There was a significant reduction in the mNAPSI and SNAPS (p < 0.005) at 6 months and a strong correlation between the change in SNAPS and mNAPSI (rho = 0.838, p < 0.001). Historical data from 57 patients commenced on Etanercept were evaluated. Mean SNAPS reduced from 3.6 to 2.0 at 3 months and 1.2 at 6 months (p < 0.05). Change in SNAPS correlated with changes in Psoriasis Area Severity Index and Dermatology Quality of Life at 3 and 6 months (r≥0.510; p ≤ 0.003). Conclusion: SNAPS is a feasible, reliable and responsive outcome instrument for psoriatic nail dystrophy.

Preventive aspect of ayurveda and yoga towards newly emerging disease COVID-19

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ranjeet S. Sawant ◽  
Bharat D. Zinjurke ◽  
Sandeep V. Binorkar
Keyword(s):  
Public Health ◽  
Severe Acute Respiratory Syndrome ◽  
Medical Care ◽  
Supportive Therapy ◽  
Prophylactic Therapy ◽  
Current Line ◽  
Therapeutic Aspect ◽  
The Past

Abstract The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.

scholarly journals Bone Pain in Multiple Myeloma (BPMM)—A Protocol for a Prospective, Longitudinal, Observational Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1596
Author(s):  
Marta Diaz-delCastillo ◽  
Rebecca E. Andrews ◽  
Aritri Mandal ◽  
Thomas L. Andersen ◽  
Andrew D. Chantry ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Observational Study ◽  
Bone Turnover ◽  
Bone Pain ◽  
Subjective Experience ◽  
Prospective Longitudinal ◽  
Bone Turnover Biomarkers

Multiple myeloma (MM) is a bone marrow neoplasia that causes bone pain in 70% patients. While preclinical models of MM have suggested that both nerve sprouting and nerve injury may be causative for the pain, there is a lack of clinical data. Thus, the primary aims of this clinical study are: (1) to provide a deep characterization of the subjective experience of pain and quality of life in MM patients; (2) to investigate disturbances in the bone innervation of MM patients. Secondary aims include exploring correlations between pain and serum inflammatory and bone turnover biomarkers. In a prospective, observational study (clinicaltrials.gov: NCT04273425), patients with suspected MM requiring a diagnostic iliac crest biopsy at Sheffield Teaching Hospital (UK) are invited to participate. Consenting patients answer seven standardized questionnaires assessing pain, quality of life and catastrophizing. Bone turnover biomarkers and inflammatory cytokines are measured in fasting serum samples, and bone innervation is evaluated in diagnostic biopsies. MM patients are invited to a follow-up upon completion of first line treatment. This will be the first deep characterization of pain in MM patients and its correlation with disturbances in bone innervation. Understanding how bone turnover and inflammation correlate to pain in MM is crucial to identify novel analgesic targets for this condition.

scholarly journals Collaborative care: enough of the why; what about the how?

2019 ◽  
Vol 215 (04) ◽  
pp. 573-576 ◽  
Author(s):  
Parashar Pravin Ramanuj ◽  
Harold Alan Pincus
Keyword(s):  
Quality Of Care ◽  
Cost Effectiveness ◽  
Health Plan ◽  
Collaborative Care ◽  
American Psychiatric Association ◽  
Routine Care ◽  
Healthcare Improvement

The clinical and cost-effectiveness of collaborative care for improving outcomes in people with mental and physical comorbidities is well established. However, translating these models into enduring change in routine care has proved difficult. In this editorial we outline how to shift the conversation on collaborative care from ‘what are we supposed to do?’ to ‘how we can do this’.Declaration of interestP.P.R. has received honoraria from Publicis LifeBrands and the Institute for Healthcare Improvement outside of the submitted work. H.A.P. reports personal fees from the BIND Health Plan outside of the submitted work; and is a Member of the Council on Quality of Care of the American Psychiatric Association.

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