HUBUNGAN PENGGUNAAN KONTRASEPSI DENGAN KEJADIAN KEHAMILAN EKTOPIK TERGANGGU DI BLU RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 2009 – 2013

Abstract: Ectopic pregnancy accounts for 1 in 200 (5-6%) maternal mortality in developed countries.2 According to the WHO, with over 60 000 annual cases in Indonesia– that is 3% of its population, the number of ectopic pregnancies in Indonesia is estimated to be on the brink to cases in developed countries.6 A risk factor for ectopic pregnancy that has surged over the years is the use of contraceptive methods. According to the research at the Department of Epidemiology and Social Medicine University of Brussels in the 90s and two consecutive research the at the Department of Obstetrics and Gynecology BLU RSUP Prof. dr. R. D. Kandou Manado in 2001 and 2011, the use of contraceptive methods have proven to have significant correlation with the incidence of ectopic pregnancy (p>0.05).5,10The issues above are what underlie the aim of this research – that is to investigate the possibility for ectopic pregnancies to occur in patients diagnosed with ectopic pregnancy with prior use of contraceptive methods at the Department of Obstetrics and Gynecology BLU RSUP Prof. dr. R. D. Kandou Manado from October 2009 – October 2013. The method applied for this research is by performing a 5 year retrospective study - analyzing the number of patients with ectopic pregnancy as well as those with prior use of contraceptive methods. The result from a Chi-Square analysis is p = 0.457, where if p < 0.05, means there is a significant correlation. Thus with such result, it is proven that there is no significant correlation between the use of contraceptive methods with the incidence of ectopic pregnancy. Keywords: ectopic pregnancy, contraceptive methods. Abstrak: Kehamilan Ektopik Terganggu (KET) merupakan penyebab 1 dari 200 (5-6%) mortalitas maternal di negara maju.2 Dengan 60.000 kasus setiap tahun atau 3% dari populasi masyarakat, angka kejadian KET di Indonesia diperkirakan tidak jauh berbeda dengan negara maju, menurut WHO.6 Adapun salah satu faktor risiko KET yang dinilai semakin meningkat dewasa ini adalah pemakaian alat-alat/ metode kontrasepsi. Ditinjau dari penelitian di Department of Epidemiology and Social Medicine University of Brussels pada tahun 90an dan penelitian di BLU RSUP Prof. dr. R. D. Kandou Manado pada tahun 2001 dan 2011, pemakaian alat kontrasepsi dengan kejadian KET memiliki hubungan yang signifikan, dengan p > 0.05. Masalah tersebut yang menjadi dasar tujuan penelitian ini, yaitu untuk menindaklanjuti kemungkinan terjadinya KET pada pasien-pasien KET dengan riwayat pemakaian kontrasepsi, dengan memberikan gambaran mengenai data-data kasus KET dengan riwayat penggunaan kontrasepsi yang diperiksa di bagian Obstetri dan Ginekologi BLU RSUP Prof. dr. R. D. Kandou Manado periode Oktober 2009 – Oktober 2013.Metode yang digunakan pada penelitian ini adalah dengan melakukan studi retrospektif, yaitu dengan melakukan pendataan jumlah pasien KET, serta riwayat penggunaan kontrasepsi oleh pasien-pasien KET tersebut dalam kurun waktu 5 tahun. Hasil yang ditemukan memperlihatkan hasil uji Chi-Square adalah p = 0.457, dimana jika nilai p < 0.05, maka dikatakan terdapat hubungan yang signifikan. Oleh karena nilai p pada uji Chi-Square di tabel 4.4.A >0.05, maka dapat dikatakan bahwa tidak terdapat hubungan yang signifikan antara riwayat penggunaan kontrasepsi dengan kejadian KET. Kata kunci: KET (Kehamilan Ektopik Terganggu), kontrasepsi.

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Ectopic pregnancy at the Gambian Tertiary hospital

African Health Sciences ◽

10.4314/ahs.v21i1.38 ◽

2021 ◽

Vol 21 (1) ◽

pp. 295-303

Author(s):

Matthew Anyanwu ◽

Grace Titilope

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Hospital ◽

Clinical Feature ◽

Chi Square ◽

Mortality And Morbidity ◽

Significant Burden ◽

Incidence Risk ◽

Ectopic Pregnancies ◽

The Tropics

Background/Aims: Ectopic pregnancy is a gynaecological emergency with significant burden of maternal mortality and morbidity in the tropics. The incidence reported in the literature range from 1:60 to 1:250 pregnancies. The aim was to determine incidence and risk factors of ectopic pregnancy in the Gambia. Methodology: A longitudinal study of ectopic pregnancy at Gambian tertiary hospital from January 2016 to April 2018. Data was collected from patients’ folders, entered into SPSS version 20 and analysed with de- scriptive statistics. The test of variation and significance was by ANOVA and Chi-square respectively with error margin set at 0.05 and confidence interval of 95%. Results: A total number of 2562 pregnancies were recorded, 43 were ectopic pregnancies. The estimated incidence was 0.2%. Majority of the patients were between 26 – 35 years (56%), primiparous (32%), heterogeneous marriage (82%) and housewives (86%). Occupation was not associated with ruptured or unruptured ectopic pregnancy (p-0.421). Low parity was associated with more ectopic pregnancy than high parity (p-0.001). The commonest clinical feature was abdominal pain (65.1%), whilst the most prominent risk factors were pelvic inflamma- tory disease (27.9%) and previous abortion (23.3%). Ectopic pregnancy was seasonal. Conclusion: The incidence rate of 0.2% was in the range reported in the literature. Low parity, previous abortion and pelvic inflammatory disease were the risk factors. Keywords: Ectopic; pregnancy; incidence; risk factors.

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HIT antibody positivity as a predictor for early cancer diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e22184 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e22184-e22184

Author(s):

Zaid Alirhayim ◽

Herman Dyal ◽

Danielle Heidemann ◽

Cesar Ochoa Perez ◽

Abdulqader Alarhayem ◽

...

Keyword(s):

Cancer Patients ◽

Cancer Diagnosis ◽

Common Finding ◽

Chi Square ◽

Early Cancer Diagnosis ◽

Number Of Patients ◽

Antibody Positivity ◽

Time To Detection ◽

And Gender ◽

Chi Square Analysis

e22184 Background: Heparin induced thrombocytopenia (HIT) is known to be caused by the presence of PF 4 antibody. Tumors exert immunomodulatory effects on the host immune response, including development of antibodies. Our aim was to analyze the presence of HIT in cancer patients and determine if HIT Ab is an adverse risk factor in patients with cancer. Methods: Patients with suspected HIT were selected. A case – control study was designed with 1:1 age and gender matched controls. We used chi – square analysis to compare proportions and Cox proportional hazard model to detect various predictors. Time to survival analysis was performed using Kaplan – Meier method. Results: Of 600 patients, 300 (63±15 years, women 48.8%) had a mean 4T pre – probability score of 4 ± 1.6. There were 132 cancers in both groups. 65 of these (49.2%) were in patients with probable HIT. The numbers of carcinomas and sarcomas were not significantly different between the two groups. There were no significant differences between the two groups when comparing the number of cancer diagnoses or the particular types of cancer diagnosed. The mean time to detection of cancer was within 9 ± 23 months for patients with HIT Ab versus 31 ± 54 months in cancer patients without HIT Ab (p <0.0001). In addition, there was a greater number of patients with at least 2 primary cancers among the HIT Ab positive group (p = 0.003). No predictive relationship between the type of cancer and the presence of HIT Ab was found (p >0.05). Patients with advanced cancer (stage 3 or 4) were also more likely to be HIT Ab positive (HR 3.61; 95% CI 1.31 – 10.11, p = 0.013). Cancer patients with HIT Ab were more likely to have venous thromboembolism as compared to cancer patients without HIT Ab (7.7% vs. 4.7, p = 0.0001). Kaplan – Meier’s showed worse mortality for cancer patients with HIT Ab than patients without the HIT Ab (Breslow statistic = 0.04). Conclusions: Among our cohort with suspected HIT, cancer was a common finding. Patients with HIT antibody positivity were more likely to have a new cancer diagnosis within 1 year of a positive result. These patients were also more likely to have thromboembolic complications and worsened mortality. These findings require further study, but perhaps suggest that the presence of HIT Ab should trigger earlier surveillance for cancer.

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Profile of Ectopic Pregnancy at Western Regional Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v13i4.18415 ◽

2017 ◽

Vol 13 (4) ◽

pp. 397-400

Author(s):

Rabi Prasad Regmi ◽

Shyam Sundar Parajuly ◽

Ananda Bahadur Shrestha ◽

Dela Joshi Singh ◽

Sarvesh Gyawali

Keyword(s):

Ectopic Pregnancy ◽

Discharge Summary ◽

Regional Hospital ◽

Contraceptive Device ◽

Beta Hcg ◽

Number Of Patients ◽

Obstetric Emergencies ◽

Life Threatening ◽

Western Regional ◽

Ectopic Pregnancies

Background & Objective: Ectopic pregnancy (EP) is one of the common life threatening obstetric emergencies which if not recognized and managed on time can be ruptured which could be a cause of death. Unfortunately, the world wide incidence of EP is in an increasing trend. The main objective of this study is to assess the frequency, trends, blood loss and management aspects of EP at Western Regional Hospital (WRH), Pokhara.Materials & Methods: The study was carried out in the department of Obstetrics and Gynecolgy, WRH. Data were collected and analyzed from patient’s records and discharge summary during the period of 2072-1-1 to 2072-9-30 B.S, retrospectively. Total number of hospital deliveries (7250) during this period was obtained from record section. Diagnosis of EP was made by urine beta- hcg (human chorionic gonado-tropin hormone) test and pelvic ultrasonography.Results: The incidence of ectopic pregnancy was one in every 168 deliveries. Forty three such ectopic pregnancies were diagnosed and managed during the period, the mean age was 26.34 years, the median being the age of 25-29 years (16 patients). Twenty seven patients had ruptured ectopic pregnancy. Of all the cases, the number of patients with heterotopic pregnancy and intra uterine contraceptive device (IUCD) in situ were one for each (2.3%). All cases were satisfactorily managed with no mortality, and a mean of 6.1 days of hospital stay.Conclusion: Ectopic pregnancies are common cause of hospital admission, irrespective of patient's age all of which were managed at WRH with no mortality.

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Towards More Sustainable Diets—Attitudes, Opportunities and Barriers to Fostering Pulse Consumption in Polish Cities

Nutrients ◽

10.3390/nu12061589 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1589 ◽

Cited By ~ 4

Author(s):

Agata Szczebyło ◽

Krystyna Rejman ◽

Ewa Halicka ◽

Wacław Laskowski

Keyword(s):

Developed Countries ◽

Preparation Time ◽

Chi Square ◽

Small Children ◽

Sustainable Diets ◽

Positive Attitudes ◽

Kohonen Neural Networks ◽

And Gender ◽

Chi Square Analysis ◽

Do So

Despite the evidence-based health benefits of pulses and their significant role in sustainable diets, consumption remains at a very low level in highly developed countries. In an attempt to fill in the knowledge gaps on factors influencing this phenomenon, a study aimed at identifying attitudes, incentives and barriers to pulse consumption was carried out in a sample of 1027 Polish urban employees aged 25–40 years. The sample (quota type) was representative in terms of age and gender. Exploratory classifications using Kohonen neural networks were performed to define profiles of participants for each analysed issue. Pearson’s chi-square analysis was used to check whether the profiles depended on socio-demographic characteristics of the respondents. The results suggest that very low pulse consumption is a result of lack of habits, discomfort after eating and long preparation time. Pulses were recognized as a good source of protein (72% of the sample), especially among women (81%). Only 43% of the sample saw pulses as a substitute for meat. The majority of consumers pictured pulses as a tasty and healthy food, although they were not sure if this is true for small children. Women recognised pulses as a more environmentally friendly food but this knowledge would not impact their intake. Profiles of respondents with positive attitudes towards increased pulse consumption were identified, constituting 39% of the sample. These consumers could eat more if they were encouraged to do so. This shows that programmes aimed at fostering greater pulse consumption are crucial to activate a change towards more sustainable diets. At the same time, simple and clear guidelines should be developed to overcome the unjustified stereotypes about pulses. These would support consumers to make healthier and more sustainable choices and help professionals carry out effective promotion and education activities.

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Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige)

Neurological Sciences ◽

10.1007/s10072-021-05066-9 ◽

2021 ◽

Author(s):

Paolo Manganotti ◽

Marcello Naccarato ◽

Ilario Scali ◽

Manuel Cappellari ◽

Bruno Bonetti ◽

...

Keyword(s):

Admission Rate ◽

Large Area ◽

Stroke Patients ◽

Chi Square ◽

Stroke Units ◽

North East ◽

The North ◽

Number Of Patients ◽

Chi Square Analysis ◽

Friuli Venezia Giulia

Abstract Background Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke. Methods We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies. Results In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers. Conclusions Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution.

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Use of a best-practice advisory to increase survivorship clinic referrals.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.53 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 53-53 ◽

Cited By ~ 1

Author(s):

Sheetal Mehta Kircher ◽

Megan Slocum ◽

Sofia F. Garcia ◽

Aubri Veneruso ◽

Alpa Patel ◽

...

Keyword(s):

Breast Cancer ◽

Best Practice ◽

Care Plan ◽

Survivorship Care Plan ◽

Breast Cancer Patients ◽

Chi Square ◽

Curative Intent ◽

Number Of Patients ◽

Practice Advisory ◽

Chi Square Analysis

53 Background: The American College of Surgeons Commission on Cancer require accredited institutions to give patients a survivorship care plan (SCPs) within six months of completing curative intent therapy. However, only a minority are receiving SCP’s. Some institutions have survivorship clinics to deliver comprehensive care, including SCP’s. Insufficient referrals to such clinics are a common barrier due to survivorship not being integrated into oncology workflows. To address this, we developed and implemented a best practice advisory (BPA) alert within our EMR to identify eligible patients and facilitate referrals to the survivorship clinic. Methods: Our pilot included breast cancer patients within medical oncology. The BPA electronic alert criteria included: stage 0-III, new patient encounter within 12 months, no SCP completed or previous referral. Upon triggering, the BPA asks “Does your patient require a SCP?” followed by 3 options: 1) SCP needed- an automatic order is generated, if signed, the BPA will not fire again, if unsigned, it will fire at the next encounter (no sooner than 30 days) and will continue until an order is placed or the response “ SCP not needed” is selected. 2) SCP not needed- the BPA will never trigger again for that patient. 3) Don’t know/still on treatment-the BPA will re-fire in 30 days. Data on frequency of BPA firing and number of referrals was compared 90 days prior and post implementation. Chi-square analysis was used. Results: Between 4/1/2015-3/31/2016, 902 patients were seen with stage 0-III breast cancer at Northwestern. Ninety days prior to implementation of the BPA, 30 patients (3.3%) were referred by 8 oncology providers. In the 90 days following implementation, the BPA fired 845 times (48.5% option 1, 24.8% option 2, 26.6% option 3) and 198 patients (22%) were referred. The difference was statistically significant ( χ2 = 141.7, p < 0.0001). Conclusions: The implementation of BPAs within an EMR is an effective way to increase referrals to a survivorship clinic, thus increasing the number of patients given SCPs. Challenges identified were having enough staff availible to deal with a rapid increase in referrals, need for refinement of BPA criteria to more precisely identify eligible patients, and provider burden.

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Racial and Ethnic Backgrounds of U.S. Randomized Controlled Trials in Obstetrics and Gynecology and Comparison to U.S. General Population: A Retrospective Review

10.22541/au.161374585.55609503/v1 ◽

2021 ◽

Author(s):

YUZURU ANZAI ◽

Noel Cercizi ◽

Yifei Wu ◽

Crystal Park ◽

Jasmine Gulati ◽

...

Keyword(s):

General Population ◽

Randomized Controlled Trials ◽

Ethnic Composition ◽

Obstetrics And Gynecology ◽

Controlled Trials ◽

Chi Square ◽

Black Race ◽

Randomized Controlled ◽

Chi Square Analysis ◽

The U.S

Objective: To determine if the racial and ethnic compositions of the participants in Obstetrics and Gynecology randomized controlled trials (RCTs) conducted in the U.S. match that of the general U.S. population. Design: Retrospective analysis of U.S. RCTs. Setting: United States. Population: Women enrolled in U.S. RCTs. Methods: Racial and ethnic composition of RCT participants published in two premier US journals, Obstetrics and Gynecology and American Journal of Obstetrics and Gynecology, from January 2010 to April 2020 were collected and analyzed. Main outcome measures: Comparison of the racial and ethnic composition of the U.S. RCTs to U.S. General population. Results: Chi-square analysis showed significant deviations from the U.S. general population in both Obstetrics (p<0.001) and Gynecology (p<0.05). We observed an overrepresentation of Black race and an underrepresentation of White and Asian races overall Obstetrics and in most subcategories. We observed an overrepresentation of Black race and an underrepresentation of Asian race in Gynecology overall and in most subcategories. White race representation was similar to the general population on average, but with wide variation across studies especially among the subcategories. Hispanic ethnicity was overall underrepresented. Conclusions: RCTs in the field of Obstetrics and Gynecology conducted in the U.S. deviate from the general population with regard to racial and ethnic distributions. Funding: NC,YW, CP, JG and SL received stipend from University of Chicago Metcalf summer internship program and Odyssey and Empower summer program. Keywords: U.S. Randomized Controlled Trials, Racial and Ethnic Backgrounds, Obstetrics and Gynecology

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Rising Trends in Ectopic Pregnancy during COVID-19 Pandemic

Current Trends in diagnosis & Treatment ◽

10.5005/jp-journals-10055-0106 ◽

2020 ◽

Vol 4 (2) ◽

pp. 84-86

Author(s):

Ripan Bala ◽

Sangeeta Pahwa ◽

Surinder Kaur ◽

Preet Kamal

Keyword(s):

Ectopic Pregnancy ◽

Treatment Plan ◽

Tertiary Care ◽

Medical Abortion ◽

Lifestyle Changes ◽

Emergency Laparotomy ◽

Exact Test ◽

Healthcare Facilities ◽

Number Of Patients ◽

Ectopic Pregnancies

ABSTRACT Introduction Coronavirus disease-2019 (COVID-19) has spread at an exponential rate in several countries. Whereas understanding of clinical consequences, prevention, and management of COVID-19 is increasing, little is known about the collateral damage caused by it. It is noteworthy that ectopic pregnancies contributed to significant obstetric emergencies in the COVID-19 pandemic and sensitized the caregivers to report the event. Materials and methods This retrospective study was conducted at the Tertiary Care Medical and Teaching Institute, Amritsar, India, to observe the rising trends of ectopic pregnancy during the lockdown period from March 22, 2020, to July 30, 2020. Data were taken from the hospital records of Emergency and Gynaecology and Obstetric departments after getting ethical clearance from the ethics committee of the institute. The details of demographic characters, clinical presentation, risk factors, and treatment plan for ectopic pregnancy, as well as associated morbidity and mortality were studied in detail in comparison to times other than during COVID-19 pandemic. Results It was observed that the proportion of ruptured ectopic pregnancies was significantly higher during the lockdown period in comparison to the prelockdown period (12/617; 1.94% vs. 17/4367; 0.381%, Fisher's exact test p 0.02). Majority of patients (91.66%) presented late with ruptured ectopic pregnancy with hemoperitoneum and had to undergo emergency laparotomy and a salpingectomy was done in 66.66% of cases. Discussion Social lifestyle changes, increased use of emergency contraceptive pills, and medical abortion pills due to poor accessibility of healthcare facilities were observed during this period. Noticeably, a high number of patients came in an emergency with failed medical abortions who were later diagnosed with ruptured ectopic pregnancies. Conclusion We think that monitoring the indirect potential consequences of COVID-19 pandemic is imperative in order to avoid unexpected deleterious complications in women's health. How to cite this article Kaur S, Kamal P, Pahwa S, et al. Rising Trends in Ectopic Pregnancy during COVID-19 Pandemic. AMEI's Curr Trends Diagn Treat 2020;4(2):84–86.

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Hubungan antara Profilaksis Kotrimoksazol dan Prevalensi Toksoplasmosis pada Pasien HIV Positif di Jember (The Association Between Prophylactic Cotrimoxazole and the Prevalence Toxoplasmosis in HIV-Positive Patients in Jember)

Pustaka Kesehatan ◽

10.19184/pk.v6i1.6613 ◽

2018 ◽

Vol 6 (1) ◽

pp. 25

Author(s):

Elly Febry Taufany ◽

Afifah Machlaurin ◽

Prihwanto Budi Subagijo

Keyword(s):

Opportunistic Infections ◽

Immune Deficiency Syndrome ◽

Hiv Positive ◽

P Value ◽

Hiv Patients ◽

Chi Square ◽

Cotrimoxazole Prophylaxis ◽

Keywords Hiv ◽

Number Of Patients ◽

Chi Square Analysis

Human immunodeficiency virus (HIV) is a virus that causes acquired immune deficiency syndrome (AIDS). HIV is a high mortality disease and the number of patients is increasing recent days. Based on dr. Soebandi Jember Hospital report in 2015, there were 1,492 HIV patients and 455 people received antiretroviral (ARV) therapy. Toxoplasmosis is one of opportunistic infections commonly found in HIV patients in central nervous system. WHO has issued guidelines for the use of cotrimoxazole as prophylaxis in HIV positive people. The purpose of this study was to determine the relationship between cotrimoxazole prophylaxis and the incidence of toxoplasmosis. This research was a case control study with retrospective approach and used chi-square analysis. The results showed that most patients were male (57%), 20-29 years in age (50%), and 41-60 kg in weight (64%). Based on the CD4 level, most HIV patients were less than 350/mm3 (96%) and total lymphocite count (TLC) also less than 1,200/mm3 (42%). There were 1 patient from 76 patients with cotrimoxazole prophylaxis and 7 patients from 52 patient without cotrimoxazole prophylaxis who developed toxoplasmosis. Based on chi-square analysis, cotrimoxazole prophylaxis reduce the incidence of toxoplasmosis in HIV positive (p-value 0,004). Keywords: HIV/AIDS, prophilaxis therapy of cotrimoxazole, toxoplasmosis infection

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Comparative effectiveness of second-line ipilimumab vs. nivolumab in combination with ipilimumab in patients with advanced melanoma who received frontline anti-PD-1 antibodies

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220924719 ◽

2020 ◽

pp. 107815522092471

Author(s):

Kelsey Baron ◽

Justin C Moser ◽

Shiven Patel ◽

Kenneth F Grossmann ◽

Sarah V Colonna ◽

...

Keyword(s):

Overall Survival ◽

Single Agent ◽

Advanced Melanoma ◽

Second Line ◽

Second Line Therapy ◽

Chi Square ◽

Line Therapy ◽

Number Of Patients ◽

Line Setting ◽

Chi Square Analysis

Introduction Anti-PD-1 antibodies are commonly used as frontline therapy for patients with metastatic melanoma. Although these medications can cause long term responses, a significant number of patients will not respond or will lose response. Optimal second-line therapy after losing response to anti-PD-1 antibodies is not well established. Therefore, we retrospectively compared the overall survival of patients who lost response to anti-PD1 antibodies between patients treated with single agent ipilimumab or ipilimumab and nivolumab. Methods A de-identified U.S. nationwide electronic health record-derived database was reviewed for patients with advanced melanoma treated with single agent anti-PD1 antibodies in the frontline setting and who subsequently received second-line ipilimumab or combination ipilimumab and nivolumab. Overall survival from initiation of second-line therapy was compared using Kaplan Meier curves and log-rank analysis. Other known prognostic markers for melanoma were analyzed for correlation with survival in a similar fashion. Disease characteristics between the two groups were compared using chi-square analysis. Results A total of 842 patients with advanced melanoma who received frontline anti-PD-1 antibodies were included for analysis. Of these, 57 received either ipilimumab ( n = 22) or ipilimumab in combination with nivolumab ( n = 35) in the second-line setting. Median survival from second-line therapy initiation for those treated with ipilimumab alone was 6 months and was 5.6 months for those treated with combination ipilimumab and anti-PD-1 antibodies, p = 0.81. Conclusions In this small, retrospective analysis, for patients who lost response to frontline anti-PD-1 therapy, patients treated with ipilimumab had similar survival to those who received ipilimumab in combination with anti-PD-1 antibodies.

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