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Ngo AD, Nguyen HL, Caglayan S, Chu DT. RNA therapeutics for the treatment of blood disorders. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2024; 203:273-286. [PMID: 38360003 DOI: 10.1016/bs.pmbts.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Blood disorders are defined as diseases related to the structure, function, and formation of blood cells. These diseases lead to increased years of life loss, reduced quality of life, and increased financial burden for social security systems around the world. Common blood disorder treatments such as using chemical drugs, organ transplants, or stem cell therapy have not yet approached the best goals, and treatment costs are also very high. RNA with a research history dating back several decades has emerged as a potential method to treat hematological diseases. A number of clinical trials have been conducted to pave the way for the use of RNA molecules to cure blood disorders. This novel approach takes advantage of regulatory mechanisms and the versatility of RNA-based oligonucleotides to target genes and cellular pathways involved in the pathogenesis of specific diseases. Despite positive results, currently, there is no RNA drug to treat blood-related diseases approved or marketed. Before the clinical adoption of RNA-based therapies, challenges such as safe delivery of RNA molecules to the target site and off-target effects of injected RNA in the body need to be addressed. In brief, RNA-based therapies open novel avenues for the treatment of hematological diseases, and clinical trials for approval and practical use of RNA-targeted are crucial.
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Affiliation(s)
- Anh Dao Ngo
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | - Hoang Lam Nguyen
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | | | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam; Faculty of Applied Sciences, International School, Vietnam National University, Hanoi, Vietnam.
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Cooper SH, Phipps EJ, Lawson D, Meier ER. How we coordinate care for uninsured children with nonmalignant hematologic disorders. Pediatr Blood Cancer 2021; 68:e29103. [PMID: 34125474 DOI: 10.1002/pbc.29103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 11/12/2022]
Abstract
Providing medical care for uninsured children with nonmalignant hematologic diagnoses presents unique challenges to medical providers and multidisciplinary staff. Financial and psychosocial stressors can hinder optimal care of the uninsured child. Maximizing coverage of medical costs through patient enrollment in state and charity care programs and capitalizing upon community partnerships can help providers achieve comprehensive care for these children. Collaboration between primary care providers, subspecialists, and multidisciplinary teams can be optimized to facilitate provision of hematology care for uninsured children. We detail our experience in establishing these collaborations to improve access to subspecialty care for children with nonmalignant hematologic disorders.
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Affiliation(s)
- Sarah Hall Cooper
- Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA
| | - Erin Jane Phipps
- Eskenazi Health/Indiana University Health, Indianapolis, Indiana, USA
| | - DeAuntae Lawson
- Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA
| | - Emily Riehm Meier
- Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA
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Peyvandi F, Tavakkoli F, Frame D, Quinn J, Kim B, Lawal A, Lee MC, Wong WY. Burden of mild haemophilia A: Systematic literature review. Haemophilia 2019; 25:755-763. [PMID: 31294906 PMCID: PMC6852304 DOI: 10.1111/hae.13777] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/12/2019] [Accepted: 05/03/2019] [Indexed: 01/19/2023]
Abstract
Introduction Although the clinical manifestations of severe haemophilia A (HA) are well studied, the challenges, if any, of living with mild HA are not clearly delineated to date. Aim To assess available evidence of clinical risks and societal/economic impacts of disease in adult patients with mild HA using a systematic literature review. Methods Prespecified study selection criteria were applied in a comprehensive literature search. Included studies varied in design and reported outcomes of interest for adults (≥13 years of age) with mild HA. Results Seventeen studies with a total of 3213 patients met eligibility criteria (published or presented in English, 1966‐2017). Most studies were observational, and the outcomes reported were too sparse and dissimilar to support a formal meta‐analysis. Mean annual bleeding rates ranged from 0.44 to 4.5 episodes per patient per year. Quality of life (QoL; SF‐36 General Health) was impacted compared to healthy controls. Health care costs and productivity were seldom assessed and no robust comparisons to healthy controls were available. Conclusion Quantifying outcomes for adult patients with mild HA remains challenging, with estimates of key QoL and cost data often based on small data sets and without comparison to population norms. Therefore, the clinical impact of mild haemophilia may be under‐represented and unmet needs may remain unaddressed. As paradigm‐changing therapies for HA emerge, stronger knowledge of mild HA can guide the development of care options that minimize burden and enhance the QoL for this segment of the haemophilia community, and for the haemophilia community in totality.
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Affiliation(s)
- Flora Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | | | | | | | - Benjamin Kim
- BioMarin Pharmaceutical Inc., Novato, California
| | | | - Mimi C Lee
- BioMarin Pharmaceutical Inc., Novato, California
| | - Wing Y Wong
- BioMarin Pharmaceutical Inc., Novato, California
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Osteonecrosis of the femoral head in sickle cell disease: prevalence, comorbidities, and surgical outcomes in California. Blood Adv 2017; 1:1287-1295. [PMID: 29296770 DOI: 10.1182/bloodadvances.2017005256] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/07/2017] [Indexed: 01/03/2023] Open
Abstract
Osteonecrosis of the femoral head (ONFH) is a prevalent complication of sickle cell disease (SCD) that has not been well described in population-based cohort studies. Using California's Office of Statewide Planning and Development discharge databases (1991-2013), we estimated the cumulative incidence of ONFH after accounting for the competing risk of death and used a multivariable Cox proportional hazards regression to identify factors associated with ONFH diagnosis. We also calculated rates of readmissions to the hospital or emergency department within 30 to 90 days of hip replacement surgery. Of the 6237 patients in our SCD cohort, 22% (n = 1356) developed ONFH at a median age of 27 years, and 23% (n = 308) of the patients with ONFH underwent hip replacement surgery at a median age of 36 years. The cumulative incidence of ONFH to age 30 years was higher among SCD patients with more severe disease (24%; vs 8% in less severe) and those with antecedent acute chest syndrome (ACS) (18%; vs 8% without prior history of ACS). From 2003 to 2013, SCD patients with more severe disease (hazard ratio [HR], 2.77; 95% confidence interval [CI], 2.38-3.23) or with antecedent ACS (HR, 1.61; CI, 1.35-1.91) were more likely to develop ONFH. Twenty-seven percent of post-hip surgery patients were readmitted within 30 days, mostly for painful vaso-occlusive crises. ONFH is a common SCD complication that increases with age; ongoing studies into prevention and effective nonsurgical interventions for SCD-induced osteonecrosis must remain a high research priority.
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Guirguis E, Brown D, Grace Y, Patel D, Henningfield S. Establishing Edoxaban’s Role in Anticoagulation. J Pharm Pract 2016; 29:228-38. [PMID: 27169733 DOI: 10.1177/0897190016647314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose This article serves as a review of the current literature regarding the role of edoxaban for the prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and the treatment of venous thromboembolism (VTE). Summary Until recent years, oral treatment options for both treatment and prevention of VTE and stroke were limited to warfarin. Dabigatran was the first new oral anticoagulant approved in over 50 years followed by rivaroxaban and apixaban. These new oral anticoagulants offer many benefits over warfarin. Edoxaban is the newest member among the oral anticoagulants and exerts its action by direct inhibition of factor Xa. It may offer some advantages in that it is the second Food and Drug Administration-approved once-daily anticoagulant available and does not interact with the cytochrome P450 (CYP450) system. However, there are concerns in patients with AF and preserved renal function (>95 mL/min), as these cohorts experienced a higher incidence of stroke in trials. Conclusion Based on the 3 clinical trials, edoxaban appears to be a safe and effective factor Xa inhibitor in patients with a creatinine clearance of <95 mL/min. It will serve as an alternative anticoagulant for those with a preference for once-daily dosing and/or taking medications that interact with the CYP450 system.
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Affiliation(s)
- Erenie Guirguis
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
| | - Dana Brown
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
| | - Yasmin Grace
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
| | - Dimple Patel
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
| | - Samantha Henningfield
- Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA
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Lin TF, Carhill P, Huang JN, Baker JR. Capacity Building for Rare Bleeding Disorders in the Remote Commonwealth of the Northern Mariana Islands. Am J Public Health 2016; 106:658-61. [PMID: 26890163 DOI: 10.2105/ajph.2016.303093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The US Pacific Commonwealth of the Northern Mariana Islands is home to an underserved hemophilia population. We developed a strategy in 2014 to build sustainable island-wide medical, patient and family, and community support for this rare disease. Collaboration with regional bleeding disorder leadership galvanized a weeklong conference series. More than 200 participants attended discipline-specific seminars; pre-post test evaluations documented educational benefits. This time-concentrated island-wide education intervention promoted the rapid identification of new cases and stimulated sustainable bleeding disorder care development. The education series proved feasible, efficient, and effective in increasing knowledge and reducing patient and professional isolation, serving as a model for improving capacity for orphan diseases (those that affect fewer than 200 000 people in any particular country) in underresourced areas.
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Affiliation(s)
- Tiffany F Lin
- Tiffany F. Lin and James N. Huang are with the Department of Pediatrics, and the Benioff Children's Hospital, University of California, San Francisco. Tiffany F. Lin is also with Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands. Pam Carhill is with Marianas Health, Saipan, Northern Mariana Islands. Judith R. Baker is with the Center for Inherited Blood Disorders, Orange, CA and the Division of Pediatric Hematology/Oncology, University of California, Los Angeles
| | - Pam Carhill
- Tiffany F. Lin and James N. Huang are with the Department of Pediatrics, and the Benioff Children's Hospital, University of California, San Francisco. Tiffany F. Lin is also with Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands. Pam Carhill is with Marianas Health, Saipan, Northern Mariana Islands. Judith R. Baker is with the Center for Inherited Blood Disorders, Orange, CA and the Division of Pediatric Hematology/Oncology, University of California, Los Angeles
| | - James N Huang
- Tiffany F. Lin and James N. Huang are with the Department of Pediatrics, and the Benioff Children's Hospital, University of California, San Francisco. Tiffany F. Lin is also with Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands. Pam Carhill is with Marianas Health, Saipan, Northern Mariana Islands. Judith R. Baker is with the Center for Inherited Blood Disorders, Orange, CA and the Division of Pediatric Hematology/Oncology, University of California, Los Angeles
| | - Judith R Baker
- Tiffany F. Lin and James N. Huang are with the Department of Pediatrics, and the Benioff Children's Hospital, University of California, San Francisco. Tiffany F. Lin is also with Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands. Pam Carhill is with Marianas Health, Saipan, Northern Mariana Islands. Judith R. Baker is with the Center for Inherited Blood Disorders, Orange, CA and the Division of Pediatric Hematology/Oncology, University of California, Los Angeles
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Richardson LC, Parker CS, Tsai J. Blood disorders and public health. Am J Prev Med 2014; 47:656-7. [PMID: 25245798 PMCID: PMC4476383 DOI: 10.1016/j.amepre.2014.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/13/2014] [Accepted: 07/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Lisa C Richardson
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
| | - Christopher S Parker
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia
| | - James Tsai
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia
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