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Montano-Loza AJ, Boursier J, Sanyal AJ, Ratziu V, Rinella M, Loomba R, Dufour J, Mozaffari E, Shringarpure R, MacConell L, Granston T, Zhou H, Trylesinski A, Harrison SA, Bedossa P, Goodman Z, Younossi Z, Noureddin M, Bugianesi E, Anstee QM. A217 NONINVASIVE ASSESSMENTS TO IDENTIFY PATIENTS WITH ADVANCED FIBROSIS DUE TO NASH: SCREENED POPULATION FROM THE REGENERATE TRIAL. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
We explored the ability of noninvasive tests (NITs) to identify patients (pts) with advanced fibrosis due to NASH.
Methods
All screened pts from the ongoing phase 3 REGENERATE with available histology data were included. Five NITs were evaluated using established literature cutoffs to identify or exclude advanced fibrosis (values between upper and lower thresholds were considered indeterminate): Aspartate Transaminase-to-Platelet Ratio Index (APRI; ≥0.57, ≤0.84), Enhanced Liver Fibrosis (ELF; ≥7.7, <9.8), Fibrosis-4 (FIB-4; ≥1.30, <2.67), NAFLD fibrosis score (NFS; ≥−1.455, <0.676), and Transient Elastography (TE; ≥7.9 kPa, <9.6 kPa). Three testing methods applied were single NIT, 2 simultaneous NITs weighted equally (NFS+ELF, FIB-4+ELF, NFS+TE, FIB-4+TE), and 2 sequential NITs with the second test performed only if the first test was indeterminate (NFS→ELF, FIB-4→ELF, NFS→TE, FIB-4→TE).
Results
4133 pts in the REGENERATE screened population had an available biopsy (baseline liver biopsy: F0, 15.5%; F1, 27.2%; F2, 21.2%; F3, 29.6%; F4, 6.5%). Of these, 96% had FIB-4, NFS, and APRI, 41% had TE, and 28% had ELF. Single NITs with upper thresholds demonstrating strong specificity for identification of advanced fibrosis were FIB-4 (97%), NFS (94%), and APRI (86%); NITs with lower thresholds demonstrating good sensitivity for identification of early fibrosis were ELF (100%) and TE (88%). Evaluation of 2 simultaneous NITs resulted in a greater percentage of pts in the indeterminate zone. Application of 2 sequential tests improved the accuracy of identification and reduced misclassification vs 2 simultaneous tests.
Conclusions
Sequential NIT strategies may decrease liver biopsy rates while maintaining the accuracy of noninvasive diagnosis in pts with advanced fibrosis due to NASH.
Funding Agencies
Intercept Pharmaceuticals
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Affiliation(s)
- A J Montano-Loza
- Division of Gastroenterology & Liver Unit, University of Alberta, Edmonton, AB, Canada
| | | | - A J Sanyal
- Virginia Commonwealth University, Richmond, VA
| | - V Ratziu
- Sorbonne Universite, Paris, Île-de-France, France
| | - M Rinella
- Northwestern University, Chicago, IL
| | - R Loomba
- University of California San Diego, La Jolla, CA
| | - J Dufour
- University of Bern, Bern, Switzerland
| | | | | | | | - T Granston
- Intercept Pharmaceuticals Inc, New York, NY
| | - H Zhou
- Intercept Pharmaceuticals Inc, New York, NY
| | | | - S A Harrison
- Pinnacle Clinical Research Center, San Antonio, TX
| | | | | | | | - M Noureddin
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Q M Anstee
- Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom
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Dummer R, Sondak V, Grichnik J, Schwartz L, Guminski A, Gutzmer R, Yi T, Trylesinski A, Sellami D, Migden M. 3347 BOLT 18-month analysis: efficacy and safety of sonidegib in patients with locally advanced basal cell carcinoma (laBCC) and evaluation of tumor response using 2 sets of composite assessment criteria. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31865-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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3
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Wang Y, Thongsawat S, Gane EJ, Liaw YF, Jia J, Hou J, Chan HLY, Papatheodoridis G, Wan M, Niu J, Bao W, Trylesinski A, Naoumov NV. Efficacy and safety of continuous 4-year telbivudine treatment in patients with chronic hepatitis B. J Viral Hepat 2013; 20:e37-46. [PMID: 23490388 PMCID: PMC3618368 DOI: 10.1111/jvh.12025] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 10/01/2012] [Indexed: 12/16/2022]
Abstract
In the phase-III GLOBE/015 studies, telbivudine demonstrated superior efficacy vs lamivudine during 2-year treatment in HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB). After completion, 847 patients had an option to continue telbivudine treatment for further 2 years. A total of 596 (70%) of telbivudine-treated patients, who were serum HBV DNA positive or negative and without genotypic resistance to telbivudine at the end of the GLOBE/015 trials, were enrolled into a further 2-year extension study. A group of 502 patients completed 4 years of continuous telbivudine treatment and were included in the telbivudine per-protocol population. Amongst 293 HBeAg-positive patients, 76.2% had undetectable serum HBV DNA and 86.0% had normal serum ALT at the end of 4 years. Notably, the cumulative rate of HBeAg seroconversion was 53.2%. Amongst 209 HBeAg-negative patients, 86.4% had undetectable HBV DNA and 89.6% had normal serum ALT. In patients who had discontinued telbivudine treatment due to HBeAg seroconversion, the HBeAg response was durable in 82% of patients (median 111 weeks of off-treatment follow-up). The cumulative 4-year resistance rate was 10.6% for HBeAg-positive and 10.0% for HBeAg-negative patients. Most adverse events were mild or moderate in severity and transient. Renal function measured by estimated glomerular filtration rate (eGFR) increased by 14.9 mL/min/1.73 m(2) (16.6%) from baseline to 4 years (P < 0.0001). In conclusion, in HBeAg-positive and HBeAg-negative CHB patients without resistance after 2 years, two additional years of telbivudine treatment continued to provide effective viral suppression with a favourable safety profile. Moreover, telbivudine achieved 53% of HBeAg seroconversion in HBeAg-positive patients.
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Affiliation(s)
- Y Wang
- Institute of Infectious Diseases, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - S Thongsawat
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityChiang Mai, Thailand
| | - E J Gane
- New Zealand Liver Unit, Auckland City HospitalAuckland, New Zealand
| | - Y-F Liaw
- Liver Research Unit, Chang Gung Memorial Hospital & UniversityTaipei, Taiwan
| | - J Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical UniversityBeijing, China
| | - J Hou
- Hepatology Unit and Department of Infectious Diseases, Nanfang HospitalGuangzhou, China
| | - H L Y Chan
- Medicine and Therapeutics, Chinese University of Hong KongHong Kong, China
| | - G Papatheodoridis
- Academic Department of Medicine, Hippokration General HospitalAthens, Greece
| | - M Wan
- Department of Infectious Diseases, ChangHai Hospital of the Second Military Medical UniversityShanghai, China
| | - J Niu
- Department of Hepatology, First hospital of Jilin UniversityJilin, China
| | - W Bao
- Novartis Pharma CorporationEast Hanover, NJ, USA
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Chan HLY, Chen YC, Gane EJ, Sarin SK, Suh DJ, Piratvisuth T, Prabhakar B, Hwang SG, Choudhuri G, Safadi R, Tanwandee T, Chutaputti A, Yurdaydin C, Bao W, Avila C, Trylesinski A. Randomized clinical trial: efficacy and safety of telbivudine and lamivudine in treatment-naïve patients with HBV-related decompensated cirrhosis. J Viral Hepat 2012; 19:732-43. [PMID: 22967105 DOI: 10.1111/j.1365-2893.2012.01600.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patients with decompensated cirrhosis owing to chronic hepatitis B viral (HBV) infection have a high morbidity/mortality rate, and the treatment remains a challenge. We studied the safety and efficacy of telbivudine and lamivudine in such patients. This noninferiority, double-blind trial randomized 232 treatment-naive patients with decompensated HBV (1:1) in 80 academic hospitals to receive once-daily telbivudine 600 mg or lamivudine 100 mg for 104 weeks. Primary composite endpoint was proportion of patients with HBV DNA <10 000 copies/mL, normal alanine aminotransferase (ALT) and Child-Turcotte-Pugh score improvement/stabilization at week 52. Response rates using a post hoc modified endpoint (HBV DNA <300 copies/mL [57 IU/mL] and ALT normalization) in intent-to-treat analysis (missing = failure) were 56.3%vs 38.0% after 76 weeks (P = 0.018) and 45.6%vs 32.9% after 104 weeks (P = 0.093) for telbivudine vs lamivudine. Telbivudine treatment was an independent predictive factor for HBV DNA <300 copies/mL and ALT normalization (P = 0.037). Response rates with protocol-defined composite endpoint in intent-to-treat analysis (M = F) were 56.2 vs 54.0% (noninferiority not achieved) and 39.1%vs 36.4% (noninferiority achieved) in telbivudine and lamivudine groups at 52 and 104 weeks. Telbivudine treatment was associated with a significant improvement in glomerular filtration rate compared to lamivudine treatment and was also associated with a trend for improvement in survival (87%vs 79%). No cases of lactic acidosis were reported. Telbivudine compared to lamivudine was associated with a higher rate of patients with both viral suppression and ALT normalization, a trend towards a higher rate of survival and significant improvement in glomerular filtration.
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Affiliation(s)
- H L Y Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
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Bevc S, Hojs R, Ekart R, Gorenjak M, Puklavec L, Nakano C, Hamano T, Fujii N, Matsui I, Obi Y, Okada N, Tsubakihara Y, Rakugi H, Isaka Y, Pisano A, Testa A, Spoto B, Sanguedolce MC, Parlongo RM, Tripepi G, Leonardis D, Mallamaci F, Zoccali C, Papale M, Gigante M, Prattichizzo C, Rocchetti MT, Battaglia M, Gesualdo L, Ranieri E, Legendre C, Babu S, Furman R, Sheerin N, Cohen D, Gaber O, Eitner F, Delmas Y, Loirat C, Greenbaum L, Bedrosian C, Zimmerhackl LB, Gane E, Deray G, Piratvisuth T, Chan HLY, Zeuzem S, Jia J, Ren H, Uddin A, Bosset S, Avila C, Trylesinski A. CKD / Human studies. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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6
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Landman R, Poupard M, Diallo M, Ngom Gueye N, Diakhate N, Ndiaye B, Toure Kane C, Trylesinski A, Diop H, Mboup S, Koita Fall M, Delaporte E, Benalycherif A, Girard P, Sow P. Tenofovir-Emtricitabine-Efavirenz in HIV-I-Infected Adults in Senegal: A 96-Week Pilot Trial in Treatment-Naive Patients. ACTA ACUST UNITED AC 2009; 8:379-84. [DOI: 10.1177/1545109709344352] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We report the results of a pilot open-label trial of a tenofovir (TDF)/emtricitabine (FTC)/efavirenz (EFV) combination conducted in Dakar, Senegal. Forty HIV-1-infected patients, naive of antiretroviral treatment and without active opportunistic disease, were included and followed through 96 weeks. At weeks 48 and 96, respectively, 82.5% and 85% of patients had HIV-1 RNA <400 copies/mL (72.5% and 77.5% with HIV-1 RNA <50 copies/mL). Between baseline and week 96, the mean (SD) CD4 count increased from 126 (102) to 338 (155) cells/mm3. The mean (SD) creatinine clearance decreased from 92 (36) to 73 (19) mL/min (P = .001). Treatment adherence was at least 94% at all scheduled visits. The efficacy and tolerability of a TDF/FTC/EFV combination were high and similar to those observed in Northern countries. This drug combination can be recommended in limited-resource countries, as did the World Health Organization (WHO) and should be made readily available as a fixed-dose combination.
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Affiliation(s)
- R. Landman
- Institut de Médecine et d'Epidémiologie Appliquée et Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses, Paris, France, roland.landman@univ-paris-diderot
| | - M. Poupard
- Institut de Médecine et d'Epidémiologie Appliquée et Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses, Paris, France
| | - M. Diallo
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
| | - N.F. Ngom Gueye
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
| | - N. Diakhate
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
| | - B. Ndiaye
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
| | - C. Toure Kane
- CHU Le Dantec, Université Cheikh Anta Diop, Laboratoire de Bactériologie-Virologie Dakar, Sénégal
| | | | - H. Diop
- CHU Le Dantec, Université Cheikh Anta Diop, Laboratoire de Bactériologie-Virologie Dakar, Sénégal
| | | | - M.B. Koita Fall
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
| | - E. Delaporte
- Institut de Recherche et Développement, UMR 145, Montpellier, France
| | - A. Benalycherif
- Institut de Médecine et d'Epidémiologie Appliquée et Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses, Paris, France
| | - P.M. Girard
- Institut de Médecine et d'Epidémiologie Appliquée et Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses, Paris, France, Hôpital Saint-Antoine, Service des Maladies Infectieuses, Paris, France
| | - P.S. Sow
- CHU de Fann, Université Cheikh Anta Diop, Service des Maladies Infectieuses, Dakar, Sénégal
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Schnepf N, Lafuente-Lafuente C, Jarrin I, Simoneau G, Magnier JD, Trylesinski A, Sellier P, Mazeron MC. Hepatitis B virus (HBV) genotype distribution and lamivudine-resistant mutations in HIV/HBV co-infected patients attending a Parisian hospital. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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8
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Landman R, Descamps D, Peytavin G, Trylesinski A, Katlama C, Girard PM, Bonnet B, Yeni P, Bentata M, Michelet C, Benalycherif A, Brun Vezinet F, Miller MD, Flandre P. Early virologic failure and rescue therapy of tenofovir, abacavir, and lamivudine for initial treatment of HIV-1 infection: TONUS study. HIV Clin Trials 2006; 6:291-301. [PMID: 16452063 DOI: 10.1310/9dqp-r7ja-75ed-rbcp] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND To assess the efficacy and safety of the triple NRTI combination of abacavir (ABC), lamivudine (3TC), and tenofovir (TDF) in a once-daily regimen. METHOD 38 HIV-naive patients (pts) were treated in a prospective open-arm study over 48 weeks (W48). Virological failure was defined as never achieving plasma HIV-1 RNA < 400 copies/mL or rebound of > or = 0.7 log10. RESULTS 12/36 (33%) pts had virologic failure at W24 and 10 additional pts had HIV RNA > 50 copies/mL at W12 or W24. There was a significant association between baseline viral load (VL) and virologic failure in 0%, 29%, and 64% pts with baseline VL levels < 4, 4-5, and > 5 log10 copies/mL, respectively (p = .014). 76% of pts developed K65R and M184V/I mutations by W24, and 19% developed M184V/I alone. At W4, 86% of pts had adequate plasma Cmin for the 3 drugs. 14 pts with K65R and M184V/I were given a rescue therapy with a successful outcome (< 50 copies/mL; median follow-up 48 weeks). CONCLUSION Convergent genetic pathway to resistance, in conjunction with lower antiretroviral potency, may explain the high rate of selection K65R and M184V mutations. These mutations did not appear to have a negative effect on rescue therapy with a variety of regimens.
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Affiliation(s)
- R Landman
- Bichat Claude Bernard Hospital, Paris, France.
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Pellegrin I, Breilh D, Birac V, Deneyrolles M, Mercié P, Trylesinski A, Neau D, Saux MC, Fleury HJ, Pellegrin JL. Pharmacokinetics and resistance mutations affect virologic response to ritonavir/saquinavir-containing regimens. Ther Drug Monit 2001; 23:332-40. [PMID: 11477313 DOI: 10.1097/00007691-200108000-00003] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors assessed the impact of protease and reverse transcription (RT) mutations and individual pharmacokinetic parameters on virologic response to a four-drug regimen including ritonavir/saquinavir. Treatment was given at the start of the study (M0) to 22 HIV-1 protease inhibitor-naive or pretreated patients. Protease and RT genes were sequenced at M0, at the time of virologic failure, or at the end of the follow-up. Plasma ritonavir and saquinavir peak C(max), C(min), and area under the curve (AUC) were determined based on samples taken 0, 1, 2, 3, 4, 6, 8, and 12 hours after administration. HIV-1 RNA decreased to less than 50 copies/mL in 11 patients (group 1). At M0, five of them had no RT mutation and 10 had three or fewer secondary protease mutations with no new mutation during follow-up. Ritonavir and saquinavir pharmacokinetics showed wide interindividual variability. Treatment failed in 11 patients (group 2): 9 had three to eight protease mutations and a mean of 5.8 RT mutations at M0, with emergence of new mutations during follow-up. Pharmacokinetics was similar to those of group 1. The other two patients with virologic failure showed no baseline primary mutation but were the only patients with insufficient saquinavir and ritonavir AUC. The authors showed the complementarity between drug-resistance genotype and individual pharmacokinetics and the potential utility of AUC and Cmax to manage treatment.
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Affiliation(s)
- I Pellegrin
- Department of Virology, Bordeaux University Hospital, Bordeaux, France.
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10
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Mouthon L, Espérou H, Trylesinski A, Gluckman E, Guillevin L. Rémission complète prolongée d'une périartérite noueuse associée à une dysmyélopoïèse après allogreffe de moelle osseuse intrafamiliale. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Taoufik Y, Peguillet I, de Goër MG, Lambert M, Gubler B, Trylesinski A, Delfraissy JF, Lantz O. Effect of highly active antiretroviral therapy on expression of interleukin-10 and interleukin-12 in HIV-infected patients. J Acquir Immune Defic Syndr 2001; 26:303-4. [PMID: 11317069 DOI: 10.1097/00126334-200104010-00001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Y Taoufik
- Laboratoire d'Immunologie, Paris, France.
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12
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Katlama C, Pellegrin JL, Lacoste D, Aquilina C, Raffi F, Pialoux G, Vittecoq D, Raguin G, Lantz O, Mouroux M, Calvez V, Trylesinski A, Montestruc F, Dohin E, Goehrs JM, Delfraissy JF. MIKADO: a multicentre, open-label pilot study to evaluate the antiretroviral activity and safety of saquinavir with stavudine and zalcitabine. HIV Med 2001; 2:20-6. [PMID: 11737372 DOI: 10.1046/j.1468-1293.2001.00046.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since eradication of HIV is unlikely, long-term management of the disease necessitates careful evaluation of the combinations of currently available drugs to determine the most potent and useful rational sequencing of regimens. OBJECTIVE To determine the antiretroviral efficacy and tolerability of saquinavir soft gelatin capsule (SQV-SGC) plus zalcitabine (ddC) and stavudine (d4T), as first-line treatment in HIV-infected patients. DESIGN Multicentre, open-label, non-comparative study. PATIENTS AND METHODS Thirty-five asymptomatic, HIV-infected adults with no prior antiretroviral treatment, a CD4 count > or =250 cells/microL and baseline > or = 5000 HIV RNA copies/mL were included in the study. Patients received SQV-SGC 1200 mg three times a day (tid), ddC 0.75 mg tid and d4T 30 or 40 mg twice a day (bid) for 24 weeks. Plasma HIV RNA, CD4 and CD8 cell counts, HIV reverse transcriptase and protease resistance genotypes, SQV plasma concentration and tolerability were evaluated. RESULTS At baseline, median HIV RNA (interquartile range) was 4.99 (4.81-5.48) log10 copies/mL, and median CD4 count was 370 (318-504) cells/microL (n = 35). At week 24, the median decrease in HIV RNA was 3.05 (2.19-3.68) log10 copies/mL. A viral load below the level of quantification (200 copies/mL and 20 copies/mL) was achieved in 63% and 34% of patients, respectively (intent-to-treat analysis). The only mutations detected were L90M substitutions in two patients. At week 24, the median CD4 count increased (P < 0.0001), and CD8 cell counts decreased (P < 0.0001), relative to baseline. In total, there were five cases of peripheral neuropathy (14%). Mean triglyceride and cholesterol levels remained within normal ranges. CONCLUSIONS Triple therapy with SQV-SGC plus ddC and d4T is a reasonably well tolerated regimen that markedly and rapidly reduces viral load with immunological improvement. This combination is an effective additional therapeutic option, with an efficacy that compares favourably to other triple regimens used in HIV treatment.
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Affiliation(s)
- C Katlama
- Service des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, Paris, France.
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13
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Mouroux M, Yvon-Groussin A, Peytavin G, Delaugerre C, Legrand M, Bossi P, Do B, Trylesinski A, Diquet B, Dohin E, Delfraissy JF, Katlama C, Calvez V. Early virological failure in naive human immunodeficiency virus patients receiving saquinavir (soft gel capsule)-stavudine-zalcitabine (MIKADO trial) is not associated with mutations conferring viral resistance. J Clin Microbiol 2000; 38:2726-30. [PMID: 10878071 PMCID: PMC87009 DOI: 10.1128/jcm.38.7.2726-2730.2000] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The MIKADO trial was designed to evaluate the efficacy of stavudine-zalcitabine-saquinavir (soft gel capsule) [d4T-ddC-SQV(SGC)] in 36 naive patients (-3.3 log(10) units at week 24 [W24]). Among the 29 patients remaining on d4T-ddC-SQV(SGC) until W24, 10 harbored a virological failure (viral load of >200 copies/ml at W24) (group 1). To determine the reasons for therapeutic failure, genotypic and phenotypic resistance test results and SQV concentrations in plasma were analyzed and compared to those in successfully treated patients (viral load of <200 copies/ml at W24) (group 2). Reverse transcriptase and protease genotypic analyses in group 1 revealed the acquisition of only one SQV-associated mutation (L90M) in only two patients. There was no significant increase in the 50 or 90% inhibitory concentration of SQV in patients with or without the L90M mutation. However, the fact that two patients developed an L90M mutation only 4 weeks after relapse points to the need for genotypic resistance testing in the context of an initial failure of the antiretroviral regimen. At W24, the median SQV concentration in group 1 (71 ng/ml) was significantly lower than in group 2 (475 ng/ml), and the plasma SQV concentration was correlated with the viral load at W24 (r = -0.5; P<0.05) and with the drop in viral load between day 0 and W24 (r = -0.5; P<0.01). These results and the fact that the plasma SQV concentrations in the two groups prior to relapse (W12) were not significantly different strongly suggest that the early failure of this combination is not due to viral resistance but to a lack of compliance, pharmacological variability, and drug interactions or a combination of these factors.
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Affiliation(s)
- M Mouroux
- Department of Virology, Pitié-Salpêtrière Hospital, Paris, France
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Demoly P, Messaad D, Trylesinski A, Faucherre V, Fabre J, Reynes J, Delmas C, Dohin E, Godard P, Bousquet J. Nelfinavir-induced urticaria and successful desensitization. J Allergy Clin Immunol 1998; 102:875-6. [PMID: 9819308 DOI: 10.1016/s0091-6749(98)70031-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P Demoly
- Centre Hospitalier Universitaire, Maladies Respiratoires, Hôpital Arnaud de Villeneuve, Montpellier Cedex 5, France
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15
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Schlatter J, Nester G, Trylesinski A. [Crack: an inhalated form of cocaine]. Presse Med 1997; 26:1695-8. [PMID: 9452751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- J Schlatter
- Service de Pharmacie (JS), Service de Psychiatrie, Centre hospitalier de Gonesse
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16
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Teixeira A, Leu J, Honderlick P, Trylesinski A, Zucman D. Variation in body weight and plasma viral load in HIV patients treated with tritherapy including a protease inhibitor. Nutrition 1997. [DOI: 10.1016/s0899-9007(97)82628-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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17
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Ghannem M, Godard S, Trylesinski A, Duhamel P, Philippe J, Sabbah L, Belhani A. [Malignant non-Hodgkin lymphoma of cardiac localization. Apropos of a case]. Ann Cardiol Angeiol (Paris) 1995; 44:345-8. [PMID: 8561438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Malignant non-Hodgkin's lymphomas are rare in the absence of human immunodeficiency virus infection and it is exceptional for a cardiac site to be the prominent feature. In our case, the malignant lymphoma was revealed by pericardial effusion in a context of alteration of the general state. Echocardiography revealed a heterogeneous mass in the right atrium and an abundant circumferential pericardial effusion. Thoracic computed tomography allowed local staging and magnetic resonance imaging (MRI) allowed a better definition, than CT scan, of the extension of the tumour into the various cardiac structures. The histological diagnosis was established on biopsy of a mediastinal lymph node. The patient died 7 months after the diagnosis, despite chemotherapy. The authors emphasize the contribution of echocardiography in the diagnosis of cardiac tumours, computed tomography in local staging, and MRI in the analysis of the various cardiac structures.
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Affiliation(s)
- M Ghannem
- Centre Médical et Cardiologique Léopold Bellan Ollencourt, Tracy-le-Mont
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18
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Trylesinski A, Carbonnel F, Bouchaud O, Beaugerie L, Gharakanian S, Rozenbaum W, Cosnes J, Gendre JP, Le Quintrec Y. Intestinal histoplasmosis in AIDS patients: report of three cases observed in France and review of the literature. Eur J Gastroenterol Hepatol 1995; 7:679-83. [PMID: 8590165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We report three cases of colonic histoplasmosis observed in a non-endemic area in patients with AIDS. The patients presented with fever, abdominal pain and an abdominal mass in the right lower quadrant. Diagnosis was obtained using Gomori-Crocott staining of endoscopic or surgical biopsies. One patient died without specific treatment and two patients had a complete remission when treated with intravenous amphotericin B but suffered a relapse when given oral itraconazole. Thus, physicians in areas where intestinal histoplasmosis is not endemic should be aware of the condition. Diagnosis can easily be obtained using Gomori-Crocott staining of colonoscopic biopsies; this should avoid unnecessary laparotomies and allow specific treatment to be instituted rapidly.
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Affiliation(s)
- A Trylesinski
- Service de Gastroentérologie et de Nutrition, Hôpital Rothschild, Paris, France
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19
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Toussaint B, Trylesinski A. Magnesium and myocardial infarction. Lancet 1994; 343:1287. [PMID: 7910290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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20
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Trylesinski A, Le Pennec MP, Guibourdenche M, Delauche-Cavallier MC, Riou JY. [Meningococcal arthritis (serogroup A) contracted during a pilgrimage to Mecca]. Pathol Biol (Paris) 1989; 37:213-4. [PMID: 2498830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Case report of one meningococcal arthritis (serogroup A) acquired during Mecca pilgrimage (August 1987). It was the first case of an outbreak of twenty infections due to Neisseria meningitidis groupe A reported in France from August 1987 to March 1988.
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Affiliation(s)
- A Trylesinski
- Service de Rhumatologie, Centre Hospitalier Général Robert Ballanger, Aulnay-Sous-Bois, France
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