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Shaikh A, Pedra G, Ruiz-Casas L, Franks B, Dhillon H, Fernandes JDDR, Mangla KK, Augusto M, Romero-Gómez M, Schattenberg JM. Risk factors for fibrosis progression in non-alcoholic steatohepatitis: Analysis of the European cohort in the real-world GAIN study. Gastroenterol Hepatol 2023:S0210-5705(23)00451-X. [PMID: 37890583 DOI: 10.1016/j.gastrohep.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 08/22/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To better understand drivers of disease progression in non-alcoholic steatohepatitis (NASH), we assessed clinical and sociodemographic markers of fibrosis progression in adults with NASH. PATIENTS AND METHODS Physician-reported patient demographics and clinical characteristics were utilised from the real-world Global Assessment of the Impact of NASH (GAIN) study. Factors associated with likelihood of fibrosis progression since NASH diagnosis were identified using a logistic regression model. RESULTS Overall, 2349 patients in Europe from the GAIN study were included; mean age was 54.6 years and 41% were women. Significant covariates included age, years since diagnosis, employment status, fibrosis stage at diagnosis, type 2 diabetes mellitus, hypertension, liver transplant and liver biopsy at diagnosis. Risk of progression was 1.16 (95% confidence interval 1.12-1.20; p<0.001) times higher for each additional year since NASH diagnosis and 5.43 (2.68-11.37; p<0.001) times higher when physicians proposed a liver transplant at diagnosis. Compared with full-time employed patients, risk of progression was 1.77 (1.19-2.60; p=0.004) times higher for unemployed patients and 3.16 (1.30-7.63; p=0.010) times higher for those unable to work due to NASH. CONCLUSIONS Disease duration, NASH severity and presence of other metabolic comorbidities could help to assess risk of progression in patients with NASH.
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Affiliation(s)
- Anum Shaikh
- HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom
| | - Gabriel Pedra
- HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom
| | - Leonardo Ruiz-Casas
- HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom
| | - Bethany Franks
- HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom.
| | - Harpal Dhillon
- HCD Economics Ltd., The Innovation Centre, Keckwick Lane, Daresbury, Cheshire WA4 4FS, United Kingdom
| | | | | | | | - Manuel Romero-Gómez
- UCM Digestive Diseases and CIBEREHD, 28029 Madrid, Spain; Virgen del Rocío University Hospital and Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, 41013 Seville, Spain
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
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2
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Martin AP, Ferri Grazzi E, Mighiu C, Chevli M, Shah F, Maher L, Shaikh A, Sagar A, Hubberstey H, Franks B, Ramos-Goñi JM, Oppe M, Tang D. Health state utilities for beta-thalassemia: a time trade-off study. Eur J Health Econ 2023; 24:27-38. [PMID: 35347553 PMCID: PMC9876862 DOI: 10.1007/s10198-022-01449-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Beta-thalassemia (BT) is an inherited blood disorder characterized by reduced levels of functional hemoglobin resulting in phenotypes ranging from clinically asymptomatic to severely anemic. Patients with BT may require lifelong regular blood transfusions supported by appropriate iron chelation therapy (ICT). This study aimed to determine how the UK general population values BT health states associated with differing transfusion burden and ICT. METHODS Composite time trade-off (cTTO) methodology was employed to elicit health state utilities in BT. Relevant BT literature related to symptom and quality-of-life impact, including physical, functional, and emotional well-being, and safety profiles of BT treatments were considered when drafting health state descriptions. Eleven health state descriptions were developed and validated by hematologists and patient advocates for clinical accuracy and completeness. 200 individuals from the UK general population participated in the cTTO interviews. RESULTS The mean age of participants was 41.50 years (SD 16.01, range 18-81); 88 (46.8%) were female. Utility values ranged from 0.78 (SD 0.34) for non-transfusion dependent BT with oral ICT to 0.37 (SD 0.50) for high transfusion burden with subcutaneous ICT in transfusion-dependent BT. CONCLUSIONS This study provides health utilities for a range of BT health states from the UK general population perspective. Importantly, lower transfusion burden and lower burden of anemia were associated with higher utilities. To a lesser extent, differential modes of ICT were found to impact utility valuations in patients with BT. The utilities obtained in this study can be employed as inputs in cost-effectiveness analyses of BT therapies.
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Affiliation(s)
| | | | | | - Manoj Chevli
- Celgene Ltd, a Bristol-Myers Squibb Company, Uxbridge, UK
| | | | - Louise Maher
- Celgene Ltd, a Bristol-Myers Squibb Company, Uxbridge, UK
| | | | | | | | | | - Juan M Ramos-Goñi
- Formerly Axentiva Solutions, Tacoronte, Santa Cruz de Tenerife, Spain
| | - Mark Oppe
- Formerly Axentiva Solutions, Tacoronte, Santa Cruz de Tenerife, Spain
| | - Derek Tang
- Bristol Myers Squibb, Princeton, NJ, USA
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3
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Woollacott I, Morgan G, Chowdary P, O'Hara J, Franks B, van Overbeeke E, Dunn N, Michelsen S, Huys I, Martin A, Cawson M, Brownrigg J, Winburn I, Thomson J. Examining patient and professional perspectives in the UK for gene therapy in haemophilia. Haemophilia 2022; 28:588-609. [PMID: 35438818 PMCID: PMC9546085 DOI: 10.1111/hae.14572] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Abstract
Introduction With the development of gene therapy for people with haemophilia (PWH), it is important to understand how people impacted by haemophilia (PIH) and clinicians prioritise haemophilia treatment attributes to support informed treatment decisions. Objective To examine the treatment attribute preferences of PIH and clinical experts in the United Kingdom (UK) and to develop a profile of gene therapy characteristics fit for use in future discrete choice experiments (DCEs). Methods Semi‐structured interviews were conducted with PIH (n = 14) and clinical experts (n = 6) who ranked pre‐defined treatment attributes by importance. Framework analysis was conducted to identify key themes and treatment attributes; points were allocated based on the rankings. Synthesis of results by a multidisciplinary group informed development of a profile of gene therapy characteristics for use in future research. Results Key themes identified by PIH and clinical experts included patient relevant features and the importance of ‘informed decision making'. The six top‐ranked treatment attributes were ‘effect on factor level’ (79 points), ‘uncertainty regarding long‐term risks’ (57 points), ‘impact on daily life’ (41 points), ‘frequency of monitoring’ (33 points), ‘impact on ability to participate in physical activity’ (29 points), and ‘uncertainty regarding long‐term benefits’ (28 points). The final treatment characteristics were categorised as therapeutic option, treatment effectiveness, safety concerns, impact on self‐management and quality of life (role limitations). Conclusion We identified several gene therapy characteristics important to PIH and clinicians in the UK. These characteristics will be used in a future DCE to further investigate patient preferences for gene therapy.
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Affiliation(s)
| | | | - Pratima Chowdary
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK
| | - Jamie O'Hara
- HCD Economics, Daresbury, UK.,Faculty of Health and Social Care, University of Chester, Chester, UK
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4
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Morgan G, Brighton S, Laffan M, Goudemand J, Franks B, Finnegan A. The Cost of Von Willebrand Disease in Europe: The CVESS Study. Clin Appl Thromb Hemost 2022; 28:10760296221120583. [PMID: 35979588 PMCID: PMC9393670 DOI: 10.1177/10760296221120583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Von Willebrand disease (VWD) is one of the most common inherited bleeding
disorders, imposing a substantial health impact and financial burden. The
Cost of von Willebrand disease in
Europe: A Socioeconomic Study
(CVESS) characterises the socio-economic cost of VWD across Germany, Spain,
Italy, France, and the UK. Methods A retrospective, cross-sectional design captured 12 months of patient disease
management, collected from August-December 2018, for 974 patients. This
enabled estimation of direct medical, direct non-medical and indirect costs,
utilising prevalence estimates to extrapolate to population level. Results Total annual direct medical cost (including/excluding von Willebrand factor
[VWF]) across all countries was the highest cost
(€2 845 510 345/€444 446 023), followed by indirect costs (€367 330 271) and
direct non-medical costs (€60 223 234). Differences were seen between
countries: the UK had the highest direct medical costs excluding VWF
(€159 791 064), Italy the highest direct-non medical (€26 564 496), and
Germany the highest indirect cost burden (€197 036 052). Total direct
medical costs per adult patient increased across VWD types with Type 1
having the lowest cost (€23 287) and Type 3 having the highest cost
(€133 518). Conclusion A substantial financial burden arises from the prevalence of VWD for the
European healthcare systems considered.
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Affiliation(s)
| | | | - Mike Laffan
- Centre for Haematology, Department of Immunology and Inflammation, 216773Imperial College London, London, UK
| | - Jenny Goudemand
- Department of Hemostasis and Transfusion, 26902Lille University Hospital, Lille, France
| | | | - Alan Finnegan
- 41953Faculty of Health and Social Care, University of Chester, Chester, UK
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Ruiz-Casas L, Pedra G, Shaikh A, Franks B, Dhillon H, Fernandes JDDR, Mangla KK, Augusto M, Schattenberg JM, Romero-Gómez M. Clinical and sociodemographic determinants of disease progression in patients with nonalcoholic steatohepatitis in the United States. Medicine (Baltimore) 2021; 100:e28165. [PMID: 34918671 PMCID: PMC8677997 DOI: 10.1097/md.0000000000028165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/17/2021] [Indexed: 01/05/2023] Open
Abstract
One fifth of patients with nonalcoholic fatty liver disease (NAFLD) may progress to nonalcoholic steatohepatitis (NASH), which can increase the risk of cirrhosis, cancer, and death. To date, reported predictors of NASH progression have been heterogeneous.We identified determinants of fibrosis progression in patients with NASH in the United States using physician-reported data from the real-world Global Assessment of the Impact of NASH (GAIN) study, including demographics and clinical characteristics, NASH diagnostic information, fibrosis stage, comorbidities, and treatment. We developed a logistic regression model to assess the likelihood of fibrosis progression since diagnosis, controlling for sociodemographic and clinical variables. An iterative nested model selection approach using likelihood ratio test determined the final model.A total of 989 patients from the GAIN US cohort were included; 46% were women, 58% had biopsy-proven NAFLD, and 74% had fibrosis stage F0-F2 at diagnosis. The final multivariable model included age, years since diagnosis, sex, employment status, smoking status, obesity, fibrosis stage, diagnostic biopsy, Vitamin E, and liver transplant proposed at diagnosis. Odds of progression were 17% higher (odds ratio, 1.17 [95% CI: 1.11-1.23]; P < .001) with each year since NASH diagnosis, 41% lower (0.59 [0.38-0.90]; P = .016) for women than men, 131% higher (2.31 [1.30-4.03]; P = .004) for smokers versus non-smokers, and 89% higher (1.89 [1.26-2.86]; P = .002) with obesity. Odds of progression were also higher with part-time, retired, unemployed, and unable to work due to NASH status versus full-time employment, and when a liver transplant was proposed at diagnosis.Disease duration and severity, obesity, smoking, and lack of full-time employment were significant determinants of fibrosis progression. These findings can support clinical and health-policy decisions to improve NASH management in the US.
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Affiliation(s)
| | | | - Anum Shaikh
- HCD Economics, Daresbury, Cheshire, United Kingdom
| | | | | | | | | | | | - Jörn M. Schattenberg
- Metabolic Liver Research Program, University Medical Center Mainz, Mainz, Germany
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6
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O'Hara J, Finnegan A, Dhillon H, Ruiz-Casas L, Pedra G, Franks B, Morgan G, Hebditch V, Jönsson B, Mabhala M, Reic T, Van Thiel I, Ratziu V, Romero-Gomez M, Bugianesi E, Schattenberg JM, Anstee QM. Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study. JHEP Rep 2020; 2:100142. [PMID: 32775976 PMCID: PMC7397699 DOI: 10.1016/j.jhepr.2020.100142] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 02/06/2023] Open
Abstract
Background & Aims Non-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. Methods The Global Assessment of the Impact of NASH (GAIN) study is a prevalence-based burden of illness study across Europe (France, Germany, Italy, Spain, and the UK) and the USA. Physicians provided demographic, clinical, and economic patient information via an online survey. In total, 3,754 patients found to have NASH on liver biopsy were stratified by fibrosis score and by biomarkers as either early or advanced fibrosis. Per-patient costs were estimated using national unit price data and extrapolated to the population level to calculate the economic burden. Of the patients, 767 (20%) provided information on indirect costs and health-related quality of life using the EuroQOL 5-D (EQ-5D; n = 749) and Chronic Liver Disease Questionnaire – Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD) (n = 723). Results Mean EQ-5D and CLDQ-NAFLD index scores were 0.75 and 4.9, respectively. For 2018, the mean total annual per patient cost of NASH was €2,763, €4,917, and €5,509 for direct medical, direct non-medical, and indirect costs, respectively. National per-patient cost was highest in the USA and lowest in France. Costs increased with fibrosis and decompensation, driven by hospitalisation and comorbidities. Indirect costs were driven by work loss. Conclusions The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in Europe and the USA, showing a substantial burden on health services and individuals. Lay summary There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in five European countries (UK, France, Germany, Spain, and Italy) and the USA. Mean total annual per patient cost of NASH was estimated at €2,763, €4,917, and €5,509 for the direct medical, direct non-medical, and indirect cost categories, respectively. There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). Direct medical, direct non-medical and indirect costs resulting from NASH were captured in a real-world setting. Extrapolating the per-patient cost to a population level demonstrates the rising prevalence of NASH and related comorbidities.
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Key Words
- CLDQ, Chronic Liver Disease Questionnaire
- CLDQ-NAFLD, Chronic Liver Disease Questionnaire – Non-Alcoholic Fatty Liver Disease
- CRF, case record form
- Cost of illness
- Cross-sectional studies
- EU5, five European
- Europe
- FIB-4, Fibrosis-4
- GAIN, Global Assessment of the Impact of NASH
- HRQoL, health-related quality of life
- NAFL non-alcoholic fatty liver NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- Non-alcoholic steatohepatitis
- OTC, over-the-counter
- PPIE, Patient Public Involvement Engagement
- T2DM, type 2 diabetes mellitus
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Affiliation(s)
- Jamie O'Hara
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | - Alan Finnegan
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | | | | | | | | | | | | | | | - Mzwandile Mabhala
- Faculty of Health and Social Care, University of Chester, Chester, UK
| | - Tatjana Reic
- Croatian Association for Liver Diseases (Hepatos), Split, Croatia
| | | | | | | | | | - Jörn M Schattenberg
- Metabolic Liver Research Program I, Department of Medicine, University Medical Center Main, Mainz, Germany
| | - Quentin M Anstee
- Institute of Translational and Clinical Research, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK
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8
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Franks B, Champagne FA, Curley JP. Postnatal maternal care predicts divergent weaning strategies and the development of social behavior. Dev Psychobiol 2015; 57:809-17. [PMID: 26095875 DOI: 10.1002/dev.21326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/01/2015] [Indexed: 12/25/2022]
Abstract
Maternal care experienced during postnatal development predicts long-term neurobiological and behavioral outcomes. However, the cascade of behavioral changes that emerge in response to maternal care has not been elucidated. In the current study, we examine naturally occurring variation in postnatal licking/grooming (LG) in C57BL/6J mice to determine its impact on preweaning maternal and pup behavior, the weaning process, the pace of developmental change, the emergence of social behavior, and indices of anxiety-like behavior in adulthood. Our analyses indicate that lower postnatal LG is associated with truncated and more infrequent maternal behavior during the preweaning period. Moreover, compared to High LG dams, Low LG dams are observed to actively wean their offspring sooner and have offspring that play more frequently. The heightened pace of developmental change observed in offspring of Low LG dams suggests a more rapid transition to behavioral and nutritional independence, which could have implications for future reproductive strategies.
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Affiliation(s)
- B Franks
- Animal Welfare Program, University of British Columbia, Vancouver, BC, Canada, V6T 1Z4
| | - F A Champagne
- Department of Psychology, Columbia University, New York, NY, 10027
| | - J P Curley
- Department of Psychology, Columbia University, New York, NY, 10027.
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Wagg A, Franks B, Ramos B, Berner T. Persistence And Adherence With Mirabegron, A New Beta-3 Receptor Agonist, Versus Antimuscarinics In Overactive Bladder: Early Experience In Canada. Value Health 2014; 17:A471. [PMID: 27201349 DOI: 10.1016/j.jval.2014.08.1336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Wagg
- University of Alberta, Edmonton, AB, Canada
| | - B Franks
- Astellas Scientific and Medical Affairs, Inc., Northbrook, IL, USA
| | - B Ramos
- Astellas Pharma Canada, Inc, Markham, ON, Canada
| | - T Berner
- Astellas Scientific and Medical Affairs, Inc., Northbrook, IL, USA
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10
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Neofytos D, Huprikar S, Reboli A, Schuster M, Azie N, Franks B, Horn D. Treatment and outcomes of Candida osteomyelitis: review of 53 cases from the PATH Alliance® registry. Eur J Clin Microbiol Infect Dis 2013; 33:135-41. [DOI: 10.1007/s10096-013-1939-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/22/2013] [Indexed: 11/30/2022]
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11
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Rostaing L, Charpentier B, Glyda M, Rigotti P, Hettich F, Franks B, Houbiers JGA, First R, Holman JM. Alefacept combined with tacrolimus, mycophenolate mofetil and steroids in de novo kidney transplantation: a randomized controlled trial. Am J Transplant 2013; 13:1724-33. [PMID: 23730730 DOI: 10.1111/ajt.12303] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 03/01/2013] [Accepted: 03/21/2013] [Indexed: 01/25/2023]
Abstract
Memory T cells play a central role in mediating allograft rejection and are a rational target for immunosuppressive therapy. Alefacept is a recombinant LFA3/IgG1 fusion protein that reduces the number of memory T cells in both psoriatic lesions and the peripheral circulation of psoriasis patients. This study evaluated the efficacy and safety of alefacept compared with placebo when combined with tacrolimus, mycophenolate mofetil and corticosteroids in de novo renal transplant recipients. Between December 2007 and March 2009 patients were randomized in a double-blind fashion to receive alefacept (n = 105) or placebo (n = 107) for 3 months and were then followed for a further 3 months. The primary efficacy endpoint was the incidence of biopsy-confirmed acute T cell mediated rejection (Banff grade ≥ 1) through Month 6. Memory T cell counts were significantly reduced in the alefacept group from Week 3 to study end compared with placebo. However, there was no significant difference between the alefacept and placebo groups for the primary efficacy endpoint (alefacept, 11.0% vs. placebo, 7.0%, p = 0.3). Patient and graft survival as well as renal function was similar between treatment groups. Safety and tolerability were generally similar between the treatment arms. Malignancy was higher in the alefacept treatment arm.
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Affiliation(s)
- L Rostaing
- Toulouse University Hospital, Toulouse, France
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12
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Curley JP, Jensen CL, Franks B, Champagne FA. Variation in maternal and anxiety-like behavior associated with discrete patterns of oxytocin and vasopressin 1a receptor density in the lateral septum. Horm Behav 2012; 61:454-61. [PMID: 22300676 PMCID: PMC3312967 DOI: 10.1016/j.yhbeh.2012.01.013] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/15/2012] [Accepted: 01/17/2012] [Indexed: 02/03/2023]
Abstract
The relationship between anxiety and maternal behavior has been explored across species using a variety of approaches, yet there is no clear consensus on the nature or direction of this relationship. In the current study, we have assessed stable individual differences in anxiety-like behavior in a large cohort (n=57) of female F2 hybrid mice. Using open-field behavior as a continuous and categorical (high vs. low) measure we examined the relationship between the anxiety-like behavior of virgin F2 females and the subsequent maternal behavior of these females. In addition, we quantified oxytocin (OTR) and vasopressin (V1a) receptor density within the lateral septum to determine the possible correlation with anxiety-like and maternal behavior. We find that, though activity levels within the open-field do predict latency to engage in pup retrieval, anxiety-like measures on this test are otherwise not associated with subsequent maternal behavior. OTR density in the dorsal lateral septum was found to be negatively correlated with activity levels in the open-field and positively correlated with frequency of nursing behavior. V1a receptor density was significantly correlated with postpartum licking/grooming of pups. Though we do not find support for the hypothesis that individual differences in trait anxiety predict variation in maternal behavior, we do find evidence for the role of OTR and V1a receptors in predicting maternal behavior in mice and suggest possible methodological issues (such as distinguishing between trait and state anxiety) that will be a critical consideration for subsequent studies of the anxiety-maternal behavior relationship. This article is part of a Special Issue entitled Oxytocin, Vasopressin, and Social Behavior.
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Affiliation(s)
- J P Curley
- Columbia University, Department of Psychology, 1190 Amsterdam Avenue, Room 406 Schermerhorn Hall, New York, NY 10025, USA.
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13
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Franks B, Corzine J. Senate candidates answer health care questions. N J Med 2000; 97:20-3. [PMID: 11011548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Franks B. Doctors know best. N J Med 2000; 97:27-8. [PMID: 10647246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Abstract
The essentialist approach to word meaning has been used to undermine the fundamental assumptions of the cognitive psychology of concepts. Essentialism assumes that a word refers to a natural kind category in virtue of category members possessing essential properties. In support of this thesis, Kripke and Putnam deploy various intuitions concerning word use under circumstances in which discoveries about natural kinds are made. Although some studies employing counterfactual discoveries and related transformations appear to vindicate essentialism, we argue that the intuitions have not been investigated exhaustively. In particular, we argue that discoveries concerning the essential properties of whole categories (rather than simply of particular category members) are critical to the essentialist intuitions. The studies reported here examine such discovery contexts, and demonstrate that words and concepts are not used in accordance with essentialism. The results are, however, consistent with "representational change" views of concepts, which are broadly Fregean in their motivation. We conclude that since essentialism is not vindicated by ordinary word use, it fails to undermine the cognitive psychology of concepts.
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Affiliation(s)
- N Braisby
- Department of Psychology, London Guildhall University, UK
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