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Trevail AM, Nicoll MAC, Freeman R, Le Corre M, Schwarz J, Jaeger A, Bretagnolle V, Calabrese L, Feare C, Lebarbenchon C, Norris K, Orlowski S, Pinet P, Plot V, Rocamora G, Shah N, Votier SC. Tracking seabird migration in the tropical Indian Ocean reveals basin-scale conservation need. Curr Biol 2023; 33:5247-5256.e4. [PMID: 37972589 DOI: 10.1016/j.cub.2023.10.060] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/20/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
Understanding marine predator distributions is an essential component of arresting their catastrophic declines.1,2,3,4 In temperate, polar, and upwelling seas, predictable oceanographic features can aggregate migratory predators, which benefit from site-based protection.5,6,7,8 In more oligotrophic tropical waters, however, it is unclear whether environmental conditions create similar multi-species hotspots. We track the non-breeding movements and habitat preferences of a tropical seabird assemblage (n = 348 individuals, 9 species, and 10 colonies in the western Indian Ocean), which supports globally important biodiversity.9,10,11,12 We mapped species richness from tracked populations and then predicted the same diversity measure for all known Indian Ocean colonies. Most species had large non-breeding ranges, low or variable residency patterns, and specific habitat preferences. This in turn revealed that maximum species richness covered >3.9 million km2, with no focused aggregations, in stark contrast to large-scale tracking studies in all other ocean basins.5,6,7,13,14 High species richness was captured by existing marine protected areas (MPAs) in the region; however, most occurred in the unprotected high seas beyond national jurisdictions. Seabirds experience cumulative anthropogenic impacts13 and high mortality15,16 during non-breeding. Therefore, our results suggest that seabird conservation in the tropical Indian Ocean requires an ocean-wide perspective, including high seas legislation.17 As restoration actions improve the outlook for tropical seabirds on land18,19,20,21,22 and environmental change reshapes the habitats that support them at sea,15,16 appropriate marine conservation will be crucial for their long-term recovery and whole ecosystem restoration.
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Affiliation(s)
- Alice M Trevail
- Environment and Sustainability Institute, University of Exeter, Penryn TR10 9FE, UK.
| | - Malcolm A C Nicoll
- Institute of Zoology, Zoological Society of London, Regent's Park, London NW14RY, UK
| | - Robin Freeman
- Institute of Zoology, Zoological Society of London, Regent's Park, London NW14RY, UK
| | - Matthieu Le Corre
- Écologie marine tropicale des océans Pacifique et Indien, UMR ENTROPIE, Université de la Réunion, 15 Avenue René Cassin, BP 7151, 97715 Saint Denis, La Réunion, France
| | - Jill Schwarz
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Audrey Jaeger
- Écologie marine tropicale des océans Pacifique et Indien, UMR ENTROPIE, Université de la Réunion, 15 Avenue René Cassin, BP 7151, 97715 Saint Denis, La Réunion, France
| | - Vincent Bretagnolle
- Centre d'Etudes Biologiques de Chizé (CEBC-CNRS), 79360 Beauvoir sur Niort, France
| | - Licia Calabrese
- Centre d'Etudes Biologiques de Chizé (CEBC-CNRS), 79360 Beauvoir sur Niort, France; Island Conservation Society, Pointe Larue, Mahé P.O Box 775, Seychelles; Island Biodiversity and Conservation Centre of the University of Seychelles, Anse Royale, Mahé, Seychelles
| | - Chris Feare
- WildWings Bird Management, 2 North View Cottages, Grayswood Common, Haslemere, Surrey GU27 2DN, UK; School of Biological, Earth and Environmental Sciences, Faculty of Science, University of New South Wales (UNSW), NSW, Sydney 2052, Australia
| | - Camille Lebarbenchon
- Université de la Réunion, UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), INSERM 1187, CNRS 9192, IRD 249, Saint Denis, La Réunion, France
| | - Ken Norris
- Natural History Museum, Cromwell Road, London SW7 5BD, UK
| | - Sabine Orlowski
- Écologie marine tropicale des océans Pacifique et Indien, UMR ENTROPIE, Université de la Réunion, 15 Avenue René Cassin, BP 7151, 97715 Saint Denis, La Réunion, France
| | - Patrick Pinet
- Parc national de La Réunion, Life+ Pétrels. 258 Rue de la République, 97431 Plaine des Palmistes, La Réunion, France
| | - Virginie Plot
- Écologie marine tropicale des océans Pacifique et Indien, UMR ENTROPIE, Université de la Réunion, 15 Avenue René Cassin, BP 7151, 97715 Saint Denis, La Réunion, France
| | - Gerard Rocamora
- Centre d'Etudes Biologiques de Chizé (CEBC-CNRS), 79360 Beauvoir sur Niort, France; Island Biodiversity and Conservation Centre of the University of Seychelles, Anse Royale, Mahé, Seychelles
| | - Nirmal Shah
- Nature Seychelles, P.O. Box 1310, The Centre for Environment and Education, Roche Caiman, Mahé, Seychelles; The Centre for Environment and Education, Roche Caiman, Mahé, Seychelles
| | - Stephen C Votier
- The Lyell Centre, Heriot-Watt University, Edinburgh EH14 4AS, UK.
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Clark BL, Carneiro APB, Pearmain EJ, Rouyer MM, Clay TA, Cowger W, Phillips RA, Manica A, Hazin C, Eriksen M, González-Solís J, Adams J, Albores-Barajas YV, Alfaro-Shigueto J, Alho MS, Araujo DT, Arcos JM, Arnould JPY, Barbosa NJP, Barbraud C, Beard AM, Beck J, Bell EA, Bennet DG, Berlincourt M, Biscoito M, Bjørnstad OK, Bolton M, Booth Jones KA, Borg JJ, Bourgeois K, Bretagnolle V, Bried J, Briskie JV, Brooke MDL, Brownlie KC, Bugoni L, Calabrese L, Campioni L, Carey MJ, Carle RD, Carlile N, Carreiro AR, Catry P, Catry T, Cecere JG, Ceia FR, Cherel Y, Choi CY, Cianchetti-Benedetti M, Clarke RH, Cleeland JB, Colodro V, Congdon BC, Danielsen J, De Pascalis F, Deakin Z, Dehnhard N, Dell'Omo G, Delord K, Descamps S, Dilley BJ, Dinis HA, Dubos J, Dunphy BJ, Emmerson LM, Fagundes AI, Fayet AL, Felis JJ, Fischer JH, Freeman AND, Fromant A, Gaibani G, García D, Gjerdrum C, Gomes ISGC, Forero MG, Granadeiro JP, Grecian WJ, Grémillet D, Guilford T, Hallgrimsson GT, Halpin LR, Hansen ES, Hedd A, Helberg M, Helgason HH, Henry LM, Hereward HFR, Hernandez-Montero M, Hindell MA, Hodum PJ, Imperio S, Jaeger A, Jessopp M, Jodice PGR, Jones CG, Jones CW, Jónsson JE, Kane A, Kapelj S, Kim Y, Kirk H, Kolbeinsson Y, Kraemer PL, Krüger L, Lago P, Landers TJ, Lavers JL, Le Corre M, Leal A, Louzao M, Madeiros J, Magalhães M, Mallory ML, Masello JF, Massa B, Matsumoto S, McDuie F, McFarlane Tranquilla L, Medrano F, Metzger BJ, Militão T, Montevecchi WA, Montone RC, Navarro-Herrero L, Neves VC, Nicholls DG, Nicoll MAC, Norris K, Oppel S, Oro D, Owen E, Padget O, Paiva VH, Pala D, Pereira JM, Péron C, Petry MV, de Pina A, Pina ATM, Pinet P, Pistorius PA, Pollet IL, Porter BJ, Poupart TA, Powell CDL, Proaño CB, Pujol-Casado J, Quillfeldt P, Quinn JL, Raine AF, Raine H, Ramírez I, Ramos JA, Ramos R, Ravache A, Rayner MJ, Reid TA, Robertson GJ, Rocamora GJ, Rollinson DP, Ronconi RA, Rotger A, Rubolini D, Ruhomaun K, Ruiz A, Russell JC, Ryan PG, Saldanha S, Sanz-Aguilar A, Sardà-Serra M, Satgé YG, Sato K, Schäfer WC, Schoombie S, Shaffer SA, Shah N, Shoji A, Shutler D, Sigurðsson IA, Silva MC, Small AE, Soldatini C, Strøm H, Surman CA, Takahashi A, Tatayah VRV, Taylor GA, Thomas RJ, Thompson DR, Thompson PM, Thórarinsson TL, Vicente-Sastre D, Vidal E, Wakefield ED, Waugh SM, Weimerskirch H, Wittmer HU, Yamamoto T, Yoda K, Zavalaga CB, Zino FJ, Dias MP. Global assessment of marine plastic exposure risk for oceanic birds. Nat Commun 2023; 14:3665. [PMID: 37402727 DOI: 10.1038/s41467-023-38900-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/19/2023] [Indexed: 07/06/2023] Open
Abstract
Plastic pollution is distributed patchily around the world's oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species.
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Affiliation(s)
| | | | - Elizabeth J Pearmain
- BirdLife International, Cambridge, UK.
- Department of Zoology, University of Cambridge, Cambridge, UK.
- British Antarctic Survey, Natural Environment Research Council, Cambridge, UK.
| | | | - Thomas A Clay
- Institute of Marine Sciences, University of California Santa Cruz, Santa Cruz, CA, USA
- People and Nature, Environmental Defense Fund, Monterey, CA, USA
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - Win Cowger
- University of California, Riverside, CA, USA
| | - Richard A Phillips
- British Antarctic Survey, Natural Environment Research Council, Cambridge, UK
| | - Andrea Manica
- Department of Zoology, University of Cambridge, Cambridge, UK
| | - Carolina Hazin
- BirdLife International, Cambridge, UK
- The Nature Conservancy, London, UK
| | | | - Jacob González-Solís
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Josh Adams
- U.S. Geological Survey, Western Ecological Research Center, Santa Cruz Field Station, Santa Cruz, CA, USA
| | - Yuri V Albores-Barajas
- Universidad Autonoma de Baja California Sur - UABCS, La Paz, Mexico
- Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico
| | - Joanna Alfaro-Shigueto
- Carrera de Biologia Marina, Universidad Cientifica del Sur, Lima, Peru
- ProDelphinus, Lima, Peru
- University of Exeter, School of Biosciences, Cornwall Campus, Exeter, UK
| | - Maria Saldanha Alho
- MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Ispa - Instituto Universitário, Lisbon, Portugal
| | | | | | | | | | - Christophe Barbraud
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | - Annalea M Beard
- St. Helena Government, Jamestown, St. Helena, UK
- Cardiff University, Cardiff, UK
| | - Jessie Beck
- Oikonos Ecosystem Knowledge, Santa Cruz, CA, USA
| | | | - Della G Bennet
- School of Biological Sciences, University of Canterbury, Christchurch, New Zealand
| | | | - Manuel Biscoito
- Marine and Environmental Sciences Centre (MARE), Museu de História Natural do Funchal, Funchal, Portugal
| | | | - Mark Bolton
- RSPB Centre for Conservation Science, Aberdeen, UK
| | | | - John J Borg
- National Museum of Natural History, Mdina, Malta
| | - Karen Bourgeois
- 3 Institut Méditerranéen de Biodiversité et d'Ecologie marine et continentale (IMBE), Aix Marseille Université, CNRS, IRD, Avignon Université, Nouméa, New Caledonia, France
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Vincent Bretagnolle
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | - Joël Bried
- Institute of Marine Sciences - OKEANOS, University of the Azores, 9901-862, Horta, Portugal
| | - James V Briskie
- School of Biological Sciences, University of Canterbury, Christchurch, New Zealand
| | - M de L Brooke
- Department of Zoology, University of Cambridge, Cambridge, UK
| | | | - Leandro Bugoni
- Universidade Federal do Rio Grande - FURG, Rio Grande, Brazil
| | - Licia Calabrese
- Island Conservation Society, Mahé, Seychelles
- Université Pierre et Marie Curie, Paris, France
- Island Biodiversity and Conservation Centre, University of Seychelles, Anse Royale, Seychelles
| | - Letizia Campioni
- MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Ispa - Instituto Universitário, Lisbon, Portugal
| | - Mark J Carey
- Department of Environmental Management and Ecology, La Trobe University, Wodonga, NSW, Australia
| | - Ryan D Carle
- Oikonos Ecosystem Knowledge, Santa Cruz, CA, USA
| | - Nicholas Carlile
- Science, Economics and Insights Division, Department of Planning and Environment, Sydney, Australia
| | - Ana R Carreiro
- University of Coimbra, MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Department of Life Sciences, Coimbra, Portugal
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Campus Agrário de Vairão, Fornelo e Vairão, Portugal
| | - Paulo Catry
- MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Ispa - Instituto Universitário, Lisbon, Portugal
| | - Teresa Catry
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Jacopo G Cecere
- Area Avifauna Migratrice, Istituto Superiore per la Protezione e la Ricerca Ambientale (ISPRA), Ozzano dell'Emilia, Italy
| | - Filipe R Ceia
- University of Coimbra, MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Department of Life Sciences, Coimbra, Portugal
| | - Yves Cherel
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | - Chang-Yong Choi
- Department of Agriculture, Forestry, and Bioresources, Seoul National University, Seoul, South Korea
| | | | - Rohan H Clarke
- School of Biological Sciences, Monash University, Melbourne, VIC, Australia
| | - Jaimie B Cleeland
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, Australia
- Australian Antarctic Division, Kingston, TAS, Australia
| | | | - Bradley C Congdon
- College of Science and Engineering, James Cook University, Cairns, Australia
| | | | - Federico De Pascalis
- Area Avifauna Migratrice, Istituto Superiore per la Protezione e la Ricerca Ambientale (ISPRA), Ozzano dell'Emilia, Italy
- Department of Environmental Science and Policy, University of Milan, Milan, Italy
| | - Zoe Deakin
- Cardiff University, Cardiff, UK
- RSPB Centre for Conservation Science, Cambridge, UK
| | - Nina Dehnhard
- Norwegian Institute for Nature Research (NINA), Trondheim, Norway
- Department of Biology, Behavioural Ecology and Ecophysiology Group, University of Antwerp, Antwerp, Belgium
| | | | - Karine Delord
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | | | - Ben J Dilley
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | | | - Jerome Dubos
- UMR ENTROPIE, Université de la Réunion, Saint-Denis, Réunion, France
| | - Brendon J Dunphy
- Institute of Marine Sciences/School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | | | | | - Annette L Fayet
- Norwegian Institute for Nature Research (NINA), Trondheim, Norway
- Department of Biology, University of Oxford, Oxford, UK
| | - Jonathan J Felis
- U.S. Geological Survey, Western Ecological Research Center, Santa Cruz Field Station, Santa Cruz, CA, USA
- United States Geological Survey, Santa Cruz, CA, USA
| | - Johannes H Fischer
- Island Conservation Society, Mahé, Seychelles
- Aquatic Unit, Department of Conservation, Wellington, New Zealand
| | | | - Aymeric Fromant
- Deakin University, Burwood, VIC, Australia
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | | | - David García
- Iniciativa de Recerca de la Biodiversitat de les Illes (IRBI), Pina, Spain
| | - Carina Gjerdrum
- Canadian Wildlife Service, Environment and Climate Change Canada, Dartmouth, Nova Scotia, Canada
| | | | - Manuela G Forero
- Departamento de Biología de la Conservación, Estación Biológica de Doñana (EBD), Consejo Superior de Investigaciones Científicas (CSIC), Sevilla, Spain
| | - José P Granadeiro
- Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa & CESAM - Centre for Environmental and Marine Studies, Lisboa, Portugal
| | | | - David Grémillet
- CEFE, Univ Montpellier, CNRS, EPHE, IRD, Montpellier, France
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | - Tim Guilford
- Department of Biology, University of Oxford, Oxford, UK
| | | | - Luke R Halpin
- Monash University, Clayton, VIC, Australia
- Halpin Wildlife Research, Vancouver, BC, Canada
| | | | - April Hedd
- Wildlife Research Division, Environment and Climate Change Canada, Mount Pearl, NC, Canada
| | - Morten Helberg
- Østfold University College, Halden, Norway
- BirdLife Norway, Sandgata 30 B, 7012, Trondheim, Norway
| | | | | | - Hannah F R Hereward
- Cardiff University, Cardiff, UK
- British Trust for Ornithology Cymru, Thoday Building, Deiniol Road, Bangor, Wales, UK
| | | | - Mark A Hindell
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, Australia
| | | | - Simona Imperio
- Area Avifauna Migratrice, Istituto Superiore per la Protezione e la Ricerca Ambientale (ISPRA), Ozzano dell'Emilia, Italy
- Institute of Geosciences and Earth Resources, CNR, Pisa, Italy
| | - Audrey Jaeger
- UMR ENTROPIE, Université de la Réunion, Saint-Denis, Réunion, France
| | - Mark Jessopp
- School of Biological, Earth & Environmental Sciences, University College Cork, Cork, Ireland
- MaREI Centre, Environmental Research Institute, University College Cork, Cork, Ireland
| | - Patrick G R Jodice
- U.S. Geological Survey South Carolina Cooperative Fish and Wildlife Research Unit, Clemson University, Clemson, SC, USA
| | - Carl G Jones
- Mauritian Wildlife Foundation, Vacoas, Mauritius
- Durrell Wildlife Conservation Trust, Trinity, Jersey
| | - Christopher W Jones
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | - Jón Einar Jónsson
- University of Iceland's Research Center at Snæfellsnes, Stykkishólmur, Iceland
| | - Adam Kane
- University College Dublin, Dublin, Ireland
| | | | - Yuna Kim
- Macquarie University, Sydney, Australia
| | | | | | - Philipp L Kraemer
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Giessen, Germany
| | - Lucas Krüger
- Instituto Antártico Chileno, Punta Arenas, Chile
- Instituto Milénio Biodiversidad de Ecosistemas Antárticos y Subantárticos (BASE), Santiago, Chile
| | - Paulo Lago
- SEO/BirdLife, Barcelona, Spain
- BirdLife Malta, Ta' Xbiex, Malta
| | - Todd J Landers
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
- Auckland Council, Auckland, New Zealand
| | - Jennifer L Lavers
- Tjaltjraak Native Title Aboriginal Corporation, Esperance, WA, Australia
| | - Matthieu Le Corre
- UMR ENTROPIE, Université de la Réunion, Saint-Denis, Réunion, France
| | - Andreia Leal
- Associação Projecto Vitó, São Filipe, Cabo Verde
| | | | - Jeremy Madeiros
- Dept. of Environment and Natural Resources, Bermuda Government, Flatts, Bermuda
| | - Maria Magalhães
- Regional Directorate for Marine Policies, Azores Government, Horta, Azores, Portugal
| | | | - Juan F Masello
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Giessen, Germany
| | - Bruno Massa
- Department of Agriculture, Food and Forest Sciences, University of Palermo, Palermo, Italy
| | | | - Fiona McDuie
- San Jose State University Research Foundation, San Jose, CA, USA
| | | | - Fernando Medrano
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | | | - Teresa Militão
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Leia Navarro-Herrero
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Verónica C Neves
- Institute of Marine Sciences - OKEANOS, University of the Azores, 9901-862, Horta, Portugal
- IMAR Instituto do Mar, Universidade dos Açores, Horta, Portugal
| | | | | | | | | | - Daniel Oro
- CEAB-CSIC, Centre d'Estudis Avançats de Blanes, Blanes, Spain
| | - Ellie Owen
- RSPB Centre for Conservation Science, Inverness, UK
- The National Trust for Scotland, Balnain House, Huntly Street, Inverness, UK
| | - Oliver Padget
- Department of Biology, University of Oxford, Oxford, UK
| | - Vítor H Paiva
- University of Coimbra, MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Department of Life Sciences, Coimbra, Portugal
| | - David Pala
- Parco naturale Regionale di Porto Conte, Alghero, Italy
| | - Jorge M Pereira
- University of Coimbra, MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Department of Life Sciences, Coimbra, Portugal
| | - Clara Péron
- Laboratoire de Biologie des Organismes et Ecosystèmes Aquatiques (UMR BOREA) - Muséum national d'Histoire Naturelle (MNHN), CNRS, IRD, SU, UCN, UA, Paris, France
| | - Maria V Petry
- Universidade do Vale do Rio dos Sinos - UNISINOS, São Leopoldo, Brazil
| | | | | | - Patrick Pinet
- Université de La Réunion, Saint-Denis, Réunion, France
| | - Pierre A Pistorius
- Marine Apex Predator Research Unit (MAPRU), Department of Zoology, Institute for Coastal and Marine Research, Nelson Mandela University, Port Elizabeth, South Africa
| | | | | | | | | | - Carolina B Proaño
- Max Planck Institute for Ornithology, Puerto Ayora, Galapagos Islands, Ecuador
| | - Júlia Pujol-Casado
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Petra Quillfeldt
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Giessen, Germany
| | - John L Quinn
- School of BEES, University College Cork, Cork, Ireland
| | - Andre F Raine
- Archipelago Research and Conservation, Kalaheo, HI, USA
| | - Helen Raine
- Archipelago Research and Conservation, Kalaheo, HI, USA
| | - Iván Ramírez
- Convention on Migratory Species (CMS), Bonn, Germany
| | - Jaime A Ramos
- University of Coimbra, MARE - Marine and Environmental Sciences Centre/ARNET - Aquatic Research Network, Department of Life Sciences, Coimbra, Portugal
| | - Raül Ramos
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Andreas Ravache
- UMR ENTROPIE (IRD, Université de La Réunion, CNRS, Université de La Nouvelle-Calédonie, Ifremer), Centre IRD Nouméa, Nouméa, New Caledonia, France
| | | | | | | | - Gerard J Rocamora
- Island Conservation Society, Mahé, Seychelles
- Island Biodiversity and Conservation Centre, University of Seychelles, Anse Royale, Seychelles
| | - Dominic P Rollinson
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | - Robert A Ronconi
- Canadian Wildlife Service, Environment and Climate Change Canada, Dartmouth, Nova Scotia, Canada
| | - Andreu Rotger
- Animal Demography and Ecology Unit (GEDA), IMEDEA (CSIC-UIB), Esporles, Spain
| | - Diego Rubolini
- Dipartimento di Scienze e Politiche Ambientali, Università degli Studi di Milano, Milano, Italy
- Istituto di Ricerca sulle Acque - Consiglio Nazionale delle Ricerche (IRSA-CNR), Brugherio, Italy
| | - Kevin Ruhomaun
- National Parks and Parks Conservation Service, Reduit, Mauritius
| | | | - James C Russell
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Peter G Ryan
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | - Sarah Saldanha
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Ana Sanz-Aguilar
- Animal Demography and Ecology Unit (GEDA), IMEDEA (CSIC-UIB), Esporles, Spain
- University of Balearic Islands, Palma, Spain
| | - Mariona Sardà-Serra
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Yvan G Satgé
- Department of Forestry and Environmental Conservation, Clemson University, Clemson, SC, USA
| | - Katsufumi Sato
- Atmosphere and Ocean Research Institute, University of Tokyo, Kashiwa City, Japan
| | - Wiebke C Schäfer
- Department of Animal Ecology and Systematics, Justus Liebig University Giessen, Giessen, Germany
| | - Stefan Schoombie
- FitzPatrick Institute of African Ornithology, DST-NRF Centre of Excellence, University of Cape Town, Cape Town, South Africa
| | - Scott A Shaffer
- Biological Sciences, San Jose State University, San Jose, CA, USA
| | | | | | | | | | - Mónica C Silva
- cE3c - Centre for Ecology, Evolution and Evolutionary Changes, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | | | - Cecilia Soldatini
- CICESE - Centro de Investigación Científica y de Educación Superior de Ensenada - Unidad La Paz, La Paz, Mexico
| | | | | | | | | | | | | | - David R Thompson
- National Institute of Water and Atmospheric Research Ltd, Wellington, New Zealand
| | | | | | - Diego Vicente-Sastre
- Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - Eric Vidal
- UMR ENTROPIE (IRD, UR, UNC, CNRS, IFREMER), Nouméa, New Caledonia, France
- UMR IMBE (IRD, AMU, CNRS, UAPV), Nouméa, France
| | | | | | - Henri Weimerskirch
- Centre d'Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, Villiers-en-Bois, France
| | - Heiko U Wittmer
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | | | - Ken Yoda
- Graduate School of Environmental Studies, Nagoya University, Nagoya, Japan
| | | | | | - Maria P Dias
- BirdLife International, Cambridge, UK
- cE3c - Centre for Ecology, Evolution and Evolutionary Changes, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
- CHANGE - Global Change and Sustainability Institute, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
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Calabrese C, Kirchner E, Husni ME, Moss B, Fernandez A, Jin Y, Calabrese L. POS0194 MORBIDITY AND MORTALITY OF BREAKTHROUGH COVID-19 IN PATIENTS WITH IMMUNE MEDIATED CONDITIONS ON B CELL DEPLETING THERAPIES AND THE EFFECTS OF MONOCLONAL ANTIBODY TREATMENT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAmong immunocompromised patients with immune mediated inflammatory diseases (IMIDs), those undergoing therapy with B cell depleting agents are among the most vulnerable to both severe COVID-19 disease and sub-optimal response to COVID-19 vaccines(1). Numerous studies have documented suppressed humoral, but relatively maintained cell mediated, responses to COVID-19 vaccines in these patients. However, the clinical significance of such immunity in terms of protection from infection and its sequelae are poorly understood. We have analyzed a large cohort of vaccinated IMIDs patients undergoing B cell depleting therapy for the presence of breakthrough infection and assessed their outcomes.Objectives:To define the frequency and outcomes of COVID-19 breakthrough infection in fully or partially vaccinated IMIDs patients receiving B cell depleting therapies.To assess the characteristics and risk factors for severe outcomes and death.MethodsAll pharmacy records from within a large health care system were electronically searched for patients undergoing B cell depleting therapies with approved monoclonal antibodies in 2020. Records with ICD codes for IMIDs but not malignancies were included; patients must also have had at least one documented COVID-19 vaccine. From this cohort all patients with breakthrough COVID-19 disease from time of 1st vaccination through December 15, 2021 were identified; each record was hand-reviewed to extract clinical data including vaccine history, demographics, comorbidities, use of monoclonal antibodies, dose and timing of B cell depleting therapy, and outcomes as assessed by an 8 point NIH ordinal scale. Univariate and multivariable logistic/proportional-odds regression models were used to examine the risk factors for severe outcomes.ResultsA total of 1677 IMIDs patients were identified who received any B cell depleting monoclonal antibody and at least one COVID-19 vaccine in 2021. From this cohort 74 patients (4.4%) experienced a breakthrough COVID-19 infection. Among the breakthrough patients 34 (46%) had a rheumatic disease (RA 11, AAV 15, SLE 2), 34 (46%) had CNS inflammatory disease (MS 32, 2 other), and 6 (8%) had immune hematologic/miscellaneous diseases. Four patients had a previous history of COVID-19 infection. Overall 24 (35%) were hospitalized with 11 patients requiring critical level care (15%) and 6 deaths (8 %). All fatal cases had rheumatic diseases. Monoclonal antibodies were given as outpatient therapy to 21 patients and among these only 1 patient was hospitalized without requiring O2 and none died. In univariate analysis only number of comorbidities had a significant positive effect (p=.001) on severe outcomes (i.e. groups 1-4 vs. groups 5-8: Table 1) while monoclonal antibody therapy was associated with more favorable outcomes (p=.005 group 1-2 vs.3-8, Table 1). There were no associations between the dose, duration or timing of the B cell therapy, concomitant therapies including glucocorticoids, vaccine status (incomplete, complete, boosted) or date of vaccination with severe outcomes.ConclusionIn IMIDs patients treated with B cell depleting therapies breakthrough infections are common with many experiencing severe outcomes. Concomitant comorbidities were associated with risk of severe disease. Monoclonal antibody therapy was used in only 28% but was associated with enhanced clinical outcomes with only 1 in 21 requiring hospitalization and zero mortality. This population of immunocompromised patients remains vulnerable to COVID-19 disease despite vaccination. More aggressive use of outpatient management with monoclonal antibody therapy and other preventive and therapeutic measures are urgently needed.Reference[1]Samuel Bitoun et al Rituximab impairs B-cell response but not T-cell response to COVID-19 vaccine in auto-immune diseases First published: 28 December 2021 Arthritis and Rheumatology https://doi.org/10.1002/art.42058Disclosure of Interestscassandra calabrese Speakers bureau: Sanofi-regeneron, Consultant of: Sanofi-regeneron, Elizabeth Kirchner Consultant of: Janssen, M Elaine Husni Consultant of: Abbvie, BMS, Novartis, Lilly, Pfizer, UCB, Regeneron, Janssen, Brandon Moss Consultant of: Biogen advisory board, Grant/research support from: Genentech/Roche and Novartis as part of investigator-initiated studies, Anthony Fernandez Consultant of: Consulting: AbbVie, Novartis, Mallinckrodt, UCB, BMS, Boehringer Ingelheim, Alexion, Grant/research support from: Research: AbbVie, Novartis, Pfizer, Corbus, Mallinckrodt, Yuxuan Jin: None declared, Leonard Calabrese Speakers bureau: Sanofi, Janssen, AbbVie, ChemoCentryx, GSK, AstraZeneca, Consultant of: Sanofi, Jansen, AbbVie, ChemoCentryx, GSK, AstraZeneca, BMS, Genentech
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Calabrese L, Valenza A. Modelling of Phase Transitions and Residual Thermal Stress of CTBN Rubber Modified Epoxy Resins during a Pultrusion Process. INT POLYM PROC 2022. [DOI: 10.1515/ipp-2007-0002] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The implicit finite difference and fourth order Runge-Kutta method are used both to solve the heat transfer problem in the pultrusion reaction and to calculate the temperature and conversion distributions within a thermoset composite profile. The aim of our work is to study the influence of a rubbery phase added to the epoxy matrix in production conditions. The results have shown that the rubber modified systems have a low exothermic temperature peak value, so that neither the amount of cured resin nor the final product properties are limited.
First of all we will show that the phase transition (gelation and vitrification) zones within the die change as the amount of rubber varies in the resin. The relationship between the position and of these zones and the resin systems will be discussed. We calculate the residual thermal stresses for all the investigated fibre/resin systems, showing a reduction when the rubber amount increases in the epoxy blend.
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Affiliation(s)
- L. Calabrese
- Dipartimento di Chimica Industriale e Ingegneria dei Materiali, University of Messina , S. Agata di Messina , Italy
| | - A. Valenza
- Dipartimento di Ingegneria Chimica dei Processi e dei Materiali, University of Palermo , Palermo , Italy
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Torres L, Pante E, González‐Solís J, Viricel A, Ribout C, Zino F, MacKin W, Precheur C, Tourmetz J, Calabrese L, Militão T, Zango L, Shirihai H, Bretagnolle V. Sea surface temperature, rather than land mass or geographic distance, may drive genetic differentiation in a species complex of highly dispersive seabirds. Ecol Evol 2021; 11:14960-14976. [PMID: 34765153 PMCID: PMC8571584 DOI: 10.1002/ece3.8180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/16/2020] [Revised: 06/27/2021] [Accepted: 07/19/2021] [Indexed: 11/09/2022] Open
Abstract
Seabirds, particularly Procellariiformes, are highly mobile organisms with a great capacity for long dispersal, though simultaneously showing high philopatry, two conflicting life-history traits that may lead to contrasted patterns of genetic population structure. Landmasses were suggested to explain differentiation patterns observed in seabirds, but philopatry, isolation by distance, segregation between breeding and nonbreeding zones, and oceanographic conditions (sea surface temperatures) may also contribute to differentiation patterns. To our knowledge, no study has simultaneously contrasted the multiple factors contributing to the diversification of seabird species, especially in the gray zone of speciation. We conducted a multilocus phylogeographic study on a widespread seabird species complex, the little shearwater complex, showing highly homogeneous morphology, which led to considerable taxonomic debate. We sequenced three mitochondrial and six nuclear markers on all extant populations from the Atlantic (lherminieri) and Indian Oceans (bailloni), that is, five nominal lineages from 13 populations, along with one population from the eastern Pacific Ocean (representing the dichrous lineage). We found sharp differentiation among populations separated by the African continent with both mitochondrial and nuclear markers, while only mitochondrial markers allowed characterizing the five nominal lineages. No differentiation could be detected within these five lineages, questioning the strong level of philopatry showed by these shearwaters. Finally, we propose that Atlantic populations likely originated from the Indian Ocean. Within the Atlantic, a stepping-stone process accounts for the current distribution. Based on our divergence time estimates, we suggest that the observed pattern of differentiation mostly resulted from historical and current variation in sea surface temperatures.
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Affiliation(s)
- Lucas Torres
- Centre d'Etudes Biologiques de ChizéUMR 7372CNRS ‐ La Rochelle UniversitéBeauvoir sur NiortFrance
- Laboratoire LIENSsUMR 7266CNRS ‐ La Rochelle UniversitéLa RochelleFrance
| | - Eric Pante
- Laboratoire LIENSsUMR 7266CNRS ‐ La Rochelle UniversitéLa RochelleFrance
| | - Jacob González‐Solís
- Department de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA)Institut de Recerca de la Biodiversitat (IRBio)Universitat de BarcelonaBarcelonaSpain
| | - Amélia Viricel
- Laboratoire LIENSsUMR 7266CNRS ‐ La Rochelle UniversitéLa RochelleFrance
| | - Cécile Ribout
- Centre d'Etudes Biologiques de ChizéUMR 7372CNRS ‐ La Rochelle UniversitéBeauvoir sur NiortFrance
| | | | - Will MacKin
- 3913 Sterling Ridge LnDurhamNorth CarolinaUSA
| | | | - Julie Tourmetz
- Société d'Etudes Ornithologiques de La RéunionSaint AndréFrance
| | - Licia Calabrese
- Island Conservation SocietyMahéSeychelles
- Faculty of Business & Sustainable DevelopmentIsland Biodiversity & Conservation CenterUniversity of SeychellesMahéSeychelles
| | - Teresa Militão
- Department de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA)Institut de Recerca de la Biodiversitat (IRBio)Universitat de BarcelonaBarcelonaSpain
| | - Laura Zango
- Department de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA)Institut de Recerca de la Biodiversitat (IRBio)Universitat de BarcelonaBarcelonaSpain
| | | | - Vincent Bretagnolle
- Centre d'Etudes Biologiques de ChizéUMR 7372CNRS ‐ La Rochelle UniversitéBeauvoir sur NiortFrance
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Calabrese L, Weinblatt ME, Shadick N, Heegaard Brahe C, Østergaard M, Hetland ML, Horton M, Flake D, Sasso E. POS0454 COMPARISON OF MBDA SCORE, PATIENT GLOBAL ASSESSMENT AND EVALUATOR GLOBAL ASSESSMENT FOR PREDICTING RISK OF RADIOGRAPHIC PROGRESSION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Busy rheumatologists may assess disease activity and risk for radiographic progression (RP) in RA with informal, qualitative versions of evaluator and/or patient global assessments (EGA and PGA). RA patient care may be improved by having a convenient, objective disease activity measure that predicts risk for RP more accurately than EGA or PGA.Objectives:To compare the abilities of MBDA score, patient global assessment and evaluator global assessment to assess risk for radiographic progression (RP), and to assess the ability of MBDA score to predict RP among patients with concordant or discordant PGA and EGA.Methods:Patients were pooled from two RCTs of patients with recent onset RA treated with conventional and biologic DMARDs (OPERA and SWEFOT, N=386) and from a registry of patients with predominantly established RA and diverse treatments (BRASS, N=380). Pearson correlations were determined between MBDA scores (adjusted for the effects of age, sex and adiposity) (scale 1-100), PGA and EGA (each on a scale of 1-10) at baseline. PGA and EGA were considered discordant when they differed by >2.5. Univariable logistic regression assessed ability to predict RP (change in TSS >5 over 1 year) for MBDA score, PGA and EGA as continuous variables; and for discordance of PGA and EGA as 2-level (concordant vs. discordant) or 3-level (PGA>EGA, concordant, EGA>PGA) categorical variables. Multivariable regression considered the main effect and interaction terms of the MBDA score, as a continuous variable, paired with each other variable, to test the ability of each pair to assess risk of RP. All models included a random effect on cohort. Odds ratios were reported for every 10-unit increase in MBDA score. Frequency of RP was determined in subgroups with MBDA score low (<30), moderate (30-44) or high (>44) for patient groups based on PGA/EGA concordance or discordance.Results:The 766 patients studied were 76% female, 76% positive for RF and/or anti-CCP Ab, with mean age 55 years, DAS28-CRP 4.7, CRP 22 mg/L, CDAI 26, SJC 9.1, PGA 4.4, EGA 3.4, MBDA score 53. No interaction was seen between MBDA score and type of cohort (early vs established RA). PGA and EGA were discordant in 294 of 766 (38%) patients and were weakly to moderately correlated (r=0.38). Among discordant patients, PGA was >EGA in 227 cases and EGA was >PGA in 67 cases. Correlations between MBDA score and PGA or EGA were r=0.41 and r=0.34, respectively. In univariable analyses, MBDA score was a statistically significant predictor of radiographic progression (OR=1.53, p=6.3x10-8) whereas PGA, EGA, 2-level discordance and 3-level discordance were not (p=0.38, 0.47, 0.74, 0.83, respectively). In multivariable analyses, significant interactions were observed between MBDA score and discordance (2-level, p=0.0029; 3-level, p=0.0087). The interaction analysis demonstrated, in PGA/EGA-concordant patients, low risk of radiographic progression when MBDA score was low and elevated risk when it was high (OR=1.33 [1.1, 1.59]). A relationship between MBDA score and RP risk was also demonstrated, with heightened trend, among discordant patients with PGA >EGA (OR=2.04 [1.53, 2.81]) and EGA >PGA (OR=3.43 [1.37, 13.8]) (Figure 1).Conclusion:MBDA score was a significant predictor of radiographic progression, whereas PGA and EGA were not. MBDA score predicted progression whether PGA and EGA were concordant or discordant. These results suggest that MBDA score detects joint-damaging disease activity more accurately than PGA and EGA and it does so whether or not PGA and EGA are in agreement.Disclosure of Interests:Leonard Calabrese Grant/research support from: AbbVie, Bristol-Myers Squibb, Cresecendo, Genentech, Gilead, GlaxoSmithKline, Horizon, Janssen, Novartis, and Sanofi., Michael E. Weinblatt Shareholder of: Canfite, Inmedix, Scipher, and Vorso, Consultant of: AbbVie, Aclaris, Amgen, Bayer, Bristol-Myers Squibb, Crescendo Bioscience, Corrona, EqRX, GSK,Genosco, Gilead, Lilly, Novartis, Pfizer, Roche, Set Point, Grant/research support from: Bristol-Myers Squibb, Myriad Genetics, Inc.,Eli Lilly and Sanofi, Nancy Shadick Consultant of: BMS, Grant/research support from: Lilly, mallinckrodt, BMS, Amgen and Sanofi, Cecilie Heegaard Brahe: None declared, Mikkel Østergaard Consultant of: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Centocor, GSK, Hospira, Janssen, Merck, Novartis, Orion, Pfizer, Regeneron, Roche, Takeda, and UCB, Grant/research support from: AbbVie, BMS, Celgene, Myriad Genetics, Inc., Janssen, and Merck, Merete L. Hetland Speakers bureau: Orion, Grant/research support from: AbbVie, Biogen, BMS, CelltrionRoche, Myriad Genetics, Inc., Eli Lily, MSD, Pfizer, and UCB, Megan Horton Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Darl Flake Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Eric Sasso Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Autoimmune
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Cohen SB, Van Vollenhoven R, Curtis JR, Calabrese L, Zerbini C, Tanaka Y, Bessette L, Richez C, Lagunes-Galindo I, Liu J, Camp H, Song Y, Anyanwu S, Burmester GR. POS0220 INTEGRATED SAFETY PROFILE OF UPADACITINIB WITH UP TO 4.5 YEARS OF EXPOSURE IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The safety and efficacy of the oral Janus kinase inhibitor upadacitinib (UPA) has been evaluated across a spectrum of patients with rheumatoid arthritis (RA) in the phase 3 SELECT clinical program.1–6Objectives:To describe the long-term integrated safety profile of UPA relative to active comparators (cutoff date: June 30, 2020) in patients with RA treated in the SELECT clinical program.Methods:This analysis included updated data from 6 randomized controlled UPA RA trials.1–6 Treatment-emergent adverse events (TEAEs; onset after first dose and ≤30 days after last dose of study drug or ≤70 days for adalimumab [ADA]) including AEs of special interest were summarized as follows: pooled UPA 15 mg once daily (QD; UPA15, 6 trials); pooled UPA 30 mg QD (UPA30, 4 trials); methotrexate (MTX, 1 trial), and ADA (1 trial). TEAEs were reported as exposure-adjusted adverse event rates (EAERs; events/100 patient-years [E/100 PY]), which included both incident and recurrent events.Results:4413 patients (UPA15, n=3209; UPA30, n=1204) received ≥1 dose of UPA, providing 10,115.4 PY of exposure. EAERs for AEs, serious AEs (SAEs), and AEs leading to discontinuation were similar for UPA15, MTX, and ADA; rates for UPA30 were numerically higher than UPA15 (Table 1). The most common AEs were upper respiratory tract infection, nasopharyngitis, and urinary tract infection for both UPA doses, and for UPA30 only, increased creatine phosphokinase (CPK). Pneumonia was the most common SAE for both UPA15 and UPA30. Serious infection rates were similar for UPA15, MTX, and ADA but higher for UPA30 (Figure 1). Rates of herpes zoster (HZ) were higher for both UPA groups (dose-dependent) vs MTX and ADA. Most HZ cases with UPA were non-serious (94%) and involved a single dermatome (74%). CPK elevations, which were mostly asymptomatic, were more common for both UPA groups (dose-dependent) vs MTX and ADA. EAERs of adjudicated gastrointestinal perforations were <0.1 and 0.2 E/100 PY for UPA15 and UPA30, respectively. Rates of non-melanoma skin cancer (due in part to more recurrent events with UPA30), anemia, and neutropenia were higher with UPA30 vs other treatment groups. Events of anemia and neutropenia were generally mild/moderate and treatment discontinuation due to these events was uncommon (<0.4%). Rates of other AEs of special interest, including major adverse cardiovascular and venous thromboembolic events, were broadly similar across treatment groups. The rate of deaths in UPA-treated patients with RA was not higher than expected for the general population (standardized mortality ratio [95% confidence interval (CI)]: UPA15, 0.43 [0.29, 0.63]; UPA30, 0.68 [0.40, 1.08]).Table 1.TEAEs in patients treated with UPA, MTX, and ADAUPA 15 mg QDUPA 30 mg QDADA 40 mg EOWMTXn32091204579314ExposureTotal, PY7023.83091.61051.8637.4Mean (SD), weeks114 (64)134 (66)95 (70)106 (67)Median (range), weeks136 (0, 232)160 (0, 231)118 (2, 231)144 (1, 221)E/100 PY (95% CI)Any AE230.7 (227.2, 234.3)283.6 (277.7, 289.6)216.6 (207.8, 225.7)227.8 (216.2, 239.8)Any SAE13.0 (12.2, 13.9)18.8 (17.3, 20.4)13.3 (11.2, 15.7)10.4 (8.0, 13.2)Any AE leading to discontinuation of study drug5.6 (5.0, 6.1)8.5 (7.5, 9.6)6.8 (5.3, 8.5)6.3 (4.5, 8.5)Deathsa0.4 (0.3, 0.6)0.6 (0.3, 0.9)0.9 (0.4, 1.6)0.5 (0.1, 1.4)aBoth treatment and non-treatment-emergent deathsEOW, every other weekConclusion:The updated safety profile of UPA with up to 4.5 years of exposure in patients with RA was comparable to previous analyses,7 with no new safety signals reported. With the exception of HZ and elevated CPK, the safety profile of UPA15, the approved dose for RA, was similar to that observed for ADA.References:[1]Burmester GR, et al. Lancet 2018;391:2503–12;[2]Smolen JS, et al. Lancet 2019;393:2303–11;[3]Fleischmann R, et al. Arthritis Rheumatol 2019;71:1788–800;[4]Genovese MC, et al. Lancet 2018;391:2513–24;[5]van Vollenhoven R, et al. Arthritis Rheumatol 2020;72:1607–20;[6]Rubbert-Roth A, et al. N Engl J Med 2020;383:1511–21;[7]Cohen SB, et al. Ann Rheum Dis 2020;79(Suppl 1):319–20.Acknowledgements:AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Hilary Wong, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of Interests:Stanley B. Cohen Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Gilead, Pfizer, Roche, and Sandoz, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Gilead, Pfizer, Roche, and Sandoz, Ronald van Vollenhoven Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, Eli Lilly, GSK, Janssen, Medac, MSD, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, Arthrogen, Bristol-Myers Squibb, Eli Lilly, GSK, Pfizer, and UCB, Jeffrey R. Curtis Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Crescendo, Janssen, Pfizer, Sanofi/Regeneron, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Crescendo, Janssen, Pfizer, Sanofi/Regeneron, and UCB, Leonard Calabrese Speakers bureau: AbbVie, Crescendo, Genentech, Horizon, Janssen, Novartis, and Sanofi, Consultant of: AbbVie, Bristol-Myers Squibb, Crescendo, Genentech, Gilead, GSK, Horizon, Janssen, Novartis, and Sanofi, Cristiano Zerbini Speakers bureau: MSD, Pfizer, and Sanofi, Consultant of: MSD, Pfizer, and Sanofi, Grant/research support from: Amgen, Eli Lilly, GSK, MSD, Novartis, Pfizer, Roche, Sanofi, and Servier, Yoshiya Tanaka Speakers bureau: AbbVie, Asahi Kasei, Astellas, Bristol-Myers Squibb, Chugai, Daiichi Sankyo, Eisai, Eli Lilly, Gilead, GSK, Janssen, Mitsubishi Tanabe, Novartis, Pfizer, Sanofi, and YL Biologics, Grant/research support from: Asahi Kasei, Chugai, Daiichi Sankyo, Eisai, Mitsubishi Tanabe, Takeda, and UCB, Louis Bessette Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Christophe Richez Speakers bureau: AbbVie, Amgen, AstraZeneca, Biogen, Bristol-Myers Squibb, Eli Lilly, GSK, MSD, and Pfizer, Consultant of: AbbVie, Amgen, AstraZeneca, Biogen, Bristol-Myers Squibb, Eli Lilly, GSK, MSD, and Pfizer, Ivan Lagunes-Galindo Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Jianzhong Liu Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Heidi Camp Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Samuel Anyanwu Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Gerd Rüdiger Burmester Speakers bureau: AbbVie, Eli Lilly, Gilead, Janssen, MSD, Pfizer, Roche, and UCB, Consultant of: AbbVie, Eli Lilly, Gilead, Janssen, MSD, Pfizer, Roche, and UCB
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Lenfant T, Kirchner E, Jin Y, Hajj-Ali R, Calabrese L, Calabrese C. Risques du nouveau vaccin recombinant contre le zona : une étude rétrospective sur 622 patients de rhumatologie. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.134] [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: 11/28/2022]
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Winthrop K, Nash P, Yamaoka K, Mysler E, Calabrese L, Khan N, Enejosa JJ, Song Y, Suboticki J, Curtis JR. THU0218 INCIDENCE AND RISK FACTORS FOR HERPES ZOSTER IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING UPADACITINIB. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Upadacitinib (UPA) is an oral JAK inhibitor approved for the treatment of rheumatoid arthritis (RA). The background rate of herpes zoster (HZ) in patients (pts) with RA is around 0.98/100 person years (PY)1. Pts with RA receiving JAK inhibitors have been reported to have an increased risk of HZ.Objectives:To evaluate the incidence and risk factors for HZ in pts with RA receiving UPA relative to active comparators in the Phase 3 clinical trial program.Methods:The incidence rate of HZ was determined in pts receiving UPA (as monotherapy [mono] or combination therapy) in five randomized Phase 3 trials (SELECT-EARLY, SELECT-MONOTHERAPY, SELECT-NEXT, SELECT-COMPARE, and SELECT-BEYOND), of which 4 evaluated both the UPA 15 and 30 mg once-daily (QD) doses and 1 trial (SELECT-COMPARE) evaluated only the 15 mg QD dose. Incidence of HZ was also determined in pts receiving adalimumab (ADA) + methotrexate (MTX) in SELECT-COMPARE and MTX mono in SELECT-EARLY. Risk factors for HZ were assessed using univariate and multivariate Cox regression models. Data cut-off was 30 June 2019.Results:Overall, 2629 pts who received UPA 15 mg QD (4565.8 patient-years [PY]), 1204 pts who received UPA 30 mg QD (2309.7 PY), 579 pts who received ADA + MTX (768.6 PY), and 314 pts who received MTX mono (456.0 PY) were analyzed. Fewer than 5% of pts across the treatment groups reported prior HZ vaccination. HZ (n/100 PY [95% CI]) occurred in 142 pts (3.1 [2.6–3.7]) with UPA 15 mg, 126 pts (5.5 [4.5–6.5]) with UPA 30 mg, 8 pts (1.0 [0.4–2.1]) with ADA + MTX, and 5 pts (1.1 [0.4–2.6]) with MTX mono. Most of the HZ cases (~71%) with UPA (Table) and all cases with ADA + MTX and MTX mono involved a single dermatome. Ophthalmic involvement was seen in 6 (4.2%) and 3 (2.4%) cases in the UPA 15 and 30 mg groups, respectively, and unilateral involvement with multiple dermatomes was seen in 26 (18.3%) and 23 (18.3%) cases. There was a single case of HZ meningitis reported in a Japanese pt on UPA 30 mg. In multivariate analyses, prior history of HZ and Asian region were associated with an increased risk of HZ in both the UPA groups (p≤0.01;Figure). In addition, pts ≥65 years old had increased risk of HZ in the 15 mg group.Conclusion:HZ events in pts with RA receiving UPA were more common in the 30 mg vs 15 mg group, and in both UPA groups compared with the ADA + MTX and MTX groups.References:[1]Smitten AL, et al. Arthritis Rheum 2007;57:1431–8Table.Summary of extent of involvement in pts with HZCategories, n (%)aAny UPA 15 mg QD(N=2629)Any UPA 30 mg QD(N=1204)Total patients with ≥1 HZ event142 (5.4)126 (10.5)Single dermatome101 (71.1)89 (70.6)Ophthalmic involvement6 (4.2)3 (2.4)HZ Oticus (Ramsay Hunt Syndrome)2 (1.4)1 (0.8)Multidermatomal (unilateral)b26 (18.3)23 (18.3)Disseminated, cutaneous only (no CNS involvement)c7 (4.9)8 (6.3)Disseminated with CNS or visceral involvement01 (0.8)dMissing8 (5.6)5 (4.0)aPts may fall into >1 category;b≤2 adjacent dermatomes;c≥3 dermatomes, unilateral nonadjacent dermatomes, or bilateral dermatomes;dHZ meningitisFigure.Multivariable-adjusted risk factors for HZ in pts receiving UPADisclosure of Interests: :Kevin Winthrop Grant/research support from: Bristol-Myers Squibb, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Galapagos, Gilead, GSK, Pfizer Inc, Roche, UCB, Peter Nash Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, MSD, Novartis, Pfizer Inc, Roche, Sanofi, UCB, Kunihiro Yamaoka Speakers bureau: AbbVie GK, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co. Ltd, Mitsubishi-Tanabe Pharma Corporation, Pfizer Japan Inc., and Takeda Pharmaceutical Company Ltd, Eduardo Mysler Grant/research support from: AbbVie, Lilly, Pfizer, Roche, BMS, Sandoz, Amgen, and Janssen., Consultant of: AbbVie, Lilly, Pfizer, Roche, BMS, Sandoz, Amgen, and Janssen., Leonard Calabrese Consultant of: AbbVie, GSK, Bristol-Myers Squibb, Genentech, Janssen, Novartis, Sanofi, Horizon, Crescendo, and Gilead, Speakers bureau: Sanofi, Horizon, Crescendo, Novartis, Genentech, Janssen, and AbbVie, Nasser Khan Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Jose Jeffrey Enejosa Shareholder of: AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Jessica Suboticki Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Jeffrey R. Curtis Grant/research support from: Abbvie, Amgen, BMS, Corrona, Crescendo, Janssen, Pfizer, Regeneron/Sanofi, and UCB, Consultant of: AbbVie, Amgen, BMS, Corrona, Crescendo, Janssen, Pfizer, Sanofi/Regeneron, and UCB
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Cohen SB, Van Vollenhoven R, Curtis JR, Calabrese L, Zerbini C, Tanaka Y, Bessette L, Schlacher C, Shaw T, Liu J, Enejosa JJ, Song Y, Burmester GR. THU0197 SAFETY PROFILE OF UPADACITINIB UP TO 3 YEARS OF EXPOSURE IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2396] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The safety and efficacy of upadacitinib (UPA), an oral JAK inhibitor, was evaluated in the phase 3 SELECT clinical program, which included 5 randomized, double-blind, controlled trials across a spectrum of rheumatoid arthritis (RA) patients (pts)1-5.Objectives:To describe the long-term integrated safety profile of UPA relative to active comparators in pts with RA treated in the SELECT program up to a cut-off date of 30 June 2019.Methods:Treatment-emergent adverse events (TEAEs: AE onset ≥first dose and ≤30 days after last dose) were summarized for the following: methotrexate (MTX, 1 trial, mean exposure 76 wks); adalimumab (ADA, 1 trial, mean exposure 69 wks); pooled UPA 15 mg (5 trials, mean exposure 90 wks); pooled UPA 30 mg (4 trials, mean exposure 100 wks). TEAEs are reported as exposure-adjusted event rates (EAERs; events/100 patient years [E/100PYs]).Results:3833 pts received ≥1 dose of UPA 15 mg [n=2629, 4565.8 PYs] or 30 mg [n=1204, 2309.7 PYs] QD, with no option to switch doses. More than half of pts received UPA for ≥96 wks (median: UPA 15, 101.9 wks; UPA 30: 111.7 wks). The EAERs of overall SAEs and AEs leading to discontinuation on UPA 15 mg were comparable to MTX and ADA; rates on UPA 30 mg were numerically higher than UPA 15 mg (Table). The most common AEs (≥5 E/100 PYs) reported with UPA 15 mg were upper respiratory tract infection (URTI), nasopharyngitis, urinary tract infection (UTI), bronchitis, increased CPK, and increased ALT. For UPA 30 mg, the most common AEs reported were URTI, UTI, increased CPK, nasopharyngitis, bacterial bronchitis, and herpes zoster (HZ). Overall rates of serious infections and opportunistic infections were comparable between UPA 15 mg, MTX, and ADA groups but were higher on UPA 30 mg (Figure). Rates of HZ were higher in both UPA groups (30 mg higher than 15 mg) vs MTX and ADA. The majority of HZ cases were non-serious (96%) and involved a single dermatome (74%). Rates of VTE were comparable across treatment groups (0.3-0.5/100 PYs), as were rates of adjudicated MACE and malignancies (excluding NMSC). Rates of NMSC in UPA 15 mg and ADA were similar, with numerically higher rates on UPA 30 mg. SMR analysis demonstrated that the number of deaths in pts with RA exposed to UPA was not higher than what would be expected for the general population.Conclusion:Through long-term follow-up, the integrated safety profile of UPA remained consistent with previous analyses, with no new signals identified.References:[1]Burmester,et al.Lancet2018;391:2503-12.[2]Genovese,et al.Lancet2018;391:2513-24.[3]Smolen,et al.Lancet2019;393:2303-11.[4]Fleischmann,et al.Arthritis Rheumatol2019;71:1788-1800.[5]van Vollenhoven,et al.Arthritis Rheumatol2018;70(Suppl 10).Table.Overall TEAEs for UPA and Active Comparators (E/100 PYs [95% CI])MTXn=314(456.0 PYs)ADA 40 mg eown=579(768.6 PYs)UPA 15 mg QDn=2629(4565.8 PYs)UPA 30 mg QDn=1204(2309.7 PYs)Any AE271.7 (256.8, 287.3)242.3 (231.4, 253.5)247.7 (243.2, 252.3)310.6 (303.5, 317.9)Any SAE12.7 (9.7, 16.4)14.6 (12.0, 17.5)12.9 (11.9, 14.0)19.8 (18.0, 21.7)Any AE leading to discontinuation7.7 (5.3, 10.7)8.2 (6.3, 10.5)6.3 (5.6, 7.1)10.0 (8.8, 11.4)Deathsa0.4 (0.1, 1.6)0.8 (0.3, 1.7)0.4 (0.2, 0.6)0.7 (0.4, 1.1)aDeaths included non-treatment emergent deaths: ADA, 1; UPA 15 mg, 3; UPA 30 mg, 3.Disclosure of Interests:Stanley B. Cohen Grant/research support from: Amgen, Abbvie, Boehringer Ingelheim, Pfizer and Sandoz, Consultant of: Amgen, Abbvie, Boehringer Ingelheim, Pfizer and Sandoz, Ronald van Vollenhoven Grant/research support from: AbbVie, Arthrogen, Bristol-Myers Squibb, GlaxoSmithKline, Lilly, Pfizer, and UCB, Consultant of: AbbVie, AstraZeneca, Biotest, Bristol-Myers Squibb, Celgene, GSK, Janssen, Lilly, Medac, Merck, Novartis, Pfizer, Roche, and UCB, Jeffrey R. Curtis Grant/research support from: Abbvie, Amgen, BMS, Corrona, Crescendo, Janssen, Pfizer, Regeneron/Sanofi, and UCB, Consultant of: AbbVie, Amgen, BMS, Corrona, Crescendo, Janssen, Pfizer, Sanofi/Regeneron, and UCB, Leonard Calabrese Consultant of: AbbVie, GSK, Bristol-Myers Squibb, Genentech, Janssen, Novartis, Sanofi, Horizon, Crescendo, and Gilead, Speakers bureau: Sanofi, Horizon, Crescendo, Novartis, Genentech, Janssen, and AbbVie, Cristiano Zerbini Grant/research support from: Amgen, GSK, Lilly, Merck, Novartis, Pfizer, Sanofi-Aventis, Servier and Roche, Consultant of: Pfizer, Speakers bureau: Merck, Pfizer, Sanofi-Aventis, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin, Louis Bessette Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Sanofi, Casey Schlacher Shareholder of: AbbVie, Employee of: AbbVie, Tim Shaw Shareholder of: AbbVie, Employee of: AbbVie, Jianzhong Liu Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Jose Jeffrey Enejosa Shareholder of: AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Gerd Rüdiger Burmester Consultant of: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Speakers bureau: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma
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Winthrop K, Calabrese L, Van den Bosch F, Yamaoka K, Selmi C, Song Y, Hendrickson B, Lagunes-Galindo I, Mcinnes I. FRI0141 CHARACTERIZATION OF SERIOUS INFECTIONS WITH UPADACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Upadacitinib (UPA) is a selective and reversible Janus kinase (JAK) inhibitor with an approved dose of 15 mg once daily (QD) for the treatment of rheumatoid arthritis (RA). Patients (pts) receiving JAK inhibitors have been reported to be at increased risk of developing serious infection events (SIE) and opportunistic infections (OI).Objectives:To evaluate the incidence of SIEs and OIs in pts with RA receiving UPA and active comparators in the Phase 3 SELECT clinical trial program.Methods:The exposure-adjusted event rate (EAER) per 100 patient-years (E/100 PY) of SIEs and OIs was determined in pts receiving UPA in five randomized Phase 3 trials (SELECT-EARLY, SELECT-MONOTHERAPY, SELECT-NEXT, SELECT-COMPARE, and SELECT-BEYOND), of which four evaluated both UPA 15 mg and 30 mg QD doses and one (SELECT-COMPARE) evaluated only UPA 15 mg QD. Incidences of SIEs and OIs were also determined in pts receiving adalimumab (ADA) + methotrexate (MTX) in SELECT-COMPARE and MTX monotherapy in SELECT-EARLY. Data were analyzed descriptively, with no statistical comparisons between groups or doses. Risk factors for SIEs were determined using a univariate Cox regression model. The data cut-off was June 30, 2019.Results:Overall, 2629 pts who received UPA 15 mg, 1204 pts who received UPA 30 mg, 579 pts who received ADA + MTX, and 314 pts who received MTX monotherapy were included in this analysis. The EAERs (E/100 PYs [95% CI]) of SIEs were 3.2 (2.7–3.7) in the UPA 15 mg group, 5.7 (4.8–6.8) in the UPA 30 mg group, 3.9 (2.6–5.6) in pts receiving ADA + MTX, and 3.1 (1.7–5.2) in pts receiving MTX monotherapy. Pneumonia was the most common SIE, with EAERs (E/100 PYs [95% CI]) of 0.7 (0.5–1.0), 1.3 (0.9–1.9), 0.7 (0.2–1.5), and 0.7 (0.1–1.9) in the UPA 15 mg, UPA 30 mg, ADA + MTX, and MTX monotherapy groups, respectively. Rates of OIs (including oral candidiasis and disseminated herpes zoster [HZ]) (E/100 PYs [95% CI]) were 0.7 (0.5–1.0), 1.3 (0.9–1.9), 0.4 (0.1–1.1), and 0 (0–0) in the UPA 15 mg, UPA 30 mg, ADA + MTX, and MTX monotherapy groups, respectively. Oral candidiasis was the most frequent OI with EAERs (E/100 PYs [95% CI]) of 0.4 (0.2–0.6) in the UPA 15 mg group, 0.6 (0.3–1.0) in the UPA 30 mg group, 0.4 (0.1–1.1) in the ADA + MTX group, and 0 (0–0) in the MTX monotherapy group. Serious adverse events of HZ were only reported in the UPA groups (0.2 E/100 PYs [95% CI: 0.1–0.3] and 0.6 E/100 PYs [95% CI: 0.4–1.1] in the UPA 15 mg and 30 mg groups, respectively). Overall, there were 3 (4 coded events), 3, 1, and 0 pts who had active tuberculosis events in the UPA 15 mg, UPA 30 mg, ADA + MTX, and MTX monotherapy groups, respectively. Risk factors for SIEs are shown in the Figure. For both UPA doses, age ≥75 years and smoking were noted to have hazard ratios >1.Conclusion:The incidence rate of SIEs and OIs was higher in the UPA 30 mg group than the UPA 15 mg group. SIEs observed with UPA 15 mg were similar to that seen with ADA although the rates of HZ were higher on UPA. Pts with RA who are ≥75 years old and/or smokers may be at higher risk than other pts with RA for SIEs while receiving UPA.Figure.Univariate analysis of SIE risk factorsDisclosure of Interests:Kevin Winthrop Grant/research support from: Bristol-Myers Squibb, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Galapagos, Gilead, GSK, Pfizer Inc, Roche, UCB, Leonard Calabrese Consultant of: AbbVie, GSK, Bristol-Myers Squibb, Genentech, Janssen, Novartis, Sanofi, Horizon, Crescendo, and Gilead, Speakers bureau: Sanofi, Horizon, Crescendo, Novartis, Genentech, Janssen, and AbbVie, Filip van den Bosch Consultant of: AbbVie, Celgene Corporation, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Speakers bureau: AbbVie, Celgene Corporation, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB, Kunihiro Yamaoka Speakers bureau: AbbVie GK, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co. Ltd, Mitsubishi-Tanabe Pharma Corporation, Pfizer Japan Inc., and Takeda Pharmaceutical Company Ltd, Carlo Selmi Grant/research support from: AbbVie, Janssen, MSD, Novartis, Pfizer, Celgene, and Leo Pharma, Consultant of: Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and Sanofi-Regeneron, Speakers bureau: AbbVie, Aesku, Alfa-Wassermann, Bristol-Myers Squibb, Biogen, Celgene, Eli-Lilly, Grifols, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi-Genzyme, UCB Pharma, Yanna Song Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Barbara Hendrickson Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ivan Lagunes-Galindo Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB
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Lenfant T, Calabrese L, Calabrese C. FRI0494 RHEUMATIC IMMUNE RELATED ADVERSE EVENTS OF CHECKPOINT INHIBITORS: A RETROSPECTIVE REVIEW OF 70 PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Immune Checkpoint inhibitors (ICI) have revolutionized cancer therapy by achieving remarkable survival benefits however, at the cost of a myriad of immune-related adverse events (irAEs)[1]. Rheumatic irAE can develop in 5-10% of patients although the true incidence is unknown given the lack of prospective studies [2]. Symptoms are heterogenous and probably underreported with few data available about their management and outcome [3].Objectives:To describe the clinical, biological, and radiological features of the largest cohort of rheumatic irAEs from ICI along with their therapeutic management, outcome and follow-up in real-world practice.Methods:A referral process for emergent rheumatic irAEs was initiated in February 2016 between the oncology and rheumatology departments at the Cleveland Clinic Foundation. All patients were evaluated by authors CC and/or LHC. Patients’ characteristics were retrospectively collected from medical charts after IRB approval.Results:70 patients referred for one or more rheumatic irAEs between February 2016 and January 2020 were included. 66% were male, median age was 60.8 years. Among them, 24 (34%) had pre-existing rheumatic complaints. Melanoma was the most frequent malignancy (56%). ICI therapy included anti-CTLA4 (40%), anti-PD1/L1 (79%), and dual therapy ipilimumab/nivolumab (41%). Rheumatic irAE occurred in a median 4 months after ICI initiation, with phenotypes including inflammatory arthritis (32 patients), sicca-like symptoms (12), polymyalgia rheumatica-like (7), and myositis (2). Oral, intravenous or intraarticular glucocorticoids (GC) were administered to 54 patients (77%). Of these 54 patients, 22 (41%) required long term GC, 19 had bone density scan and 15 received pneumocystis (PJP) prophylaxis. One PJP case, 1 osteoporotic fracture and 2 avascular necrosis cases were reported. 16 patients received conventional DMARDS (23%) and 9 received biologics (13%). ICI therapy was held for rheumatic irAE in 31% of cases and for another systemic irAE in 29%. Median follow-up was 13.6 months, at end of follow-up 51 patients were still on treatment for rheumatic irAE and 41% of them were still symptomatic despite ongoing treatment.Conclusion:Rheumatic irAEs are heterogeneous and often chronic requiring prolonged immunomodulatory therapy. Prospective studies are required to define optimal management of rheumatic irAEs that maintain long-term oncologic outcomes.References:[1]Suarez-Almazor ME, Kim ST, Abdel-Wahab N, Diab A. Review: Immune-Related Adverse Events With Use of Checkpoint Inhibitors for Immunotherapy of Cancer. Arthritis Rheumatol 2017;69:687–99.https://doi.org/10.1002/art.40043.[2]Abdel-Wahab N, Suarez-Almazor ME. Frequency and distribution of various rheumatic disorders associated with checkpoint inhibitor therapy. Rheumatol (United Kingdom) 2019;58:vii40–8.https://doi.org/10.1093/rheumatology/kez297.[3]Kostine M, Rouxel L, Barnetche T, Veillon R, Martin F, Dutriaux C, et al. Rheumatic disorders associated with immune checkpoint inhibitors in patients with cancer-clinical aspects and relationship with tumour response: a single-centre prospective cohort study. Ann Rheum Dis 2018;77:393–8.https://doi.org/10.1136/annrheumdis-2017-212257.Disclosure of Interests:Tiphaine Lenfant: None declared, Leonard Calabrese Consultant of: AbbVie, GSK, Bristol-Myers Squibb, Genentech, Janssen, Novartis, Sanofi, Horizon, Crescendo, and Gilead, Speakers bureau: Sanofi, Horizon, Crescendo, Novartis, Genentech, Janssen, and AbbVie, cassandra calabrese Consultant of: AbbvieGSK, Speakers bureau: Sanofi-Genzyme
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Affiliation(s)
- R Accorona
- Division of Otorhinolaryngology, "San Maurizio" Hospital, via L. Böhler 5, 39100, Bolzano, Italy.
| | - A Iandelli
- Department of Otorhinolaryngology-Head and Neck Surgery, "San Martino" Hospital IRCCS, University of Genoa, Genoa, Italy
| | - L Calabrese
- Division of Otorhinolaryngology, "San Maurizio" Hospital, via L. Böhler 5, 39100, Bolzano, Italy
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Affiliation(s)
- R Accorona
- Division of Otorhinolaryngology, "San Maurizio" Hospital, Bolzano, Italy
| | - L Gazzini
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy.
| | - L Calabrese
- Division of Otorhinolaryngology, "San Maurizio" Hospital, Bolzano, Italy
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Accorona R, Calabrese L. African statue with goiter. J Endocrinol Invest 2019; 42:1253-1254. [PMID: 30788771 DOI: 10.1007/s40618-019-01024-7] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Representations of thyroid swelling, intended as an enlarged anterior neck in the artworks of various periods are sporadically reported in the literature. MATERIALS AND METHODS An African statue belonging to the African Yoruba culture has been analysed. RESULTS Members of Ogboni Society in Yoruba culture used this statues to represent a real subject and to communicate between the living and dead. CONCLUSION The statue reported seems to represent a case of real goiter.
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Affiliation(s)
- R Accorona
- Division of Otorhinolaryngology, "San Maurizio" Hospital, via L. Böhler 5, 39100, Bolzano, Italy.
| | - L Calabrese
- Division of Otorhinolaryngology, "San Maurizio" Hospital, via L. Böhler 5, 39100, Bolzano, Italy
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Kostine M, Finckh A, Bingham C, Visser K, Leipe J, Schulze-Koops H, Choy E, Benesova K, Radstake T, Cope A, Lambotte O, Gottenberg JE, Allenbach Y, Jamal S, Marabelle A, Larkin J, Haanen JBAG, Calabrese L, Mariette X, Schaeverbeke T. EULAR recommendations for the diagnosis and the management of rheumatic immune-related adverse events due to cancer immunotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.123] [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: 11/12/2022] Open
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Tagliabue M, Gandini S, Navach V, Maffini F, Bruschini R, Giugliano G, Tommasino M, Calabrese L, Ansarin M. PO-097 The role of T-N tract in advanced stage tongue cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30263-4] [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: 10/27/2022]
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Capodiferro S, Calabrese L, Maffini F, Cascardi E, Favia G, Maiorano E. Dentinogenic ghost cell tumour in a 20-year-old male with previous squamous cell carcinoma of the tongue. J BIOL REG HOMEOS AG 2019; 33:269-273. [PMID: 30654855] [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: 06/09/2023]
Affiliation(s)
- S Capodiferro
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - L Calabrese
- Division of Otolaryngology, Bolzano Hospital, Bolzano, Italy
| | - F Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - E Cascardi
- Department of Emergency and Organ Transplantation, Aldo Moro University, Bari
| | - G Favia
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - E Maiorano
- Department of Emergency and Organ Transplantation, Aldo Moro University, Bari, Italy
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Calabrese L, Fiore V, Scalici T, Valenza A. Experimental assessment of the improved properties during aging of flax/glass hybrid composite laminates for marine applications. J Appl Polym Sci 2018. [DOI: 10.1002/app.47203] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- L. Calabrese
- Department of EngineeringUniversity of Messina Contrada Di Dio (Sant'Agata), 98166, Messina Italy
| | - V. Fiore
- Department of Ingegneria Civile, Ambientale, Aerospaziale, dei MaterialiUniversity of Palermo Viale delle Scienze, Edificio 6, 90128, Palermo Italy
| | - T. Scalici
- Department of Ingegneria Civile, Ambientale, Aerospaziale, dei MaterialiUniversity of Palermo Viale delle Scienze, Edificio 6, 90128, Palermo Italy
| | - A. Valenza
- Department of Ingegneria Civile, Ambientale, Aerospaziale, dei MaterialiUniversity of Palermo Viale delle Scienze, Edificio 6, 90128, Palermo Italy
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Piperopoulos E, Calabrese L, Mastronardo E, Abdul Rahim SH, Proverbio E, Milone C. Assessment of sorption kinetics of carbon nanotube‐based composite foams for oil recovery application. J Appl Polym Sci 2018. [DOI: 10.1002/app.47374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- E. Piperopoulos
- Department of EngineeringUniversity of Messina 98166 Messina Italy
- National Interuniversity Consortium of Materials Science and Technology (INSTM) 50121 Florence Italy
| | - L. Calabrese
- Department of EngineeringUniversity of Messina 98166 Messina Italy
- CNR ITAE Institute 98126 Messina Italy
| | - E. Mastronardo
- Thermochemical Processes UnitIMDEA Energy Institute 28935 Madrid Spain
- Materials Science and EngineeringNorthwestern University 60208 Evanston Illinois
| | - S. H. Abdul Rahim
- National Unit for Environmental Research and Services (NUERS)Kuwait University 5969 Khaldiya Kuwait
| | - E. Proverbio
- Department of EngineeringUniversity of Messina 98166 Messina Italy
- National Interuniversity Consortium of Materials Science and Technology (INSTM) 50121 Florence Italy
| | - C. Milone
- Department of EngineeringUniversity of Messina 98166 Messina Italy
- National Interuniversity Consortium of Materials Science and Technology (INSTM) 50121 Florence Italy
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Salehikahrizsangi P, Raeissi K, Karimzadeh F, Calabrese L, Patane S, Proverbio E. Erosion-corrosion behavior of highly hydrophobic hierarchical nickel coatings. Colloids Surf A Physicochem Eng Asp 2018. [DOI: 10.1016/j.colsurfa.2018.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Aims and Background In stage I oral squamous cell carcinoma, clinical examination and imaging techniques are unable to identify 60-90% of patients at risk of micrometastasis, while the sentinel node biopsy technique allows to avoid the morbidity of elective neck dissection in patients not actually affected by micrometastases. Materials and methods Forty-one T1-T2N0 patients underwent lymphoscintigraphy after peritumoral injection of human albumin labeled with 99Tc. Focal areas of radiotracer uptake were marked on the skin preoperatively. The sentinel lymph node (SLN) was identified by the combined use of blue dye and gamma probe and subsequently removed. Complete neck dissection was then performed in all patients and the histological findings were compared with those of SLN biopsy. Results The SLN was identified in 95% of the patients; in four cases (10%) two SLNs were isolated. In 18% of our patients the SLNs were located outside the expected drainage area. When the histology of the negative SLNs was compared with the pathological status of the neck dissection specimens no false negatives were found. Five SLNs in four patients contained micrometastases and were the only positive lymph nodes. Conclusion SLN biopsy can be a valuable staging technique in T1 and T2 oral cancer with uninvolved neck in patients whose lymphatic drainage of the neck has not been altered by previous surgery or radiotherapy. It provides reliable detection of micrometastasis, indicating which level(s) should be removed ipsilaterally or contralaterally, and allows the surgeon to accurately plan neck dissection, taking into consideration the pattern of lymphatic drainage of each individual patient. In this way unnecessary neck dissection and its morphofunctional sequelae can be avoided in a considerable number of patients.
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Affiliation(s)
- F Ionna
- Istituto Nazionale Tumori, Fondazione Pascale, Naples
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Abstract
Introduction Gingival hypertrophy is a frequent condition associated to the increased number of patients taking some categories of drugs. The goal of this work is to emphasize the importance of diagnosis to set a proper therapy. Material and methods The plaque accumulation in patients having a poor oral hygiene damages the periodontium and requires the application of strict professional and home hygiene protocols. Results and conclusion The drug-induced gingival proliferation knowledge is essential in order to succeed in working with the internist and in planning a precise therapy, without interfering with the metabolism of drugs, often necessary and irreplaceable for patients' health.
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Affiliation(s)
- F Luciani
- Catholic University "Our Lady of Good Counsel", Tirana, Albania
| | - G Paolantonio
- Catholic University "Our Lady of Good Counsel", Tirana, Albania
| | - C Calabrese
- Department Odontostomatology ASL RM/B, Rome, Italy
| | - L Calabrese
- University of Rome "Tor Vergata", Director and Chief U.O.C. MaxilloFacial Surgery, Department of Clinical Science and Translational Medicine, PTV Foundation Rome, Rome, Italy
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Calabrese L, Bonaccorsi L, Bruzzaniti P, Freni A, Proverbio E. Morphological and functional aspects of zeolite filled siloxane composite foams. J Appl Polym Sci 2017. [DOI: 10.1002/app.45683] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L. Calabrese
- Department of Engineering; University of Messina, Contrada di Dio Sant'Agata; Messina 98166 Italy
- Istituto di Chimica dei Composti Organo Metallici (ICCOM-CNR), CNR-Consiglio Nazionale delle Ricerche, Via G. Moruzzi 1; Pisa I-56124 Italy
| | - L. Bonaccorsi
- Department of Civil Engineering, Energy, Environment and Materials; University Mediterranea of Reggio Calabria, Salita Melissari; Reggio Calabria 89124 Italy
| | - P. Bruzzaniti
- Department of Engineering; University of Messina, Contrada di Dio Sant'Agata; Messina 98166 Italy
| | - A. Freni
- Istituto di Chimica dei Composti Organo Metallici (ICCOM-CNR), CNR-Consiglio Nazionale delle Ricerche, Via G. Moruzzi 1; Pisa I-56124 Italy
| | - E. Proverbio
- Department of Engineering; University of Messina, Contrada di Dio Sant'Agata; Messina 98166 Italy
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25
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Franza F, Aquino K, Calabrese L, Cervone A, Fiorentino N, De Guglielmo S, Iandoli M, Soddu A, Solomita B, Fasano V. Screening for metabolic syndrome in older patients with severe mental illness: Two-years observational study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionPatients with serious psychiatric illness (SMI) have a reduced quality of life and life expectancy than the general population. Metabolic syndrome (MS) is a clinical aspect determining who should be considered to reduce the risk of serious and chronic organic factors, even more significant in the elderly.ObjectivesTo evaluate metabolic screening of elderly patients with severe mental illness (SMI).AimsTo evaluate the importance of routine screening of metabolic parameters in elderly guests of residential facilities with or without SMI; metabolic screening at baseline and after two of hospitalization.MethodsElderly inpatients (44 Tot) with Severe Mental Illness (SMI: bipolar disorder: 34%; schizophrenia: 46%; other: 20%) vs elderly inpatients (78 Tot). Data collected at baseline: psychiatric diagnosis; any previous diagnosis of hypertension, diabetes, dyslipidemia; ECG. At baseline and for two years were administered following scale: BPRS; PANSS; Qli; MMSE, ADL.ResultsAfter two years metabolic screening has recorded at least one of the new interactions between the five factors of MS (ATP III) in 50% of patients with: one (34%); two (21%); three (11%); four (3%) new altered parameters. In MS inpatients, 53% of new metabolic alterations were recorded in 53% (MS inpatients) vs 23% without MS after two years.ConclusionsOur results showed a higher frequency of MS in patients with SMI than comparison subjects. Haloperidol was the antipsychotic medication that caused minor impact on the development of metabolic disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sollini M, Calabrese L, Zangheri B, Erba P, Gramaglia A, Gasparini M. 18 F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.017] [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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Sollini M, Calabrese L, Zangheri B, Erba PA, Gramaglia A, Gasparini M. (18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer. Rev Esp Med Nucl Imagen Mol 2015; 35:121-3. [PMID: 26653282 DOI: 10.1016/j.remn.2015.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 11/29/2022]
Abstract
A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management.
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Affiliation(s)
- M Sollini
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy.
| | - L Calabrese
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
| | - B Zangheri
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
| | - P A Erba
- Regional Center of Nuclear Medicine, University of Pisa, Via Savi 10, 56125 Pisa, Italy
| | - A Gramaglia
- Radiation Oncology Unit, Policlinico di Monza, Via Amati 111, 20900 Monza, Italy
| | - M Gasparini
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
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Winthrop KL, Novosad SA, Baddley JW, Calabrese L, Chiller T, Polgreen P, Bartalesi F, Lipman M, Mariette X, Lortholary O, Weinblatt ME, Saag M, Smolen J. Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance. Ann Rheum Dis 2015; 74:2107-16. [DOI: 10.1136/annrheumdis-2015-207841] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/28/2015] [Indexed: 12/27/2022]
Abstract
No consensus has previously been formed regarding the types and presentations of infectious pathogens to be considered as ‘opportunistic infections’ (OIs) within the setting of biologic therapy. We systematically reviewed published literature reporting OIs in the setting of biologic therapy for inflammatory diseases. The review sought to describe the OI definitions used within these studies and the types of OIs reported. These findings informed a consensus committee (infectious diseases and rheumatology specialists) in deliberations regarding the development of a candidate list of infections that should be considered as OIs in the setting of biologic therapy. We reviewed 368 clinical trials (randomised controlled/long-term extension), 195 observational studies and numerous case reports/series. Only 11 observational studies defined OIs within their methods; no consistent OI definition was identified across studies. Across all study formats, the most numerous OIs reported were granulomatous infections. The consensus group developed a working definition for OIs as ‘indicator’ infections, defined as specific pathogens or presentations of pathogens that ‘indicate’ the likelihood of an alteration in host immunity in the setting of biologic therapy. Using this framework, consensus was reached upon a list of OIs and case-definitions for their reporting during clinical trials and other studies. Prior studies of OIs in the setting of biologic therapy have used inconsistent definitions. The consensus committee reached agreement upon an OI definition, developed case definitions for reporting of each pathogen, and recommended these be used in future studies to facilitate comparison of infection risk between biologic therapies.
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Molloy E, Calabrese L. FRI0162 Progressive Multifocal Leukoencephalopathy Associated with Biologic Therapy in Rheumatic Diseases: Strengthening Association with Rituximab. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6082] [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: 11/03/2022]
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Bykerk VP, Cush J, Winthrop K, Calabrese L, Lortholary O, de Longueville M, van Vollenhoven R, Mariette X. Update on the safety profile of certolizumab pegol in rheumatoid arthritis: an integrated analysis from clinical trials. Ann Rheum Dis 2015; 74:96-103. [PMID: 24092417 PMCID: PMC4283674 DOI: 10.1136/annrheumdis-2013-203660] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [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] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 08/29/2013] [Accepted: 09/08/2013] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To report the long-term safety data of certolizumab pegol (CZP) in rheumatoid arthritis (RA) accumulated as of 30 November 2011. DESIGN Data from 10 completed randomised controlled trials (RCT) of CZP in RA and several open-label extensions (OLE) were pooled across all doses. Reported adverse events (AE) occurred between the first dose and 84 days after the last dose. All deaths, serious infectious events (SIE) and malignancies were reviewed by external experts, classified according to predefined rules, and validated by an external steering committee. Incidence rates (IR) and event rates (ER) per 100 patient-years (PY) are presented. RESULTS 4049 RA patients who received CZP were included in the safety pooling; total exposure 9277 PY, mean exposure 2.1 years (range 0.04-7.6). SIE, most frequently pneumonia (IR 0.73/100 PY), were the most common serious AE, occurring more frequently in CZP compared to placebo-treated patients in RCT (IR 5.61/100 PY vs 1.35/100 PY, odds ratio (OR) 4.35, 95% CI 0.65 to 29.30). SIE rates were lower in the CZP-treated population including OLE (ER 4.33/100 PY). 44 patients developed tuberculosis (IR 0.47/100 PY), 39 from high endemic regions. 58 deaths occurred in CZP-exposed patients (IR 0.63/100 PY) and 70 developed malignancies excluding non-melanoma skin cancer (IR 0.76/100 PY), including five lymphomas (IR 0.05/100 PY). CONCLUSIONS No new or unexpected safety signals associated with CZP emerged in this updated long-term safety analysis. While SIE rates were higher for CZP than for placebo in RCT, the rate decreased with continued exposure to CZP. These rates are consistent with data previously reported for CZP and other tumour necrosis factor inhibitors.
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Affiliation(s)
- V P Bykerk
- Hospital for Special Surgery, New York, New York, USA
| | - J Cush
- Baylor Research Institute and Baylor University Medical Center, Dallas, Texas, USA
| | - K Winthrop
- Oregan Health and Science University, Portland, Oregon, USA
| | - L Calabrese
- Department of Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, Ohio, USA
| | - O Lortholary
- IHU Imagine, Université Paris Descartes, Hôpital Necker Enfants malades, Paris, France
| | | | | | - X Mariette
- Université Paris-Sud, AP-HP, Hôpitaux universitaires Paris-Sud, Paris, France
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Franza F, Cervone A, Battista A, Calabrese L, Fasano V, Fiorentino N, Iandoli M, Mazziotti di Celso R, Soddu A, Solomita B. EPA-0395 – Metabolic alterations associated with first and second generation antipsychotics: an twenty-years open study. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77818-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Alten R, Bingham CO, Cohen S, Calabrese L, Curtis JR, Block A, Fay J, Kelly S, Luo A, Wong D, Genovese MC. SAT0001 Antibody Response to Pneumococcal and Influenza Vaccination in Patients With RA Receiving Subcutaneous Abatacept. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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John S, Calabrese L, Uchino K, Tepper S, Stillman M, Hajj-Ali R. Long-term outcomes of patients with Reversible Cerebral Vasoconstriction Syndrome (RCVS). Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Cerejo R, Hammad T, Obusez E, John S, Uchino K, Jones S, Hui F, Calabrese L, Hajj-Ali R. Vessel wall characteristics using high-resolution magnetic resonance imaging in reversible cerebral vasoconstriction syndrome and central nervous system vasculitis. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.098] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Franza F, Aquino K, Fasano V, Soddu A, Fiorentino N, Mazziotti di Celso R, Calabrese L, Iandoli M, Battista A. 1369 – Efficacy, tolerability and remission in switching antipsychotics study: nineteen years of schizophrenia. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76414-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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36
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Cannella L, Babic A, Andreola G, Elezi R, Rabascio C, Negri M, Calabrese L, Lionetti M, Laszlo D. O-26 G-CSF AND PLERIXAFOR AS NON-TOXIC AND EFFECTIVE FIRST-LINE MOBILIZING APPROACH IN PATIENTS WITH MULTIPLE MYELOMA CANDIDATE TO ASCT. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70027-7] [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: 10/27/2022]
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37
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Bharat A, Xie F, Baddley JW, Beukelman T, Chen L, Calabrese L, Delzell E, Grijalva CG, Patkar NM, Saag K, Winthrop KL, Curtis JR. Incidence and risk factors for progressive multifocal leukoencephalopathy among patients with selected rheumatic diseases. Arthritis Care Res (Hoboken) 2012; 64:612-5. [PMID: 22162369 DOI: 10.1002/acr.21564] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To ascertain the incidence of progressive multifocal leukoencephalopathy (PML) in patients with selected rheumatic diseases, to describe the characteristics of PML cases occurring in this setting, and to evaluate the extent to which such cases occurred in the context of biologic therapies such as rituximab or tumor necrosis factor antagonists. METHODS We conducted a large population-based study to describe the incidence and risk factors for PML among patients with rheumatoid arthritis, psoriatic arthritis, psoriasis, juvenile idiopathic arthritis, inflammatory bowel disease, and ankylosing spondylitis using national inpatient and outpatient administrative data from the entire Center for Medicare and Medicaid Services from 2000-2009. Suspected PML cases were identified using hospital discharge diagnosis codes. Risk factors for PML were evaluated using outpatient data ≥6 months prior to PML diagnosis. RESULTS Among 2,030,578 patients with autoimmune diseases of interest, a total of 53 PML cases were identified (2.6 per 100,000 patients). Most PML cases had human immunodeficiency virus (HIV) and/or cancer. Nine PML cases had evidence for biologic use prior to PML hospitalization, of which 3 had neither HIV nor malignancy and were exposed to biologics within 12 (rituximab) or 6 months (all other biologics) prior to PML diagnosis. PML occurred at an estimated incidence of 0.2 per 100,000 patients with autoimmune diseases who did not have HIV or malignancy. CONCLUSION PML occurs at a very low incidence among patients with rheumatic diseases but can occur even in the absence of HIV or malignancy.
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Affiliation(s)
- A Bharat
- University of Alabama at Birmingham, AL, USA
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Nath A, Major E, Aksamit A, Calabrese L, Sejvar J, Kotton C, Barhams M. Establishment of a Registry To Identify Cases of PML Using Uniform Diagnostic Criteria (S08.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s08.002] [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: 11/15/2022] Open
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Cocorocchio E, Peccatori F, Vanazzi A, Piperno G, Calabrese L, Botteri E, Travaini L, Preda L, Martinelli G. High-dose chemotherapy in relapsed or refractory Hodgkin lymphoma patients: a reappraisal of prognostic factors. Hematol Oncol 2012; 31:34-40. [DOI: 10.1002/hon.2014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 11/10/2022]
Affiliation(s)
- E Cocorocchio
- Haematoncology Division; European Institute of Oncology; Milan; Italy
| | - F Peccatori
- Haematoncology Division; European Institute of Oncology; Milan; Italy
| | - A Vanazzi
- Haematoncology Division; European Institute of Oncology; Milan; Italy
| | - G Piperno
- Radiotherapy Division; European Institute of Oncology; Milan; Italy
| | - L Calabrese
- Haematoncology Division; European Institute of Oncology; Milan; Italy
| | - E Botteri
- Epidemiology and Biostatistics Division; European Institute of Oncology; Milan; Italy
| | - L Travaini
- Nuclear Medicine Division; European Institute of Oncology; Milan; Italy
| | - L Preda
- Radiology Division; European Institute of Oncology; Milan; Italy
| | - G Martinelli
- Haematoncology Division; European Institute of Oncology; Milan; Italy
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Dunet V, Dabiri A, Allenbach G, Goyeneche Achigar A, Waeber B, Feihl F, Heinzer R, Prior JO, Van Velzen JE, Schuijf JD, De Graaf FR, De Graaf MA, Schalij MJ, Kroft LJ, De Roos A, Jukema JW, Van Der Wall EE, Bax JJ, Lankinen E, Saraste A, Noponen T, Klen R, Teras M, Kokki T, Kajander S, Pietila M, Ukkonen H, Knuuti J, Pazhenkottil AP, Nkoulou RN, Ghadri JR, Herzog BA, Buechel RR, Kuest SM, Wolfrum M, Gaemperli O, Husmann L, Kaufmann PA, Andreini D, Pontone G, Mushtaq S, Antonioli L, Bertella E, Formenti A, Cortinovis S, Ballerini G, Fiorentini C, Pepi M, Koh AS, Flores JS, Keng FYJ, Tan RS, Chua TSJ, Pontone G, Andreini D, Bertella E, Mushtaq S, Annoni AD, Tamborini G, Fusari M, Ballerini G, Bartorelli AL, Pepi M, Ewe SH, Ng ACT, Delgado V, Schuijf J, Van Der Kley F, Colli A, De Weger A, Marsan NA, Schalij MJ, Bax JJ, Yiu KH, Ng AC, Delgado V, Ewe SH, Van Der Kley F, De Weger A, Kroft LJ, De Roos A, Schuijf JD, Bax JJ, Timmer SAJ, Knaapen P, Germans T, Dijkmans PA, Lubberink M, Ten Berg JM, Ten Cate FJ, Russel IK, Lammertsma AA, Van Rossum AC, Wong YY, Lubberink M, Ruiter G, Raijmakers P, Knaapen P, Van Der Laarse WJ, Westerhof N, Greer C, Chokshi A, Jones M, Schaefle K, Bhatia K, Shimbo D, Schulze PC, Nakajima K, Okuda K, Matsuo S, Vonk-Noordegraaf A, Kirihara Y, Ishikawa T, Taki J, Yoshita M, Yamada M, Kinuya S, Salacata A, Keavey S, Chavarri V, Mills J, Youssef G, Chen J, Nagaraj H, Bhambhani P, Kliner DE, Soman P, Garcia EV, Heo J, Iskandrian AE, Jain M, Lin B, Leung E, Walker A, Nkonde C, Wackers F, Bond S, Baskin A, Declerck J, Schindler T, Ratib O, Zaidi H, Jimenez-Santos M, Wisenberg G, Alexanderson Rosas E, Ricalde A, Soto ME, Mendoza G, Aguilar M, Romero E, Pena-Cabral MA, Jacome R, Meave A, Williams SP, Marriot C, Colice G, Mcardle JR, Lankford A, Kajdasz DK, Reed CR, Mazzanti M, Angelini L, Pimpini L, Angelozzi F, Ascoli G, Williams K, Perna GP, Jacobson A, Lessig HJ, Gerson MC, Cerqueira MD, Narula J, Ashikaga K, Akashi YJ, Kamijima R, Uematsu M, Etele J, 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Enriksson I, Proenca G, Delgado P, Rosario L, Sequeira J, Kosa I, Vassanyi I, Egyed CS, Kozmann GY, Morita S, Nanasato M, Nanbu I, Yoshida Y, Hirayama H, Allam A, Sharef A, Shawky I, Farid M, Mouden M, Ottervanger JP, Timmer JR, De Boer MJ, Reiffers S, Jager PL, Knollema S, Nasr GM, Mohy Eldin M, Ragheb M, Casans-Tormo I, Diaz-Exposito R, Hurtado-Mauricio FJ, Ruano R, Diego M, Gomez-Caminero F, Albarran C, Martin De Arriba A, Rosero A, Lopez R, Martin Luengo C, Garcia-Talavera JR, Laitinen IEK, Rudelius M, Weidl E, Henriksen G, Wester HJ, Schwaiger M, Pan XB, Schindler T, Quercioli A, Zaidi H, Ratib O, Declerck JM, Alexanderson Rosas E, Jacome R, Jimenez-Santos M, Romero E, Pena-Cabral MA, Meave A, Gonzalez J, Rouzet F, Bachelet L, Alsac JM, Suzuki M, Louedec L, Petiet A, Chaubet F, Letourneur D, Michel JB, Le Guludec D, Aktas A, Cinar A, Yaman G, Bahceci T, Kavak K, Gencoglu A, Jimenez-Heffernan A, Sanchez De Mora E, Lopez-Martin J, Lopez-Aguilar R, Ramos C, Salgado C, Ortega A, Sanchez-Gonzalez C, Roa J, Tobaruela A, Nesterov SV, Turta O, Maki M, Han C, Knuuti J, Daou D, Tawileh M, Chamouine SO, Coaguila C, Aguade-Bruix S, Mariscal-Labrador E, Cuberas-Borros G, Sabate-Fernandez M, Pizzi MN, Kisiel-Gonzalez N, Garcia-Dorado D, Castell-Conesa J, Candell-Riera J, Daou D, Tawileh M, Coaguila C, De Araujo Goncalves P, Sousa PJ, Marques H, O'neill J, Pisco J, Cale R, Brito J, Gaspar A, Machado FP, Roquette J, Alexanderson Rosas E, Jimenez-Santos M, Martinez M, Melendez G, Kimura E, Romero E, Pena-Cabral MA, Jacome R, Ochoa JM, Meave A, Alessio AM, Patel A, Lautamaki R, Bengel FM, Bassingthwaighte JB, Caldwell JH, Rahbar K, Seifarth H, Schafers M, Stegger L, Spieker T, Hoffmeier A, Maintz D, Scheld H, Schober O, Weckesser M, Aoki H, Matsunari I, Kajinami K, Martin Fernandez M, Barreiro Perez M, Fernandez Cimadevilla OV, Leon Duran D, Velasco Alonso E, Florez Munoz JP, Luyando LH, Ghadri JR, Pazhenkottil AP, Nkoulou RN, Husmann L, Buechel RR, Herzog BA, Wolfrum M, Gaemperli O, Templin C, Kaufmann PA, De Graaf FR, Schuijf JD, Veltman CE, Van Velzen JE, Kroft LJ, De Roos A, Reiber JHC, Jukema JW, Van Der Wall EE, Bax JJ, Venuraju S, Yerramasu A, Atwal S, Lahiri A, Kunimasa T, Shiba M, Ishii K, Aikawa J, Van Velzen JE, Schuijf JD, De Graaf FR, Kroner ESJ, Kroft LJ, De Roos A, Schalij MJ, Jukema JW, Van Der Wall EE, Bax JJ, Pontone G, Andreini D, Bertella E, Mushtaq S, Formenti A, Annoni AD, Ballerini G, Fiorentini C, Bartorelli AL, Pepi M, Ho KT, Yong QW, Chua KC, Panknin C, Roos CJ, Van Werkhoven JM, Schuijf JD, Van Velzen JE, Witkowska-Grzeslo AJ, Boogers MJ, Kroft LJ, De Roos A, Jukema JW, Bax JJ, Yerramasu A, Venuraju S, Anand DV, Atwal S, Dey D, Berman D, Lahiri A, De Graaf FR, Schuijf JD, Veltman CE, Van Werkhoven JM, Van Velzen JE, Kroft LJ, De Roos A, Jukema JW, Van Der Wall EE, Bax JJ, Mut F, Giubbini R, Lusa L, Massardo T, Iskandrian A, Dondi M, Sato A, Kakefuda Y, Ojima E, Adachi T, Atsumi A, Ishizu T, Seo Y, Hiroe M, Aonuma K, Kruk M, Pracon R, Kepka C, Pregowski J, Kowalewska A, Pilka M, Opolski M, Michalowska I, Dzielinska Z, Demkow M, Stoll V, Sabharwal N, Chakera A, Ormerod O, Fernandes H, Bernardes M, Martins E, Oliveira P, Vieira T, Terroso G, Oliveira A, Faria T, Ventura F, Pereira J, Fukuzawa S, Inagaki M, Sugioka J, Ikeda A, Okino S, Maekawa J, Uchiyama T, Kamioka N, Ichikawa S, Afshar M, Alvi R, Aguilar N, Ippili R, Shaqra H, Bella J, Bhalodkar N, Dos Santos A, Daicz M, Cendoya LO, Marrero HG, Casuscelli J, Embon M, Vera Janavel G, Duronto E, Gurfinkel EP, Cortes CM, Takeishi Y, Nakajima K, Yamasaki Y, Nishimura T, Hayes Brown K, Collado F, Alhaji M, Green J, Alexander S, Vashistha R, Jain S, Aldaas F, Shanes J, Doukky R, Ashikaga K, Akashi YJ, Uemarsu M, Kamijima R, Yoneyama K, Omiya K, Miyake Y, Brodov Y, Venuraju S, Yerramasu A, Raval U, Lahiri A, Berezin A, Seden V, Koretskaya E, Berezin A, Panasenko TA, Matsuo S, Nakajima K, Kinuya S, Veltman CE, Boogers MJ, Chen J, Delgado V, Van Bommel RJ, Van Der Hiel B, Dibbets-Schneider P, Van Der Wall EE, Garcia EV, Bax JJ, Rutten-Vermeltfoort I, Gevers MMJ, Verhoeven B, Dijk Van AB, Raaijmakers E, Raijmakers PGHM, Engvall JE, Gjerde M, De Geer J, Olsson E, Quick P, Persson A, Mazzanti M, Marini M, Pimpini L, Perna GP, Marciano C, Gargiulo P, Galderisi M, D'amore C, Savarese G, Casaretti L, Paolillo S, Cuocolo A, Perrone Filardi P, Thompson RC, Al-Amoodi M, Thompson EC, Kennedy K, Bybee KA, Mcghie AI, O'keefe JH, Bateman TM, Van Der Palen RLF, Mavinkurve-Groothuis AM, Bulten B, Bellersen L, Van Laarhoven HWM, Kapusta L, De Geus-Oei LF, Pollice PP, Bonifazi MB, Pollice FP, Clements IP, Hodge DO, Scott CG, Daou D, Tawileh M, Coaguila C, De Ville De Goyet M, Brichard B, Pirotte T, Moniotte S, Tio RA, Elvan A, Dierckx RAIO, Slart RHJA, Furuhashi T, Moroi M, Hase H, Joki N, Masai H, Kunimasa T, Nakazato R, Fukuda H, Sugi K, Kryczka K, Kaczmarska E, Kepka C, Dzielinska Z, Petryka J, Mazurkiewicz L, Kruk M, Pregowski J, Demkow M, Ruzyllo W, Smanio P, Vieira Segundo E, Siqueira M, Kelendjian J, Ribeiro J, Alaca J, Oliveira M, Alves F, Peovska I, Maksimovic J, Vavlukis M, Kostova N, Pop Gorceva D, Majstorov V, Zdraveska M, Hussain S, Djearaman M, Hoey E, Morus L, Erinfolami O, Macnamara A, Kepka C, Kruk M, Pregowski J, Opolski MP, Pracon R, Michalowska I, Ruzyllo W, Witkowski A, Demkow M, Berti V, Ricci F, Gallicchio R, Acampa W, Cerisano G, Vigorito C, Sciagra' R, Pupi A, Cuocolo A, Nasr GM, Sliem H, Collado FM, Alhaji M, Schmidt S, Maheshwari A, Kiriakos R, Hayes Brown K, Vashistha R, Mwansa V, Shanes J, Doukky R, Ljubojevic S, Sedej S, Holzer M, Marsche G, Marijanski V, Kockskaemper J, Pieske B, Alexanderson Rosas E, Jacome R, Jimenez-Santos M, Romero E, Pena-Cabral MA, Ochoa JM, Ricalde A, Alexanderson G, Meave A, Mohani A, Khanna P, Liu Y, Sinusas A, Lee F, Pinas VA, Van Eck-Smit BLF, Verberne HJ, Lammertsma AA, De Bruin CM, Windhorst AD, Pena H, Guilhermina G, Wilk M, Srour Y, Godinho F, Jimenez-Angeles L, Ruiz De Jesus O, Yanez-Suarez O, Vallejo E, Reyes E, Chan M, Hossen ML, Underwood SR, Karu A, Bokhari S, Aguade-Bruix S, Cuberas-Borros G, Pineda V, Gracia-Sanchez LM, Pizzi MN, Garcia-Burillo A, Garcia-Dorado D, Castell-Conesa J, Candell-Riera J, Zavadovskiy K, Lishmanov YU, Saushkin W, Kovalev I, Chernishov A, Pontone G, Andreini D, Cortinovis S, Bertella E, Mushtaq S, Annoni A, Formenti A, Bartorelli AL, Fiorentini C, Pepi M, Tarkia M, Saraste A, Saanijoki T, Oikonen V, Savunen T, Green MA, Strandberg M, Teras M, Knuuti J, Roivainen A, Gaeta MC, Fernandez Y, Artigas C, Deportos J, Geraldo L, Flotats A, La Delfa V, Carrio I, Wong YY, Lubberink M, Ruiter G, Knaapen P, Raijmakers P, Laarse WJ, Vonk-Noordegraaf A, Izquierdo Gomez MM, Lacalzada Almeida J, Barragan Acea A, De La Rosa Hernandez A, Juarez Prera R, Blanco Palacios G, Bonilla Arjona JA, Jimenez Rivera JJ, Iribarren Sarrias JL, Laynez Cerdena I, Dedic A, Rossi A, Ten Kate GJR, Dharampal A, Moelker A, Galema TW, Mollet N, De Feyter PJ, Nieman K, Andreini D, Pontone G, Mushtaq S, Formenti A, Bertella E, Annoni A, Ballerini G, Fiorentini C, Pepi M, Andreini D, Pontone G, Mushtaq S, Bartorelli AL, Trabattoni D, Bertella E, Annoni A, Formenti A, Fiorentini C, Pepi M, Broersen A, Frenay M, Boogers MM, Kitslaar PH, Van Velzen JE, Schuijf JD, Dijkstra J, Bax JJ, Reiber JHC, Pontone G, Andreini D, Mushtaq S, Bertella E, Annoni DA, Muratori M, Fusari M, Ballerini G, Bartorelli AL, Pepi M, Masai H, Moroi M, Johki N, Kunimasa T, Tokue M, Nakazato R, Furuhashi T, Fukuda H, Hase H, Sugi K, Dharampal AS, Weustink AC, Rossi A, Neefjes LAE, Papadopoulou SL, Chen C, Mollet NRA, Boersma EH, Krestin GP, De Feyter PJ, Purvis JA, Sharma D, Hughes SM, Zafrir N, Maddahi J, Berman DS, Taillefer R, Udelson J, Devine M, Lazewatsky J, Bhat G, Washburn D, Yerramasu A, Patel D, Mazurek T, Tandon S, Bansal S, Inzucchi S, Staib L, Davey J, Chyun D, Young L, Wackers F, Fukuda H, Moroi M, Masai H, Kunimasa T, Nakazato R, Furuhashi T, Sugi K, Harbinson MT, Wells G, Dougan J, Borges-Neto S, Phillips H, Farzaneh-Far A, Starr Z, Shaw LK, Fiuzat M, O'connor C, Henzlova M, Duvall WL, Levine A, Baber U, Croft L, Sahni S, Sethi S, Hermann L, Allam AH, Wann LS, Thompson RC, Nureldin A, Gomaa A, Badr I, Soliman MAT, Hany HAR, Sutherland ML, Thomas GS, Yiu KH, Schuijf J, Van Werkhoven JM, De Graaf F, Pazhenkottil A, Jukema JW, Bax JJ, De Roos A, Kroft LJ, Kaufmann PA, Kroner ESJ, Van Velzen JE, Boogers MJ, Siebelink HMJ, Schalij MJ, Kroft LJ, De Roos A, Reiber JH, Schuijf JD, Bax JJ, Ayub M, Naveed T, Azhar M, Van Tosh A, Faber TL, Votaw JR, Reichek N, Pulipati B, Palestro C, Nichols KJ, Einstein AJ, Khawaja T. Abstracts. Eur Heart J Suppl 2011. [DOI: 10.1093/eurheartj/sur013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cerdonio M, Congiu-Castellano A, Calabrese L, Morante S, Pispisa B, Vitale S. Room-temperature magnetic properties of oxy- and carbonmonoxyhemoglobin. Proc Natl Acad Sci U S A 2010; 75:4916-9. [PMID: 16592578 PMCID: PMC336232 DOI: 10.1073/pnas.75.10.4916] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The magnetic susceptibility and the density of human oxy-(HbO(2)) and carbonmonoxyhemoglobin (HbCO) solutions of various concentrations have been measured at room temperature, with pure water used as a calibrant. Solutions of unstripped and stripped HbO(2) at pH 7.2 in unbuffered water solvent were always found to be less diamagnetic than pure water, whereas solutions of HbCO in identical conditions were always found to be more diamagnetic than pure water. After correcting for concentration-dependent density changes and assuming the HbCO samples to be fully diamagnetic, the paramagnetic reduction of the diamagnetic susceptibility of HbO(2) corresponds to a molar susceptibility per heme (chi(M) (heme)) of 2460 +/- 600 x 10(-6) cgs/mol.
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Affiliation(s)
- M Cerdonio
- Facoltà di Scienze, Free University of Trento, POVO, Trento, Italy
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Longari V, Calabrese L, Zito F, Lambertini R, Leo R, Rognoni M, Marotta G, Gerundini P. 59 poster: Effect of Respiration Motion on SUV Assessement. Radiother Oncol 2010. [DOI: 10.1016/s0167-8140(15)34478-9] [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: 10/23/2022]
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Martinelli G, Ryan G, Seymour JF, Nassi L, Steffanoni S, Alietti A, Calabrese L, Pruneri G, Santoro L, Kuper-Hommel M, Tsang R, Zinzani PL, Taghian A, Zucca E, Cavalli F. Primary follicular and marginal-zone lymphoma of the breast: clinical features, prognostic factors and outcome: a study by the International Extranodal Lymphoma Study Group. Ann Oncol 2009; 20:1993-9. [PMID: 19570964 DOI: 10.1093/annonc/mdp238] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
MESH Headings
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/therapy
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Male
- Prognosis
- Treatment Outcome
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Affiliation(s)
- G Martinelli
- Division of Haematology, European Institute of Oncology, Milan, Italy.
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Alkureishi LWT, Burak Z, Alvarez JA, Ballinger J, Bilde A, Britten AJ, Calabrese L, Chiesa C, Chiti A, de Bree R, Gray HW, Hunter K, Kovacs AF, Lassmann M, Leemans CR, Mamelle G, McGurk M, Mortensen J, Poli T, Shoaib T, Sloan P, Sorensen JA, Stoeckli SJ, Thomsen JB, Trifiro G, Werner J, Ross GL. Joint Practice Guidelines for Radionuclide Lymphoscintigraphy for Sentinel Node Localization in Oral/Oropharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 2009; 16:3190-210. [PMID: 19795174 PMCID: PMC2766455 DOI: 10.1245/s10434-009-0726-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Indexed: 02/06/2023]
Abstract
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. Preparation of this guideline was carried out by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial (SENT) Committee.
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Affiliation(s)
- L W T Alkureishi
- Department of Plastic Surgery, University of Chicago Medical Center, Chicago, USA.
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Calabrese L, Giugliano G, Bruschini R, Ansarin M, Navach V, Grosso E, Gibelli B, Ostuni A, Chiesa F. Compartmental surgery in tongue tumours: description of a new surgical technique. Acta Otorhinolaryngol Ital 2009; 29:259-264. [PMID: 20162027 PMCID: PMC2821124] [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] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 08/05/2009] [Indexed: 05/28/2023]
Abstract
The aim of curative surgical oncology is to remove the primary tumour with a wide margin of normal tissue. What constitutes a sufficiently wide margin particularly in oral cancer is fundamentally unclear. The currently accepted standard is to remove the primary lesion with a 1.5-2 cm circumferential macroscopic margin. In the last ten years, anatomical considerations in the approach to primary, advanced and untreated tumours of the tongue led us to develop and improve a new surgical approach to their demolition and reconstruction. From July 1999 to July 2009, at the European Institute of Oncology in Milano, Italy, 155 patients were treated, while defining and refining the concept of compartmental tongue surgery (CTS) and its main components: 1) anatomical approach to the disease that requires removal of the primary lesion and all of the potential pathways of progression--muscular, lymphatic and vascular; 2) identification of a distinct territory at risk of metastatic representation of the disease: the parenchymal structures between the primary tumour and the cervical lymphatic chain that include the muscular (mylohyoid), neuro-vascular (lingual nerve and vein) and glandular (sublingual and submandibular) tissues; 3) preparation for a rational reconstruction in consideration of a functional defect resulting from this anatomical demolition.
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Affiliation(s)
- L Calabrese
- Department of Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
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Laszlo D, Pruneri G, Andreola G, Radice D, Calabrese L, Rafaniello PR, Nassi L, Sammassimo S, Alietti A, Agazzi A, Vanazzi A, Martinelli G. Tissue microarrays in diffuse large B-cell lymphomas: are they really able to identify distinct prognostic groups in lymphomas of both nodal and extranodal origin? Int J Surg Pathol 2009; 19:417-24. [PMID: 19793830 DOI: 10.1177/1066896909345596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Diffuse large B-cell lymphomas (DLBCL) can be divided into different subgroups (germinal center B-cell-like [GCB] and non-GCB) according to their gene expression profiles. Immunohistochemistry has been proposed as a surrogate for identifying these subgroups, but data about its efficacy in providing prognostic information are conflicting. METHODS AND RESULTS This study retrospectively analyzed a series of 105 DLBCL, defined as GCB and non-GCB according to CD10, bcl-6, and MUM1 expression. All patients received a first-line anthracycline-based (CHOP-like) chemotherapy. A total of 50 patients (48%) were identified as GCB and 55 (52%) as non-GCB. The overall response rate was 89% (94/105), with 62 (59%) complete response. Disease progressions were equally distributed between the 2 subgroups and were not significantly different (P = .756) considering the primary site of involvement (nodal or extranodal). The median follow-up was 62 months (range 5-126 months). Overall survival at 5 years was not significantly different between the groups (P = .3468) and was 72.3% and 66.6% for GCB and non-GCB, respectively. CONCLUSION The results do not support the prognostic value of GCB and non-GCB immunohistochemical categories in DLBCL of both nodal and extranodal origin. Furthermore, a limited number of antigens may be not sufficient to identify the same patterns defined by cDNA microarray. Prospective studies are warranted to address this issue.
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Affiliation(s)
- D Laszlo
- European Institute of Oncology, Milan, Italy.
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Rabascio C, Laszlo D, Andreola G, Saronni L, Radice D, Rigacci L, Fabbri A, Frigeri F, Calabrese L, Billio A, Bertolini F, Martinelli G. Expression of the human concentrative nucleotide transporter 1 (hCNT1) gene correlates with clinical response in patients affected by Waldenström's Macroglobulinemia (WM) and small lymphocytic lymphoma (SLL) undergoing a combination treatment with 2-chloro-2'-deoxyadenosine (2-CdA) and Rituximab. Leuk Res 2009; 34:454-7. [PMID: 19647871 DOI: 10.1016/j.leukres.2009.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 06/25/2009] [Accepted: 07/02/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE Resistance to nucleoside analogues agents is likely to be multifactorial and could involve a number of mechanisms affecting drug penetration, metabolism and targeting. In vitro studies of resistant human cell lines have confirmed that human concentrative nucleoside transporter 1 (hCNT1)-deficient cells display resistance. EXPERIMENTAL DESIGN We applied real-time PCR method to assess the mRNA expression of equilibrative and concentrative nucleoside transporter (hENT1, hCNT1), deoxycytidine and deoxyguanosine kinase (dCK, dGK), 5'-nucleotidase (5'-NT), ribonucleotide reductase catalytic and regulatory (RR1, RR2) subunits in bone marrow cells from 32 patients with Waldenström's Macroglobulinemia (WM) and small lymphocytic lymphoma (SLL) who received 2CdA-based chemotherapy. Responses to chemotherapy, were then correlated to the expression of these markers. RESULTS All 32 patients enrolled expressed lower levels of hCNT1 as compared to healthy donors. In univariate analysis, lower expression level of hCNT1 (p=0.0021) and RR2 (p=0.02) correlated with response to chemotherapy. In particular, patients with low levels of hCNT1 achieved inferior clinical response. No significant correlation between these genes expression and age, stage of disease was found. This study suggests that nucleotidase expression levels can be used to identify subgroups of WM and SLL patients who will likely respond differently to a 2CdA-based therapy.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Cladribine/administration & dosage
- Female
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Male
- Membrane Transport Proteins/genetics
- Middle Aged
- Models, Biological
- Prognosis
- Rituximab
- Treatment Outcome
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/genetics
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Affiliation(s)
- C Rabascio
- Dept of Haematology, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy.
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Laszlo D, Rabascio C, Andreola G, Pruneri G, Raia V, Calabrese L, Radice D, Saronni L, Martinelli G. Chlorambucil – rituximab as first line combination therapy in follicular non-Hodgkin's lymphoma: A clinical and biological analysis. Leuk Lymphoma 2009; 48:437-8. [PMID: 17325914 DOI: 10.1080/10428190601078134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mannarini L, Kratochvil V, Calabrese L, Gomes Silva L, Morbini P, Betka J, Benazzo M. Human Papilloma Virus (HPV) in head and neck region: review of literature. Acta Otorhinolaryngol Ital 2009; 29:119-126. [PMID: 20140157 PMCID: PMC2815356] [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] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 05/03/2009] [Indexed: 05/28/2023]
Abstract
The evidence that human papillomavirus infection is related to head and neck squamous cell carcinoma is supported by molecular and epidemiological data. The definition of a distinct subset of head and neck squamous cell carcinoma, independent of the traditional risk factors and with different clinical presentation and outcome, has led to increasing interest in human papillomavirus infection. This review summarizes current knowledge regarding human papillomavirus biology, oncogenic mechanisms, risk factors for transmission, clinical significance and prophylactic strategies.
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Affiliation(s)
- L Mannarini
- Department of Otolaryngology HN Surgery, University of Pavia, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
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Costa S, Giugliano G, Santoro L, Ywata De Carvalho A, Massaro MA, Gibelli B, De Fiori E, Grosso E, Ansarin M, Calabrese L. Role of prophylactic central neck dissection in cN0 papillary thyroid cancer. Acta Otorhinolaryngol Ital 2009; 29:61-69. [PMID: 20111614 PMCID: PMC2808683] [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] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 03/08/2009] [Indexed: 05/28/2023]
Abstract
Prophylactic central neck dissection in papillary thyroid cancer is controversial. In this retrospective cohort study, the aim was to assess possible advantages of prophylactic central neck dissection with total thyroidectomy in cN0 papillary thyroid cancer. A total of 244 consecutive patients with papillary thyroid cancer, without clinical and ultrasound nodal metastases (cN0), were evaluated out of 1373 patients operated for a thyroid disease at the Istituto Europeo di Oncologia, Milan, Italy from 1994 to 2006. Of these 244 patients, 126 (Group A) underwent thyroidectomy with central neck dissection, while 118 (Group B) underwent thyroidectomy alone. Demographic, clinical and pathological features were analysed. Overall recurrence rate was 6.3% (8/126) in Group A and 7.7% (9/118) in Group B, with a mean follow-up of 47 (Group A) and 64 (Group B) months. In Group A patients, 47% were pN1a and all patients with recurrence had nodal involvement (p = 0.002). Survival rate did not differ in the two groups. Nine patients were lost to follow-up. Group A patients were older and their tumours were larger in size; according to the pT distribution, a higher extra-capsular invasion rate was observed. The two groups were equivalent as far as concerns histological high risk variants and multifocality. Nodal metastases correlated with stage: pT1-2 vs. pT3-T4a, p = 0.0036. A lower risk of nodal metastases was related to thyroiditis (p = 0.0034). In conclusion, central neck metastases were predictive of recurrence without influencing prognosis. From data obtained, possible greatest efficacy of central neck dissection in pT3-4 papillary thyroid cancer without thyroiditis is suggested.
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Affiliation(s)
- S Costa
- Head and Neck Surgery Department, Istituto Europeo di Oncologia, Milan, Italy.
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