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Xie W, Ravi P, Buyse M, Halabi S, Kantoff P, Sartor O, Soule H, Clarke N, Dignam J, James N, Fizazi K, Gillessen S, Mottet N, Murphy L, Parulekar W, Sandler H, Tombal B, Williams S, Sweeney CJ. Validation of metastasis-free survival as a surrogate endpoint for overall survival in localized prostate cancer in the era of docetaxel for castration-resistant prostate cancer. Ann Oncol 2024; 35:285-292. [PMID: 38061427 PMCID: PMC10922430 DOI: 10.1016/j.annonc.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Prior work from the Intermediate Clinical Endpoints in Cancer of the Prostate (ICECaP) consortium (ICECaP-1) demonstrated that metastasis-free survival (MFS) is a valid surrogate for overall survival (OS) in localized prostate cancer (PCa). This was based on data from patients treated predominantly before 2004, prior to docetaxel being available for the treatment of metastatic castrate-resistant prostate cancer (mCRPC). We sought to validate surrogacy in a more contemporary era (ICECaP-2) with greater availability of docetaxel and other systemic therapies for mCRPC. PATIENTS AND METHODS Eligible trials for ICECaP-2 were those providing individual patient data (IPD) after publication of ICECaP-1 and evaluating adjuvant/salvage therapy for localized PCa, and which collected MFS and OS data. MFS was defined as distant metastases or death from any cause, and OS was defined as death from any cause. Surrogacy was evaluated using a meta-analytic two-stage validation model, with an R2 ≥ 0.7 defined a priori as clinically relevant. RESULTS A total of 15 164 IPD from 14 trials were included in ICECaP-2, with 70% of patients treated after 2004. The median follow-up was 8.3 years and the median postmetastasis survival was 3.1 years in ICECaP-2, compared with 1.9 years in ICECaP-1. For surrogacy condition 1, Kendall's tau was 0.92 for MFS with OS at the patient level, and R2 from weighted linear regression (WLR) of 8-year OS on 5-year MFS was 0.73 (95% confidence interval 0.53-0.82) at the trial level. For condition 2, R2 was 0.83 (95% confidence interval 0.64-0.89) from WLR of log[hazard ratio (HR)]-OS on log(HR)-MFS. The surrogate threshold effect on OS was an HR(MFS) of 0.81. CONCLUSIONS MFS remained a valid surrogate for OS in a more contemporary era, where patients had greater access to docetaxel and other systemic therapies for mCRPC. This supports the use of MFS as the primary outcome measure for ongoing adjuvant trials in localized PCa.
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Affiliation(s)
- W Xie
- Dana-Farber Cancer Institute, Boston, USA
| | - P Ravi
- Dana-Farber Cancer Institute, Boston, USA
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve; I-BioStat, Hasselt University, Hasselt, Belgium
| | | | | | | | - H Soule
- Prostate Cancer Foundation, Santa Monica, USA
| | - N Clarke
- The Christie NHS Foundation Trust, Manchester, UK
| | - J Dignam
- University of Chicago, Chicago, USA
| | - N James
- The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, UK
| | - K Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - S Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona; Università della Svizzera Italiana, Lugano, Switzerland
| | - N Mottet
- Mutualite Francoise Loire, St Etienne, France
| | - L Murphy
- Medical Research Council at UCL, London, UK
| | - W Parulekar
- Queens University, Kingston, Ontario, Canada
| | - H Sandler
- Cedars-Sinai Medical Center, Los Angeles, USA
| | - B Tombal
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - S Williams
- Peter MacCallum Cancer Centre, Melbourne
| | - C J Sweeney
- South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia.
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Thornton P, Reader V, Digby Z, Smolak P, Lindsay N, Harrison D, Clarke N, Watt AP. Reversal of High Fat Diet-Induced Obesity, Systemic Inflammation, and Astrogliosis by the NLRP3 Inflammasome Inhibitors NT-0249 and NT-0796. J Pharmacol Exp Ther 2024; 388:813-826. [PMID: 38336379 DOI: 10.1124/jpet.123.002013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/14/2023] [Accepted: 01/02/2024] [Indexed: 02/12/2024] Open
Abstract
Systemic and cerebral inflammatory responses are implicated in the pathogenesis of obesity and associated metabolic impairment. While the NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome has been linked to obesity-associated inflammation, whether it contributes to the development or maintenance of obesity is unknown. We provide support for a direct role of saturated fatty acids, such as palmitic acid, as NLRP3 activating stimuli in obese states. To investigate whether NLRP3 activation contributes to the pathogenesis of diet-induced obesity (DIO) in mice, we tested two different clinical-stage NLRP3 inflammasome inhibitors. We demonstrate a contributory role of this key inflammasome to established obesity and associated systemic and cerebral inflammation. By comparing their effects to calorie restriction, we aimed to identify specific NLRP3-sensitive mechanisms contributing to obesity-induced inflammation (as opposed to be those regulated by weight loss per se). In addition, a direct comparison of an NLRP3 inhibitor to a glucagon like peptide-1 receptor agonist, semaglutide (Wegovy), in the DIO model allowed an appreciation of the relative efficacy of these two therapeutic strategies on obesity, its associated systemic inflammatory response, and cerebral gliosis. We show that two structurally distinct, NLRP3 inhibitors, NT-0249 and NT-0796, reverse obesity in the DIO mouse model and that brain exposure appears necessary for efficacy. In support of this, we show that DIO-driven hypothalamic glial fibrillary acidic protein expression is blocked by dosing with NT-0249/NT-0796. While matching weight loss driven by semaglutide or calorie restriction, remarkably, NLRP3 inhibition provided enhanced improvements in disease-relevant biomarkers of acute phase response, cardiovascular inflammation, and lipid metabolism. SIGNIFICANCE STATEMENT: Obesity is a global health concern that predisposes individuals to chronic disease such as diabetes and cardiovascular disease at least in part by promoting systemic inflammation. We report that in mice fed a high-fat, obesogenic diet, obesity is reversed by either of two inhibitors of the intracellular inflammatory mediator NLRP3. Furthermore, NLRP3 inhibition reduces both hypothalamic gliosis and circulating biomarkers of cardiovascular disease risk beyond what can be achieved by either the glucagon like peptide-1 agonist semaglutide or calorie restriction alone.
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Affiliation(s)
- Peter Thornton
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Valérie Reader
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Zsofia Digby
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Pamela Smolak
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Nicola Lindsay
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - David Harrison
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Nick Clarke
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
| | - Alan P Watt
- NodThera, Cambridge, United Kingdom (P.T., V.R., Z.D., N.L., D.H., N.C., A.P.W.) and Seattle, Washington (P.S.)
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Abdel-Aty H, O'Shea L, Amos C, Brown LC, Grist E, Attard G, Clarke N, Cross W, Parker C, Parmar M, As NV, James N. The STAMPEDE2 Trial: a Site Survey of Current Patterns of Care, Access to Imaging and Treatment of Metastatic Prostate Cancer. Clin Oncol (R Coll Radiol) 2023; 35:e628-e635. [PMID: 37507278 DOI: 10.1016/j.clon.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
AIMS The forthcoming STAMPEDE2 trial has three comparisons in metastatic hormone-sensitive prostate cancer. We aim to determine clinical practices among STAMPEDE trial investigators for access to imaging and therapeutic choices and explore their interest in participation in STAMPEDE2. MATERIALS AND METHODS The survey was developed and distributed online to 120 UK STAMPEDE trial sites. Recipients were invited to complete the survey between 16 and 30 May 2022. The survey consisted of 30 questions in five sections on access to stereotactic ablative body radiotherapy (SABR), 177lutetium-prostate-specific membrane antigen-617 (177Lu-PSMA-617), choice of systemic therapies and use of positron emission tomography/computerised tomography and whole-body magnetic resonance imaging. RESULTS From 58/120 (48%) sites, 64 respondents completed the survey: 55/64 (86%) respondents were interested to participate in SABR, 44/64 (69%) in 177Lu-PSMA-617 and 56/64 (87.5%) in niraparib with abiraterone comparisons; 45/64 (70%) respondents had access to bone, spine and lymph node metastases SABR delivery and 7/64 (11%) to 177Lu-PSMA-617. In addition to androgen deprivation therapy, 60/64 (94%) respondents used androgen receptor signalling inhibitors and 46/64 (72%) used docetaxel; 29/64 (45%) respondents would consider triplet therapy with androgen deprivation therapy, androgen receptor signalling inhibitors and docetaxel. Positron emission tomography/computerised tomography was available to 62/64 (97%) respondents and requested by 45/64 (70%) respondents for disease uncertainty on conventional imaging and 39/64 (61%) at disease relapse. Whole-body magnetic resonance imaging was available to 24/64 (38%) respondents and requested by 13/64 (20%) respondents in highly selected patients. In low-volume disease, 38/64 (59%) respondents requested scans at baseline and disease relapse. In high-volume disease, 29/64 (45%) respondents requested scans at baseline, best response (at prostate-specific antigen nadir) and disease relapse; 54/64 (84%) respondents requested computerised tomography and bone scan for best response assessment. CONCLUSION There is noteworthy disparity in clinical practice across current study sites, however most have expressed an interest in participation in the forthcoming STAMPEDE2 trial.
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Affiliation(s)
- H Abdel-Aty
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden Hospital NHS Foundation Trust, London, UK; The Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at UCL, London, UK.
| | - L O'Shea
- The Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at UCL, London, UK
| | - C Amos
- The Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at UCL, London, UK
| | - L C Brown
- The Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at UCL, London, UK
| | - E Grist
- Cancer Institute, University College London, London, UK
| | - G Attard
- Cancer Institute, University College London, London, UK
| | - N Clarke
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, UK
| | - W Cross
- Department of Urology, St James's University Hospital, Leeds, UK
| | - C Parker
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - M Parmar
- The Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at UCL, London, UK
| | - N Vas As
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - N James
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiotherapy, The Royal Marsden Hospital NHS Foundation Trust, London, UK
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Maitre P, Haris M, Portner R, Hoskin P, Hudson A, Wylie J, Logue J, Conroy R, Tran A, Serra M, Croxford W, Song Y, Oates J, Ramani V, Clarke N, Choudhury A. Outcomes in Locally Advanced Non-Metastatic Prostate Cancer Presenting with Low PSA at Diagnosis. Int J Radiat Oncol Biol Phys 2023; 117:e413-e414. [PMID: 37785368 DOI: 10.1016/j.ijrobp.2023.06.1561] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Men with low serum prostate-specific antigen (PSA) and high Gleason grade group (GGG) are thought to have poor outcomes compared to high PSA secretors. However, there is limited outcome data to support this. We report clinical outcomes from a single-institutional cohort of men presenting with locally advanced prostate cancer but low serum PSA. MATERIALS/METHODS Data from electronic database of a UK tertiary cancer center was acquired for men with histological diagnosis of prostate adenocarcinoma, GGG 4 or 5, stage ≥cT3a, and PSA <10ug/L at diagnosis. Men with metastatic disease, or prior androgen deprivation therapy (ADT) were excluded. Biochemical progression was defined as per Phoenix criteria (PSA > nadir+2) for primary radiotherapy, or PSA >0.2 ug/L after primary prostatectomy (and post-operative radiotherapy, if received). Overall survival (OS, from date of diagnosis to death), metastasis-free survival (MFS, from diagnosis to first recorded metastasis or death), and biochemical progression free survival (bPFS, from diagnosis to biochemical progression or death) were estimated by Kaplan Meier method, and multivariable analysis performed using Cox proportional hazards method. RESULTS Medical records of 7,200 men presenting with non-metastatic prostate cancer from 2013 to 2021 were screened, of which 270 men satisfying the eligibility criteria were included for this study. Initial analysis of 123 men shows median PSA at presentation 7.1 ug/L (IQR 5.6-8.5), and median age 70 years (IQR 65-75). Histology was GGG 4 in 47.6% and 5 in 52.4%. Tumor stage was cT3a in 56.6%, cT3b in 36.9%, and T4 in 6.6%. Pelvic nodes were involved in 5% patients. Majority (83.7%) were treated with radical radiotherapy (external beam alone 64.2%, brachytherapy boost 19.5%), with 24 months ADT; 11.4% underwent radical prostatectomy, and 4.9% received ADT alone. Three men (2.4%) received docetaxel, and one received abiraterone. At a median follow up of 66 months (IQR 27-77), 36 (29.3%) patients had biochemical failure. Total 23 (18.6%) patients had metastases at recurrence, which were visceral in 4%, bone-only in 10%, and nodal-only in 4%. Total 38 (30.6%) patients had died, 23% with prostate cancer and 11% due to other causes. Five-year bPFS was 65.9%, MFS 69.0%, and OS was 77.4%. GGG 5 (versus 4) was associated with significantly worse 5-year bPFS (59.4% vs 73.9%, HR 1.8, 95% CI 1.0-3.2, p = 0.05) and MFS (59.2% vs 81.6%, HR 2.2, 1.2-4.2, p = 0.02). On multivariable analysis including age and PSA at diagnosis, only GGG 5 was associated with worse bPFS (HR 1.8, 1.0-3.3, p = 0.05) and MFS (HR 2.42, 1.25-4.67, p = 0.009). CONCLUSION Men with low secreting but high Gleason grade group prostate cancer are a relatively rare group with poor clinical outcomes despite being non-metastatic. Ongoing work (expected completion June 2023) will analyze remaining cases, and compare outcomes within an expanded multicentric cohort with matched controls having elevated PSA at presentation.
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Affiliation(s)
- P Maitre
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - M Haris
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - R Portner
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - P Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - A Hudson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - J Wylie
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - J Logue
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - R Conroy
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - A Tran
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - M Serra
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - W Croxford
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Y Song
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - J Oates
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - V Ramani
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - N Clarke
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - A Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK, Manchester, United Kingdom
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Clarke N, Barnett C. Seeing like an epidemiologist? Mobilising people against COVID-19. Hist Human Sci 2023; 36:49-70. [PMID: 37153713 PMCID: PMC10151919 DOI: 10.1177/09526951231170574] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Diaries and other materials in the Mass Observation Archive have been characterised as intersubjective and dialogic. They have been used to study top-down and bottom-up processes, including how ordinary people respond to sociological constructs and, more broadly, the footprint of social science in the 20th century. In this article, we use the Archive's COVID-19 collections to study how attempts to govern the pandemic by mobilising ordinary people to see like an epidemiologist played out in the United Kingdom during 2020. People were asked to think in terms of populations and groups; rates, trends, and distributions; the capacity of public services; and complex systems of causation. How did they respond? How did they use the statistics, charts, maps, concepts, identities, and roles they were given? We find evidence of engagement with science plural; confident and comfortable engagement with epidemiological terms and concepts; sceptical and reluctant engagement with epidemiological subject positions; use of both scientific and moral literacy to negotiate regulations and guidance; and use of scientific literacy to compare and judge government performance. Governing the pandemic through scientific literacy was partially successful, but in some unexpected ways.
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Clarke N, Barnett C. Archiving the COVID-19 pandemic in Mass Observation and Middletown. Hist Human Sci 2023; 36:3-25. [PMID: 37153715 PMCID: PMC10151920 DOI: 10.1177/09526951231152139] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The COVID-19 pandemic generated debates about how pandemics should be known. There was much discussion of what role the human sciences could play in knowing - and governing - the pandemic. In this article, we focus on attempts to know the pandemic through diaries, other biographical writing, and related forms like mass photography. In particular, we focus on the archiving of such forms by Mass Observation in the UK and the Everyday Life in Middletown (EDLM) project in the USA, and initial analyses of such material by scholars from across the human sciences. Our main argument is that archiving the pandemic was informed by, and needs viewing through, the history of the human sciences - including the distinctive histories and human sciences of Mass Observation and Middletown. The article finishes by introducing a Special Section that engages with archiving the pandemic in two senses: the archiving of diaries and related forms by Mass Observation and the EDLM project, and the archiving of initial encounters between researchers and this material by History of the Human Sciences. The Special Section seeks to know the pandemic from the human sciences in the present and to archive knowing the pandemic from the human sciences for the future.
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Jones C, Gray S, Brown M, Brown J, Mc Closkey E, Rai B, Clarke N, Sachdeva A. Fracture and fall risk in men with advanced or metastatic prostate cancer treated with novel androgen receptor signalling inhibitors: A systematic review and meta-analysis of randomised controlled trials. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01036-9] [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: 02/12/2023]
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Jones C, Sachdeva A, Murphy L, Murray M, Brown L, Brown J, Mc Closkey E, Attard G, Parmar M, James N, Sydes M, Clarke N. Clinical fracture incidence in metastatic hormone-sensitive prostate cancer and risk-reduction following addition of zoledronic acid to androgen deprivation therapy with or without docetaxel: Long-term results from the STAMPEDE trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Zhao SS, Harrison SR, Chan A, Clarke N, Davis C, Eddison J, Gregory WJ, Jones GT, Marzo-Ortega H, Murphy DJ, Sandhu V, Sengupta R, Siebert S, Thompson B, Webb D, Yates M, Gaffney K. Treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope. Rheumatol Adv Pract 2023; 7:rkad039. [PMID: 37197377 PMCID: PMC10183299 DOI: 10.1093/rap/rkad039] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 05/19/2023] Open
Abstract
Pharmacological management has advanced considerably since the 2015 British Society for Rheumatology axial spondyloarthritis (axSpA) guideline to incorporate new classes of biologic DMARDs (bDMARDs, including biosimilars), targeted synthetic DMARDs (tsDMARDs) and treatment strategies such as drug tapering. The aim of this guideline is to provide an evidence-based update on pharmacological management of adults with axSpA (including AS and non-radiographic axSpA) using b/tsDMARDs. This guideline is aimed at health-care professionals in the UK who care directly for people with axSpA, including rheumatologists, rheumatology specialist nurses, allied health professionals, rheumatology specialty trainees and pharmacists; people living with axSpA; and other stakeholders, such as patient organizations and charities.
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Affiliation(s)
- Sizheng Steven Zhao
- Correspondence to: Sizheng Steven Zhao, Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9LJ, UK. E-mail:
| | - Stephanie R Harrison
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Antoni Chan
- Department of Rheumatology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | | | - Charlotte Davis
- Department of Rheumatology, Leeds Teaching Hospitals Trust, UK
| | | | - William J Gregory
- Rheumatology Department, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Greater Manchester, UK
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Gareth T Jones
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK
| | - Helena Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Daniel J Murphy
- Department of Rheumatology, Honiton Surgery, Royal Devon & Exeter Hospital, Exeter, UK
| | - Virinderjit Sandhu
- Department of Rheumatology, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Raj Sengupta
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals, Bath, UK
| | - Stefan Siebert
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | - Ben Thompson
- Rheumatology Department, The Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK
| | - Dale Webb
- National Axial Spondyloarthritis Society (NASS), London, UK
| | - Max Yates
- Centre for Epidemiology, Norwich Medical School, University of East Anglia, Norwich, UK
- Rheumatology Department, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Karl Gaffney
- Rheumatology Department, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
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Clarke N, Barnett C. Beyond compliance: Good citizenship during the COVID-19 pandemic. Trans Inst Br Geogr 2022; 48:TRAN12587. [PMID: 36714037 PMCID: PMC9874751 DOI: 10.1111/tran.12587] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/15/2022] [Indexed: 06/18/2023]
Abstract
In the UK, discussion of good citizenship during the COVID-19 pandemic largely focused on compliance and non-compliance with government rules. In this paper, we offer an alternative point of focus. Pandemic governance proceeded not only through rules/morality, but also through freedom/ethics. Good citizenship, therefore, involved practical reasoning in response to situations. We demonstrate this using diaries and other forms of writing collected by Mass Observation during the first six months of the pandemic. Responses to government rules and guidance varied by situation. Many people found governance through freedom/ethics confusing and burdensome. Faced with ethical dilemmas, they managed risks and responsibilities by deliberating, weighing justifications, and sometimes falling back on rules of thumb or heuristics. Discussion of good citizenship during future emergencies would benefit from a greater focus on situations, dilemmas, and justifications.
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Affiliation(s)
- Nick Clarke
- Geography and Environmental ScienceUniversity of SouthamptonSouthamptonUK
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Soong W, Chipps B, Carr W, Trevor J, Clarke N, Carstens D, Genofre E, Ambrose C. QUALITY OF LIFE IMPROVEMENTS WITH BIOLOGIC INITIATION AMONG SPECIALIST-TREATED US PATIENTS WITH SEVERE ASTHMA. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.630] [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: 11/11/2022]
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Oya M, Armstrong A, Thiery-Vuillemin A, Shore N, Procopio G, Arslan Ç, Mehra N, Parnis F, Brown E, Constans Schlurmann F, Joung J, Sugimoto M, Sartor O, Liu YZ, Poehlein C, Desai C, Del Rosario P, Clarke N, Saad F. 157O Biomarker analysis and updated results from the phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.194] [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: 12/05/2022] Open
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Burdett S, Fisher D, Parker C, Sydes M, Pommier P, Sargos P, Spratt D, Kishan A, Brihoum M, Catton C, Chabaud S, Clarke N, Cook A, Latorzeff I, Tierney J, Vale C. LBA64 Duration of androgen suppression with post-operative radiotherapy (DADSPORT): A collaborative meta-analysis of aggregate data. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.067] [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: 11/25/2022] Open
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14
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Attard G, Murphy L, Clarke N, Cross W, Gillessen S, Amos C, Brawley C, Jones R, Pezaro C, Malik Z, Montazeri A, Millman R, Cook A, Gilbert D, Langley R, Parker C, Sydes M, Brown L, Parmar M, James N. LBA62 Comparison of abiraterone acetate and prednisolone (AAP) or combination enzalutamide (ENZ) + AAP for metastatic hormone sensitive prostate cancer (mHSPC) starting androgen deprivation therapy (ADT): Overall survival (OS) results of 2 randomised phase III trials from the STAMPEDE protocol. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.065] [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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15
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Parker C, Clarke N, Cook A, Catton C, Cross W, Kynaston H, Logue J, Petersen P, Neville P, Persad R, Payne H, Saad F, Stirling A, Parulekar W, Parmar M, Sydes M. LBA9 Duration of androgen deprivation therapy (ADT) with post-operative radiotherapy (RT) for prostate cancer: First results of the RADICALS-HD trial (ISRCTN40814031). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.064] [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: 11/01/2022] Open
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16
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Saad F, Armstrong A, Thiery-Vuillemin A, Oya M, Shore N, Procopio G, Arslan C, Mehra N, Parnis F, Brown E, Constans Schlurmann F, Joung J, Sugimoto M, Sartor O, Liu YZ, Poehlein C, Desai C, Del Rosario P, Clarke N. 1357O Biomarker analysis and updated results from the Phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1945] [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: 11/26/2022] Open
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17
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Tekkis NP, Rafi D, Brown S, Courtney A, Kawka M, Howell AM, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Brown S, Kawka M, Mclean K, Savva N, Wilkinson P, Sam AH, Singal A, Chia C, Chia W, Ganesananthan S, Ooi SZY, Pengelly S, Wellington J, Mak S, Subbiah Ponniah H, Heyes A, Aberman I, Ahmed T, Al-Shamaa S, Appleton L, Arshad A, Awan H, Baig Q, Benedict K, Berkes S, Citeroni NL, Damani A, de Sancha A, Fisayo T, Gupta S, Haq M, Heer B, Jones A, Khan H, Kim H, Meiyalagan N, Miller G, Minta N, Mirza L, Mohamed F, Ramjan F, Read P, Soni L, Tailor V, Tas RN, Vorona M, Walker M, Winkler T, Bardon A, Acquaah J, Ball T, Bani W, Elmasry A, Hussein F, Kolluri M, Lusta H, Newman J, Nott M, Perwaiz MI, Rayner R, Shah A, Shaw I, Yu K, Cairns M, Clough R, Gaier S, Hirani D, Jeyapalan T, Li Y, Patel CR, Shabir H, Wang YA, Weatherhead A, Dhiran A, Renney O, Wells P, Ferguson S, Joyce A, Mergo A, Adebayo O, Ahmad J, Akande O, Ang G, Aniereobi E, Awasthi S, Banjoko A, Bates J, Chibada C, Clarke N, Craner I, Desai DD, Dixon K, Duffaydar HI, Kuti M, Mughal AZ, Nair D, Pham MC, Preest GG, Reid R, Sachdeva GS, Selvaratnam K, Sheikh J, Soran V, Stoney N, Wheatle M, Howarth K, Knapp-Wilson A, Lee KS, Mampitiya N, Masson C, McAlinden JJ, McGowan N, Parmar SC, Robinson B, Wahid S, Willis L, Risquet R, Adebayo A, Dhingra L, Kathiravelupillai S, Narayanan R, Soni J, Ghafourian P, Hounat A, Lennon KA, Abdi Mohamud M, Chou W, Chong L, Graham CJ, Piya S, Riad AM, Vennard S, Wang J, Kawar L, Maseland C, Myatt R, Tengku Saifudin TNS, Yong SQ, Douglas F, Ogbechie C, Sharma K, Zafar L, Bajomo MO, Byrne MHV, Obi C, Oluyomi DI, Patsalides MA, Rajananthanan A, Richardson G, Clarke A, Roxas A, Adeboye W, Argus L, McSweeney J, Rahman-Chowdhury M, Hettiarachchi DS, Masood MT, Antypas A, Thomas M, de Andres Crespo M, Zimmerman M, Dhillon A, Abraha S, Burton O, Jalal AHB, Bailey B, Casey A, Kathiravelupillai A, Missir E, Boult H, Campen D, Collins JM, Dulai S, Elhassan M, Foster Z, Horton E, Jones E, Mahapatra S, Nancarrow T, Nyamapfene T, Rimmer A, Robberstad M, Robson-Brown S, Saeed A, Sarwar Y, Taylor C, Vetere G, Whelan MK, Williams J, Zahid D, Chand C, Matthews M. The impact of the COVID-19 pandemic on UK medical education. A nationwide student survey. Med Teach 2022; 44:574-575. [PMID: 34428109 DOI: 10.1080/0142159x.2021.1962835] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
| | - Damir Rafi
- School of Medicine, Imperial College London, London, UK
| | - Sam Brown
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Alona Courtney
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Michal Kawka
- School of Medicine, Imperial College London, London, UK
| | - Ann-Marie Howell
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Kenneth McLean
- Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK
| | - Matthew Gardiner
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | | | - Peter Hutchinson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Paris Tekkis
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paul Wilkinson
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Amir H Sam
- School of Medicine, Imperial College London, London, UK
| | - Nicos Savva
- Division of Management Science and Operations, London Business School, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Acquaah
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - T Ball
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - W Bani
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Elmasry
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - F Hussein
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Kolluri
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - H Lusta
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - J Newman
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Nott
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M I Perwaiz
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - R Rayner
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Shah
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - I Shaw
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - K Yu
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | | | | | - S Gaier
- Queen Mary University of London
| | | | | | - Y Li
- Queen Mary University of London
| | | | | | | | | | - A Dhiran
- St George's Hospital Medical School
| | - O Renney
- St George's Hospital Medical School
| | - P Wells
- St George's Hospital Medical School
| | | | - A Joyce
- The Queen's University of Belfast
| | | | | | - J Ahmad
- The University of Birmingham
| | | | - G Ang
- The University of Birmingham
| | | | | | | | - J Bates
- The University of Birmingham
| | | | | | | | | | - K Dixon
- The University of Birmingham
| | | | - M Kuti
- The University of Birmingham
| | | | - D Nair
- The University of Birmingham
| | | | | | - R Reid
- The University of Birmingham
| | | | | | | | - V Soran
- The University of Birmingham
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Soni
- The University of Cambridge
| | | | | | | | | | - W Chou
- The University of East Anglia
| | | | | | - S Piya
- The University of Edinburgh
| | | | | | - J Wang
- The University of Edinburgh
| | | | | | | | | | | | | | | | | | | | | | | | - C Obi
- The University of Leicester
| | | | | | | | | | | | | | | | - L Argus
- The University of Manchester
| | | | | | | | | | | | | | | | | | | | | | | | | | - B Bailey
- University of Brighton and Sussex
| | - A Casey
- University of Brighton and Sussex
| | | | - E Missir
- University of Brighton and Sussex
| | - H Boult
- University of Exeter Medical School
| | - D Campen
- University of Exeter Medical School
| | | | - S Dulai
- University of Exeter Medical School
| | | | - Z Foster
- University of Exeter Medical School
| | - E Horton
- University of Exeter Medical School
| | - E Jones
- University of Exeter Medical School
| | | | | | | | - A Rimmer
- University of Exeter Medical School
| | | | | | - A Saeed
- University of Exeter Medical School
| | - Y Sarwar
- University of Exeter Medical School
| | - C Taylor
- University of Exeter Medical School
| | - G Vetere
- University of Exeter Medical School
| | | | | | - D Zahid
- University of Exeter Medical School
| | - C Chand
- University of Hull and the University of York
| | - M Matthews
- University of Hull and the University of York
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18
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Swinton M, Mariam N, Tan J, Afferi L, Lonati C, Moshini M, Lau M, Ramani V, Sangar V, Clarke N, Mistry H, Elumalai T, Hoskin P, Choudhury A. PD-0418 Resect or Preserve? Comparing treatment strategies in clinically node positive bladder cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02853-5] [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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19
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Macartney MGW, Clarke N, Collins JA, Mullen S. Interesting case of traumatic paediatric chest pain: don't forget the vessels. Arch Dis Child 2022; 107:39-40. [PMID: 33931401 PMCID: PMC8685608 DOI: 10.1136/archdischild-2021-321621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Matthew G W Macartney
- Paediatric Emergency Medicine, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Nick Clarke
- Radiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Julie-Ann Collins
- Paediatric Emergency Medicine, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Stephen Mullen
- Paediatric Emergency Medicine, Royal Belfast Hospital for Sick Children, Belfast, UK
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Rajamohan M, Jayhoon Z, Gomez B, Tankel F, Clarke N, Foskett S, Baumann A, Quilty S, Kozor R, Wong C. Heart Failure in Indigenous and Non-Indigenous Central Australians. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.477] [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: 10/16/2022]
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21
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Kotecki N, Champiat S, Delord JP, Vinceneux A, Jungels C, Marabelle A, Korakis I, Wojciekowski S, Block E, Clarke N, Fromond C, Poirier N, Costantini D, Vasseur B, Cassier P. 983P Phase I dose escalation study in patients (pts) with advanced solid tumours receiving first-in-class BI 765063, a selective signal-regulatory protein α (SIRPα) inhibitor, in combination with ezabenlimab (BI 754091), a programmed cell death protein 1 (PD-1) inhibitor. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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22
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Attard G, Brown L, Clarke N, Murphy L, Cross W, Jones R, Gillessen S, Russell J, Cook A, Bowen J, Lydon A, Pedley I, Parikh O, Chowdhury S, Malik Z, Matheson D, Parker C, Sydes M, Parmar M, James N. LBA4 Abiraterone acetate plus prednisolone (AAP) with or without enzalutamide (ENZ) added to androgen deprivation therapy (ADT) compared to ADT alone for men with high-risk non-metastatic (M0) prostate cancer (PCa): Combined analysis from two comparisons in the STAMPEDE platform protocol. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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23
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Parry M, Sujenthiran A, Nossiter J, Morris M, Berry B, Cathcart P, Clarke N, Payne H, van der Meulen J, Aggarwal A. PD-0768 Treatment-related toxicity of prostate bed versus whole pelvis post-prostatectomy radiation therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07047-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Brown M, Hart C, Sachdeva A, Oliveira P, Frankhauser C, Wedge D, Clarke N. Localised activation of the EMT switch by peri–neural invading epithelial cells in prostate cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00810-1] [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: 10/20/2022]
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25
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Fankhauser C, Afferi L, Stroup S, Rocco N, Olson K, Bagrodia A, Cazzaniga W, Mayer E, Nicol D, Islamoglu E, De Vergie S, Ragheed S, Eggener S, Nazzani S, Nicolai N, Hugar L, Sexton W, Matei DV, Hermanns T, Hamilton R, Hiester A, Albers P, Clarke N, Mattei A. Perioperative safety and short-term oncological outcomes of minimally invasive retroperitoneal lymph node dissection. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01040-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Parry M, Cowling T, Sujenthiran A, Nossiter J, Berry B, Cathcart P, Clarke N, Payne H, Aggarwal A, Van der Meulen J. PO-1178: Identifying skeletal-related events for prostate cancer in routinely collected hospital data. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01196-8] [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: 11/16/2022]
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27
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Parry M, Sujenthiran A, Nossiter J, Cathcart P, Clarke N, Payne H, Aggarwal A. PD-0060: Treatment-related toxicity of hypofractionated radiation therapy for prostate cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00086-4] [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: 11/24/2022]
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28
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Parry M, Sujenthiran A, Cowling T, Nossiter J, Cathcart P, Clarke N, Payne H, Van der Meulen J, Aggarwal A. PO-1177: Treatment-related toxicity using prostate only vs prostate and pelvic lymph node radiation therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01195-6] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boegman S, Stellingwerff T, Shaw G, Clarke N, Graham K, Cross R, Siegler JC. The Impact of Individualizing Sodium Bicarbonate Supplementation Strategies on World-Class Rowing Performance. Front Nutr 2020; 7:138. [PMID: 33015117 PMCID: PMC7509055 DOI: 10.3389/fnut.2020.00138] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 06/05/2020] [Accepted: 07/16/2020] [Indexed: 11/30/2022] Open
Abstract
Contemporary meta-analyses have generally demonstrated a positive effect of sodium bicarbonate (NaHCO3) supplementation on exercise performance. However, despite these claims, there is limited data on contrasting individualized and standardized timing of NaHCO3 ingestion prior to exercise to further enhance performance outcomes. Purpose: To determine whether NaHCO3 ingestion timing impacts 2,000-m rowing time-trial (TT) performance in elite-level rowers (Senior National team including Olympic/World Championships level) adhering to their own individualized pre-race strategies (e.g. nutrition, warm-up, etc.). Methods: Twenty three (n = 23) rowers across two research centers (using the exact same methods/protocols) completed three trials: NaHCO3 loading profile at rest to determine the individual's time-to-peak bicarbonate concentration [HCO3-], followed by two randomized 0.3 g·kgBM−1 NaHCO3 supplementation experimental trials conducted at different time points [consensus timing (CON): TT performed 60 min post-NaHCO3 ingestion; and individualized peak (IP): TT performed at the rower's individual peak [HCO3-] determined from the profiling trial post-NaHCO3 ingestion]. Results: There was a significant mean difference of +2.9 [± 0.4 mmol·L−1HCO3- for IP vs. CON (95% CI 2.0 to 3.8 mmol·L−1); p = 0.02; d = 1.08] at pre warm-up, but not immediately prior to the TT (post warm-up). Performance times were significantly different between IP (367.0 ± 10.5 s) vs. CON (369.0 ± 10.3 s); p = 0.007; d = 0.15). Conclusions: The present study demonstrated a small but significant performance effect of an individualized NaHCO3 ingestion strategy. Similarities after warm-up between pre-TT sHCO3- values (CON ~ + 5.5 mmol·L−1; IP ~ + 6 mmol·L−1), however, would suggest this effect was not a result of any meaningful differences in blood alkalinity.
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Affiliation(s)
- Susan Boegman
- Canadian Sport Institute Pacific, Victoria, BC, Canada
| | - Trent Stellingwerff
- Canadian Sport Institute Pacific, Victoria, BC, Canada.,Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada
| | - Gregory Shaw
- Swimming Australia, High Performance Unit, Brisbane, QLD, Australia
| | - Nick Clarke
- Canadian Sport Institute Pacific, Victoria, BC, Canada.,Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada
| | - Kenneth Graham
- Sport and Exercise Science Program, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
| | - Rebecca Cross
- Sport and Exercise Science Program, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
| | - Jason C Siegler
- Sport and Exercise Science Program, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
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Baik J, Lee T, Oates J, Aziz O, Wilson M, Shenjere P, Shanks J, Oliveira P, Wylie J, Leahy M, Sangar V, Clarke N. Surgical outcomes of adult patients with abdominopelvic sarcomas. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32944-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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31
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O'Connor M, Waller J, Gallagher P, O'Donovan B, Clarke N, Keogh I, MacCarthy D, O'Sullivan E, Timon C, Martin C, O'Leary J, Sharp L. Barriers and facilitators to discussing HPV with head and neck cancer patients: A qualitative study using the theoretical domains framework. Patient Educ Couns 2020; 103:S0738-3991(20)30318-9. [PMID: 32565003 DOI: 10.1016/j.pec.2020.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/11/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The incidence of human papillomavirus-associated head and neck cancers (HPV-HNC) is increasing worldwide. Research in other clinical contexts has shown that healthcare professionals (HCPs) can find discussing HPV with patients challenging. However, limited research has been conducted in HNC. This study aimed to investigate barriers and facilitators to, discussing HPV among HCPs caring for patients with HNC in Ireland. METHODS Semi-structured telephone/face-to-face interviews were conducted with HCPs. Barriers and facilitators to discussing HPV with patients were identified using the Theoretical Domains Framework (TDF). RESULTS 20 HCPs (8 clinicians, 3 nurses, 9 allied healthcare professionals) were interviewed. Barriers to discussing HPV included professionals' lack of HPV knowledge, difficulties in talking about sexual issues with patients and lack of privacy to discuss HPV in busy clinic settings. Facilitators included increasing public and patient awareness of the link between HPV and HNC and professional education and skills development. CONCLUSIONS This is the first theoretically informed study to identify barriers and facilitators to discussing HPV with HNC patients. HCPs consider HPV discussions to be an essential part of HNC patient care. PRACTICE IMPLICATIONS Understanding the issues associated with patient-provider HPV communication will help develop effective interventions to support HCPs in their HPV discussions.
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Affiliation(s)
- M O'Connor
- National Cancer Registry Ireland, Kinsale Road, Cork, Ireland
| | - J Waller
- Department of Behavioural Science and Health, University College London, London, UK
| | - P Gallagher
- School of Psychology, Dublin City University, Dublin, Ireland
| | - B O'Donovan
- National Cancer Registry Ireland, Kinsale Road, Cork, Ireland.
| | - N Clarke
- School of Psychology, Dublin City University, Dublin, Ireland
| | - I Keogh
- College of Medicine Nursing & Health Sciences, National University of Ireland Galway, Ireland
| | - D MacCarthy
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Dublin, Ireland
| | - E O'Sullivan
- Cork University Dental School and Hospital, Cork, Ireland
| | - C Timon
- St. James's Hospital, James's Street, Dublin, Ireland
| | - C Martin
- Department of Histopathology, University of Dublin, Trinity College, Ireland; Department of Pathology, Coombe Women and Infants University Hospital, Ireland
| | - J O'Leary
- Department of Histopathology, University of Dublin, Trinity College, Ireland; Department of Pathology, Coombe Women and Infants University Hospital, Ireland
| | - L Sharp
- Institute of Health & Society, Newcastle University, UK
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32
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Longdon E, Mistry H, Pratt O, Donnelly A, O'Neill S, Nachiappan M, Darwin L, Clarke N, Hartley R. Variables associated with survival in patients with invasive bladder cancer with and without surgery. Anaesthesia 2020; 75:887-895. [PMID: 32329060 DOI: 10.1111/anae.15034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2020] [Indexed: 12/16/2022]
Abstract
We recorded the survival of 141 patients assessed for radical cystectomy, which included cardiopulmonary exercise testing. The median Kaplan-Meier survival estimates were: 1540 days for the whole cohort; 2200 days after cystectomy scheduled (n = 108); and 843 days without surgery. The mortality hazard remained double that expected for a matched general population, but survival was better in patients scheduled for surgery than those who were not: the mortality hazard ratio (95%CI) after cystectomy was 0.43 (0.26-0.73) the mortality hazard without surgery, p = 0.001. The mortality hazard ratios for the three-variable Bayesian Model Averaging survival model for all 141 patients were: referral for surgery (0.5); haemoglobin concentration (0.98); and efficiency of carbon dioxide output (1.05). Efficiency of carbon dioxide output was the single variable in the postoperative model (n = 108), mortality hazard 1.08 (per unit increase). The ratio of observed to expected peak oxygen consumption associated best with mortality in 33 patients not referred for surgery, hazard ratio 0.001. Our results can inform consultations with patients with invasive bladder cancer and suggest that interventions to increase fitness and haemoglobin may improve survival in patients who do and who do not undergo radical cystectomy.
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Affiliation(s)
- E Longdon
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - H Mistry
- Department of Pharmacy, University of Manchester, UK
| | - O Pratt
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - A Donnelly
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - S O'Neill
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - M Nachiappan
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - L Darwin
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
| | - N Clarke
- Department of Urology, Salford Royal NHS Foundation Trust, Salford, UK.,Department of Surgery, The Christie Hospital, Manchester, UK
| | - R Hartley
- Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK
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Clarke N, Gallagher C, Pitman B, Tu S, Hanna-Rivero N, Kangaharan N, Roberts-Thomson K, Lau D, Mahajan R, Sanders P, Wong C. 692 Anticoagulation Prescription for Indigenous and Non-Indigenous Patients With Atrial Fibrillation in Central Australia. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.699] [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: 11/16/2022]
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Jeffries A, Costello B, Corkill W, Varghese S, Tayeb H, Gallagher C, Clarke N, Pitman B, Tu S, Hanna-Rivero N, Kangaharan N, Wong C. 376 Long-Term Prognostic Value of Coronary Artery Calcium in Indigenous and Non-Indigenous Australians. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.383] [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: 11/24/2022]
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Clarke N, Gallagher C, Pitman B, Tu S, Hanna-Rivero N, Kangaharan N, Roberts-Thomson K, Lau D, Mahajan R, Sanders P, Wong C. 033 Age Discrepancy in Cardiometabolic Risk Factor Profiles in Indigenous and Non-Indigenous Australians With Atrial Fibrillation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.040] [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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Rana K, Sabab A, Tu S, Hanna-Rivero N, Clarke N, Pitman B, Gallagher C, Mahajan R, Lau D, Sanders P, Wong C. 246 Prevalence and Prognostic Impact of Iron Deficiency Anaemia in Atrial Fibrillation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.253] [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: 11/26/2022]
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Clarke N, Kangaharan N, Costello B, Tu S, Hanna-Rivero N, Agahari I, Choo W, Pitman B, Gallagher C, Haji K, Robertson-Thomson K, Sanders P, Wong C. 701 Left Atrial, Pulmonary Vein, and Left Atrial Appendage Anatomy in Indigenous Individuals: Implications for Atrial Fibrillation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.708] [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: 11/30/2022]
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Honecker F, Aparicio J, Berney D, Beyer J, Bokemeyer C, Cathomas R, Clarke N, Cohn-Cedermark G, Daugaard G, Dieckmann KP, Fizazi K, Fosså S, Germa-Lluch JR, Giannatempo P, Gietema JA, Gillessen S, Haugnes HS, Heidenreich A, Hemminki K, Huddart R, Jewett MAS, Joly F, Lauritsen J, Lorch A, Necchi A, Nicolai N, Oing C, Oldenburg J, Ondruš D, Papachristofilou A, Powles T, Sohaib A, Ståhl O, Tandstad T, Toner G, Horwich A. ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann Oncol 2019; 29:1658-1686. [PMID: 30113631 DOI: 10.1093/annonc/mdy217] [Citation(s) in RCA: 179] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The European Society for Medical Oncology (ESMO) consensus conference on testicular cancer was held on 3-5 November 2016 in Paris, France. The conference included a multidisciplinary panel of 36 leading experts in the diagnosis and treatment of testicular cancer (34 panel members attended the conference; an additional two panel members [CB and K-PD] participated in all preparatory work and subsequent manuscript development). The aim of the conference was to develop detailed recommendations on topics relating to testicular cancer that are not covered in detail in the current ESMO Clinical Practice Guidelines (CPGs) and where the available level of evidence is insufficient. The main topics identified for discussion related to: (1) diagnostic work-up and patient assessment; (2) stage I disease; (3) stage II-III disease; (4) post-chemotherapy surgery, salvage chemotherapy, salvage and desperation surgery and special topics; and (5) survivorship and follow-up schemes. The experts addressed questions relating to one of the five topics within five working groups. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel. A consensus vote was obtained following whole-panel discussions, and the consensus recommendations were then further developed in post-meeting discussions in written form. This manuscript presents the results of the expert panel discussions, including the consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.
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Affiliation(s)
- F Honecker
- Tumor and Breast Center ZeTuP, St. Gallen, Switzerland; Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany.
| | - J Aparicio
- Department of Medical Oncology, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - D Berney
- Department of Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - J Beyer
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany
| | - R Cathomas
- Department of Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - N Clarke
- Department of Surgery, The Christie NHS Foundation Trust, Manchester, UK
| | - G Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K-P Dieckmann
- Department of Urology, Asklepios Klinik Altona, Hamburg, Germany
| | - K Fizazi
- Department of Cancer Medicine, Gustave Roussy, University of Paris Sud, Villejuif, France
| | - S Fosså
- Department of Oncology, Oslo University Hospital Radiumhospitalet, Oslo, Norway
| | - J R Germa-Lluch
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona University, Barcelona, Spain
| | - P Giannatempo
- Department of Medical Oncology, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - J A Gietema
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - S Gillessen
- Department of Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen; University of Bern, Bern, Switzerland
| | - H S Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway; Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway
| | - A Heidenreich
- Department of Urology, Uro-Oncology, Robot-assisted and Specialised Urologic Surgery, University of Cologne, Cologne, Germany
| | - K Hemminki
- Department of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - R Huddart
- Department of Radiotherapy and Imaging, The Institute of Cancer Research, Royal Marsden Hospital, Sutton, UK
| | - M A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada
| | - F Joly
- Department of Urology-Gynaecology, Centre Francois Baclesse, Caen, France
| | - J Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A Lorch
- Department of Urology, Genitourinary Medical Oncology, Heinrich-Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - A Necchi
- Department of Medical Oncology, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - N Nicolai
- Department of Surgery, Urology and Testis Surgery Unit, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - C Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany
| | - J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - D Ondruš
- 1st Department of Oncology, St. Elisabeth Cancer Institute, Comenius University Faculty of Medicine, Bratislava, Slovak Republic
| | - A Papachristofilou
- Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - T Powles
- Department of Medical Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - A Sohaib
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | - O Ståhl
- Department of Oncology, Skane University Hospital, Lund University, Lund, Sweden
| | - T Tandstad
- The Cancer Clinic, St. Olavs Hospital, Trondheim, Norway
| | - G Toner
- Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia
| | - A Horwich
- The Institute of Cancer Research, Royal Marsden Hospital, Sutton, UK
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Clarke N, Ruff M. P14.86 Bevacizumab-associated intracerebral hemorrhage in patients with CNS malignancy: A single-center retrospective cohort study. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.321] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Gliomas are a known risk factor for the development of spontaneous intracranial hemorrhage (ICH) independent of therapies directed against them, with studies reporting an incidence of 1.9–3.8%. Bevacizumab (BEV) is a humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF) FDA approved for recurrent glioblastoma. ICH is commonly considered to be a potential adverse effect of BEV use in patients with glioma, with previous retrospective studies describing incidence of intracerebral hemorrhage ranging from 1.9–3.3%.
Material and METHODS
We performed a single center (Mayo Clinic, Rochester, MN) retrospective chart review of all patients who received BEV therapy at our institution for a diagnosis of primary CNS malignancy. We used ICD-9 and ICD-10 codes to identify adult patients with primary CNS neoplasms that subsequently developed ICH.
RESULTS
We screened 10,507 adult patients with a diagnosis of primary CNS neoplasm treated at our center from 01/31/2008 to 12/31/2018 and found 644 patients treated with bevacizumab. Of these, 23 (3.6%) suffered an ICH within 12 weeks of a BEV infusion (median 9 days post infusion, 1–24 IQR). The dose of BEV in all hemorrhages was either 10 mg/kg every two weeks (n = 21) or 15 mg/kg every three weeks (n = 2). No patients treated with infusions at 7.5 mg/kg every three weeks (n = 79) or 5 mg/kg every two weeks (n = 17) suffered ICH events, however this did not meet significance (P = 0.06) when compared to patients on 10 mg/kg or above. The median ICH score was 1 (0–2 IQR). There was an increase in ECOG scores documented at clinical follow up following the hemorrhage compared to the pre-hemorrhage functional status (ECOG 3.28 versus 1.2, p = < 0.0001), with 13 patients (56%) having developed severe debility or death (ECOG 4 n = 3, ECOG 5 n = 10).
CONCLUSION
In our single-center cohort of patients with a primary diagnosis of CNS neoplasms treated with BEV, ICH occurred in 3.6% of patients. Those who experienced an ICH in proximity to BEV infusion had significant morbidity and mortality with a clear decline in functional status. There was a signal of dose response as far as ICH incidence in our cohort with dosages 10 mg/kg per infusion or above.
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Affiliation(s)
- N Clarke
- Mayo Clinic, Rochester, MN, United States
| | - M Ruff
- Mayo Clinic, Rochester, MN, United States
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Brannan M, Bernardotto M, Clarke N, Varney J. Moving healthcare professionals - a whole system approach to embed physical activity in clinical practice. BMC Med Educ 2019; 19:84. [PMID: 30876426 PMCID: PMC6419815 DOI: 10.1186/s12909-019-1517-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 03/11/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Healthcare professionals are key informants to support individual behaviour change, and although there has been some progress in empowering clinicians to promote physical activity and health at work, an effective strategy overarching the whole medical educational journey is still lacking. This report provides an overview from the Moving Healthcare Professionals programme (MHPP), a whole-system educational approach to embed prevention and physical activity promotion into clinical practice. METHODS The MHPP model integrates educational resources into three core domains of medical education: undergraduate education, postgraduate education and continuing professional development. The interventions are designed to spiral through existing educational approaches rather than as additional special study modules or bolt-on courses, thus reducing self-selection bias in exposure. Interventions include spiral undergraduate education materials, e-learning, embedded post-graduate resources and face-to-face peer-to-peer education. RESULTS To date the MHPP model has been applied in two key areas, physical activity and health and work. The physical activity programme in a partnership between Public Health England and Sport England has delivered face-to-face training to 17,105 healthcare professionals, embedded materials in almost three quarters of English medical schools and overseen > 95,000 e-learning modules completed over two and half years. Evaluation of the individual elements of the model is ongoing and aims to show improvements in knowledge, skills and practice. Further evaluation is planned to assess patient impact. CONCLUSIONS The MHPP model offers a coherent whole-system approach to embed public health action into existing healthcare education models, and as such provides a framework for rapid change as well as upstream implementation to support the clinicians of today and tomorrow.
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Affiliation(s)
| | | | | | - Justin Varney
- Public Health, Birmingham City Council, Birmingham, UK
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Jeffries A, Costello B, Tayeb H, Varghese S, Gallagher C, Chang D, Clarke N, Pitman B, Kanagaharan N, Wong C. Prognostic Value of Computed Tomography Coronary Angiography (CTCA) in Remote Indigenous and Non-Indigenous Australians. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.307] [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: 11/24/2022]
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Clarke N, Kangaharan N, Gallagher C, Pitman B, Mahajan R, Lau D, Sanders P, Wong C. Prevalence of Atrial Fibrillation in Remote Indigenous and non-Indigenous Populations: A Ten-Year Study in Central Australia. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.518] [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: 11/26/2022]
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Jennings W, Clarke N, Moss J, Stoker G. The Decline in Diffuse Support for National Politics: The Long View on Political Discontent in Britain. Public Opin Q 2017; 81:748-758. [PMID: 29731522 PMCID: PMC5927329 DOI: 10.1093/poq/nfx020] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This research note considers how to track long-term trajectories of political discontent in Britain. Many accounts are confined to using either survey data drawn from recent decades or imperfect behavioral measures such as voting or party membership as indicators of political disengagement. We instead develop an approach that provides the long view on political disaffection. We first consider time-series data available from repeated survey measures. We next replicate historic survey questions to observe change in public opinion relative to earlier points in time. Finally, we use Stimson's (1991) dyad-ratios algorithm to construct an over-time index of political discontent that combines data from multiple poll series. This reveals rising levels of political discontent for both specific and diffuse measures of mass opinion. Our method and findings offer insights into the rising tide of disillusionment afflicting many contemporary democracies.
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Affiliation(s)
- Will Jennings
- Will Jennings is a professor of political science and public policy at the University of Southampton, Southampton, UK. Nick Clarke is an associate professor of human geography at the University of Southampton, Southampton, UK. Jonathan Moss is a senior research assistant at the University of Southampton, Southampton, UK. Gerry Stoker is chair of governance at the University of Southampton, Southampton, UK, and Centenary Research Professor of Governance at the Institute for Governance and Policy Analysis, University of Canberra, Canberra, Australia. The authors thank Roger Mortimore and Laurence Stellings and participants at a workshop at New Place, Southampton, for their comments on an earlier version of this paper. The authors also thank YouGov for conducting the October 2014 online survey that is used in their analysis; and they thank the editors and three anonymous reviewers for their useful comments on the manuscript. This work was supported by the UK Economic and Social Research Council for the research project “Popular Understandings of Politics in Britain, 1937–2014” [ES/L007185/1 to N.C., G.S., and W.J.]
| | - Nick Clarke
- Will Jennings is a professor of political science and public policy at the University of Southampton, Southampton, UK. Nick Clarke is an associate professor of human geography at the University of Southampton, Southampton, UK. Jonathan Moss is a senior research assistant at the University of Southampton, Southampton, UK. Gerry Stoker is chair of governance at the University of Southampton, Southampton, UK, and Centenary Research Professor of Governance at the Institute for Governance and Policy Analysis, University of Canberra, Canberra, Australia. The authors thank Roger Mortimore and Laurence Stellings and participants at a workshop at New Place, Southampton, for their comments on an earlier version of this paper. The authors also thank YouGov for conducting the October 2014 online survey that is used in their analysis; and they thank the editors and three anonymous reviewers for their useful comments on the manuscript. This work was supported by the UK Economic and Social Research Council for the research project “Popular Understandings of Politics in Britain, 1937–2014” [ES/L007185/1 to N.C., G.S., and W.J.]
| | - Jonathan Moss
- Will Jennings is a professor of political science and public policy at the University of Southampton, Southampton, UK. Nick Clarke is an associate professor of human geography at the University of Southampton, Southampton, UK. Jonathan Moss is a senior research assistant at the University of Southampton, Southampton, UK. Gerry Stoker is chair of governance at the University of Southampton, Southampton, UK, and Centenary Research Professor of Governance at the Institute for Governance and Policy Analysis, University of Canberra, Canberra, Australia. The authors thank Roger Mortimore and Laurence Stellings and participants at a workshop at New Place, Southampton, for their comments on an earlier version of this paper. The authors also thank YouGov for conducting the October 2014 online survey that is used in their analysis; and they thank the editors and three anonymous reviewers for their useful comments on the manuscript. This work was supported by the UK Economic and Social Research Council for the research project “Popular Understandings of Politics in Britain, 1937–2014” [ES/L007185/1 to N.C., G.S., and W.J.]
| | - Gerry Stoker
- Will Jennings is a professor of political science and public policy at the University of Southampton, Southampton, UK. Nick Clarke is an associate professor of human geography at the University of Southampton, Southampton, UK. Jonathan Moss is a senior research assistant at the University of Southampton, Southampton, UK. Gerry Stoker is chair of governance at the University of Southampton, Southampton, UK, and Centenary Research Professor of Governance at the Institute for Governance and Policy Analysis, University of Canberra, Canberra, Australia. The authors thank Roger Mortimore and Laurence Stellings and participants at a workshop at New Place, Southampton, for their comments on an earlier version of this paper. The authors also thank YouGov for conducting the October 2014 online survey that is used in their analysis; and they thank the editors and three anonymous reviewers for their useful comments on the manuscript. This work was supported by the UK Economic and Social Research Council for the research project “Popular Understandings of Politics in Britain, 1937–2014” [ES/L007185/1 to N.C., G.S., and W.J.]
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Macken WL, Clarke N, Nadeem M, Coghlan D. Life After the Event: A Review of Basic Life Support Training for Parents Following Apparent Life-Threatening Events and Their Experience and Practices Following Discharge. Ir Med J 2017; 110:572. [PMID: 28737312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2/13 (15%) of children. Non-medical grade monitors were in use by 10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge.
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Affiliation(s)
- W L Macken
- Department of General Paediatrics, National Children's Hospital, Tallaght, Dublin
| | - N Clarke
- Department of General Paediatrics, National Children's Hospital, Tallaght, Dublin
| | - M Nadeem
- Department of General Paediatrics, National Children's Hospital, Tallaght, Dublin
| | - D Coghlan
- Department of General Paediatrics, National Children's Hospital, Tallaght, Dublin
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Affiliation(s)
- N Clarke
- School of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK
| | - D C J Main
- School of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK
| | - E S Paul
- School of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK
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Affiliation(s)
- J Price
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, Easter Bush, Roslin, Midlothian, Scotland EH25 9RG
| | - N Clarke
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, Easter Bush, Roslin, Midlothian, Scotland EH25 9RG
| | - E M Welsh
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, Easter Bush, Roslin, Midlothian, Scotland EH25 9RG
| | - N Waran
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, Easter Bush, Roslin, Midlothian, Scotland EH25 9RG
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Xie W, Sweeney C, Regan M, Nakabayashi M, Buyse M, Clarke N, Collette L, Dignam J, Fizazi K, Habibian M, Halabi S, Kantoff P, Parulekar W, Sandler H, Sartor O, Soule H, Sydes M, Tombal B, Williams S. Metastasis free survival (MFS) is a surrogate for overall survival (OS) in localized prostate cancer (CaP). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aggarwal A, Nossiter J, Cathcart P, van der Meulen J, Rashbass J, Clarke N, Payne H. Organisation of Prostate Cancer Services in the English National Health Service. Clin Oncol (R Coll Radiol) 2016; 28:482-489. [DOI: 10.1016/j.clon.2016.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 11/28/2022]
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Topo P, Mäki O, Saarikalle K, Clarke N, Begley E, Cahill S, Arenlind J, Holthe T, Morbey H, Hayes K, Gilliard J. Assessment of a Music-Based Multimedia Program for People with Dementia. Dementia 2016. [DOI: 10.1177/1471301204045164] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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
Music in different forms is widely used in dementia care and several studies have shown that music-based activities support the well-being of people with dementia. The aim of this article is to describe the first results of an assessment study of a music-based multimedia program called ‘Picture Gramophone’ (PG). The assessment was carried out in dementia day care units ( n= 5) in Finland, Ireland, Norway and the UK. In this article we describe the results from the first three weeks. Altogether, 28 people participated in the first interview and five dropped out over the three weeks. Most participants used the PG and, according to staff, most of them benefited from its use. Our results suggest that multimedia products can be used in dementia care if support is available and the design of the product takes into account the user requirements of people with dementia.
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Affiliation(s)
- Päivi Topo
- National Research and Development Centre for Welfare and Health (STAKES),
Finland,
| | - Outi Mäki
- National Research and Development Centre for Welfare and Health (STAKES),
Finland,
| | - Kristiina Saarikalle
- National Research and Development Centre for Welfare and Health (STAKES),
Finland,
| | - Nick Clarke
- Dementia Services Information and Development Centre, Dublin
| | - Emer Begley
- Dementia Services Information and Development Centre, Dublin,
| | - Suzanne Cahill
- Dementia Services Information and Development Centre, Dublin,
| | | | | | | | | | | |
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