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Hendriks N, Koeneman MM, van de Sande AJ, Penders CG, Piek JM, Kooreman LF, van Kuijk SM, Hoosemans L, Sep SJ, de Vos Van Steenwijk PJ, van Beekhuizen HJ, Slangen BF, Nijman HW, Kruitwagen RF, Kruse AJ. Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3): A Nonrandomized Multicenter Study. J Immunother 2022; 45:180-186. [PMID: 35180719 PMCID: PMC8906243 DOI: 10.1097/cji.0000000000000414] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 04/21/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022]
Abstract
Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN.
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Affiliation(s)
- Natasja Hendriks
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
| | - Margot M. Koeneman
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
| | | | - Charlotte G.J. Penders
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
| | - Jurgen M.J. Piek
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven
| | | | - Sander M.J. van Kuijk
- Department of Methodology and Statistics
- CAPHRI—School for Care and Public health Research Institute, Maastricht University, Maastricht
| | | | - Simone J.S. Sep
- Internal Medicine, Maastricht University Medical Center
- CAPHRI—School for Care and Public health Research Institute, Maastricht University, Maastricht
| | | | | | - Brigitte F.M. Slangen
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
| | - Hans W. Nijman
- Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen
| | - Roy F.P.M. Kruitwagen
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
| | - Arnold-Jan Kruse
- Departments of Obstetrics and Gynecology
- GROW—School for Oncology and Developmental Biology
- Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, The Netherlands
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De Jong N, Backes WH, Jansen JF, van Boxtel MP, Schram MT, Stehouwer CD, Dagnelie PC, van Greevenbroek MM, van der Kallen CJ, Kroon AA, Schaper NC, Eussen SJ, Koster A, Wesselius A, Sep SJ, Koehler S. White matter network structure as a substrate of cognitive brain reserve in cerebral small‐vessel disease: The Maastricht Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.056389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nathan De Jong
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
| | - Walter H. Backes
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Jacobus F.A. Jansen
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Eindhoven University of Technology Eindhoven Netherlands
| | - Martin P.J. van Boxtel
- Maastricht University Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
| | - Miranda T. Schram
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Coen D.A. Stehouwer
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Pieter C. Dagnelie
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | | | - Carla J.H. van der Kallen
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Abraham A. Kroon
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Nicolaas C. Schaper
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | | | | | - Anke Wesselius
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Simone J.S. Sep
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology Hoensbroek Netherlands
| | - Sebastian Koehler
- Maastricht University Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
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Nielen JT, Driessen JH, Dagnelie PC, Boonen A, van den Bemt B, van Onzenoort HA, Neef C, Henry RM, Burden AM, Sep SJ, van der Kallen CJ, Schram MT, Schaper N, Stehouwer CD, Smits L, de Vries F. Drug utilization in the Maastricht Study: A comparison with nationwide data. Medicine (Baltimore) 2020; 99:e18524. [PMID: 31895787 PMCID: PMC6946313 DOI: 10.1097/md.0000000000018524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Within the southern region of the Netherlands, the Maastricht Study is an on-going observational prospective population-based cohort study that focuses on the etiology of Type 2 diabetes mellitus (T2DM). Representativeness of the participating population is a crucial but often an unknown factor in population-based cohort studies such as the Maastricht Study. We therefore aimed to assess the representativeness of the study population by comparing drug utilization of the participants of the Maastricht Study with the general population of the Netherlands.Since T2DM patients were oversampled in this study, a sampling method was applied in order to ensure a similar distribution of T2DM over the study population. Drug use in the study population was compared with drug use in the population of the Netherlands, using a Z-test to compare 2 independent proportions.In general, drug use in the study was similar compared with national data. However, in the age group 65 to 74 years total drug use was lower in the study population (833/1000 persons) versus nationwide data (882/1000 persons). The use of pulmonary medications was lower (104/1000 persons vs 141/1000 persons) and the use of hypnotics/anxiolytics was higher (90/1000 persons vs 36/1000 persons) in the Maastricht Study as compared with national data.Drug use in the Maastricht Study population is largely comparable to that in the total Dutch population aged 45 to 74. Therefore, data on drug use by participants in the Maastricht Study can be used to perform studies assessing outcomes associated with drug use.
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Affiliation(s)
- Johannes T.H. Nielen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
| | - Johanna H.M. Driessen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht
- School for nutrition, and translational research in metabolism (NUTRIM), Maastricht University
| | - Pieter C. Dagnelie
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- School for Public Health and Primary Care (CAPHRI), Maastricht University
| | - Annelies Boonen
- School for Public Health and Primary Care (CAPHRI), Maastricht University
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center +, Maastricht
| | - Bart van den Bemt
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Department of Pharmacy, Sint Maartenskliniek
- Department of Pharmacy, Radboud University Medical Center, Nijmegen
| | - Hein A.W. van Onzenoort
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Department of Clinical Pharmacy, Amphia Hospital, Breda
| | - Cees Neef
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
| | - Ronald M.A. Henry
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Andrea M. Burden
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Eidgenossische Technische Hochschule Zurich, Zurich, Switzerland
| | - Simone J.S. Sep
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Carla J. van der Kallen
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Miranda T. Schram
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Nicolaas Schaper
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Coen D.A. Stehouwer
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Department of Epidemiology, Maastricht University
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Luc Smits
- Department of Epidemiology, Maastricht University
| | - Frank de Vries
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center +
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht
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Martens RJ, Houben AJ, Kooman JP, Berendschot TT, Dagnelie PC, van der Kallen CJ, Kroon AA, Leunissen KM, van der Sande FM, Schaper NC, Schouten JS, Schram MT, Sep SJ, Sörensen BM, Henry RM, Stehouwer CD. Microvascular endothelial dysfunction is associated with albuminuria. J Hypertens 2018; 36:1178-1187. [DOI: 10.1097/hjh.0000000000001674] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Pulakka A, Stenholm S, Bosma H, Schaper NC, Savelberg HH, Stehouwer CD, van der Kallen CJ, Dagnelie PC, Sep SJ, Koster A. Association Between Employment Status and Objectively Measured Physical Activity and Sedentary Behavior—The Maastricht Study. J Occup Environ Med 2018; 60:309-315. [DOI: 10.1097/jom.0000000000001254] [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: 11/25/2022]
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Sep SJ, Smits LJ, Prins MH, Spaanderman ME, Peeters LL. Simple Prepregnant Prediction Rule for Recurrent Early-onset Hypertensive Disease in Pregnancy. Reprod Sci 2009; 16:80-7. [DOI: 10.1177/1933719108324889] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Simone J.S. Sep
- Department of Obstetrics and Gynaecology, University Medical Centre Maastricht and the Research Institute Growth and Development (GROW), Maastricht University, Faculty of Medicine, Department of Epidemiology, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, Netherlands
| | - Luc J.M. Smits
- Department of Epidemiology, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, Netherlands
| | - Martin H. Prins
- Department of Epidemiology, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, Netherlands
| | - Marc E.A. Spaanderman
- Department of Obstetrics and Gynaecology, University Medical Centre, Nijmegen, Netherlands
| | - Louis L.H. Peeters
- Department of Obstetrics and Gynaecology, University Medical Centre Maastricht and the Research Institute Growth and Development (GROW), Maastricht University, Faculty of Medicine
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