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Haberman RH, Zhou YY, Catron S, Felipe A, Jano K, Reddy SM, Scher JU. Psychosocial Factors Significantly Contribute to Joint Pain Persistence in Psoriatic Arthritis. J Rheumatol 2024; 51:318-320. [PMID: 38428986 PMCID: PMC10914320 DOI: 10.3899/jrheum.2023-0909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Rebecca H Haberman
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York;
| | - Ying Yin Zhou
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
| | - Sydney Catron
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
| | - Adamary Felipe
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
| | - Kathryn Jano
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
| | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, NYU Grossman School of Medicine, New York
- Colton Center for Autoimmunity, NYU Grossman School of Medicine, New York, New York, USA
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Chat VS, Ellebrecht CT, Kingston P, Bell S, Gondo G, Cordoro KM, Desai SR, Duffin KC, Feldman SR, Garg A, Gelfand JM, Gladman D, Green LJ, Gudjonsson J, Han G, Hawkes JE, Kircik L, Koo J, Langley R, Lebwohl M, Michael Lewitt G, Liao W, Martin G, Orbai AM, Reddy SM, Richardson V, Ritchlin CT, Schwartzman S, Siegel EL, Van Voorhees AS, Wallace EB, Weinberg JM, Winthrop KL, Yamauchi P, Armstrong AW. Vaccination Recommendations for Adults Receiving Biologics and Oral Therapies for Psoriasis and Psoriatic Arthritis: Delphi Consensus from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol 2024:S0190-9622(24)00243-3. [PMID: 38331098 DOI: 10.1016/j.jaad.2023.12.070] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/30/2023] [Accepted: 12/05/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND For psoriatic patients who need to receive non-live or live vaccines, evidence-based recommendations are needed regarding whether to pause or continue systemic therapies for psoriasis and/or psoriatic arthritis. OBJECTIVE To evaluate literature regarding vaccine efficacy and safety and to generate consensus-based recommendations for adults receiving systemic therapies for psoriasis and/or psoriatic arthritis receiving non-live or live vaccines. METHODS Using a modified Delphi process, 22 consensus statements were developed by the National Psoriasis Foundation Medical Board and COVID-19 Task Force, and infectious disease experts. RESULTS Key recommendations include continuing most oral and biologic therapies without modification for patients receiving non-live vaccines; consider interruption of methotrexate for non-live vaccines. For patients receiving live vaccines, discontinue most oral and biologic medications before and after administration of live vaccine. Specific recommendations include discontinuing most biologic therapies, except for abatacept, for 2-3 half-lives before live vaccine administration and deferring next dose 2-4 weeks after live vaccination. LIMITATIONS Studies regarding infection rates after vaccination are lacking. CONCLUSION Interruption of anti-psoriatic oral and biologic therapies is generally not necessary for patients receiving non-live vaccines. Temporary interruption of oral and biologic therapies before and after administration of live vaccines is recommended in most cases.
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Affiliation(s)
- Vipawee S Chat
- Department of Dermatology, Keck School of Medicine at USC, Los Angeles, California
| | - Christoph T Ellebrecht
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Paige Kingston
- Department of Dermatology, Keck School of Medicine at USC, Los Angeles, California
| | - Stacie Bell
- National Psoriasis Foundation, Portland, Oregon
| | | | - Kelly M Cordoro
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
| | - Seemal R Desai
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas; Innovative Dermatology, Plano, Texas
| | | | - Steven R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Amit Garg
- Department of Dermatology, Donald and Barbara Zucker School of Medicine, Hempstead, New York
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Dafna Gladman
- Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | - Johann Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
| | - George Han
- Department of Dermatology, Donald and Barbara Zucker School of Medicine, Hempstead, New York
| | - Jason E Hawkes
- Department of Dermatology, University of California, Davis, Rocklin, California
| | | | - John Koo
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
| | - Richard Langley
- Division of Clinical Dermatology & Cutaneous Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Wilson Liao
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California
| | - George Martin
- Dr. George Martin Dermatology Associates, Kihei, Hawaii
| | - Ana-Maria Orbai
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Soumya M Reddy
- Division of Rheumatology, NYU Grossman School of Medicine, New York, New York
| | - Veronica Richardson
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Christopher T Ritchlin
- Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, NY
| | - Sergio Schwartzman
- Division of Rheumatology, Weill Cornell Medical Center, New York, New York
| | - Evan L Siegel
- Department of Rheumatology, Arthritis and Rheumatism Associates, Rockville, Maryland
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Elizabeth B Wallace
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jeffrey M Weinberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kevin L Winthrop
- Division of Infectious Diseases, Oregon Health and Science University, Portland, Oregon
| | - Paul Yamauchi
- Dermatology Institute & Skin Care Center, Santa Monica, California
| | - April W Armstrong
- Division of Dermatology, University of California Los Angeles, Los Angeles, California.
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Reddy SM, Xue K, Husni ME, Scher JU, Stephens-Shields AJ, Goel N, Koplin J, Craig ET, Walsh JA, Ogdie A. Use of the Bath Ankylosing Spondylitis Disease Activity Index in Patients With Psoriatic Arthritis With and Without Axial Disease. J Rheumatol 2024; 51:139-143. [PMID: 38101918 DOI: 10.3899/jrheum.2023-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To evaluate whether the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a responsive instrument in psoriatic arthritis (PsA) and whether it differentiates between axial and peripheral disease activity in PsA. METHODS Individuals with PsA initiating therapy in a longitudinal cohort study based in the United States were included. Axial PsA (axPsA), most often also associated with peripheral disease, was defined as fulfillment of the Assessment of Spondyloarthritis international Society axial spondyloarthritis classification criteria or presence of axial disease imaging features. Baseline BASDAI, individual BASDAI items, patient global assessment, patient pain, and Routine Assessment of Patient Index Data 3, and score changes following therapy initiation were descriptively reported. Standardized response means (SRMs) were calculated as the mean change divided by the SD of the change. RESULTS The mean (SD) baseline BASDAI score at the time of therapy initiation was 5.0 (2.2) among those with axPsA (n = 40) and 4.8 (2.0) among those with peripheral-only disease (n = 79). There was no significant difference in patient-reported outcome scores between the groups. The mean change for BASDAI was similar among axial vs peripheral disease (-0.75 vs -0.83). SRMs were similar across axial vs peripheral disease for BASDAI (-0.37 vs -0.44) and the individual BASDAI items. CONCLUSION BASDAI has reasonable responsiveness in PsA but does not differentiate between axPsA and peripheral PsA. (ClinicalTrials.gov: NCT03378336).
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Affiliation(s)
- Soumya M Reddy
- S.M. Reddy, MD, J.U. Scher, MD, Department of Medicine and Rheumatology, New York University, New York, New York
| | - Katie Xue
- K. Xue, BS, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - M Elaine Husni
- M.E. Husni, MD, MPH, Department Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio
| | - Jose U Scher
- S.M. Reddy, MD, J.U. Scher, MD, Department of Medicine and Rheumatology, New York University, New York, New York
| | - Alisa J Stephens-Shields
- A.J. Stephens-Shields, PhD, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Niti Goel
- N. Goel, MD, Patient Research Partner, and Department of Medicine, Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina
| | - Joelle Koplin
- J. Koplin, CRNP, Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ethan T Craig
- E.T. Craig, MD, Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, and Department of Medicine/Rheumatology, Michael J. Crescenz Veterans Medical Center, Philadelphia, Pennsylvania
| | - Jessica A Walsh
- J.A. Walsh, MD, MBA, Department of Medicine and Rheumatology, University of Utah, Salt Lake City, Utah
| | - Alexis Ogdie
- A. Ogdie, MD, MSCE, Department of Medicine/Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Haberman RH, Ahmed T, Um S, Zhou YY, Catron S, Jano K, Felipe A, Eichman S, Rice AL, Lydon E, Moussavi S, Neimann AL, Reddy SM, Adhikari S, Scher JU. Racial and ethnic determinants of psoriatic arthritis phenotypes and disease activity. Rheumatology (Oxford) 2024:keae066. [PMID: 38305279 DOI: 10.1093/rheumatology/keae066] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/29/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE Individuals of racially and ethnically diverse backgrounds are underrepresented in psoriatic arthritis (PsA) research/clinical trials, despite evidence that their disease presentation, severity and course may be distinct. Here we aim to describe how race, ethnicity and other socioeconomic factors inform disease characteristics in PsA. METHODS 817 consecutive patients with PsA from a large, diverse metropolitan area, were enrolled in an observational, longitudinal registry. Demographics, medical history, medication use, and psoriatic disease phenotype and activity were all recorded and analyzed. RESULTS The population was 77.4% non-Hispanic White, 2.2% Black, 7.1% Asian, and 9.9% identified as other races or multiracial, and 11.8% identified as Hispanic. Hispanic and non-White individuals had higher tender joint counts (p= 0.033) with similar swollen joint counts (p= 0.308) and medication use (p= 0.171). They also had high rates of radiographic axial disease. Hispanic individuals were significantly more likely to have higher tender joint counts (p= 0.029), higher RAPID3 scores (p= 0.004), and moderate-severe psoriasis (p= 0.010) compared with non-Hispanic White individuals. CONCLUSION In this diverse cohort, 22.6% of patients identified as underrepresented racial and/or ethnic groups, mostly Asian or Hispanic. Despite similar swollen joint counts and medication use, non-white individuals have higher tender joint counts compared with white individuals. Phenotypically, they also were more likely to have radiographic axial involvement. These findings may reflect differences in PsA presentation, experience and outcomes in individuals of various racial and ethnic groups, which need to be taken into consideration in clinical care and research design.
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Affiliation(s)
- Rebecca H Haberman
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Tasneem Ahmed
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Seungha Um
- Department of Population Healthy, New York University Grossman School of Medicine, NY, NY, USA
| | - Ying Yin Zhou
- Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Sydney Catron
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Kathryn Jano
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Adamary Felipe
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Stephanie Eichman
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Alexandra L Rice
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Eileen Lydon
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Sarah Moussavi
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Andrea L Neimann
- Ronald O. Perelman, Department of Dermatology, New York University School of Medicine, NY, NY, USA
| | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
| | - Samrachana Adhikari
- Department of Population Healthy, New York University Grossman School of Medicine, NY, NY, USA
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NY, NY, USA
- Colton Center for Autoimmunity, New York University Grossman School of Medicine, NY, NY, USA
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Jin JQ, Cronin A, Roberts-Toler C, Yeroushalmi S, Hadeler E, Spencer RK, Elhage KG, Gondo G, Wallace EB, Reddy SM, Han G, Kaffenberger J, Davis MS, Hakimi M, Scher JU, Armstrong AW, Bhutani T, McLean RR, Liao W. Sociodemographic and clinical characteristics associated with multiple biologic failure in psoriasis: A 2015-2022 prospective cohort analysis of the CorEvitas psoriasis registry. J Am Acad Dermatol 2023; 89:974-983. [PMID: 37495173 DOI: 10.1016/j.jaad.2023.06.058] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Psoriasis patients with poor therapeutic response to multiple biologic agents are not well-characterized. OBJECTIVE To describe the characteristics associated with development of multiple biologic failure (MBF) versus good clinical response (GR) to the first biologic. METHODS This prospective cohort analysis evaluated patients in the multicenter CorEvitas Psoriasis Registry who initiated their first biologic between 2015 and 2020 and were followed for ≥24 months. Multivariable logistic regression identified sociodemographic, clinical, and patient-reported outcomes that differed between MBF (discontinued ≥2 biologics of different classes, each used for ≥90 days, due to inadequate efficacy) and GR (continued use of first biologic for ≥2 years) patients. RESULTS One thousand thirty-nine patients were analyzed (490 GR [47.2%], 65 MBF [6.3%]). Female sex, shorter psoriasis duration, earlier year of biologic initiation, prior nonbiologic systemic therapy use, history of hyperlipidemia, and Medicaid insurance were significantly associated with MBF, though the latter 2 variables exhibited wider confidence intervals, indicating a lower level of support. The first-to-second biologic sequence most observed with MBF was Tumor necrosis factor-α inhibitor to IL-17 inhibitor use. LIMITATIONS Biologic adherence between visits was not evaluated. CONCLUSION Approximately 6% of psoriasis patients met MBF criteria. The results identify characteristics associated with MBF that may distinguish patients warranting more frequent follow-up.
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Affiliation(s)
- Joy Q Jin
- School of Medicine, University of California San Francisco, San Francisco, California; Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | | | - Samuel Yeroushalmi
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Edward Hadeler
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | | | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center, New York, New York
| | - George Han
- Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Jessica Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center, New York, New York
| | - April W Armstrong
- Department of Dermatology, University of Southern California, Los Angeles, California
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | | | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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Stephen AN, Dennison SR, Holden MA, Reddy SM. Rapid sub-nanomolar protein determination in serum using electropolymerized molecularly imprinted polymers (E-MIPs). Analyst 2023; 148:5476-5485. [PMID: 37767770 DOI: 10.1039/d3an01498c] [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] [Indexed: 09/29/2023]
Abstract
Rapid detection of biologicals is important for a range of applications such as medical screening and diagnostics. Antibodies are typically employed for biosensing with high sensitivity and selectivity but can take months to prepare. Here, we investigate electropolymerized molecularly imprinted polymers (E-MIPs), which are produced in minutes as alternative-antibody rapid biosensors for the selective recognition of model proteins bovine haemoglobin (BHb) and bovine serum albumin (BSA). We evaluated two disposable screen-printed electrodes (SPE) designated AT-Au and BT-Au based on their different annealing temperatures. E-MIPs for BHb demonstrated an imprinting factor of 146 : 1 at 1 nM and 12 : 1 at 0.1 nM, showing high effectiveness of E-MIPs compared to their control non-imprinted polymers. The BHb imprinted E-MIP, when tested against BSA as a non-target protein, gave a selectivity factor of 6 : 1 for BHb. Sensor sensitivity directly depended on the nature of the SPE, with AT-Au SPE demonstrating limits of detection in the sub-micromolar range typically achieved for MIPs, while BT-Au SPE exhibited sensitivity in the sub-nanomolar range for target protein. We attribute this to differences in electrode surface area between AT-Au and BT-Au SPEs. The E-MIPs were also tested in calf serum as a model biological medium. The BT-Au SPE MIPs detected the presence of target protein in <10 min with an LOD of 50 pM and LOQ of 100 pM, suggesting their suitability for protein determination in serum with minimal sample preparation. Using electrochemical impedance spectroscopy, we determine equilibrium dissociation constants (KD) for E-MIPs using the Hill-Langmuir adsorption model. KD of BHb E-MIP was determined to be 0.86 ± 0.11 nM.
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Affiliation(s)
- A N Stephen
- Department of Chemistry, UCLan Centre for Smart Materials, School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - S R Dennison
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK
| | - M A Holden
- Department of Chemistry, UCLan Centre for Smart Materials, School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - S M Reddy
- Department of Chemistry, UCLan Centre for Smart Materials, School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
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Karmacharya P, Stull C, Stephens-Shields A, Husni ME, Scher JU, Craig E, Fitzsimmons R, Reddy SM, Magrey MN, Ogdie A, Walsh JA. Responsiveness and Minimum Clinically Important Difference in Patient-Reported Outcome Measures Among Patients With Psoriatic Arthritis: A Prospective Cohort Study. Arthritis Care Res (Hoboken) 2023; 75:2182-2189. [PMID: 36913210 DOI: 10.1002/acr.25111] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/31/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To determine the responsiveness to therapy and minimum clinically important improvement (MCII) for patient-reported outcome measures in psoriatic arthritis (PsA) and to examine the impact of baseline disease activity on the ability to demonstrate change. METHODS A longitudinal cohort study was performed within the PsA Research Consortium. Patients completed several patient-reported outcomes, including the Routine Assessment of Patient Index Data, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Psoriatic Arthritis Impact of Disease 12-item (PsAID12) questionnaire, and others. The mean change in the scores between visits and standardized response means (SRMs) were calculated. The MCII was calculated as the mean change in score among patients who reported minimal improvement. SRMs and MCIIs were compared among subgroups with moderate to highly active PsA and those with lower disease activity. RESULTS Among 171 patients, 266 therapy courses were included. The mean ± SD age was 51 ± 13.8 years, 53% were female, and the mean swollen and tender joint counts were 3 and 6, respectively, at baseline. SRMs and MCII for all measures were small to moderate, although greater among those with higher baseline disease activity. BASDAI had the best SRM overall and for less active PsA, and the clinical Disease Activity of PsA (cDAPSA) and PsAID12 were best for those with higher disease activity. CONCLUSION SRMs and MCII were relatively small in this real-world population, particularly among those with lower disease activity at baseline. BASDAI, cDAPSA, and PsAID12 had good sensitivity to change, but selection for use in trials should consider the baseline disease activity of patients to be enrolled.
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Affiliation(s)
| | - Courtney Stull
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | | | | | | | | | - Marina N Magrey
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
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Reddy SM, Mahmood H. Development of a multiagency protocol to support people with No Recourse to Public Funds in Wolverhampton (UK). Perspect Public Health 2023; 143:272-274. [PMID: 35766318 DOI: 10.1177/17579139221106574] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND No Recourse to Public Funds (NRPF) status is applied to individuals and families that are subject to immigration control, resulting in them having restricted access to state-funded benefits within England. NRPF is a public health risk as it increases the risk of destitution among vulnerable migrants. AIMS The aim of this study was to engage with public and voluntary sector staff within Wolverhampton working with people with a NRPF status to develop and create an easily accessible guide ('protocol') to help facilitate identification of appropriate cross-sector interventions and support. METHODS Data were collected via an online survey as well as face-to-face semi-structured interviews with local NRPF stakeholders. RESULTS Four themes emerged from the thematic analysis of participant responses: understanding NRPF statuses, varying support requirements, poor communication and awareness of vulnerabilities. Currently, in England, there does not appear to be a standardised localised protocol which can be used to reduce the complexities and confusion encountered by public and voluntary sectors who support people with NRPF status. CONCLUSION The findings from this study have allowed the Wolverhampton NRPF to create an online information resource that includes training events to raise the awareness of NRPF, as well as the development of a localised multiagency protocol that has better equipped it to support and safeguard people with NRPF.
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Affiliation(s)
- S M Reddy
- Public Health, City of Wolverhampton Council, Wolverhampton WV1 1SH, UK
| | - H Mahmood
- Population Health, NHS Confederation, London, UK
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El Sharif HF, Dennison SR, Tully M, Crossley S, Mwangi W, Bailey D, Graham SP, Reddy SM. Evaluation of electropolymerized molecularly imprinted polymers (E-MIPs) on disposable electrodes for detection of SARS-CoV-2 in saliva. Anal Chim Acta 2022; 1206:339777. [PMID: 35473858 PMCID: PMC8974637 DOI: 10.1016/j.aca.2022.339777] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 02/07/2023]
Abstract
We investigate electropolymerized molecularly imprinted polymers (E-MIPs) for the selective recognition of SARS-CoV-2 whole virus. E-MIPs imprinted with SARS-CoV-2 pseudoparticles (pps) were electrochemically deposited onto screen printed electrodes by reductive electropolymerization, using the water-soluble N-hydroxmethylacrylamide (NHMA) as functional monomer and crosslinked with N,N'-methylenebisacrylamide (MBAm). E-MIPs for SARS-CoV-2 showed selectivity for template SARS-CoV-2 pps, with an imprinting factor of 3:1, and specificity (significance = 0.06) when cross-reacted with other respiratory viruses. E-MIPs detected the presence of SARS-CoV-2 pps in <10 min with a limit of detection of 4.9 log10 pfu/mL, suggesting their suitability for detection of SARS-CoV-2 with minimal sample preparation. Using electrochemical impedance spectroscopy (EIS) and principal component analysis (PCA), the capture of SARS-CoV-2 from real patient saliva samples was also evaluated. Fifteen confirmed COVID-19 positive and nine COVID-19 negative saliva samples were compared against the established loop-mediated isothermal nucleic acid amplification (LAMP) technique used by the UK National Health Service. EIS data demonstrated a PCA discrimination between positive and negative LAMP samples. A threshold real impedance signal (ZRe) ≫ 4000 Ω and a corresponding charge transfer resistance (RCT) ≫ 6000 Ω was indicative of absence of virus (COVID-19 negative) in agreement with values obtained for our control non-imprinted polymer control. A ZRe at or below a threshold value of 600 Ω with a corresponding RCT of <1200 Ω was indicative of a COVID-19 positive sample. The presence of virus was confirmed by treatment of E-MIPs with a SARS-CoV-2 specific monoclonal antibody.
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Affiliation(s)
- H F El Sharif
- Department of Chemistry, UCLan Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire, Preston, PR1 2HE, United Kingdom
| | - S R Dennison
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, United Kingdom
| | - M Tully
- The Pirbright Institute, Pirbright, Woking, Surrey, GU24 0NF, United Kingdom
| | - S Crossley
- The Pirbright Institute, Pirbright, Woking, Surrey, GU24 0NF, United Kingdom
| | - W Mwangi
- The Pirbright Institute, Pirbright, Woking, Surrey, GU24 0NF, United Kingdom
| | - D Bailey
- The Pirbright Institute, Pirbright, Woking, Surrey, GU24 0NF, United Kingdom
| | - S P Graham
- The Pirbright Institute, Pirbright, Woking, Surrey, GU24 0NF, United Kingdom
| | - S M Reddy
- Department of Chemistry, UCLan Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire, Preston, PR1 2HE, United Kingdom.
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10
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Haberman RH, Herati R, Simon D, Samanovic M, Blank RB, Tuen M, Koralov SB, Atreya R, Tascilar K, Allen JR, Castillo R, Cornelius AR, Rackoff P, Solomon G, Adhikari S, Azar N, Rosenthal P, Izmirly P, Samuels J, Golden B, Reddy SM, Neurath MF, Abramson SB, Schett G, Mulligan MJ, Scher JU. Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease. Ann Rheum Dis 2021; 80:1339-1344. [PMID: 34035003 PMCID: PMC8219484 DOI: 10.1136/annrheumdis-2021-220597] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the humoral and cellular immune response to messenger RNA (mRNA) COVID-19 vaccines in patients with immune-mediated inflammatory diseases (IMIDs) on immunomodulatory treatment. METHODS Established patients at New York University Langone Health with IMID (n=51) receiving the BNT162b2 mRNA vaccination were assessed at baseline and after second immunisation. Healthy subjects served as controls (n=26). IgG antibody responses to the spike protein were analysed for humoral response. Cellular immune response to SARS-CoV-2 was further analysed using high-parameter spectral flow cytometry. A second independent, validation cohort of controls (n=182) and patients with IMID (n=31) from Erlangen, Germany, were also analysed for humoral immune response. RESULTS Although healthy subjects (n=208) and patients with IMID on biologic treatments (mostly on tumour necrosis factor blockers, n=37) demonstrate robust antibody responses (over 90%), those patients with IMID on background methotrexate (n=45) achieve an adequate response in only 62.2% of cases. Similarly, patients with IMID on methotrexate do not demonstrate an increase in CD8+ T-cell activation after vaccination. CONCLUSIONS In two independent cohorts of patients with IMID, methotrexate, a widely used immunomodulator for the treatment of several IMIDs, adversely affected humoral and cellular immune response to COVID-19 mRNA vaccines. Although precise cut-offs for immunogenicity that correlate with vaccine efficacy are yet to be established, our findings suggest that different strategies may need to be explored in patients with IMID taking methotrexate to increase the chances of immunisation efficacy against SARS-CoV-2 as has been demonstrated for augmenting immunogenicity to other viral vaccines.
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Affiliation(s)
- Rebecca H Haberman
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Ramin Herati
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Marie Samanovic
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Rebecca B Blank
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Michael Tuen
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Sergei B Koralov
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, USA
| | - Raja Atreya
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Joseph R Allen
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Rochelle Castillo
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Amber R Cornelius
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Paula Rackoff
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Gary Solomon
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Samrachana Adhikari
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Natalie Azar
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Pamela Rosenthal
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Peter Izmirly
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Medicine, NYU Langone Orthopedic Hospital, New York, New York, USA
| | - Brian Golden
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Markus F Neurath
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Steven B Abramson
- New York University Grossman School of Medicine, New York, New York, USA
- Rheumatology Research, NYU-NYU Langone Orthopedic Hospital, New York, New York, USA
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Mark J Mulligan
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
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11
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Wan MT, Walsh JA, Craig ET, Husni ME, Scher JU, Reddy SM, Leung YY, Ogdie A. A comparison of physical function instruments in psoriatic arthritis: HAQ-DI vs MDHAQ vs PROMIS10 global physical health. Rheumatology (Oxford) 2021; 60:2307-2316. [PMID: 33313838 PMCID: PMC8599834 DOI: 10.1093/rheumatology/keaa591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Physical function is a core outcome in PsA. We examined the construct validity and responsiveness of three commonly used instruments to assess physical function in PsA: HAQ disability index (HAQ-DI), MultiDimensional HAQ (MDHAQ) and the Patient-Reported Outcomes Measurement Information System (PROMIS®) Global-10. METHODS Between 2016 and 2019, patients with PsA were enrolled in the Psoriatic Arthritis Research Consortium longitudinal cohort study in the USA. Correlations were calculated at baseline and among change scores using Spearman's correlation coefficient. Standardized response means were calculated. Agreement with the 20% improvement cut-off was used to determine the potential effect of using MDHAQ or the PROMIS Global-10 physical health (GPH) subscore in place of HAQ-DI when assessing the ACR20. RESULTS A total of 274 patients were included in the analysis. The mean age of patients was 49 years and 51% were male. At baseline, the mean HAQ-DI was 0.6 (s.d. 0.6; range 0-3), the mean MDHAQ was 1.8 (s.d. 1.6; range 0-10) and the mean GPH T-score was 43.4 (s.d. 9.3; range 0-100). All three instruments were strongly correlated at baseline (rho 0.75-0.85). Change scores were moderately correlated (rho 0.42-0.71). Among therapy initiators, the mean change between two visits in HAQ-DI, MDHAQ and GPH was -0.1 (s.d. 0.4), -0.2 (s.d. 1.2) and 2.5 (s.d. 6.1), respectively. The standardized response means were 0.18, 0.16 and 0.41, respectively. CONCLUSION The three instruments tested are not directly interchangeable but have overall similar levels of responsiveness.
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Affiliation(s)
- Marilyn T Wan
- Department of Dermatology
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | | | - Ethan T Craig
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - M Elaine Husni
- Division of Rheumatology, Cleveland Clinic, Cleveland, OH
| | - Jose U Scher
- Division of Rheumatology, New York University School of Medicine, New York, NY, USA
| | - Soumya M Reddy
- Division of Rheumatology, New York University School of Medicine, New York, NY, USA
| | - Ying-Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore
| | - Alexis Ogdie
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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12
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Manasson J, Wallach DS, Guggino G, Stapylton M, Badri MH, Solomon G, Reddy SM, Coras R, Aksenov AA, Jones DR, Girija PV, Neimann AL, Heguy A, Segal LN, Dorrestein PC, Bonneau R, Guma M, Ciccia F, Ubeda C, Clemente JC, Scher JU. Interleukin-17 Inhibition in Spondyloarthritis Is Associated With Subclinical Gut Microbiome Perturbations and a Distinctive Interleukin-25-Driven Intestinal Inflammation. Arthritis Rheumatol 2020; 72:645-657. [PMID: 31729183 DOI: 10.1002/art.41169] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 11/12/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To characterize the ecological effects of biologic therapies on the gut bacterial and fungal microbiome in psoriatic arthritis (PsA)/spondyloarthritis (SpA) patients. METHODS Fecal samples from PsA/SpA patients pre- and posttreatment with tumor necrosis factor inhibitors (TNFi; n = 15) or an anti-interleukin-17A monoclonal antibody inhibitor (IL-17i; n = 14) underwent sequencing (16S ribosomal RNA, internal transcribed spacer and shotgun metagenomics) and computational microbiome analysis. Fecal levels of fatty acid metabolites and cytokines/proteins implicated in PsA/SpA pathogenesis or intestinal inflammation were correlated with sequence data. Additionally, ileal biopsies obtained from SpA patients who developed clinically overt Crohn's disease (CD) after treatment with IL-17i (n = 5) were analyzed for expression of IL-23/Th17-related cytokines, IL-25/IL-17E-producing cells, and type 2 innate lymphoid cells (ILC2s). RESULTS There were significant shifts in abundance of specific taxa after treatment with IL-17i compared to TNFi, particularly Clostridiales (P = 0.016) and Candida albicans (P = 0.041). These subclinical alterations correlated with changes in bacterial community co-occurrence, metabolic pathways, IL-23/Th17-related cytokines, and various fatty acids. Ileal biopsies showed that clinically overt CD was associated with expansion of IL-25/IL-17E-producing tuft cells and ILC2s (P < 0.05), compared to pre-IL-17i treatment levels. CONCLUSION In a subgroup of SpA patients, the initiation of IL-17A blockade correlated with features of subclinical gut inflammation and intestinal dysbiosis of certain bacterial and fungal taxa, most notably C albicans. Further, IL-17i-related CD was associated with overexpression of IL-25/IL-17E-producing tuft cells and ILC2s. These results may help to explain the potential link between inhibition of a specific IL-17 pathway and the (sub)clinical gut inflammation observed in SpA.
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Affiliation(s)
- Julia Manasson
- New York University School of Medicine, New York, New York
| | | | | | | | | | - Gary Solomon
- New York University School of Medicine, New York, New York
| | - Soumya M Reddy
- New York University School of Medicine, New York, New York
| | | | - Alexander A Aksenov
- Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego
| | - Drew R Jones
- New York University School of Medicine, New York, New York
| | | | | | - Adriana Heguy
- New York University School of Medicine, New York, New York
| | | | - Pieter C Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego
| | - Richard Bonneau
- Simons Foundation, New York University, and Courant Institute of Mathematical Sciences, New York, New York
| | | | | | - Carles Ubeda
- La Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, Spain, and CIBERESP, Madrid, Spain
| | | | - Jose U Scher
- New York University School of Medicine, New York, New York
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13
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Walsh JA, Wan MT, Willinger C, Husni ME, Scher JU, Reddy SM, Ogdie A. Measuring Outcomes in Psoriatic Arthritis: Comparing Routine Assessment of Patient Index Data and Psoriatic Arthritis Impact of Disease. J Rheumatol 2019; 47:1496-1505. [PMID: 31575704 DOI: 10.3899/jrheum.190219] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/18/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the construct validity of Routine Assessment of Patient Index Data 3 (RAPID3) and Psoriatic Arthritis Impact of Disease (PsAID) in patients with psoriatic arthritis (PsA). In examining construct validity, we also addressed scores among subgroups with severe psoriasis, poly articular disease, enthesitis, and dactylitis, and evaluated influences of sociodemographic factors and comorbidities (contextual factors) on these patient-reported outcomes (PRO). METHODS Patients with PsA were enrolled in the Psoriatic Arthritis Research Consortium (PARC) between 2014 and 2016. PARC is a longitudinal observational cohort study conducted at 4 US institutions. In this cross-sectional study, construct validity was assessed by examining Spearman correlation coefficients for RAPID3 and PsAID with physician-reported disease activity measures and other PRO [e.g., Medical Outcomes Study Short Form-12 physical component summary/mental component summary (SF-12 PCS/MCS), Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F)]. Contextual factors and disease subgroups were assessed in multivariable linear regression models with RAPID3 or PsAID12 as outcomes of interest and the hypothesized contextual factors as covariates. RESULTS Among 401 patients enrolled in PARC, 347 completed RAPID3 or PsAID12. Of these, most were white females with a mean age of 51.7 years (SD 14.02). RAPID3 and PsAID were highly correlated (r = 0.90). These measures were also correlated with the SF-12 PCS (r = -0.67) and FACIT-F (r = -0.77). Important contextual factors and disease subgroups included enthesitis, joint counts, education, insurance type, and depression. CONCLUSION RAPID3 and PsAID12 have excellent construct validity in PsA and are strongly correlated despite differing items. Contextual factors (i.e., the presence of depression and obesity) should be considered when interpreting raw scores of the RAPID3 and PsAID12.
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Affiliation(s)
- Jessica A Walsh
- J.A. Walsh, MD, MBA, A. Ogdie, MD, MSCE, Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Marilyn T Wan
- M.T. Wan, MBChB, MPH, Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | | | - Jose U Scher
- J.U. Scher, MD, S.M. Reddy MD, New York University School of Medicine, New York, New York, USA
| | - Soumya M Reddy
- J.U. Scher, MD, S.M. Reddy MD, New York University School of Medicine, New York, New York, USA
| | - Alexis Ogdie
- J.A. Walsh, MD, MBA, A. Ogdie, MD, MSCE, Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia;
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14
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Gimeno IM, Cortes AL, Reddy SM, López de Juan Abad B, Käser T, Limsatanun A. Highly virulent Marek's disease virus strains affect T lymphocyte function and viability of splenocytes in commercial meat-type chickens. Avian Pathol 2019; 48:564-572. [PMID: 31294636 DOI: 10.1080/03079457.2019.1643451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In previous studies, we have demonstrated that very virulent plus Marek's disease viruses (vv+MDV) are highly immunosuppressive in commercial meat-type chickens. The specific objectives of this work were to evaluate if vv+MDV immunosuppression (MDV-IS) is induced by reduction of lymphocyte responsiveness and/or viability. Three experiments were conducted to (i) compare vv+MDV 686 with a partially attenuated 686-BAC; (ii) compare vv+MDV strains (648A and 686) with vMDV (GA) and vvMDV (Md5); and (iii) compare chickens vaccinated with Md5-BACΔMEQ and with CVI988 + HVT. In each experiment, spleens were collected at 28-30 days post infection and lymphocytes were isolated and investigated in three ways: their proliferative response to Concanavalin A (ConA) was analysed by MTT proliferation assay; cell death, and expression of CD45 and MHC-I was studied by flow cytometry; and MHC-IA and β-2 microglobulin (B2M) expression was evaluated by real time RT-PCR. Splenocytes of chickens inoculated with vv+MDV were severely impaired to proliferate when exposed to ConA. Furthermore, vv+MDV induced severe splenocyte death that did not occur after infection with v or vvMDV strains. Vaccination with CVI988 + HVT, and at less level with Md5-BACΔMEQ reduced these negative effects. This is in contrast to our previous results in which Md5-BACΔMEQ but not CVI988 + HVT protected against MDV-IS suggesting that although cell death and decrease lymphocyte function seem to be related to MDV virulence and certainly will be associated with immunosuppression, they might not fully explain the previously reported MDV-IS. RESEARCH HIGHLIGHTS vv+MDV induces extensive death in splenocytes in meat-type chickens 28-30 dpi. vv+MDV impairs lymphocyte function in meat-type chickens 28-30 dpi. Vaccination protects against splenocyte death and reduced lymphocyte function. Cell lysis and reduced lymphocyte function do not fully explain MDV-IS.
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Affiliation(s)
- I M Gimeno
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University , Raleigh , NC , USA
| | - A L Cortes
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University , Raleigh , NC , USA
| | - S M Reddy
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University , College Station , TX , USA
| | - B López de Juan Abad
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University , Raleigh , NC , USA
| | - T Käser
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University , Raleigh , NC , USA
| | - A Limsatanun
- Department of Population Health and Pathobiology, Veterinary School, North Carolina State University , Raleigh , NC , USA.,Faculty of Veterinary Science, Prince of Songkla University , Hat Yai, Kho Hong, Songhkla , Thailand
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15
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Adrada BE, Valero V, Reddy SM, Barcenas CH, Candelaria R, Wei W, Rauch GM. Abstract P6-02-04: Ultrasound assessment of residual disease after neoadjuvant chemotherapy (NACT) in node positive triple negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-02-04] [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: 11/16/2022]
Abstract
Abstract
Purpose: To determine accuracy of preoperative ultrasound after NACT to predict residual disease in triple negative breast cancer (TNBC) patients with confirmed axillary nodal metastasis.
Methods: This is an institutional review board approved retrospective study of TNBC patients who received NACT at MD Anderson Cancer Center from January 1999 - June 2015. We identified 327 TNBC patients who had cytologically confirmed breast and nodal disease at baseline evaluation and had preoperative ultrasound evaluation of residual disease. Ultrasound response was divided in tree categories: radiologic complete response (rCR) - complete resolution of the malignant mass); near-rCR - no discernible mass, only an isoechoic flat tumoral bed); and residual disease (RD) - a discernible mass is seen. Axillary ultrasound images were evaluated for lymph node size, cortical thickness and residual morphological type after NAC (type I-VI). Ultrasound breast and axillary findings were compared with final surgical pathology.
Results: In 89 cases (27%), pCR was achieved. 74% (242/327) were unifocal and 26% (86/327) multifocal. Ultrasound rCR was seen in 11% patients (36/327). Of those, 64% (23/36) showed pCR and 36% (13/36) showed residual disease. Ultrasound near-rCR was seen in 26% (84/327). Of those, pCR was seen 49 % (41/84) and residual disease in 51% (43/84). Residual disease was seen in 63% (207/327), 12% (25/207) showed pCR and 88% (182/207) showed residual disease. Regarding axillary lymph nodes, long axis diameter mean was 1.57 cm for patients with pCR and 1.6 cm for no pCR, short axis diameter mean was 0.67 cm for pCR and 0.87 cm for no pCR. Cortical thickness mean was 2 mm for pCR versus 9 mm for no pCR.
Sensitivity of ultrasound for assessment residual disease (ultrasound was considered positive if either breast ultrasound or axillary ultrasound showed residual disease) was 97%. Specificity is 22.47% with a NPV of 74% and PPV of 77%.
Conclusion: Breast and axillary ultrasound performed after NACT showed low specificity but high sensitive to detect residual disease. rCR and near rCR were related with pCR in 64% and 49 % of the cases respectively.
Citation Format: Adrada BE, Valero V, Reddy SM, Barcenas CH, Candelaria R, Wei W, Rauch GM. Ultrasound assessment of residual disease after neoadjuvant chemotherapy (NACT) in node positive triple negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-02-04.
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Affiliation(s)
- BE Adrada
- MD Anderson Cancer Center, Houston, TX
| | - V Valero
- MD Anderson Cancer Center, Houston, TX
| | - SM Reddy
- MD Anderson Cancer Center, Houston, TX
| | | | | | - W Wei
- MD Anderson Cancer Center, Houston, TX
| | - GM Rauch
- MD Anderson Cancer Center, Houston, TX
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16
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Alexander A, Marx AN, Reddy SM, Reuben JM, Le-Petross HC, Lane D, Huang ML, Krishnamurthy S, Gong Y, Gombos DS, Patel N, Tung CI, Allen RC, Kandl TJ, Wu J, Liu S, Patel AB, Futreal A, Wistuba I, Layman RM, Valero V, Tripathy D, Ueno NT, Lim B. Abstract OT3-05-04: Phase II study of atezolizumab, cobimetinib, and eribulin in patients with recurrent or metastatic inflammatory breast cancer (IBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot3-05-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: IBCs that do not completely respond to chemotherapy often have dysregulated immune pathways, and novel therapies are needed to improve outcomes in recurrent/metastatic disease. One-third of IBCs express the atezolizumab target PD-L1, and cobimetinib increases PD-L1 expression; thus, we hypothesize that atezolizumab and cobimetinib may act synergistically in IBC. The FDA-approved agent eribulin is active in IBC and has anti-stem cell activity and can reverse the IBC phenotype of epithelial-to-mesenchymal transition. Hence the use of eribulin as a chemotherapy backbone in combination with other novel agents is well justified.
Trial Design: This single-arm, open-label trial is enrolling patients with recurrent IBC or de novo metastatic IBC that has progressed on at least 1 line of standard chemotherapy. During a 4-week pharmacodynamic window, patients have an upfront biopsy, receive atezolizumab and cobimetinib treatment for 4 weeks, and have a second biopsy. Triple-combination treatment then commences, with standard eribulin dosing. After 4 cycles of eribulin, patients receive maintenance targeted therapy until disease progression or intolerable toxicity.
Eligibility Criteria: Patients with metastatic IBC of any molecular subtype must have measurable disease (per RECIST 1.1) amenable to biopsy. Patients with HER2+ disease must have received both pertuzumab and T-DM1. Patients with treated stable brain metastases are allowed. Patients must have recovered from the acute effects of any prior therapies and have adequate hematologic, organ, and cardiac function. Patients with autoimmune diseases or a history of pneumonitis are ineligible.
Specific Aims: The primary objective is to determine the overall response rate (ORR) of the combination therapy. Secondary objectives include determining the safety and tolerability, clinical benefit rate, response duration, progression-free survival, 2-year overall survival rate and predictive biomarker analyses.
Statistical Methods: The trial will enroll up to 9 patients in its phase I/safety lead-in portion and up to 33 patients total. A Bayesian optimal interval design is used to efficiently determine the maximum tolerated cobimetinib dose in phase I. Patients start cobimetinib at the FDA-approved dose of 60 mg/day with a target toxicity rate is 0.3. Phase II will enroll 24 patients to determine the efficacy of the triple-combination therapy. The historical ORR in metastatic IBC is 10%; our sample size provides 80% power to detect an ORR improvement to 25%.
Accrual: The trial has enrolled 7 patients since its start in August 2017.
Citation Format: Alexander A, Marx AN, Reddy SM, Reuben JM, Le-Petross HC, Lane D, Huang ML, Krishnamurthy S, Gong Y, Gombos DS, Patel N, Tung CI, Allen RC, Kandl TJ, Wu J, Liu S, Patel AB, Futreal A, Wistuba I, Layman RM, Valero V, Tripathy D, Ueno NT, Lim B. Phase II study of atezolizumab, cobimetinib, and eribulin in patients with recurrent or metastatic inflammatory breast cancer (IBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-05-04.
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Affiliation(s)
- A Alexander
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - AN Marx
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - SM Reddy
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - JM Reuben
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - HC Le-Petross
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Lane
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - ML Huang
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Y Gong
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - DS Gombos
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Patel
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - CI Tung
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - RC Allen
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - TJ Kandl
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Wu
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Liu
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - AB Patel
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Futreal
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - I Wistuba
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - RM Layman
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - V Valero
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Tripathy
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - NT Ueno
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Lim
- University of Texas MD Anderson Cancer Center, Houston, TX
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17
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Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, Dubreuil M, Dunham J, Husni ME, Kenny S, Kwan-Morley J, Lin J, Marchetta P, Mease PJ, Merola JF, Miner J, Ritchlin CT, Siaton B, Smith BJ, Van Voorhees AS, Jonsson AH, Shah AA, Sullivan N, Turgunbaev M, Coates LC, Gottlieb A, Magrey M, Nowell WB, Orbai AM, Reddy SM, Scher JU, Siegel E, Siegel M, Walsh JA, Turner AS, Reston J. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol 2018; 71:5-32. [PMID: 30499246 DOI: 10.1002/art.40726] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 09/11/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.
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Affiliation(s)
- Jasvinder A Singh
- University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | | | | | - Dafna D Gladman
- University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | - Janice Lin
- Stanford University, Stanford, California
| | | | - Philip J Mease
- Swedish-Providence Health Systems and University of Washington, Seattle, Washington
| | - Joseph F Merola
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julie Miner
- Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia
| | | | | | - Benjamin J Smith
- Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee
| | | | - Anna Helena Jonsson
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | - Alice Gottlieb
- New York Medical College at Metropolitan Hospital, New York, New York
| | | | | | | | - Soumya M Reddy
- New York University School of Medicine, New York, New York
| | - Jose U Scher
- New York University School of Medicine, New York, New York
| | - Evan Siegel
- Arthritis & Rheumatism Associates, Rockville, Maryland
| | | | - Jessica A Walsh
- University of Utah and George E. Wahlen VeteranS Affairs Medical Center, Salt Lake City, Utah
| | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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18
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Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, Dubreuil M, Dunham J, Husni ME, Kenny S, Kwan-Morley J, Lin J, Marchetta P, Mease PJ, Merola JF, Miner J, Ritchlin CT, Siaton B, Smith BJ, Van Voorhees AS, Jonsson AH, Shah AA, Sullivan N, Turgunbaev M, Coates LC, Gottlieb A, Magrey M, Nowell WB, Orbai AM, Reddy SM, Scher JU, Siegel E, Siegel M, Walsh JA, Turner AS, Reston J. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2475530318812244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). Methods: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. Results: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. Conclusion: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.
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Affiliation(s)
- Jasvinder A. Singh
- University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | | | - Alexis Ogdie
- University of Pennsylvania, Philadelphia, PA, USA
| | - Dafna D. Gladman
- University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada
| | - Chad Deal
- Cleveland Clinic, Cleveland, OH, USA
| | - Atul Deodhar
- Oregon Health & Science University, Portland, OR, USA
| | | | | | | | | | | | | | | | - Philip J. Mease
- Swedish-Providence Health Systems and University of Washington, Seattle, WA, USA
| | - Joseph F. Merola
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Julie Miner
- Comprehensive Therapy Consultants and Therapy Steps, Roswell, GA, USA
| | | | | | - Benjamin J. Smith
- Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee, FL, USA
| | | | | | | | | | | | | | - Alice Gottlieb
- New York Medical College at Metropolitan Hospital, New York, NY, USA
| | | | | | | | | | - Jose U. Scher
- New York University School of Medicine, New York, NY, USA
| | - Evan Siegel
- Arthritis & Rheumatism Associates, Rockville, MA, USA
| | | | - Jessica A. Walsh
- University of Utah and George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
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19
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Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, Dubreuil M, Dunham J, Husni ME, Kenny S, Kwan-Morley J, Lin J, Marchetta P, Mease PJ, Merola JF, Miner J, Ritchlin CT, Siaton B, Smith BJ, Van Voorhees AS, Jonsson AH, Shah AA, Sullivan N, Turgunbaev M, Coates LC, Gottlieb A, Magrey M, Nowell WB, Orbai AM, Reddy SM, Scher JU, Siegel E, Siegel M, Walsh JA, Turner AS, Reston J. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Care Res (Hoboken) 2018; 71:2-29. [PMID: 30499259 DOI: 10.1002/acr.23789] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 09/11/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.
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Affiliation(s)
- Jasvinder A Singh
- University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | | | | | - Dafna D Gladman
- University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | - Janice Lin
- Stanford University, Stanford, California
| | | | - Philip J Mease
- Swedish-Providence Health Systems and University of Washington, Seattle, Washington
| | - Joseph F Merola
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julie Miner
- Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia
| | | | | | - Benjamin J Smith
- Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee
| | | | - Anna Helena Jonsson
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | - Alice Gottlieb
- New York Medical College at Metropolitan Hospital, New York, New York
| | | | | | | | - Soumya M Reddy
- New York University School of Medicine, New York, New York
| | - Jose U Scher
- New York University School of Medicine, New York, New York
| | - Evan Siegel
- Arthritis & Rheumatism Associates, Rockville, Maryland
| | | | - Jessica A Walsh
- University of Utah and George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
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20
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Callis Duffin K, FitzGerald O, Kavanaugh A, Mease PJ, Merola JF, Ogdie A, O'Sullivan D, Reddy SM, Ritchlin CT, Coates LC. GRAPPA 2017 Project Report. J Rheumatol Suppl 2018; 94:48-51. [PMID: 29858355 DOI: 10.3899/jrheum.180139] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
At the 2017 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members received updates on several ongoing educational and research efforts. Among them were updates on GRAPPA's continued education efforts; GRAPPA's continued research efforts, including the Biomarker Project, a collaborative research effort to identify and study biomarkers of joint damage; treatment recommendations, including recommendations and core principles related to biosimilars; efforts to update GRAPPA's Website and to create a GRAPPA smart-phone application (app); and the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network.
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Affiliation(s)
- Kristina Callis Duffin
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Oliver FitzGerald
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Artie Kavanaugh
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Philip J Mease
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Joseph F Merola
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Alexis Ogdie
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Denis O'Sullivan
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Soumya M Reddy
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Christopher T Ritchlin
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford
| | - Laura C Coates
- From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. .,K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford.
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21
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Kayser WC, Carstens GE, Washbun KE, Lawhon SD, Reddy SM, Skidmore AL, Chevaux E, Pinchak WE. 101 Effects of Live Yeast Supplementation on Complete Blood Cell Count and Febrile Responses in Heifers after Viral-Bacterial Respiratory Challenge. J Anim Sci 2018. [DOI: 10.1093/jas/sky027.107] [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: 11/13/2022] Open
Affiliation(s)
- W C Kayser
- Department of Animal Science, Texas A&M University, College Station, TX
| | | | - K E Washbun
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - S D Lawhon
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX
| | - S M Reddy
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX
| | | | - E Chevaux
- Lallemand Animal Nutrition, Milwaukee, WI
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22
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Alexander A, Willey J, Sun H, Parker CA, Marx AN, Wood AL, Reddy SM, Reuben JM, Bassett RL, Le-Petross HT, Krishnamurthy S, Gong Y, Woodward WA, Valero V, Ueno NT, Lim B. Abstract OT1-02-05: A single arm phase II study of adjuvant anti-PD1 (pembrolizumab) in combination with hormonal therapy in patients with hormone receptor (HR)-positive localized inflammatory breast cancer (IBC) who did not achieve a pathological complete response (pCR) to neoadjuvant chemotherapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-02-05] [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: 11/16/2022]
Abstract
Abstract
Background: The pCR rate to conventional chemotherapy in hormone receptor positive IBC has historically been low (7.4% for HR+ HER2-, and 30% for HR+ HER2+), and despite the use of adjuvant endocrine therapy, the recurrence rate is still as high as 40%. To date, no targeted agent is proven to improve the efficacy of adjuvant endocrine therapy within the IBC population to improve this poor disease free survival (DFS). One plausible reason for the poor efficacy of endocrine therapy is a suppressed immune system, which allows tumor cells to avoid detection despite expression of potential immunogenic surface antigens.
Trial Design: This is a single arm trial that will enroll stage III HR+ IBC patients who have completed neoadjuvant therapy but had residual disease at mastectomy. Enrollment should be before or within 2 months of beginning endocrine therapy. Monitoring of DFS will be done with radiological imaging every 3 cycles (starting at cycle 4) as clinically indicated, per standard of care. Pembrolizumab is given on day 1 of each 21 day cycle for up to 2 years if the disease is controlled, and hormonal therapy will be administered per standard of care.
Eligibility Criteria: Clinical stage 3 IBC ER+/PR+ and HER2 negative patients who completed neoadjuvant chemotherapy and surgery with evidence of residual cancer in the breast or lymph nodes, but be clinically disease-free with good performance status at the start of study. Patients also must have adequate hematologic and organ function, and have recovered from the acute effects from prior treatments.
Specific Aims: The primary objective is to determine the disease free survival (DFS) at 2 years of patients with adjuvant therapy using Pembrolizumab in combination with standard adjuvant hormonal therapy. The secondary objective is to determine the safety and toxicity profile of this combination.
Statistical Methods: With a sample size of 37 patients, assuming that 80% are alive (20% increase from historical data) and disease-free at 2 years, and all patients are followed for >2 years after enrollment with no dropout, a 95% confidence interval around the 2-year estimate of DFS will be generated. DFS will then be compared with the historical control rate of 60% by year 2 using a one-sided exponential MLE test.
Accrual: To date we have enrolled 3 patients since activation in January 2017, and the target enrollment is 37 patients.
Contact information: For more information or to refer a patient, please contact study coordinator, Angela Alexander - aalexand@mdanderson.org
Citation Format: Alexander A, Willey J, Sun H, Parker CA, Marx AN, Wood AL, Reddy SM, Reuben JM, Bassett RL, Le-Petross HT, Krishnamurthy S, Gong Y, Woodward WA, Valero V, Ueno NT, Lim B. A single arm phase II study of adjuvant anti-PD1 (pembrolizumab) in combination with hormonal therapy in patients with hormone receptor (HR)-positive localized inflammatory breast cancer (IBC) who did not achieve a pathological complete response (pCR) to neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-02-05.
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Affiliation(s)
- A Alexander
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Willey
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - H Sun
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - CA Parker
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - AN Marx
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - AL Wood
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - SM Reddy
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - JM Reuben
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - RL Bassett
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - HT Le-Petross
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Y Gong
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - WA Woodward
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - V Valero
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - NT Ueno
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Lim
- University of Texas MD Anderson Cancer Center, Houston, TX
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23
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Reddy SM, Reuben A, Jiang H, Roszik J, Tetzlaff MT, Reuben J, Wang L, Tsujikawa T, Barua S, Rao A, Villareal L, Wood A, Woodward W, Ueno NT, Krishnamurthy S, Wargo JA, Mittendorf EA. Abstract P3-05-08: Lymphoid and myeloid cell characterization of inflammatory breast cancer tumor microenvironment and correlation to pathological complete response. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-05-08] [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: 11/16/2022]
Abstract
Abstract
Background: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer with poor response rates to current chemotherapy regimens. With recent successes of immune targeted therapies in other solid tumors and a growing understanding of how the immune tumor microenvironment (TME) affects non-IBC outcomes, we sought to characterize the immune TME in IBC to identify biomarkers of treatment response and potential targets for drug development.
Methods: Pre-treatment core biopsy samples were identified from the MD Anderson Cancer Center IBC tissue bank from patients with stage III and de novo stage IV (with T4d) disease who received neoadjuvant chemotherapy (NAC) with intent to take to mastectomy. Lymphocytes were characterized by stromal tumor infiltrating lymphocyte (sTIL) quantification, CD8 T cell quantification, and T cell receptor sequencing. PD-L1 expression was assessed using DAKO 22C3 clone on tumor and immune cells. Myeloid cells were characterized using a multiplex immunohistochemistry approach, using CD68 and CD163 for macrophage markers, tryptase for mast cell marker, HLA-DR for class II antigen presentation marker, and cytokeratin as tumor marker. Spatial analyses were performed by determining probabilities of finding cell 1 of interest within 20 uM of cell 2 of interest and computing area under the curve for statistical comparison.
Results: 91 patients with stage III (N=62) or de novo stage IV (n=29) disease were identified. Breast cancer subtype included 25 triple negative, 34 HER2+ and 32 HER2-HR+. 86 patients received a mastectomy, of whom 33 (38.4%) patients experienced a pathologic complete response (pCR). sTIL was higher in stage III tumors (11.9 vs 4.8%, p<0.001) and in those having a pCR (13.8 vs 7.3%, p=0.019). CD8 T cell density (available in 48 cases) similarly was higher in stage III patients (360.3 vs 178.8 counts/mm2, p=0.040) and pCR cases (452.3 vs 219.2 counts/mm2, p=0.080) but also higher in HER2+ disease (560.9 for HER2+ vs 239.9 counts/mm2, p=0.087 for TNBC and 153.6 counts/mm2, p=0.005 for HER2-HR+). T cell clonality (available in 32 cases) ranged from 0.004 to 0.242 but showed no correlation to tumor characteristics or response. PD-L1 complete tumor membranous expression was seen in only 1 of 47 cases, whereas PD-L1 positivity on immune cells was seen on 36.2% of cases; neither correlated to response. Myeloid cell assessment (available in 25 cases) showed higher mast cell infiltration in non-pCR cases (63.8 vs 26.8 counts/mm2, p=0.008) and spatial analysis (performed on 10 cases) identified that closer proximity of mast cells to CD8 T cells correlates with response (AUC 6.0 vs 2.2, p=0.017), suggesting a possible immunosuppressive mechanism. HLA-DR analysis demonstrated no difference by response as a single stain marker, but co-localization of HLA-DR with cell type shows higher HLA-DR expression on tumor cells in non-responders (14.6 vs 1.6%, p=0.031).
Conclusions: Higher TIL and CD8 T cell density are correlated with improved responses to NAC in IBC. Mast cell infiltration and HLA-DR expression on tumor cells are inversely correlated to response and suggest possible mechanisms of resistance. Mast cells could present potential therapeutic target in IBC.
Citation Format: Reddy SM, Reuben A, Jiang H, Roszik J, Tetzlaff MT, Reuben J, Wang L, Tsujikawa T, Barua S, Rao A, Villareal L, Wood A, Woodward W, Ueno NT, Krishnamurthy S, Wargo JA, Mittendorf EA. Lymphoid and myeloid cell characterization of inflammatory breast cancer tumor microenvironment and correlation to pathological complete response [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-05-08.
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Affiliation(s)
- SM Reddy
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Reuben
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Jiang
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - J Roszik
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - MT Tetzlaff
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - J Reuben
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - L Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Tsujikawa
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Barua
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Rao
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - L Villareal
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Wood
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - W Woodward
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - NT Ueno
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - S Krishnamurthy
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - JA Wargo
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - EA Mittendorf
- The University of Texas MD Anderson Cancer Center, Houston, TX; Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX; Oregon Health and Sciences University, Portland, OR; Kyoto Prefectural University of Medicine, Kyoto, Japan
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24
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Gopalakrishnan V, Spencer CN, Nezi L, Reuben A, Andrews MC, Karpinets TV, Prieto PA, Vicente D, Hoffman K, Wei SC, Cogdill AP, Zhao L, Hudgens CW, Hutchinson DS, Manzo T, Petaccia de Macedo M, Cotechini T, Kumar T, Chen WS, Reddy SM, Szczepaniak Sloane R, Galloway-Pena J, Jiang H, Chen PL, Shpall EJ, Rezvani K, Alousi AM, Chemaly RF, Shelburne S, Vence LM, Okhuysen PC, Jensen VB, Swennes AG, McAllister F, Marcelo Riquelme Sanchez E, Zhang Y, Le Chatelier E, Zitvogel L, Pons N, Austin-Breneman JL, Haydu LE, Burton EM, Gardner JM, Sirmans E, Hu J, Lazar AJ, Tsujikawa T, Diab A, Tawbi H, Glitza IC, Hwu WJ, Patel SP, Woodman SE, Amaria RN, Davies MA, Gershenwald JE, Hwu P, Lee JE, Zhang J, Coussens LM, Cooper ZA, Futreal PA, Daniel CR, Ajami NJ, Petrosino JF, Tetzlaff MT, Sharma P, Allison JP, Jenq RR, Wargo JA. Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients. Science 2018; 359:97-103. [PMID: 29097493 PMCID: PMC5827966 DOI: 10.1126/science.aan4236] [Citation(s) in RCA: 2689] [Impact Index Per Article: 448.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 10/17/2017] [Indexed: 12/11/2022]
Abstract
Preclinical mouse models suggest that the gut microbiome modulates tumor response to checkpoint blockade immunotherapy; however, this has not been well-characterized in human cancer patients. Here we examined the oral and gut microbiome of melanoma patients undergoing anti-programmed cell death 1 protein (PD-1) immunotherapy (n = 112). Significant differences were observed in the diversity and composition of the patient gut microbiome of responders versus nonresponders. Analysis of patient fecal microbiome samples (n = 43, 30 responders, 13 nonresponders) showed significantly higher alpha diversity (P < 0.01) and relative abundance of bacteria of the Ruminococcaceae family (P < 0.01) in responding patients. Metagenomic studies revealed functional differences in gut bacteria in responders, including enrichment of anabolic pathways. Immune profiling suggested enhanced systemic and antitumor immunity in responding patients with a favorable gut microbiome as well as in germ-free mice receiving fecal transplants from responding patients. Together, these data have important implications for the treatment of melanoma patients with immune checkpoint inhibitors.
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Affiliation(s)
- V Gopalakrishnan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - C N Spencer
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Nezi
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A Reuben
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - M C Andrews
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - T V Karpinets
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P A Prieto
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - D Vicente
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - K Hoffman
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - S C Wei
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A P Cogdill
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Zhao
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - C W Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - D S Hutchinson
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - T Manzo
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - M Petaccia de Macedo
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - T Cotechini
- Department of Cell, Developmental and Cell Biology, Oregon Health and Sciences University, Portland, OR 97239, USA
| | - T Kumar
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - W S Chen
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - S M Reddy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - R Szczepaniak Sloane
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J Galloway-Pena
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - H Jiang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P L Chen
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - E J Shpall
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - K Rezvani
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A M Alousi
- Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - R F Chemaly
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - S Shelburne
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L M Vence
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P C Okhuysen
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - V B Jensen
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A G Swennes
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - F McAllister
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - E Marcelo Riquelme Sanchez
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Y Zhang
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - E Le Chatelier
- Centre de Recherche de Jouy-en-Josas, Institut National de la Recherche Agronomique, 78352 Jouy-en-Josas, France
| | - L Zitvogel
- Centre d'Investigation Clinique Biothérapie, Institut Gustave-Roussy, 94805 Villejuif Cedex, France
| | - N Pons
- Centre de Recherche de Jouy-en-Josas, Institut National de la Recherche Agronomique, 78352 Jouy-en-Josas, France
| | - J L Austin-Breneman
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L E Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - E M Burton
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J M Gardner
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - E Sirmans
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J Hu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A J Lazar
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - T Tsujikawa
- Department of Cell, Developmental and Cell Biology, Oregon Health and Sciences University, Portland, OR 97239, USA
| | - A Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - H Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - I C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - W J Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - S P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - S E Woodman
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - R N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - M A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L M Coussens
- Department of Cell, Developmental and Cell Biology, Oregon Health and Sciences University, Portland, OR 97239, USA
| | - Z A Cooper
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P A Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - C R Daniel
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - N J Ajami
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - J F Petrosino
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - M T Tetzlaff
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - P Sharma
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J P Allison
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - R R Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Reddy SM, Barcenas CH, Sinha AK, Hsu L, Moulder SL, Tripathy D, Hortobagyi GN, Valero V. Long-term survival outcomes of triple-receptor negative breast cancer survivors who are disease free at 5 years and relationship with low hormone receptor positivity. Br J Cancer 2017; 118:17-23. [PMID: 29235566 PMCID: PMC5765226 DOI: 10.1038/bjc.2017.379] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 08/25/2017] [Accepted: 10/04/2017] [Indexed: 12/31/2022] Open
Abstract
Background: We counsel our triple-negative breast cancer (TNBC) patients that the risk of recurrence is highest in the first 5 years after diagnosis. However, there are limited data with extended follow-up on the frequency, characteristics, and predictors of late events. Methods: We queried the MD Anderson Breast Cancer Management System database to identify patients with stage I–III TNBC who were disease free at 5 years from diagnosis. The Kaplan–Meier method was used to estimate yearly recurrence-free interval (RFI), recurrence-free survival (RFS), and distant relapse-free survival (DRFS), as defined by the STEEP criteria. Cox proportional hazards model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We identified 873 patients who were disease free at least 5 years from diagnosis with median follow-up of 8.3 years. The 10-year RFI was 97%, RFS 91%, and DRFS 92% the 15-year RFI was 95%, RFS 83%, and DRFS 84%. On a subset of patients with oestrogen receptor and progesterone receptor percentage recorded, low hormone receptor positivity conferred higher risk of late events on multivariable analysis for RFS only (RFI: HR=1.98, 95% CI=0.70–5.62, P-value=0.200; RFS: HR=1.94, 95% CI=1.05–3.56, P-value=0.034; DRFS: HR=1.72, 95% CI=0.92–3.24, P-value=0.091). Conclusions: The TNBC survivors who have been disease free for 5 years have a low probability of experiencing recurrence over the subsequent 10 years. Patients with low hormone receptor-positive cancers may have a higher risk of late events as measured by RFS but not by RFI or DRFS.
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Affiliation(s)
- S M Reddy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - C H Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - A K Sinha
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - L Hsu
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - S L Moulder
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - D Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - G N Hortobagyi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - V Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
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Okhovat JP, Ogdie A, Reddy SM, Rosen CF, Scher JU, Merola JF. Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network Consortium (PPACMAN) Survey: Benefits and Challenges of Combined Rheumatology-dermatology Clinics. J Rheumatol 2017; 44:693-694. [DOI: 10.3899/jrheum.170148] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Optimal management of patients with both psoriasis and psoriatic arthritis (PsA) necessitates collaboration among dermatologists and rheumatologists. In this manuscript, we discuss challenges and opportunities for dual care models for patients with psoriasis and PsA and the results of a survey of combined clinics based in North America.
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Reddy SM, Wargo JA, Reuben A, Reuben J, Woodward W, Ueno N, Mittendorf EA, Krishnamurthy S. Abstract P3-16-01: Immune characterization of inflammatory breast cancer and correlation to pathological complete response. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-16-01] [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: 11/16/2022]
Abstract
Abstract
Background:
Treatment of inflammatory breast cancer (IBC) includes neoadjuvant chemotherapy (NAC) followed by mastectomy and radiation. Responses are limited however with low pathological complete response (pCR) rates and poor survival. Recent RNA expression studies suggest that activated T cell signaling pathways and immunomodulatory markers such as PD-L1 are associated with a higher pCR rate in IBC; however comprehensive studies of tumor infiltrating lymphocytes (TIL) and protein expression of immunomodulatory molecules are lacking. There is a critical need therefore to study molecular and immune determinants of therapeutic response in IBC, with the goal of identifying biomarkers and actionable strategies to improve treatment outcomes.
Methods:
Baseline core biopsies from 36 IBC patients, 22 with stage III and 14 with stage IV disease were evaluated. Of these, 21 stage III and 10 stage IV patients underwent mastectomy following NAC, the latter for palliative purposes. Tumor subtype distribution was 14 patients with HER2-/HR-, 6 with HER2+/HR-, 11 with HER2-/HR+, and 5 with HER2+/HR+ disease. TIL infiltration in the tumor stroma was quantified on H&E slides based on consensus guidelines as well as by immunohistochemistry (IHC) staining for CD8. PD-L1 expression in the TIL and invasive tumor was evaluated by IHC in tumors with >1%TIL.
Results:
Stromal TIL were found in the invasive tumor on pretreatment biopsies in 26 (72%) patients, with TIL percentages ranging from 1% to 60% (mean=11.6; sd=13.8); of note, 1 patient biopsy sample only had tumor emboli on the tissue block and therefore was not evaluable. Higher TIL infiltrate was noted in stage III versus stage IV disease (mean TIL 11.6% versus 3.5%, p=0.028). Mean TIL infiltrate was 11.5% in HER2-/HR-, 10.0% in HER2+/HR-, 10.4% in HER2+/HR+, and 3.6% in HER2-/HR+ tumors (p=NS). At mastectomy, 7/21 stage III patients and 1/10 stage IV patients achieved a pCR. Mean TIL was 13.4% in the pCR group versus 8.2% in the non-pCR group (p=0.37) CD8 and PD-L1 staining was performed on samples with >1%TIL (n=15, of which 14 samples were available for additional staining). An average of 42% of TIL stained positive for CD8 (range 10-80%). There was no significant relationship between %CD8 and pCR, stage, or receptor status. None of these 14 patients demonstrated membranous PD-L1 positivity but all had focal weak cytoplasmic staining in the lymphocytes.
Conclusions:
Differences exist in the presence of stromal TIL in distinct groups within IBC (stage III versus stage IV disease and across histologic subtypes) and may contribute to differential responses to therapy. When comparing these results to published non-IBC literature (FinHER trial), our IBC patient cohort had lower TIL infiltrate in several histologic subtypes (HER2-/HR- 11.5% vs 25%, p=0.015), HER2+/HR-(10% vs 20%, p=0.10), and HER-/HR+ disease (3.6 vs 7.5%, p=0.01); TIL was comparable for HER2+/HR+ disease. Additional studies are underway (including multiplex analysis of myeloid and lymphoid markers, T cell receptor sequencing, and molecular profiling) in pre-treatment and surgical samples to better understand mechanisms of treatment response and resistance.
Citation Format: Reddy SM, Wargo JA, Reuben A, Reuben J, Woodward W, Ueno N, Mittendorf EA, Krishnamurthy S. Immune characterization of inflammatory breast cancer and correlation to pathological complete response [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-16-01.
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Affiliation(s)
- SM Reddy
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - JA Wargo
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Reuben
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Reuben
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - W Woodward
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Ueno
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - EA Mittendorf
- University of Texas MD Anderson Cancer Center, Houston, TX
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Reddy SM, Crean S, Martin AL, Burns MD, Palmer JB. Real-world effectiveness of anti-TNF switching in psoriatic arthritis: a systematic review of the literature. Clin Rheumatol 2016; 35:2955-2966. [DOI: 10.1007/s10067-016-3425-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/08/2016] [Accepted: 09/18/2016] [Indexed: 11/28/2022]
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Reddy SM, Sinha A, Syed M, Barcenas C, Valero V. Abstract P4-10-09: Relapse-free survival of triple negative breast cancer long term survivors and characterization of late events in MD Anderson experience. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-10-09] [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: 11/16/2022]
Abstract
Abstract
Background:
Stage I-III TNBC patients have a high risk of disease relapse during the first 5 years after diagnosis. However, there is limited data on the risk of late relapse in TNBC survivors who are disease free at 5 years or more from diagnosis. We sought to characterize this risk in a cohort of TNBC long-term survivors from a large institutional database.
Methods:
The MD Anderson Breast Cancer Management System database was queried for TNBC survivors who were disease free 5 years or more from diagnosis. Demographic, tumor, and treatment data was extracted. Electronic medical records were searched to confirm pathology reports for invasive breast cancer diagnosis, triple negative receptor status, and hormone receptor percentage (%). The primary and secondary outcomes of interest were relapse free survival (RFS) and distant relapse free survival (DRFS). Patients were censored at time of developing a second primary breast cancer or at last follow-up time for those who were alive during the study. We used ACP-ASCO definition of ER and PR <1% and HER2/neu negative (IHC 0-1 or ratio <2 and average copy number <4) but also included patients with low ER/PR(1-9%) and HER2 normal. Kaplan-Meier analysis was performed to compare RFS and DRFS for the overall population and categorized by ER/PR <1%, and ER/PR 1-9%.
Results:
We identified 1038 patients who had a median follow-up of 8.0 years. Receptor % information was available on 69% of patients, with 78% of them meeting current TNBC definition. From the total cohort of 130, 12.5% suffered event(s) that occurred after 5 years from diagnosis, with 86.2% of them occurring within 5-10 years of diagnosis. The event rate was 16.4% among patients with ER/PR 1-9% versus 11.3% among patients with ER/PR <1%. Table 1 shows RFS and DRFS by year from diagnosis for the entire cohort and categorized by % receptor. 18 patients developed second primary breast cancer as first event and were censored. Of total events recorded, 53(40.8%) were deaths and 77(59.2%) were recurrences, of which 51(66%) were distant and 26(34%) local, of whom 12(46.2%) subsequently developed distant metastases. Among patients who initially presented with distant recurrence, frequencies of initial sites of metastases are shown in Table 2.
Conclusions:
TNBC long term survivors are still at risk for relapse events after 5 years from diagnosis, and it is important to quantity this risk when counseling our patients. Frequency of late events was higher among patients with low hormone receptor positivity. Multivariate modeling of predictors of late recurrence is ongoing.
Table 1: RFS and DRFS by Year from Diagnosis All PatientsER/PR <1%ER/PR 1-9%Year From DiagnosisRFSDRFSRFSDRFSRFSDRFS4-51.01.01.01.01.01.05-60.950.960.940.950.940.956-70.930.940.930.940.910.927-80.900.920.900.920.870.898-90.860.880.870.890.810.849-100.840.870.840.860.800.8310-120.810.840.810.830.800.8312-150.730.780.730.750.670.74
Table 2: Site of Initial Distant RecurrenceSiteN (%)Lung/Pleura28 (54.9)Bone19 (37.3)Distant Lymph Nodes19 (37.3)Liver11 (21.6)Brain/Spinal Cord8 (15.7)Colorectal/Pancreas/Kidney/Adrenal6 (11.7)Other2 (3.9)*Patients presenting with multiple sites of distant recurrence are counted in each category.
Citation Format: Reddy SM, Sinha A, Syed M, Barcenas C, Valero V. Relapse-free survival of triple negative breast cancer long term survivors and characterization of late events in MD Anderson experience. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-09.
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Affiliation(s)
- SM Reddy
- MD Anderson Cancer Center, Houston, TX
| | - A Sinha
- MD Anderson Cancer Center, Houston, TX
| | - M Syed
- MD Anderson Cancer Center, Houston, TX
| | | | - V Valero
- MD Anderson Cancer Center, Houston, TX
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Reddy SM, Kopetz S, Morris J, Parikh N, Qiao W, Overman MJ, Fogelman D, Shureiqi I, Jacobs C, Malik Z, Jimenez CA, Wolff RA, Abbruzzese JL, Gallick G, Eng C. Phase II study of saracatinib (AZD0530) in patients with previously treated metastatic colorectal cancer. Invest New Drugs 2015; 33:977-84. [PMID: 26062928 DOI: 10.1007/s10637-015-0257-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/02/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Src has a critical role in tumor cell migration and invasion. Increased Src activity has been shown to correlate with disease progression and poor prognosis, suggesting Src could serve as a therapeutic target for kinase inhibition. Saracatinib (AZD0530) is a novel selective oral Src kinase inhibitor. METHODS Metastatic colorectal cancer patients who had received one prior treatment and had measurable disease were enrolled in this phase 2 study. Saracatinib was administered at 175 mg by mouth daily for 28 day cycles until dose-limiting toxicity or progression as determined by staging every 2 cycles. The primary endpoint was improvement in 4 month progression-free survival. Design of Thall, Simon, and Estey was used to monitor proportion of patients that were progression free at 4 months. The trial was opened with plan to enroll maximum of 35 patients, with futility assessment every 10 patients. RESULTS A total of 10 patients were enrolled between January and November 2007. Further enrollment was stopped due to futility. Median progression-free survival was 7.9 weeks, with all 10 patients showing disease progression following radiographic imaging. Median overall survival was 13.5 months. All patients were deceased by time of analysis. Observed adverse events were notable for a higher than expected number of patients with grade 3 hypophosphatemia (n = 5). CONCLUSION Saracatinib is a novel oral Src kinase inhibitor that was well tolerated but failed to meet its primary endpoint of improvement in 4 month progression-free survival as a single agent in previously treated metastatic colorectal cancer patients.
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Affiliation(s)
- S M Reddy
- Hematology-Oncology Fellow, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 463, Houston, TX, 77030, USA,
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Scher JU, Ubeda C, Artacho A, Attur M, Isaac S, Reddy SM, Marmon S, Neimann A, Brusca S, Patel T, Manasson J, Pamer EG, Littman DR, Abramson SB. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol 2015; 67:128-39. [PMID: 25319745 DOI: 10.1002/art.38892] [Citation(s) in RCA: 501] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 09/23/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To characterize the diversity and taxonomic relative abundance of the gut microbiota in patients with never-treated, recent-onset psoriatic arthritis (PsA). METHODS High-throughput 16S ribosomal RNA pyrosequencing was utilized to compare the community composition of gut microbiota in patients with PsA (n = 16), patients with psoriasis of the skin (n = 15), and healthy, matched control subjects (n = 17). Samples were further assessed for the presence and levels of fecal and serum secretory IgA (sIgA), proinflammatory proteins, and fatty acids. RESULTS The gut microbiota observed in patients with PsA and patients with skin psoriasis was less diverse when compared to that in healthy controls. This could be attributed to the reduced presence of several taxa. Samples from both patient groups showed a relative decrease in abundance of Coprococcus species, while samples from PsA patients were also characterized by a significant reduction in Akkermansia, Ruminococcus, and Pseudobutyrivibrio. Supernatants of fecal samples from PsA patients revealed an increase in sIgA levels and decrease in RANKL levels. Analysis of fatty acids revealed low fecal quantities of hexanoate and heptanoate in both patients with PsA and patients with psoriasis. CONCLUSION Patients with PsA and patients with skin psoriasis had a lower relative abundance of multiple intestinal bacteria. Although some genera were concomitantly decreased in both conditions, PsA samples had a lower abundance of reportedly beneficial taxa. This gut microbiota profile in PsA was similar to that previously described in patients with inflammatory bowel disease and was associated with changes in specific inflammatory proteins unique to this group, and distinct from that in patients with skin psoriasis and healthy controls. Thus, the role of the gut microbiome in the continuum of psoriasis-PsA pathogenesis and the associated immune response merits further study.
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Affiliation(s)
- Jose U Scher
- New York University and New York University Hospital for Joint Diseases, New York, New York
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32
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Ogdie A, Schwartzman S, Eder L, Maharaj AB, Zisman D, Raychaudhuri SP, Reddy SM, Husni E. Comprehensive Treatment of Psoriatic Arthritis: Managing Comorbidities and Extraarticular Manifestations. J Rheumatol 2014; 41:2315-22. [DOI: 10.3899/jrheum.140882] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis that can lead to decreased health-related quality of life and permanent joint damage leading to functional decline. In addition to joint and skin manifestations, both psoriasis and PsA are associated with numerous comorbidities and extraarticular/cutaneous manifestations, which may influence the physician’s choice of therapy. The objectives of this review are (1) to identify comorbidities in patients with PsA based on the available evidence; (2) to examine the effects of these comorbidities or extraarticular/cutaneous manifestation on the management of patients with PsA as well as the selection of therapy; and (3) to highlight research needs around comorbidities and treatment paradigms. This review is part of a treatment recommendations update initiated by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
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Prasad GS, Govardhan P, Girisham S, Reddy SM. Fungal mediated generation of mammalian metabolites of fenofibrate and enhanced pharmacological activity of the main metabolite fenofibric acid. Drug Metab Lett 2014; 8:88-95. [PMID: 24910236 DOI: 10.2174/1872312808666140606103227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/27/2014] [Accepted: 05/31/2014] [Indexed: 11/22/2022]
Abstract
Different fungi viz. Aspergillus niger NCIM 589, A.ochraceous NCIM 1140, Cunninghamella blakesleeana NCIM 687, C. echinulata NCIM 691, Rhizopus stolonifer NCIM 880, Mucor rouxi MTCC 386, Trichothecium roseum NCIM 1147 were screened for their potential to biotransform anti-hyperlipidemia and anti-hypertriglyceridemia drug, fenofibrate to fenofibric acid, the active metabolite and other mammalian metabolites. Among the fungi screened C. blakesleeana transformed fenofibrate to fenofibric acid and other three metabolites. HPLC, LC-MS/MS analysis and previous reports confirmed the transformation of fenofibrate and metabolites as fenofibric acid (M1), reduced fenofibric acid (M2), reduced fenofibric acid taurine conjugate (M3), reduced fenofibric acid ester glucuronide (M4), the mammalian metabolites reported previously. The results proved the potential of C.blakesleeana NCIM 687 in the production of mammalian phase I (M1 and M2) and phase II (M3 and M4) metabolites in large quantities and also as an in vitro model for drug metabolism studies.
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Affiliation(s)
| | | | | | - S M Reddy
- Department of Microbiology, Kakatiya University, Warangal-506009, Telangana, India.
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Wang Y, Lupiani B, Reddy SM, Lamont SJ, Zhou H. RNA-seq analysis revealed novel genes and signaling pathway associated with disease resistance to avian influenza virus infection in chickens. Poult Sci 2014; 93:485-93. [PMID: 24570473 DOI: 10.3382/ps.2013-03557] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Avian influenza virus (AIV) is a type A virus of the family Orthomyxoviridae. Avian influenza virus infection can cause significant economic losses to the poultry industry, and raises a great public health threat due to potential host jump from animals to humans. To develop more effective intervention strategies to prevent and control AIV infection in poultry, it is essential to elucidate molecular mechanisms of host response to AIV infection in chickens. The objective of this study was to identify genes and signal pathways associated with resistance to AIV infection in 2 genetically distinct highly inbred chicken lines (Fayoumi, relatively resistant to AIV infection, and Leghorn, susceptible to AIV infection). Three-week-old chickens were inoculated with 10(7) EID50 of low pathogenic H5N3 AIV, and lungs and trachea were harvested 4 d postinoculation. Four cDNA libraries (1 library each for infected and noninfected Leghorn, and infected and noninfected Fayoumi) were prepared from the lung samples and sequenced by Illumina Genome Analyzer II, which yielded a total of 116 million, 75-bp single-end reads. Gene expression levels of all annotated chicken genes were analyzed using CLC Genomics Workbench. DESeq was used to identify differentially expressed transcripts between infected and noninfected birds and between genetic lines (false discovery rate < 0.05 and fold-change > 2). Of the expressed transcripts in a total of 17,108 annotated chicken genes in Ensembl database, 82.44 and 81.40% were identified in Leghorn and Fayoumi birds, respectively. The bioinformatics analysis suggests that the hemoglobin family genes, the functional involvements for oxygen transportation and circulation, and cell adhesion molecule signaling pathway play significant roles in disease resistance to AIV infection in chickens. Further investigation of the roles of these candidate genes and signaling pathways in the regulation of host-AIV interaction can lead new directions for the development of antiviral drugs or vaccines in poultry.
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Affiliation(s)
- Y Wang
- Department of Animal Science, University of California, Davis 95616
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Reddy SM, Anandarajah AP, Fisher MC, Mease PJ, Greenberg JD, Kremer JM, Reed G, Chen R, Messing S, Kaukeinen K, Ritchlin CT. Comparative analysis of disease activity measures, use of biologic agents, body mass index, radiographic features, and bone density in psoriatic arthritis and rheumatoid arthritis patients followed in a large U.S. disease registry. J Rheumatol 2010; 37:2566-72. [PMID: 20843908 DOI: 10.3899/jrheum.100483] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare disease activity, radiographic features, and bone density in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) matched cohorts. METHODS Disease activity and radiographic data in the Consortium of Rheumatology Researchers of North America database from 2001 to 2008 were compared for 2481 patients with PsA and 17,107 patients with RA subsequently matched for age, gender, and disease duration. Radiographic outcomes included presence of erosions, and joint deformity. In addition, bone mineral density (BMD) scores for lumbar spine (L-spine) and femoral neck were compared using the same matching criteria plus weight and smoking status. RESULTS Tender (4.5 vs 3.4, p < 0.001) and swollen (4.4 vs 2.9, p < 0.012) joint counts, and modified Health Assessment Questionnaire scores were significantly higher (0.4 vs 0.3, p < 0.001) in patients with RA compared with patients with PsA. Patient general health and pain scores were also higher in patients with RA vs patients with PsA. Joint erosions (47.4% vs 37.6%, p = 0.020) and deformity (25.2% vs 21.6%, p = 0.021) were more prevalent in RA than PsA. In multivariate analysis, a reduced prevalence of erosions in PsA vs RA was noted (OR 0.609, p < 0.001). After matching, T-scores for L-spine (-0.54 vs -0.36, p = 0.077) and femoral neck (-0.88 vs -0.93, p = 0.643) were similar in patients with RA and patients with PsA, although body weight was a major confounder. CONCLUSION The level of disease activity and radiographic damage was significantly higher for RA vs PsA subjects, although the magnitude of differences was relatively small. BMD levels were comparable between cohorts. Outcomes in patients with PsA and patients with RA may be more similar than previously reported.
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Affiliation(s)
- Soumya M Reddy
- New York University School of Medicine-Hospital for Joint Diseases, New York, USA.
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Shyam Prasad G, Girisham S, Reddy SM. Microbial transformation of albendazole. Indian J Exp Biol 2010; 48:415-420. [PMID: 20726341] [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: 05/29/2023]
Abstract
Screening scale studies were performed to biotransform anthelmintic drug albendazole by using twelve bacterial strains representing six genera and five actinomycetes cultures. Among the cultures studied, Bacillus subtilis MTCC 619, Escherichia coli MTCC 118 and Klebsiella pneumoniae MTCC 109 could transform albendazole to one metabolite whereas, Enterobacter aerogenes NCIM 2695, Klebsiella aerogenes NCIM 2258, Pseudomonas aeruginosa NCIM 2074 and Streptomyces griseus NCIM 2622 could transform albendazole into two metabolites in significant quantities. The transformation of albendazole was identified by HPLC. Based on LC-MS-MS data, the two metabolites were predicted to be albendazole sulfoxide (M1) and albendazole sulfone (M2), the major mammalian metabolites reported previously. Since M1 is active metabolite, the results prove the versatility of microorganisms to perform industrially attractive chemical reactions.
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Affiliation(s)
- G Shyam Prasad
- Department of Microbiology, Kakatiya University, Warangal 506 009, India.
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Greenberg JD, Reddy SM, Schloss SG, Kurucz OS, Bartlett SJ, Abramson SB, Bingham CO. Comparison of an in vitro tuberculosis interferon-gamma assay with delayed-type hypersensitivity testing for detection of latent Mycobacterium tuberculosis: a pilot study in rheumatoid arthritis. J Rheumatol 2008; 35:770-775. [PMID: 18322990] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Recommendations for screening for latent Mycobacterium tuberculosis (MTB) infection have been proposed but are not well studied in patients with rheumatoid arthritis (RA). We estimated the prevalence of anergy in RA and evaluated different methods to detect MTB exposure. METHODS This was a prospective pilot study of 61 patients with RA and 42 healthy controls. Tuberculin skin test (TST) antigen, Candida, and tetanus toxoid were injected intradermally using the Mantoux method. Subjects negative for TST returned for a second-step test. Whole-blood interferon-gamma (IFN-gamma) release to mycobacterial antigens was evaluated with the first-generation QuantiFeron test (QIFN). RESULTS Cutaneous anergy in patients with RA was not significantly different than healthy controls (p = 0.154), and was not affected by disease modifying antirheumatic drugs (p = 0.270). In patients with RA, 16.4% had positive TST with 10 mm cutoff vs 11.9% of controls. Using a 5 mm cutoff, 21.3% of patients with RA were positive, and this increased to 29.5% with a second-step TST. QIFN detected MTB exposure in 18% of patients with RA and 19% of controls (p = 0.897). However, indeterminate QIFN tests were higher in RA patients (11.5%) compared to controls (2.4%), demonstrating a lower sensitivity to detect latent MTB. CONCLUSION Cutaneous anergy may be less common than previously reported in patients with RA. patients. However, the single-step TST and 10 mm cutoff may fail to detect all cases of latent exposure in RA patients. High rates of indeterminate results in QIFN testing suggest that QIFN should not be employed as an alternative, single-screening test in patients with RA. These pilot results require confirmation in larger studies to determine the optimal screening strategy in RA.
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Affiliation(s)
- Jeffrey D Greenberg
- Department of Rheumatology, NYU-Hospital for Joint Diseases, New York, New York, USA
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Reddy SM, Joshi K, Shyam KS, Thingnam. Study of pulmonary arterial pressures and histopathological changes in patients having. Indian J Thorac Cardiovasc Surg 2006. [DOI: 10.1007/s12055-006-0540-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: 11/30/2022] Open
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Devendra Singh KH, Reddy SM, Grover A, Thingnam SKS. Comparison of mitral valve area, pulmonary function and pulmonary artery hypertension in patients with chronic rheumatic mitral stenosis undergoing surgical closed mitral valvotomy (SCMV) versus percutaneous balloon mitral valvotomy (PBMV). Indian J Thorac Cardiovasc Surg 2006. [DOI: 10.1007/s12055-006-0666-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: 11/30/2022] Open
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Reddy SM, Hitchin S, Melayah D, Pandey AK, Raffier C, Henderson J, Marmeisse R, Gay G. The auxin-inducible GH3 homologue Pp-GH3.16 is downregulated in Pinus pinaster root systems on ectomycorrhizal symbiosis establishment. New Phytol 2006; 170:391-400. [PMID: 16608463 DOI: 10.1111/j.1469-8137.2006.01677.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
In an attempt to determine whether auxin-regulated plant genes play a role in ectomycorrhizal symbiosis establishment, we screened a Pinus pinaster root cDNA library for auxin-upregulated genes. This allowed the identification of a cDNA, Pp-GH3.16, which encodes a polypeptide sharing extensive homologies with GH3 proteins of different plants. Pp-GH3.16 was specifically upregulated by auxins and was not affected by cytokinin, gibberellin, abscisic acid or ethylene, or by heat shock, water stress or anoxia. Pp-GH3.16 mRNAs were quantified in pine roots inoculated with two ectomycorrhizal fungi, Hebeloma cylindrosporum and Rhizopogon roseolus. Surprisingly, Pp-GH3.16 was downregulated following inoculation with both fungal species. The downregulation was most rapid on establishment of symbiosis with an indole-3-acetic acid (IAA)-overproducing mutant of H. cylindrosporum, which overproduced mycorrhizas characterized by a hypertrophic Hartig net. This indicates that, despite being auxin-inducible, Pp-GH3.16 can be downregulated on establishment of symbiosis with a fungus that releases auxin. By contrast, Pp-GH3.16 was not downregulated in pine root systems inoculated with a nonmycorrhizal mutant of H. cylindrosporum, suggesting that the downregulation we observed in mycorrhizal root systems was a component of the molecular cross-talk between symbiotic partners at the origin of differentiation of symbiotic structures.
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Affiliation(s)
- S M Reddy
- Université Lyon 1, UMR CNRS 5557, USC INRA 1193 d'Ecologie Microbienne Bât. A. Lwoff, 43 boulevard du 11 Novembre 1918, 69622 Villeurbanne Cedex, France
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Abstract
Outcome measures in psoriatic arthritis (PsA) have been primarily borrowed from the assessment of rheumatoid arthritis and ankylosing spondylitis, although several specific measures for PsA have been established. The advent of new therapeutic agents for the treatment of PsA has made the need for specific outcome measures for PsA more critical to evaluate the heterogeneous manifestations of this disease and features that are unique to its assessment. Several outcome measures have been validated for use in PsA clinical trials while others are being evaluated by groups such as The Group for Assessment of Psoriasis and Psoriatic Arthritis for future use in clinical trials.
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Affiliation(s)
- Soumya M Reddy
- Division of Rheumatology, New York University School of Medicine and Hospital for Joint Diseases, Peter D. Seligman Center for Advanced Therapeutics, 246 E. 20th St., Suite 101, New York, NY 10003, USA.
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Gimeno IM, Witter RL, Hunt HD, Reddy SM, Lee LF, Silva RF. The pp38 gene of Marek's disease virus (MDV) is necessary for cytolytic infection of B cells and maintenance of the transformed state but not for cytolytic infection of the feather follicle epithelium and horizontal spread of MDV. J Virol 2005; 79:4545-9. [PMID: 15767457 PMCID: PMC1061578 DOI: 10.1128/jvi.79.7.4545-4549.2005] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Marek's disease virus has a unique phosphoprotein, pp38, which is suspected to play an important role in Marek's disease pathogenesis. The objective of the present study was to utilize a mutant virus lacking the pp38 gene (rMd5Deltapp38) to better characterize the biological function of pp38. This work shows that the pp38 gene is necessary to establish cytolytic infection in B cells but not in feather follicle epithelium, to produce an adequate level of latently infected T cells, and to maintain the transformed status in vivo.
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Affiliation(s)
- I M Gimeno
- USDA-Agriculture Research Service, Avian Disease and Oncology Laboratory, East Lansing, MI 48823, USA
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Abstract
OBJECTIVE To describe a case of postirradiation morphea and subcutaneous polyarteritis nodosa occurring simultaneously in a patient and to review the literature on postirradiation autoimmune phenomenon and the potential pathogenesis of such changes. METHODS A 75-year-old woman with breast cancer treated with chemotherapy and radiation who developed postirradiation morphea and subcutaneous polyarteritis nodosa, both inside and outside of the field of radiation, is described. Literature searches were performed on postirradiation morphea and other radiation-related inflammatory cutaneous conditions and the potential pathogenic mechanisms involved. RESULTS Twenty-five cases of postirradiation morphea and 8 cases of postirradiation panniculitis were reported in the literature. Only 3 cases of morphea with distant vasculitis occurring in the same patient have been reported and each of these patients had features suggestive of an underlying connective tissue disease. This is the first case of morphea and subcutaneous polyarteritis nodosa occurring in the same location both inside and outside the field of radiation. CONCLUSIONS Postirradiation morphea is an uncommon condition but is being increasingly recognized. Related phenomena following radiation include postirradiation panniculitis and now postirradiation subcutaneous polyarteritis nodosa. Radiation may be responsible for inducing some of the pathogenic changes seen in scleroderma and other autoimmune diseases. Rheumatologists should be aware of these potential complications of radiation treatment.
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Affiliation(s)
- Soumya M Reddy
- Division of Rheumatology, New York University School of Medicine-Hospital for Joint Diseases, NY, USA.
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Munjam S, Girisham S, Reddy SM. Production of lipases by four anoxygenic purple non-sulphur phototrophic bacteria. Hindustan Antibiot Bull 2005; 47-48:32-35. [PMID: 18697729] [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: 05/26/2023]
Abstract
Production of lipases by Rhodopseudomonas palustris, Rhodobacter sphaeroides, Rhodocyclus gelatinosus and Rhodocyclus tenuis in different synthetic media was investigated. Rc. gelatinosus followed by Rb. sphaeroides were good producers of lipases, while Rps. palustris and Rc. tenuis were poor in lipase secretion. Lipase secretion by Rc. gelatinosus was adaptive in nature, while other three bacterial behavior was inconsistent. No positive correlation could be observed between growth and lipase production.
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Affiliation(s)
- Srinivas Munjam
- Department of Microbiology, Kakatiya University, Warangal 506 009, India
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Silva RF, Reddy SM, Lupiani B. Expansion of a unique region in the Marek's disease virus genome occurs concomitantly with attenuation but is not sufficient to cause attenuation. J Virol 2004; 78:733-40. [PMID: 14694105 PMCID: PMC368850 DOI: 10.1128/jvi.78.2.733-740.2004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pathogenic Marek's disease viruses (MDVs) have two head-to-tail copies of a 132-bp repeat. As MDV is serially passaged in cell culture, the virus becomes attenuated and the number of copies of the 132-bp repeat increases from 2 to often more than 20 copies. To determine the role of the repeats in attenuation, we used five overlapping cosmid clones that spanned the MDV genome to reconstitute infectious virus (rMd5). By mutating the appropriate cosmids, we generated clones of infectious MDVs that contained zero copies of the 132-bp repeats, rMd5(Delta132); nine copies of the 132-bp repeats, rMd5(9-132); and nine copies of the 132-bp repeats inserted in the reverse orientation, rMd5(rev9-132). After two passages in cell culture, wild-type Md5, rMd5, and rMd5(Delta132) were stable. However, rMd5(9-132) and rMd5(rev9-132) contained a population of viruses that contained from 3 to over 20 copies of the repeats. A major 1.8-kb mRNA, containing two copies of the 132-bp repeat, was present in wild-type Md5 and rMd5 but was not present in rMd5(Delta132), rMd5(9-132), rMd5(rev9-132), or an attenuated MDV. Instead, the RNAs transcribed from the 132-bp repeat region in rMd5(9-132) and rMd5(rev9-132) closely resembled the pattern of RNAs transcribed in attenuated MDVs. When inoculated into susceptible day-old chicks, all viruses produced various lesions. Thus, expansion of the number of copies of 132-bp repeats, which accompanies attenuation, is not sufficient in itself to attenuate pathogenic MDVs.
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Affiliation(s)
- R F Silva
- Avian Disease and Oncology Laboratory, Agricultural Research Service, U.S. Department of Agriculture, East Lansing, Michigan 48823, USA.
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Lee LE, Witter RL, Reddy SM, Wu P, Yanagida N, Yoshida S. Protection and Synergism by Recombinant Fowl Pox Vaccines Expressing Multiple Genes from Marek's Disease Virus. Avian Dis 2003; 47:549-58. [PMID: 14562881 DOI: 10.1637/6073] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recombinant fowl poxviruses (rFPVs) were constructed to express genes from serotype 1 Marek's disease virus (MDV) coding for glycoproteins B, E, I, H, and UL32 (gB1, gE, gI, gH, and UL32). An additional rFPV was constructed to contain four MDV genes (gB1, gE, gI, and UL32). These rFPVs were evaluated for their ability to protect maternal antibody-positive chickens against challenge with highly virulent MDV isolates. The protection induced by a single rFPV/gB1 (42%) confirmed our previous finding. The protection induced by rFPV/gI (43%), rFPV/gB1UL32 (46%), rFPV/gB1gEgI (72%), and rFPV/gB1gEgIUL32 (70%) contributed to additional knowledge on MDV genes involved in protective immunity. In contrast, the rFPV containing gE, gH, or UL32 did not induce significant protection compared with turkey herpesvirus (HVT). Levels of protection by rFPV/gB1 and rFPV/gl were comparable with that of HVT. Only gB1 and gI conferred synergism in rFPV containing these two genes. Protection by both rFPV/gB1gEgI (72%) and rFPV/gB1gEgIUL32(70%) against Marek's disease was significantly enhanced compared with a single gB1 or gI gene (40%). This protective synergism between gB1 and gI in rFPVs may be the basis for better protection when bivalent vaccines between serotypes 2 and 3 were used. When rFPV/gB1gIgEUL32 + HVT were used as vaccine against Md5 challenge, the protection was significantly enhanced (94%). This synergism between rFPV/gB1gIgEUL32 and HVT indicates additional genes yet to be discovered in HVT may be responsible for the enhancement.
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Affiliation(s)
- Lucy E Lee
- USDA, Agricultural Research Service, Avian Disease and Oncology Laboratory, 3606 East Mt. Hope Road, East Lansing, MI 48823, USA
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Ravindranatha BM, Nandi S, Raghu HM, Reddy SM. In vitro maturation and fertilization of buffalo oocytes: effects of storage of ovaries, IVM temperatures, storage of processed sperm and fertilization media. Reprod Domest Anim 2003; 38:21-6. [PMID: 12535325 DOI: 10.1046/j.1439-0531.2003.00390.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Studies were conducted to examine the possibility of preserving slaughterhouse-derived buffalo ovaries at 4 degrees C for 0 (control), 12 and 24 h to maintain the developmental competence of the oocytes (experiment 1), to assess the effect of incubation temperature during oocyte maturation on rates of in vitro maturation (IVM) and in vitro fertilization (IVF) of buffalo oocytes and embryo development (experiment 2), and to examine the effect of storage at 25 degrees C for 0 (control), 4 and 8 h of frozen-thawed buffalo sperm and BO and H-TALP as sperm processing and fertilization media on cleavage and embryo development in vitro of buffalo oocytes (experiment 3) in order to optimize the IVF technology in buffalo. Results suggested that storage of ovaries at 4 degrees C for 12 or 24 h significantly (p < 0.05) reduced the developmental potential of oocytes. Incubation temperatures during the IVM influenced the fertilization rate but had no significant effect on maturation and subsequent embryo development. The incubation temperature of 38.5 degrees C during IVM was found to be optimum for embryo production in vitro. Storage of frozen-thawed sperm at 25 degrees C for 8 h significantly (p < 0.05) decreased its ability to cleave the oocytes. Sperm processed in BO medium had significantly (p < 0.05) higher ability to cleave the oocytes than the H-TALP medium.
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Raghu HM, Nandi S, Reddy SM. Follicle size and oocyte diameter in relation to developmental competence of buffalo oocytes in vitro. Reprod Fertil Dev 2002; 14:55-61. [PMID: 12051523 DOI: 10.1071/rd01060] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [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: 06/22/2001] [Accepted: 11/23/2001] [Indexed: 11/23/2022] Open
Abstract
Follicular size, oocyte morphology and diameter were investigated for their possible relationship with in vitro developmental competence of buffalo oocytes. Cumulus oocytes complexes (COCs), aspirated from small (<3 mm), medium (3-8 mm) and large (>8 mm) follicles of normal ovaries and cystic ovarian follicles of abattoir-derived ovaries, were graded for their morphological appearance and were cultured to assess their developmental competence. The influence of cystic follicles on maturational competence of COCs recovered from co-existing follicles of cystic ovaries was studied. The mean diameter of oocytes from follicles of different size were examined, and the influence of oocyte diameter--(i) <126 microm; (ii) 127-144 microm; (iii) 145-162 microm; and (iv) >163 microm--on in vitro maturation, cleavage and embryo yield was studied. Results suggested that increased fertilization, cleavage and embryo development were significantly (P<0.05) higher in COCs aspirated from large follicles, followed by medium and small-sized normal follicles, and the presence of cystic follicles had no significant (P<0.05) effect on the maturation competence of the COCs recovered from co-existing follicles. The mean diameter of the buffalo oocyte obtained from normal ovaries was found to be 146.4 microm and the rate of blastocyst production in vitro was significantly higher (P<0.05) in oocytes with diameters greater than 145 microm. In conclusion, the larger the size of the follicles and oocytes, the greater the developmental competence in vitro of buffalo oocytes.
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Affiliation(s)
- H M Raghu
- University of Agricultural Sciences, Hebbal, Bangalore, India
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Abstract
The benzidines, 3,3'-diaminobenzidine (DAB), 3,3'-dimethoxybenzidine (DMOB) and 3,3',5,5'-tetramethylbenzidine (TMB) were enzymatically oxidised to detect hydrogen peroxide, using the quartz crystal. The oxidised product mainly remains in suspension, resulting in a limited quartz sensor signal. We have used two non-ionic surfactants, Tween 80 and Triton X-100 to interact with the oxidised amphiphilic products to increase their solubility and surface activity, and their ability to adsorb to the crystal surface. Tween 80 exhibits optimised response effects for DAB, DMOB and TMB at 0.012, 0.005, and 0.002% (v/v), respectively, whereas Triton X-100 is optimum at 0.1, 0.2, and 0.006% (v/v), respectively. As a result, we have improved the quartz crystal sensor sensitivity to peroxide. The use of Triton X-100 gave an improved response time.
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Affiliation(s)
- S P Martin
- Centre for Clinical Science and Measurement, School of Biomedical and Life Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
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Raghu HM, Nandi S, Reddy SM. Effect of insulin, transferrin and selenium and epidermal growth factor on development of buffalo oocytes to the blastocyst stage in vitro in serum-free, semidefined media. Vet Rec 2002; 151:260-5. [PMID: 12233827 DOI: 10.1136/vr.151.9.260] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The in vitro development of buffalo oocytes up to the blastocyst stage was studied in serum-free, semidefined media containing bovine serum albumin, follicle-stimulating hormone (FSH), insulin, transferrin and selenium (ITS) and epidermal growth factor (EGF). In experiment 1, oocytes aspirated from abattoir-derived ovaries were cultured in eight serum-free, semidefined culture media containing different combinations of these four factors. In experiment 2, the maturation of buffalo oocytes and the development of the embryos were compared in a complex co-culture system and in the serum-free, semidefined media. Supplementation with FSH and EGF significantly (P < 0.05) increased the maturation rates of buffalo oocytes, and the yield of blastocysts was higher (P < 0.05) in media containing EGF and ITS. The yield of blastocysts was lower in the serum-free semidefined media (P < 0.05) than in the complex co-culture system.
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Affiliation(s)
- H M Raghu
- University of Agricultural Sciences, Hebbal, Bangalore, Karnataka, India
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