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Scibona P, Burgos Pratx LD, Savoy N, Recart D, Elia Y, Seoane FN, Arrigo D, Portalis MR, Roldan A, Cassoratti BA, Diaz JC, Antonelli CE, Perez L, Posadas-Martinez L, Belloso WH, Simonovich V. Long-term antibody titers variation in unvaccinated patients receiving convalescent plasma or placebo for severe SARS-CoV-2 pulmonary infection. Transfus Apher Sci 2023; 62:103785. [PMID: 37620184 DOI: 10.1016/j.transci.2023.103785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Convalescent plasma (CP) became a prominent treatment in the early stages of the SARS-CoV-2 pandemic. In Argentina, a randomized clinical trial was executed to compare the use of CP in inpatients with severe COVID-19 pneumonia versus placebo. No differences in clinical outcomes or overall mortality between groups were observed. We conducted a cohort study in outpatients enrolled in the trial to describe long-term antibody titer variations between CP and placebo recipients. METHODS Patients' total SARS-CoV-2 IgG antibodies against spike protein were collected 3, 6 and 12 months after hospital discharge from August 2020 to December 2021. In addition, reinfections, deaths and vaccination status were retrieved. Statistical analysis was performed using antibody geometric mean titers (GMT). All estimations were made considering the date of the trial infusion (placebo or CP) as time 0. RESULTS From the 93 patients included in the follow-up, 64 had received CP and 29 placebo. We excluded all 12-month measurements because they were collected after the patients' vaccination date. At 90 days post-infusion, patients had an antibody GMT of 8.1 (IQR 7.4-8.1) in the CP group and 8.8 (IQR 8.1-9.1) in the placebo group. At 180 days, both groups had a GMT of 8.1 (IQR 7.4-8.1). No statistical differences in GMT were found between CP and placebo groups at 90 days (p = 0.12) and 180 days (p = 0.25). No patients registered a new COVID-19 infection; one died in the CP group from an ischemic stroke. CONCLUSIONS No differences were observed in long-term antibody titers in unvaccinated patients that received CP or placebo after severe COVID-19 pneumonia.
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Affiliation(s)
- Paula Scibona
- Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
| | - Leandro Daniel Burgos Pratx
- Transfusional Medicine Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199 Buenos Aires, Argentina
| | - Nadia Savoy
- Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
| | - Delfina Recart
- Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina.
| | - Yasmin Elia
- Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
| | - Facundo Nahuel Seoane
- Virology Section, Central Laboratory, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
| | - Diego Arrigo
- Virology Section, Central Laboratory, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
| | - Maximo Rousseau Portalis
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121A6B Buenos Aires, Argentina
| | - Agustina Roldan
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121A6B Buenos Aires, Argentina
| | | | - Julio Cesar Diaz
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121A6B Buenos Aires, Argentina
| | | | - Lucia Perez
- Department of Research, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199 Buenos Aires, Argentina
| | - Lourdes Posadas-Martinez
- Department of Research, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199 Buenos Aires, Argentina
| | - Waldo H Belloso
- Terra Nova Innovation Unit, Hospital Italiano de Buenos Aires, Argentina
| | - Ventura Simonovich
- Clinical Pharmacology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 C1199, Buenos Aires, Argentina
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Lüthy IA, Pérez Martínez S, Simonovich V, Pinto G. JOINT MEETING SAIC SAB AAFE AACYTAL 2023. Medicina (B Aires) 2023; 83 Suppl 5:1-261. [PMID: 38051641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
| | | | | | - Gabriel Pinto
- Asociación Argentina de Ciencia y Tecnología de Animales de Laboratorio (AACYTAL)
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Sánchez-Peña R, Colmegna P, Garelli F, De Battista H, García-Violini D, Moscoso-Vásquez M, Rosales N, Fushimi E, Campos-Náñez E, Breton M, Beruto V, Scibona P, Rodriguez C, Giunta J, Simonovich V, Belloso WH, Cherñavvsky D, Grosembacher L. Artificial Pancreas: Clinical Study in Latin America Without Premeal Insulin Boluses. J Diabetes Sci Technol 2018; 12:914-925. [PMID: 29998754 PMCID: PMC6134619 DOI: 10.1177/1932296818786488] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Emerging therapies such as closed-loop (CL) glucose control, also known as artificial pancreas (AP) systems, have shown significant improvement in type 1 diabetes mellitus (T1DM) management. However, demanding patient intervention is still required, particularly at meal times. To reduce treatment burden, the automatic regulation of glucose (ARG) algorithm mitigates postprandial glucose excursions without feedforward insulin boluses. This work assesses feasibility of this new strategy in a clinical trial. METHODS A 36-hour pilot study was performed on five T1DM subjects to validate the ARG algorithm. Subjects wore a subcutaneous continuous glucose monitor (CGM) and an insulin pump. Insulin delivery was solely commanded by the ARG algorithm, without premeal insulin boluses. This was the first clinical trial in Latin America to validate an AP controller. RESULTS For the total 36-hour period, results were as follows: average time of CGM readings in range 70-250 mg/dl: 88.6%, in range 70-180 mg/dl: 74.7%, <70 mg/dl: 5.8%, and <50 mg/dl: 0.8%. Results improved analyzing the final 15-hour period of this trial. In that case, the time spent in range was 70-250 mg/dl: 94.7%, in range 70-180 mg/dl: 82.6%, <70 mg/dl: 4.1%, and <50 mg/dl: 0.2%. During the last night the time spent in range was 70-250 mg/dl: 95%, in range 70-180 mg/dl: 87.7%, <70 mg/dl: 5.0%, and <50 mg/dl: 0.0%. No severe hypoglycemia occurred. No serious adverse events were reported. CONCLUSIONS The ARG algorithm was successfully validated in a pilot clinical trial, encouraging further tests with a larger number of patients and in outpatient settings.
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Affiliation(s)
- Ricardo Sánchez-Peña
- Instituto Tecnológico de Buenos Aires, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- Ricardo Sánchez-Peña, PhD, National Scientific and Technical Research Council (CONICET), Instituto Tecnológico de Buenos Aires (ITBA), Av Madero 399, Buenos Aires, C1106ACD, Argentina.
| | - Patricio Colmegna
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- University of Virginia, Charlottesville, VA, USA
- Universidad Nacional de Quilmes, Bernal, Buenos Aires, Argentina
| | - Fabricio Garelli
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- Universidad Nacional de La Plata, La Plata, Buenos Aires Argentina
| | - Hernán De Battista
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- Universidad Nacional de La Plata, La Plata, Buenos Aires Argentina
| | - Demián García-Violini
- Instituto Tecnológico de Buenos Aires, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Marcela Moscoso-Vásquez
- Instituto Tecnológico de Buenos Aires, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Nicolás Rosales
- Universidad Nacional de La Plata, La Plata, Buenos Aires Argentina
| | - Emilia Fushimi
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- Universidad Nacional de La Plata, La Plata, Buenos Aires Argentina
| | | | - Marc Breton
- University of Virginia, Charlottesville, VA, USA
| | - Valeria Beruto
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Paula Scibona
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Javier Giunta
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Scibona P, Angriman F, Simonovich V, Heller MM, Belloso WH. [Cardiovascular pharmacogenomics]. Arch Cardiol Mex 2014; 84:25-31. [PMID: 24636047 DOI: 10.1016/j.acmx.2013.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 11/05/2013] [Accepted: 11/12/2013] [Indexed: 11/26/2022] Open
Abstract
Cardiovascular disease remains a major cause of morbidity and mortality worldwide. Current medical practice takes into account information based on population studies and benefits observed in large populations or cohorts. However, individual patients present great differences in both toxicity and clinical efficacy that can be explained by variations in adherence, unknown drug to drug interactions and genetic variability. The latter seems to explain from 20% up to 95% of patient to patient variability. Treating patients with cardiovascular disorders faces the clinician with the challenge to include genomic analysis into daily practice. There are several examples within cardiovascular disease of treatments that can vary in toxicity or clinical usefulness based on genetic changes. One of the main factors affecting the efficacy of Clopidogrel is the phenotype associated with polymorphisms in the gene CYP 2C9. Furthermore, regarding oral anticoagulants, changes in CYP2C9 and VKORC1 play an important role in changing the clinical response to anticoagulation. When analyzing statin treatment, one of their main toxicities (myopathy) can be predicted by the SLCO1B1 polymorphism. The potential for prediction of toxicity and clinical efficacy from the use of genetic analysis warrants further studies aiming towards its inclusion in daily clinical practice.
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Affiliation(s)
- Paula Scibona
- Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Federico Angriman
- Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Ventura Simonovich
- Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Martina M Heller
- Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Waldo H Belloso
- Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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