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Peretti M, Rebaudet S, Chiche L, Pegliasco H, Coquet E. Concerted and multidisciplinary management of COVID-19 drug therapies during the first two epidemic waves in a tertiary hospital in Marseille, France: Results of the PHARMA-COVID study. PLoS One 2023; 18:e0283165. [PMID: 36930624 PMCID: PMC10022761 DOI: 10.1371/journal.pone.0283165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES To evaluate the impact of local therapeutic recommendation updates made by the COVID multidisciplinary consultation meeting (RCP) at the Hôpital Européen Marseille (HEM) through the description of the drug prescriptions for COVID-19 during the first two waves of the epidemic. METHODS This retrospective observational study analysed data from the hospital's pharmaceutical file. We included all patients hospitalized for COVID-19 between February 1, 2020 and January 21, 2021 and extracted specific anti-COVID-19 therapies (ST) from computerized patient record, as well as patients' demographic characteristics, comorbidities and outcome. The evolution of ST prescriptions during the study period was described and put into perspective with the updates of local recommendations made during the first (V1, from 2/24/2020 to 7/27/2020), and second (V2, from 7/28/2020 to 1/21/2021) epidemic waves. RESULTS A total of 607 COVID-19 hospitalized patients, 197 during V1 and 410 during V2. Their mean age was 65 years-old, and they presented frequent comorbidities. In total, 93% of hospitalized patients received ST: anticoagulants (90%), glucocorticoids (39%) mainly during V2 (49% vs 17%, P<0.001), and azithromycin (30%) mainly during V1 (71% vs 10%, P<0.001). Lopinavir/ritonavir and hydroxychloroquine were prescribed to 17 and 7 inpatients, respectively, and only during V1. Remdesivir was never administered. A total of 22 inpatients were enrolled into clinical trials. CONCLUSIONS The effective dissemination of evidence-based and concerted recommendations seems to have allowed an optimized management of COVID-19 drug therapies in the context of this emerging infection with rapidly evolving therapeutic questions.
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Affiliation(s)
| | - Stanislas Rebaudet
- Service d’Infectiologie et de Médecine Interne, Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille Univ, Inserm, IRD, ISSPAM, Marseille, France
| | - Laurent Chiche
- Service d’Infectiologie et de Médecine Interne, Hôpital Européen, Marseille, France
- * E-mail:
| | | | - Emilie Coquet
- Service de Pharmacie, Hôpital Européen, Marseille, France
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Grimaud F, Penaranda G, Stavris C, Retornaz F, Brunel V, Cailleres S, Pegliasco H, Le Treut J, Grisoni V, Coquet E, Chiche L, Rognon A. Adverse Events Induced by PD-1/PD-L1 Inhibitors: A Real-World Single-Centre Experience with a Management-Based Approach. Ther Clin Risk Manag 2021; 17:669-677. [PMID: 34234443 PMCID: PMC8256379 DOI: 10.2147/tcrm.s308194] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/08/2021] [Indexed: 01/11/2023] Open
Abstract
AIM To assess the efficacy and tolerance of programmed death-1 (PD-1) and PD-ligand 1 (PD-L1) inhibitors and the impact of a standardised management-based protocol in a real-world setting. PATIENTS AND METHODS Data from patients who had received anti-PD-(L)1 were collected from our pharmacy database. Clinical response and toxicity were assessed using RECIST criteria and CTCAE version 5.0, respectively. Overall survival (OS) and progression-free survival (PFS) were estimated with the Kaplan-Meier method. Potential prognostic factors were identified using Cox's model. RESULTS A total of 196 patients and 201 lines of treatment were included (median age: 66 (range: 38-89) years). Types of cancer included non-small cell lung cancer (73%), transitional cell carcinoma (10%), renal cell carcinoma (6%), small cell lung cancer (5%), head and neck squamous cell carcinoma (4%) and classical Hodgkin's lymphoma (1%). Twenty-five (12%) patients had pre-existing autoimmune conditions. Our standardised management-based protocol included 129 (64%) patients. Objective response rate was 29%, median OS was 10 months (IQR: 7-15) and median PFS was 5 months (IQR: 1-22). Patients with an abnormal baseline complete blood count had a worse OS (HR=2.48 [95% CI: 1.24-4.96]; p=0.0103). Thirty-three (16%) patients experienced severe (grade 3 or 4) immune-related adverse event (irAE). There were three (1%) irAE-related deaths. AEs resolved faster when patients were assessed by an internist before anti-PD-(L)1 initiation (p=0.0205). CONCLUSION PD-1 and PD-L1 inhibitors are effective and safe in a real-world setting. Implementation of a standardised management-based protocol with internal medicine specialists is an effective way to optimise irAE management.
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Affiliation(s)
- Fabien Grimaud
- Department of Pharmacy, Hôpital Européen, Marseille, France
| | | | - Chloé Stavris
- Department of Internal Medicine, Hôpital Européen, Marseille, France
| | | | - Véronique Brunel
- Department of Haemato-Oncology, Hôpital Européen, Marseille, France
| | - Sylvie Cailleres
- Department of Haemato-Oncology, Hôpital Européen, Marseille, France
| | - Hervé Pegliasco
- Department of Pulmonology, Hôpital Européen, Marseille, France
| | | | | | - Emilie Coquet
- Department of Pharmacy, Hôpital Européen, Marseille, France
| | - Laurent Chiche
- Department of Internal Medicine, Hôpital Européen, Marseille, France
| | - Amélie Rognon
- Department of Pharmacy, Hôpital Européen, Marseille, France
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Stavris C, Charpin C, Halfon P, Retornaz F, Coquet E, Rognon A, Pegliasco H, Chiche L. Dépistage et prise en charge multidisciplinaire des complications auto-immunes de l’immunothérapie du cancer : une expérience monocentrique avec évaluation interniste systématique. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dahari H, Canini L, Graw F, Uprichard SL, Araújo ESA, Penaranda G, Coquet E, Chiche L, Riso A, Renou C, Bourliere M, Cotler SJ, Halfon P. HCV kinetic and modeling analyses indicate similar time to cure among sofosbuvir combination regimens with daclatasvir, simeprevir or ledipasvir. J Hepatol 2016; 64:1232-9. [PMID: 26907973 PMCID: PMC5081285 DOI: 10.1016/j.jhep.2016.02.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [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] [Received: 10/12/2015] [Revised: 12/24/2015] [Accepted: 02/08/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Recent clinical trials of direct-acting-antiviral agents (DAAs) against hepatitis C virus (HCV) achieved >90% sustained virological response (SVR) rates, suggesting that cure often took place before the end of treatment (EOT). We sought to evaluate retrospectively whether early response kinetics can provide the basis to individualize therapy to achieve optimal results while reducing duration and cost. METHODS 58 chronic HCV patients were treated with 12-week sofosbuvir+simeprevir (n=19), sofosbuvir+daclatasvir (n=19), or sofosbuvir+ledipasvir in three French referral centers. HCV was measured at baseline, day 2, every other week, EOT and 12weeks post EOT. Mathematical modeling was used to predict the time to cure, i.e., <1 virus copy in the entire extracellular body fluid. RESULTS All but one patient who relapsed achieved SVR. Mean age was 60±11years, 53% were male, 86% HCV genotype-1, 9% HIV coinfected, 43% advanced fibrosis (F3), and 57% had cirrhosis. At weeks 2, 4 and 6, 48%, 88% and 100% of patients had HCV<15IU/ml, with 27%, 74% and 91% of observations having target not detected, respectively. Modeling results predicted that 23 (43%), 16 (30%), 7 (13%), 5 (9%) and 3 (5%) subjects were predicted to reach cure within 6, 8, 10, 12 and 13weeks of therapy, respectively. The modeling suggested that the patient who relapsed would have benefitted from an additional week of sofosbuvir+ledipasvir. Adjusting duration of treatment according to the modeling predicts reduced medication costs of 43-45% and 17-30% in subjects who had HCV<15IU/ml at weeks 2 and 4, respectively. CONCLUSIONS The use of early viral kinetic analysis has the potential to individualize duration of DAA therapy with a projected average cost saving of 16-20% per 100-treated persons.
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Affiliation(s)
- Harel Dahari
- The Program for Experimental & Theoretical Modeling, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA; Theoretical Biology & Biophysics Group, Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - Laetitia Canini
- The Program for Experimental & Theoretical Modeling, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom
| | - Frederik Graw
- Center for Modeling and Simulation in the Biosciences, BioQuant Center, Heidelberg University, Heidelberg, Germany
| | - Susan L Uprichard
- The Program for Experimental & Theoretical Modeling, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA
| | | | | | - Emilie Coquet
- Internal Medicine and Infectious Disease, Hôpital Européen, Marseille, France
| | - Laurent Chiche
- Internal Medicine and Infectious Disease, Hôpital Européen, Marseille, France
| | - Aurelie Riso
- Division of Hepatology, Hôpital Saint Joseph, Marseille, France
| | | | - Marc Bourliere
- Division of Hepatology, Hôpital Saint Joseph, Marseille, France
| | - Scott J Cotler
- The Program for Experimental & Theoretical Modeling, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA
| | - Philippe Halfon
- Laboratoire Alphabio, Marseille, France; Internal Medicine and Infectious Disease, Hôpital Européen, Marseille, France.
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Dahari H, Canini L, Graw F, Uprichard SL, Araujo EA, Penaranda G, Coquet E, Riso A, Renou C, Bourlière M, Cotler SJ, Halfon P. HCV kinetic and modeling analyses indicate similar time to cure among sofosbuvir combination regimens with daclatasvir, simeprevir or ledipasvir. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)31122-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Coquet E, Coutet J, Renzullo C, Penaud J. Kalaemia disorders: a warning for clinical pharmacists? Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.379] [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: 11/04/2022] Open
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Coquet E, Remoissenet M, Dinda PT. Oscillations of a highly discrete breather with a critical regime. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 2000; 62:5767-76. [PMID: 11089136 DOI: 10.1103/physreve.62.5767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2000] [Revised: 06/30/2000] [Indexed: 11/07/2022]
Abstract
We analyze carefully the essential features of the dynamics of a stationary discrete breather in the ultimate degree of energy localization in a nonlinear Klein-Gordon lattice with an on-site double-well potential. We demonstrate the existence of three different regimes of oscillatory motion in the breather dynamics, which are closely related to the motion of the central particle in an effective potential having two nondegenerate wells. In given parameter regions, we observe an untrapped regime, in which the central particle executes large-amplitude oscillations from one to the other side of the potential barrier. In other parameter regions, we find the trapped regime, in which the central particle oscillates in one of the two wells of the effective potential. Between these two regimes we find a critical regime in which the central particle undergoes several temporary trappings within an untrapped regime. Importantly, our study reveals that in the presence of purely anharmonic coupling forces, the breather compactifies, i.e., the energy becomes abruptly localized within the breather.
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Affiliation(s)
- E Coquet
- Laboratoire de Physique de l'Universite de Bourgogne, UMR CNRS No. 5027, Avenue A. Savary, Boiinsertion markte Postale 47 870, 21078 Dijon Cedex, France
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Crettez JM, Coquet E, Bouillot J, Le Roy J, Pannetier J. Temperature Dependence of the Structure of Li1-xHxIO3 Studied by High Resolution Neutron Powder Diffraction between 10 and 380 K. J SOLID STATE CHEM 1993. [DOI: 10.1006/jssc.1993.1223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Coquet E, Peyrard M, Crettez JM. Size effects on a two-dimensional hexagonal lattice with application to lithium iodate. Phys Rev B Condens Matter 1992; 45:10213-10225. [PMID: 10000924 DOI: 10.1103/physrevb.45.10213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Crettez JM, Coquet E, Pannetier J, Bouillot J, Durand-Le Floch M. Neutron structure refinement of γ- and β-lithium lodate: Comparison between α, γ, and β phases. J SOLID STATE CHEM 1985. [DOI: 10.1016/0022-4596(85)90050-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Crettez JM, Coquet E, Pannetier J, Bouillot J, Durand-Le Floch M. α, γ and β phases of lithium iodate by neutron scattering and NMR. Acta Crystallogr A 1984. [DOI: 10.1107/s0108767384093338] [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: 11/10/2022] Open
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Coquet E, Crettez JM, Pannetier J, Bouillot J, Damien JC. Effect of temperature on interatomic distances in pyroelectric α-LiIO3. Acta Crystallogr B Struct Sci 1983. [DOI: 10.1107/s0108768183002657] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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