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Gross N, Miller D, Khushanlani N, Divi V, Ruiz E, Lipson E, Meier F, Su Y, Swiecicki P, Atlas J, Geiger J, Hauschild A, Choe J, Hughes B, Yoo SY, Fenech K, Mathias M, Han H, Fury M, Rischin D. 789O Neoadjuvant cemiplimab in patients (pts) with stage II–IV (M0) cutaneous squamous cell carcinoma (CSCC): Primary analysis of a phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kaplan S, Bogojevic DI, Rainville C, Gross N. A multinational, drug utilization study of lipegfilgrastim use in real-world setting in Europe. Support Care Cancer 2022; 30:9191-9201. [PMID: 36044089 DOI: 10.1007/s00520-022-07341-7] [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: 02/21/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Lipegfilgrastim (Lonquex, Teva Pharma B.V.) is approved for reduction in neutropenia duration and febrile neutropenia incidence. In the framework of lipegfilgrastim regulatory approval in the EU, the Health Authorities requested a drug utilization study. This study was conducted to characterize prescribing patterns of lipegfilgrastim and quantify the extent of on- and off-label use of lipegfilgrastim in real-world setting in Europe. METHODS Information on lipegfilgrastim use between January 2014 and March 2020 was abstracted from medical records in hospital and outpatient clinical settings. Indication for lipegfilgrastim was classified either as on-label or off-label use according to pre-determined criteria. The primary endpoint was the extent of lipegfilgrastim off-label use based on the most recent lipegfilgrastim cycle. RESULTS Records of 481 patients were obtained from five European countries. Lipegfilgrastim was most commonly prescribed for prevention of neutropenia by oncologists and hematologists. Patients who were administered lipegfilgrastim were primarily ≥ 55 years old (65.1%) and female (65.7%). The most frequent underlying diagnosis was breast cancer (38.3%). For the most recent lipegfilgrastim cycle, on-label use was recorded in 452/459 patients with no missing data (98.5%), while off-label use was recorded in 7/459 patients (1.5%). The majority of off-label use was attributed to use with non-cytotoxic chemotherapy (57.1%). Off-label use of lipegfilgrastim across all treatment cycles with no missing data was 11/1547 cycles (0.7%). CONCLUSION Using real-world data, these findings confirm the low rate of lipegfilgrastim off-label use as reported in a preceding feasibility study, indicating very high adherence to the approved indication.
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Affiliation(s)
- Sigal Kaplan
- Teva Pharmaceutical Industries Ltd, 12 Hatrufa St, 4250483, Netanya, Israel.
| | - Dana Ilic Bogojevic
- Teva Pharmaceutical Industries Ltd, 400 Interpace Pkwy, Parsippany, NJ, 07054, USA
| | - Carolyn Rainville
- Teva Pharmaceutical Industries Ltd, 41 Moores Road, Malvern, PA, 19355, USA
| | - Nicholas Gross
- Teva Pharmaceutical Industries Ltd, 145 Brandywine Pkwy, West Chester, PA, 19380, USA
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Hauser RA, Barkay H, Fernandez HH, Factor SA, Jimenez-Shahed J, Gross N, Marinelli L, Wilhelm A, Alexander J, Gordon MF, Savola JM, Anderson KE. Long-Term Deutetrabenazine Treatment for Tardive Dyskinesia Is Associated With Sustained Benefits and Safety: A 3-Year, Open-Label Extension Study. Front Neurol 2022; 13:773999. [PMID: 35280262 PMCID: PMC8906841 DOI: 10.3389/fneur.2022.773999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Deutetrabenazine is a vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia (TD) in adults. In two 12-week pivotal studies, deutetrabenazine demonstrated statistically significant improvements in Abnormal Involuntary Movement Scale (AIMS) scores, with favorable safety/tolerability in TD patients. This study reports long-term efficacy and safety of deutetrabenazine in a 3-year, single-arm, open-label extension (OLE) study. Methods Patients who completed the pivotal studies could enroll in this single-arm OLE study, titrating up to 48 mg/day based on dyskinesia control and tolerability. Efficacy was assessed based on change from baseline in total motor AIMS score, Clinical Global Impression of Change (CGIC) and Patient Global Impression of Change (PGIC), and quality of life (QOL) assessments. Safety evaluation included adverse event (AE) incidence, reported using exposure-adjusted incidence rates, and safety scales. Results 343 patients enrolled in the study (6 patients were excluded). At Week 145 (mean dose: 39.4 ± 0.83 mg/day), mean ± SE change from baseline in total motor AIMS score was −6.6 ± 0.37 and 67% of patients achieved ≥50% improvement in total motor AIMS score. Based on CGIC and PGIC, 73% and 63% of patients achieved treatment success, respectively. QOL improvements were also observed. Deutetrabenazine was generally well tolerated, with low rates of mild-to-moderate AEs and no new safety signals; most safety scales remained unchanged over time. Conclusions Long-term deutetrabenazine treatment was associated with sustained improvement in AIMS scores, indicative of clinically meaningful long-term benefit, and was generally well tolerated. Results suggest deutetrabenazine may provide increasing benefit over time without increases in dose.
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Affiliation(s)
- Robert A Hauser
- University of South Florida Parkinson's Disease and Movement Disorders Center, Tampa, FL, United States
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Sajatovic M, Finkbeiner S, Wilhelm A, Barkay H, Chaijale N, Gross N, Gordon MF. Long-Term Safety and Efficacy of Deutetrabenazine in Younger and Older Patients With Tardive Dyskinesia. Am J Geriatr Psychiatry 2022; 30:360-371. [PMID: 34511333 DOI: 10.1016/j.jagp.2021.08.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To assess long-term safety and efficacy of deutetrabenazine in younger (<55 years) and older (≥55 years) adult participants with tardive dyskinesia (TD). DESIGN Three-year, single-arm, open-label extension (OLE) study enrolling participants who completed the 12-week, pivotal ARM-TD or AIM-TD studies. SETTING Seventy-six centers in the United States and Europe. PARTICIPANTS A total of 337 participants with TD (119 younger and 218 older). INTERVENTION Deutetrabenazine was initiated at 12 mg/day and titrated once weekly by 6 mg/day using a response-driven dosing regimen until adequate dyskinesia control was reached or a clinically significant adverse event occurred. MEASUREMENTS This post hoc analysis assessed change and percent change from baseline in total motor Abnormal Involuntary Movement Scale (AIMS) score, response rates for ≥50% AIMS improvement, Clinical Global Impression of Change (CGIC), Patient Global Impression of Change (PGIC), and safety in younger and older participants with TD. RESULTS After 3 years of open-label treatment, mean deutetrabenazine dose was ∼39.5 mg/day in both groups. Mean±SE changes from baseline in total motor AIMS score were -6.7 ± 0.62 and -6.5 ± 0.47 in younger and older participants, respectively (percent changes: -61.4% ± 4.10% and -54.6% ± 3.01%); 76% of younger and 62% of older participants achieved ≥50% AIMS response. Most younger and older participants achieved treatment success per CGIC (67% and 76%) and PGIC (64% and 63%). Deutetrabenazine was generally well tolerated in both groups. CONCLUSIONS Deutetrabenazine treatment was associated with sustained improvements in total motor AIMS score, treatment success, and improved quality of life, and was well tolerated in younger and older adults with TD in this 3-year OLE study.
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Affiliation(s)
- Martha Sajatovic
- University Hospitals Cleveland Medical Center (MS), Case Western Reserve University School of Medicine, Cleveland, OH.
| | | | - Amanda Wilhelm
- Teva Pharmaceuticals (SF, AW, NCNG, MFG), West Chester, PA
| | | | - Nayla Chaijale
- Teva Pharmaceuticals (SF, AW, NCNG, MFG), West Chester, PA
| | - Nicholas Gross
- Teva Pharmaceuticals (SF, AW, NCNG, MFG), West Chester, PA
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Frank S, Testa C, Edmondson MC, Goldstein J, Kayson E, Leavitt BR, Oakes D, O’Neill C, Vaughan C, Whaley J, Gross N, Gordon MF, Savola JM. The Safety of Deutetrabenazine for Chorea in Huntington Disease: An Open-Label Extension Study. CNS Drugs 2022; 36:1207-1216. [PMID: 36242718 PMCID: PMC9653309 DOI: 10.1007/s40263-022-00956-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Deutetrabenazine is approved in the USA, China, Australia, Israel, Brazil, and South Korea for the treatment of chorea associated with Huntington disease. OBJECTIVE We aimed to evaluate the long-term safety and tolerability of deutetrabenazine for the treatment of Huntington disease. METHODS This open-label, single-arm, multi-center study included patients who completed a double-blind study (Rollover) and patients who converted overnight from a stable tetrabenazine dose (Switch). Exposure-adjusted incidence rates (adverse events per person-year) were calculated. Efficacy was analyzed using a stable post-titration timepoint (8 weeks). Changes in the Unified Huntington's Disease Rating Scale total motor score and total maximal chorea score from baseline to week 8, as well as those from week 8 to week 145 (or the last visit on the study drug if that occurred earlier), were evaluated as both efficacy and safety endpoints during the study. RESULTS Of 119 patients (Rollover, n = 82; Switch, n = 37), 100 (84%) completed ≥ 1 year of treatment. End-of-study exposure-adjusted incidence rates for adverse events in Rollover and Switch, respectively, were: any, 2.57 and 4.02; serious, 0.11 and 0.14; leading to dose suspension, 0.05 and 0.04. Common adverse events (≥ 4% either cohort) included somnolence (Rollover, 20%; Switch, 30%), depression (32%; 22%), anxiety (27%; 35%), insomnia (23%; 16%), and akathisia (6%; 11%). Adverse events of interest included suicidality (9%; 5%) and parkinsonism (4%; 8%). Mean dose at week 8 was 38.1 mg (Rollover) and 36.5 mg (Switch). Mean dose across cohorts after titration was 37.6 mg; at the final visit, mean dose across cohorts was 45.7 mg. Patients showed minimal change in the Unified Huntington's Disease Rating Scale total maximal chorea scores with stable dosing from weeks 8-145 or at the end of treatment, but total motor score increased versus week 8 (mean change [standard deviation]: 8.2 [11.9]). There were no unexpected adverse events upon drug withdrawal, and mean (standard deviation) total maximal chorea scores increased 4.7 (4.6) units from week 8 to 1-week follow-up. CONCLUSIONS Adverse events observed with long-term deutetrabenazine exposure were consistent with previous studies. Reductions in chorea persisted over time. Upon treatment cessation, there was no unexpected worsening of chorea. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01897896.
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Affiliation(s)
- Samuel Frank
- Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Kirstein 228, Boston, MA, 02215, USA.
| | - Claudia Testa
- University of North Carolina School of Medicine, Chapel Hill, NC USA
| | - Mary C. Edmondson
- University of North Carolina School of Medicine, Chapel Hill, NC USA
| | | | | | - Blair R. Leavitt
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, BC Canada
| | | | - Christine O’Neill
- Wake Forest University Baptist Medical Center, Winston Salem, NC USA
| | | | - Jacquelyn Whaley
- Center for Health and Technology, University of Rochester, Rochester, NY USA
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Ernst N, Friedrich M, Bieber K, Kasperkiewicz M, Gross N, Sadik C, Zillikens D, Schmidt E, Ludwig R, Hartmann K. Expression of PD‐1 and Tim‐3 is increased in skin of patients with bullous pemphigoid and pemphigus vulgaris. J Eur Acad Dermatol Venereol 2020; 35:486-492. [DOI: 10.1111/jdv.16780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
Affiliation(s)
- N. Ernst
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - M. Friedrich
- Department of Dermatology University of Luebeck Luebeck Germany
- Laboratory of Emerging Infections Bernhard Nocht Institute for Tropical Medicine Hamburg Germany
| | - K. Bieber
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
| | - M. Kasperkiewicz
- Department of Dermatology University of Luebeck Luebeck Germany
- Department of Dermatology Keck School of Medicine University of Southern California Los Angeles CA USA
| | - N. Gross
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - C.D. Sadik
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - D. Zillikens
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - E. Schmidt
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
- Department of Dermatology University of Luebeck Luebeck Germany
| | - R.J. Ludwig
- Luebeck Institute of Experimental Dermatology University of Luebeck Luebeck Germany
- Center for Research on Inflammation of the Skin University of Luebeck Luebeck Germany
| | - K. Hartmann
- Department of Dermatology University of Luebeck Luebeck Germany
- Division of Allergy Department of Dermatology University of Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
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Klendar V, Gross N, Korzhenevsky A. CHANGES IN THE FUNCTIONAL STATUS IN CHILDREN WITH CEREBRAL PALSY WHEN PERFORMING CYCLIC MOVEMENTS. hsm 2019. [DOI: 10.14529/hsm190314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Aim. The article aims at improving functional activity in children with cerebral palsy based on the features of adaptation to cyclic motions. Materials and methods. 23 children with cerebral palsy aged from 2 to 14 years participated in the study regardless of the form of disease. Functional shifts were assessed under the effect of cyclic load on the cardiovascular system. The following methods were used for the study: heart rate variability analysis based on the changes in total power spectrum (TPw, mc2), relative values of heart rate spectrum characteristics (HF%, LF%, VLF%), and the Stress Index (SI). Results. It was established that long-term hyponesia affected negatively hemodynamics in children with cerebral palsy and contributed to a decrease in adaptation mechanisms. The initial functional status of children with cerebral palsy was characterized by low values of adaptation reserves, aerobic power, and recovery potential. Adaptive capabilities in children when growing up from 3 to 12 years decrease to asthenization. Conclusion. Motor performance is the most effective factor influencing improvement of functional capabilities in children with cerebral capabilities. The movements of the cyclic type contribute to an increase in excitability and muscle lability, as well as to the development of general endurance.
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Gross N, Ferrarotto R, Nagarajan P, Bell D, El-Naggar A, Johnson J, Yuan Y, Glisson B, Wong M, Rosenthal D, Esmaeli B, Migden M, Wargo J, Weber R, Myers J. Phase II study of neoadjuvant cemiplimab prior to surgery in patients with stage III/IV (M0) cutaneous squamous cell carcinoma of the head and neck (CSCC-HN). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.071] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gordon MF, Grachev ID, Mazeh I, Dolan Y, Reilmann R, Loupe PS, Fine S, Navon-Perry L, Gross N, Papapetropoulos S, Savola JM, Hayden MR. Quantification of Motor Function in Huntington Disease Patients Using Wearable Sensor Devices. Digit Biomark 2019; 3:103-115. [PMID: 32095771 DOI: 10.1159/000502136] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 04/15/2019] [Accepted: 07/16/2019] [Indexed: 01/17/2023] Open
Abstract
Previous studies have demonstrated the feasibility and promise of wearable sensors as objective measures of motor impairment in Parkinson disease and essential tremor. However, there are few published studies that have examined such an application in Huntington disease (HD). This report provides an evaluation of the potential to objectively quantify chorea in HD patients using wearable sensor data. Data were derived from a substudy of the phase 2 Open-PRIDE-HD study, where 17 patients were screened and 15 patients enrolled in the substudy and ultimately 10 patients provided sufficient wearable sensor data. The substudy was designed to provide high-resolution data to inform design of predictive algorithms for chorea quantification. During the entire course of the 6-month study, in addition to chorea ratings from 18 in-clinic assessments, 890 home assessments, and 1,388 responses to daily reminders, 33,000 h of high-resolution accelerometer data were captured continuously from wearable smartwatches and smartphones. Despite its limited sample size, our study demonstrates that arm chorea can be characterized using accelerometer data during static assessments. Nonetheless, the small sample size limits the generalizability of the model. The sensor-based model can quantify the chorea level with high correlation to the chorea severity reported by both clinicians and patients. In addition, our analysis shows that the chorea digital signature varies between patients. This work suggests that digital wearable sensors have the potential to support clinical development of medications in patients with movement disorders, such as chorea. However, additional data would be needed from a larger number of HD patients with a full range of chorea severity (none to severe) with and without intervention to validate this potentially predictive technology.
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Affiliation(s)
- Mark Forrest Gordon
- Specialty Clinical Development, Teva Pharmaceutical Industries Ltd., Frazer, Pennsylvania, USA
| | - Igor D Grachev
- Guide Pharmaceutical Consulting, LLC, Millstone Township, New Jersey, USA
| | - Itzik Mazeh
- Advanced Analytics Department, Intel, Petah Tikva, Israel
| | - Yonatan Dolan
- Advanced Analytics Department, Intel, Petah Tikva, Israel
| | - Ralf Reilmann
- George Huntington Institute and Department of Radiology University of Münster, Münster, Germany.,Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Pippa S Loupe
- Specialty Research and Development, Teva Pharmaceutical Industries Ltd., New Orleans, Louisiana, USA
| | - Shai Fine
- Data Science Institute, Interdisciplinary Center, Herzliya, Israel
| | | | - Nicholas Gross
- Specialty Clinical Development, Teva Pharmaceutical Industries Ltd., Frazer, Pennsylvania, USA
| | | | | | - Michael R Hayden
- Global Research and Development, Teva Pharmaceutical Industries Ltd., Petah Tikva, Israel.,Prilenia Therapeutics, Herzliya, Israel
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Baakman AC, Zuiker R, van Gerven JMA, Gross N, Yang R, Fetell M, Gershon A, Gilgun-Sherki Y, Hellriegel E, Spiegelstein O. Central nervous system effects of the histamine-3 receptor antagonist CEP-26401, in comparison with modafinil and donepezil, after a single dose in a cross-over study in healthy volunteers. Br J Clin Pharmacol 2019; 85:970-985. [PMID: 30710391 DOI: 10.1111/bcp.13885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 12/19/2018] [Accepted: 01/07/2019] [Indexed: 01/27/2023] Open
Abstract
AIMS In previous studies, the histamine-3 receptor antagonist CEP-26401 had a subtle effect on spatial working memory, with the best effect seen at the lowest dose tested (20 μg), and a dose-dependent disruption of sleep. In the current study, 3 low-dose levels of CEP-26401 were compared with modafinil and donepezil. METHODS In this double-blind, placebo- and positive-controlled, randomized, partial 6-way cross-over study, 40 healthy subjects received single doses of placebo, CEP-26401 (5, 25 or 125 μg) or modafinil 200 mg or donepezil 10 mg. Pharmacokinetic and pharmacodynamic measurements were performed predose and at designated time points postdose. RESULTS The main endpoint between-errors of the spatial working memory-10-boxes task only improved for the 125 μg dose of CEP-26401 with a difference of 2.92 (confidence interval [CI] -1.21 to 7.05), 3.24 (CI -1.57 to 8.04) and 7.45 (CI 2.72 to 12.19) for respectively the 5, 25 and 125 μg dose of CEP-26401, -1.65 (CI -0.572 to 1.96) for modafinil and - 3.55 (CI -7.13 to 0.03) for donepezil. CEP-26401 induced an improvement of adaptive tracking, saccadic peak velocity and reaction time during N-back, but a dose-related inhibition of sleep and slight worsening of several cognitive parameters at the highest dose. CEP-26401 significantly changed several subjective visual analogue scales, which was strongest at 25 μg, causing the same energizing and happy feeling as modafinil, but with a more relaxed undertone. DISCUSSION Of the doses tested, the 25 μg dose of CEP-26401 had the most optimal balance between favourable subjective effects and sleep inhibition. Whether CEP-26401 can have beneficial effects in clinical practice remains to be studied.
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Affiliation(s)
| | - Rob Zuiker
- Centre for Human Drug Research, Leiden, Netherlands
| | | | - Nicholas Gross
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Ronghua Yang
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Michael Fetell
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Ari Gershon
- Global Patient Safety and Pharmacovigilance, Teva Pharmaceuticals, Petah Tikva, Israel.,Formerly Global Patient Safety and Pharmacovigilance, Teva Pharmaceuticals, Petah Tikva, Israel
| | | | - Edward Hellriegel
- Research and Development Teva Pharmaceuticals, West Chester, Pennsylvania, USA
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Gross N. The COPD Pipeline XXXX. Chronic Obstr Pulm Dis 2019; 6:115-117. [PMID: 30775429 DOI: 10.15326/jcopdf.6.1.2018.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- St Francis Hospital and University Medical Research, LLC
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Reilmann R, McGarry A, Grachev ID, Savola JM, Borowsky B, Eyal E, Gross N, Langbehn D, Schubert R, Wickenberg AT, Papapetropoulos S, Hayden M, Squitieri F, Kieburtz K, Landwehrmeyer GB. Safety and efficacy of pridopidine in patients with Huntington's disease (PRIDE-HD): a phase 2, randomised, placebo-controlled, multicentre, dose-ranging study. Lancet Neurol 2018; 18:165-176. [PMID: 30563778 DOI: 10.1016/s1474-4422(18)30391-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/26/2018] [Accepted: 10/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous trials have shown that pridopidine might reduce motor impairment in patients with Huntington's disease. The aim of this study was to ascertain whether higher doses of pridopidine than previously tested reduce motor symptoms in a dose-dependent manner while maintaining acceptable safety and tolerability. METHODS PRIDE-HD was a randomised, placebo-controlled, phase 2, dose-ranging study in adults (aged ≥21 years) with Huntington's disease at outpatient clinics in 53 sites across 12 countries (Australia, Austria, Canada, Denmark, France, Germany, Italy, Poland, Russia, the Netherlands, the UK, and the USA). Eligible patients had clinical onset after age 18 years, 36 or more cytosine-adenine-guanine repeats in the huntingtin gene, motor symptoms (Unified Huntington's Disease Rating Scale total motor score [UHDRS-TMS] ≥25 points), and reduced independence (UHDRS independence score ≤90%). Patients were randomly assigned (1:1:1:1:1) with centralised interactive-response technology to receive one of four doses of pridopidine (45, 67·5, 90, or 112·5 mg) or placebo orally twice a day for 52 weeks. Randomisation was stratified within centres by neuroleptic drug use. The primary efficacy endpoint was change in the UHDRS-TMS from baseline to 26 weeks, which was assessed in all randomised patients who received at least one dose of study drug and had at least one post-baseline efficacy assessment (full analysis set). Participants and investigators were masked to treatment assignment. This trial is registered with EudraCT (2013-001888-23) and ClinicalTrials.gov (NCT02006472). FINDINGS Between Feb 13, 2014, and July 5, 2016, 408 patients were enrolled and randomly assigned to receive placebo (n=82) or pridopidine 45 mg (n=81), 67·5 mg (n=82), 90 mg (n=81), or 112·5 mg (n=82) twice daily for 26 weeks. The full analysis set included 397 patients (81 in the placebo group, 75 in the 45 mg group, 79 in the 67·5 mg group, 81 in the 90 mg group, and 81 in the 112·5 mg group). Pridopidine did not significantly change the UHDRS-TMS at 26 weeks compared with placebo at any dose. The most frequent adverse events across all groups were diarrhoea, vomiting, nasopharyngitis, falls, headache, insomnia, and anxiety. The most common treatment-related adverse events were insomnia, diarrhoea, nausea, and dizziness. Serious adverse events occurred in the pridopidine groups only and were most frequently falls (n=5), suicide attempt (n=4), suicidal ideation (n=3), head injury (n=3), and aspiration pneumonia (n=3). No new safety or tolerability concerns emerged in this study. One death in the pridopidine 112·5 mg group due to aspiration pneumonia was considered to be possibly related to the study drug. INTERPRETATION Pridopidine did not improve the UHDRS-TMS at week 26 compared with placebo and, thus, the results of secondary or tertiary analyses in previous trials were not replicated. A potentially strong placebo effect needs to be ruled out in future studies. FUNDING Teva Pharmaceutical Industries.
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Affiliation(s)
- Ralf Reilmann
- George Huntington Institute, Münster, Germany; Department of Clinical Radiology, University of Münster, Münster, Germany; Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Andrew McGarry
- Movement Disorders Center, Cooper University Health Care, Camden, NJ, USA
| | | | | | | | - Eli Eyal
- Teva Pharmaceutical Industries, Petach Tikva, Israel
| | | | - Douglas Langbehn
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | | | | | | | | | - Ferdinando Squitieri
- Unita' Operativa Ricerca e Cura Huntington e Malattie Rare, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Karl Kieburtz
- Center for Health & Technology, University of Rochester Medical Center, Rochester, NY, USA
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Khatib H, Gross N. Symposium review: Embryo survival-A genomic perspective of the other side of fertility. J Dairy Sci 2018; 102:3744-3753. [PMID: 30293848 DOI: 10.3168/jds.2018-15252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/20/2018] [Accepted: 07/31/2018] [Indexed: 01/13/2023]
Abstract
The majority of embryonic loss in cattle occurs within the first 3 to 4 wk of pregnancy, and there are currently no accurate predictors of pregnancy outcome. Existing embryo quality assessment methods include morphological evaluation and embryo biopsy. These methods are not accurate and carry some health risks to the developing embryo, respectively. Therefore, there is need to identify noninvasive biomarkers such as microRNA that can predict embryo quality and pregnancy outcome. Furthermore, researchers need a better understanding of the dynamic interaction between the mother and the embryo. The transcriptome of the uterus shows plasticity that depends on the embryo type so that the expression level of some genes for in vivo embryos would be different from that of in vitro-produced embryos. Similarly, the embryonic transcriptome and epigenome change in response to different environmental factors such as stress, diet, disease, and physiological status of the mother. This embryo-mother crosstalk could be better understood by investigating the molecular signaling that occurs at different stages of embryonic development. Although transcriptomics is a useful tool to assess the roles of genes and pathways in embryo quality and maternal receptivity, it does not provide the exact functions of these genes, and it shows correlation rather than causality. Therefore, an in-depth functional genomic analysis is needed for better understanding of the molecular mechanisms controlling embryo development. In this review, we discuss recent genomic technologies such as RNA interference, gapmer technology, and genome editing techniques used in humans and livestock to elucidate the molecular mechanisms of genes affecting embryo development.
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Affiliation(s)
- H Khatib
- Department of Animal Sciences, University of Wisconsin, Madison 53706.
| | - N Gross
- Department of Animal Sciences, University of Wisconsin, Madison 53706
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Abstract
Acetylcholine binds to muscarinic receptors to play a key role in the pathophysiology of asthma, leading to bronchoconstriction, increased mucus secretion, inflammation and airway remodelling. Anticholinergics are muscarinic receptor antagonists that are used in the treatment of chronic obstructive pulmonary disease and asthma. Recent in vivo and in vitro data have increased our understanding of how acetylcholine contributes to the disease manifestations of asthma, as well as elucidating the mechanism of action of anticholinergics. This review assesses the latest literature on acetylcholine in asthma pathophysiology, with a closer look at its role in airway inflammation and remodelling. New insights into the mechanism of action of anticholinergics, their effects on airway remodelling, and a review of the efficacy and safety of long-acting anticholinergics in asthma treatment will also be covered, including a summary of the latest clinical trial data. Pre-clinical data suggest that anticholinergics can reduce acetylcholine-induced airway inflammation and remodellinghttp://ow.ly/xqAQ30loP8F
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Affiliation(s)
| | - Nicholas Gross
- University Medical Research LLC, St Francis Hospital, Hartford, CT, USA
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Gross N. The COPD Pipeline XXXVII. Chronic Obstr Pulm Dis 2018; 5:66-71. [PMID: 29629406 DOI: 10.15326/jcopdf.5.1.2017.0184] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- 1- St Francis Hospital and University Medical Research, LLC
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Gross N. The COPD Pipeline XXXIX. Chronic Obstr Pulm Dis 2018; 5:338-340. [PMID: 30723790 DOI: 10.15326/jcopdf.5.4.2018.0155] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- St Francis Hospital and University Medical Research, LLC
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Gross N. The COPD Pipeline XXXVIII. Chronic Obstr Pulm Dis 2018; 5:144-147. [PMID: 30374452 DOI: 10.15326/jcopdf.5.2.2018.0136] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- St Francis Hospital and University Medical Research, LLC
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Hiraki DD, Jones CD, Gross N, Grumet FC, Zehnder JL. Familial Coagulation Factor V Deficiency Caused by a Novel 4 Base Pair Insertion in the Factor V Gene: Factor V Stanford. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryAn index patient with pseudohomozygosity for factor V Leiden was identified. Each of his two children inherited a different paternal factor V allele; a daughter was heterozygous for factor V Leiden, with 100% factor V activity, and a son was heterozygous for factor V deficiency, with 50% factor V activity. Genomic DNA was obtained from family members, and the 25 factor V exons and flanking intronic regions were sequenced in the proband and confirmed in the children. Within exon 13 of factor V, a 4 base insertion was found at NT 2856 in the proband and son, but not the daughter. This mutation, here designated factor V Stanford, results in a frameshift with loss of a thrombin activation site (R1545V) and premature termination of translation at amino acid 1560.
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Affiliation(s)
- Nicholas Gross
- University Medical Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut
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Lagrèze WA, Gross N, Biermann J, Joachimsen L. [Indications and technique for transconjunctival optic nerve sheath fenestration : Video article]. Ophthalmologe 2017; 114:953-958. [PMID: 28905110 DOI: 10.1007/s00347-017-0563-2] [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: 10/18/2022]
Abstract
BACKGROUND Placement of a ventricular shunt is the primary surgical procedure for lowering intracranial pressure in pseudotumor cerebri syndrome; however, if ophthalmological symptoms prevail over neurological symptoms or if there are no neurological symptoms at all, optic nerve sheath fenestration may be a valuable option for relief of pressure on the retrobulbar optic nerve when papilledema caused by pseudotumor cerebri syndrome threatens vision despite previous conservative measures. METHODS This review covers the indications, technique and results of optic nerve sheath fenestration compared to competing procedures based on a systematic literature search, analysis of own cases and a documentation of the surgical technique. SURGICAL TECHNIQUE After performing a medial transconjunctival orbitotomy the medial rectus muscle tendon is temporarily detached and the eye abducted by traction sutures. Using confocal illumination under a surgical microscope, the optic nerve can be visualized using orbital spatulas and the sheath can be punctured with a microscalpel. A video of this operation is available online. CONCLUSION Transconjunctival optic nerve sheath fenestration is a relatively safe method to reduce the rate of visual loss in pseudotumor cerebri syndrome. In selected cases it can be a useful alternative to ventriculoperitoneal/atrial shunts or venous stents.
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Affiliation(s)
- W A Lagrèze
- Klinik für Augenheilkunde, Medizinische Fakultät, Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - N Gross
- Klinik für Augenheilkunde, Medizinische Fakultät, Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - J Biermann
- Klinik für Augenheilkunde, Medizinische Fakultät, Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - L Joachimsen
- Klinik für Augenheilkunde, Medizinische Fakultät, Universität Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Gross N. The COPD Pipeline XXXV. Chronic Obstr Pulm Dis 2017; 4:247-251. [PMID: 28848935 DOI: 10.15326/jcopdf.4.3.2017.0154] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- University Medical Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut
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Gross N. The COPD Pipeline XXXIV. Chronic Obstr Pulm Dis 2017; 4:159-161. [PMID: 28848925 DOI: 10.15326/jcopdf.4.2.2017.0138] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- University Medical Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut
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Affiliation(s)
- Nicholas Gross
- Emeritus Professor of Medicine and Molecular Biology, Stritch-Loyola School of Medicine, Chicago, Illinois
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Gross N. The COPD Pipeline XXXII. Chronic Obstr Pulm Dis 2016; 3:688-692. [PMID: 28848893 PMCID: PMC5556764 DOI: 10.15326/jcopdf.3.3.2016.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Nicholas Gross
- Emeritus Professor of Medicine and Molecular Biology, Stritch-Loyola School of Medicine, Chicago, Illinois
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Gross N. The COPD Pipeline XXXI. Chronic Obstr Pulm Dis 2016; 3:589-593. [PMID: 28848883 PMCID: PMC5559161 DOI: 10.15326/jcopdf.3.2.2016.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Nicholas Gross
- Stritch-Loyola School of Medicine, Maywood, Illinois (Emeritus Professor)
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Gross N, Oldenburg S, Lawinger J, Grez M, Crenshaw TD. 421 Development of an imaging technique using clinical CT-scans to detect osteochondritic-like lesions in femoral growth plates of growing pigs. J Anim Sci 2016. [DOI: 10.2527/msasas2016-421] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Goepfert R, Lewin J, Barrow M, Gunn G, Fuller C, Beadle B, Garden A, Rosenthal D, Kies M, Papadimitrakopoulou V, Lai S, Gross N, Schwartz D, Hutcheson K. Long-Term Patient-Reported Dysphagia in Low-Risk Oropharyngeal Carcinoma After Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.12.329] [Citation(s) in RCA: 1] [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: 10/22/2022]
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Du L, Chen X, Cao Y, Lu L, Zhang F, Bornstein S, Li Y, Owens P, Malkoski S, Said S, Jin F, Kulesz-Martin M, Gross N, Wang XJ, Lu SL. Overexpression of PIK3CA in murine head and neck epithelium drives tumor invasion and metastasis through PDK1 and enhanced TGFβ signaling. Oncogene 2016; 35:4641-52. [PMID: 26876212 PMCID: PMC4985507 DOI: 10.1038/onc.2016.1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [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: 03/16/2015] [Revised: 12/15/2015] [Accepted: 12/18/2015] [Indexed: 12/12/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) patients have a poor prognosis, with invasion and metastasis as major causes of mortality. The phosphatidylinositol 3-kinase (PI3K) pathway regulates a wide range of cellular processes crucial for tumorigenesis, and PIK3CA amplification and mutation are among the most common genetic alterations in human HNSCC. Compared to the well-documented roles of the PI3K pathway in cell growth and survival, the roles of the PI3K pathway in tumor invasion and metastasis have not been well delineated. We generated a PIK3CA-genetically engineered mouse model (PIK3CA-GEMM) in which wildtype PIK3CA is overexpressed in head and neck epithelium. Although PIK3CA overexpression alone was not sufficient to initiate HNSCC formation, it significantly increased tumor susceptibility in an oral-carcinogenesis mouse model. PIK3CA overexpression in mouse oral epithelium increased tumor invasiveness and metastasis by increasing epithelial-mesenchymal transition and by enriching a cancer stem cell phenotype in tumor epithelial cells. In addition to these epithelial alterations, we also observed marked inflammation in tumor stroma. AKT is a central signaling mediator of the PI3K pathway. However, molecular analysis suggested that progression of PIK3CA-driven HNSCC is facilitated by PDK1 and enhanced TGFβ signaling rather than by AKT. Examination of human HNSCC clinical samples revealed that both PIK3CA and PDK1 protein levels correlated with tumor progression, highlighting the significance of this pathway. In summary, our results offer significant insight into how PIK3CA-overexpression drives HNSCC invasion and metastasis, providing a rationale for targeting PI3K/PDK1 and TGFβ signaling in advanced HNSCC patients with PIK3CA amplification.
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Affiliation(s)
- L Du
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Otolaryngology, Fourth University Hospital of China Medical University, Shengyang, China
| | - X Chen
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Y Cao
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Surgical Oncology, The First University Hospital of China Medical University, Shengyang, Liaoning, China
| | - L Lu
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - F Zhang
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S Bornstein
- Department of Otolaryngology, Oregon Health and Science University, Portland, OR, USA
| | - Y Li
- Department of Otolaryngology, Oregon Health and Science University, Portland, OR, USA
| | - P Owens
- Department of Otolaryngology, Oregon Health and Science University, Portland, OR, USA
| | - S Malkoski
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S Said
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - F Jin
- Department of Surgical Oncology, The First University Hospital of China Medical University, Shengyang, Liaoning, China
| | - M Kulesz-Martin
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - N Gross
- Department of Otolaryngology, Oregon Health and Science University, Portland, OR, USA
| | - X-J Wang
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S-L Lu
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Rosenbruch J, Walterspacher S, Scholz T, Venturini S, Gross N, Ottenbacher J, Sorichter S. Detektion schlafbezogener Atmungsstörungen – Methodenvergleich von Sättigungsanalyse und Polysomnografie. Pneumologie 2016. [DOI: 10.1055/s-0036-1571961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hutcheson K, Gunn G, Gross N, Barrow M, Kies M, Garden A, Schwartz D, Lewin J. Prospective Longitudinal Swallowing Outcomes After Chemotherapy and Split-Field IMRT for Advanced-Stage T1-2 Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gross N. The COPD Pipeline XXIX. Chronic Obstr Pulm Dis 2015; 2:370-374. [PMID: 28848857 DOI: 10.15326/jcopdf.2.4.2015.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Nicholas Gross
- Stritch-Loyola School of Medicine, Maywood, Illinois.,St. Francis Hospital, Hartford, Connecticut
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Gross N, Greos LS, Meltzer EO, Spangenthal S, Fishman RS, Spyker DA, Cassella JV. Safety and tolerability of inhaled loxapine in subjects with asthma and chronic obstructive pulmonary disease--two randomized controlled trials. J Aerosol Med Pulm Drug Deliv 2015; 27:478-87. [PMID: 24745666 DOI: 10.1089/jamp.2013.1114] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loxapine, a first-generation antipsychotic, delivered with a novel inhalation delivery device developed for the acute treatment of agitation in patients with schizophrenia or bipolar disorder was evaluated in subjects with asthma or chronic obstructive pulmonary disease (COPD). METHODS Separate randomized, double-blind, parallel-arm, placebo-controlled trials compared two administrations of inhaled loxapine (10 mg) 10 hr apart with placebo in 52 subjects with asthma and in 53 subjects with COPD. A thermally-generated drug aerosol of loxapine was delivered to the deep lung for rapid systemic absorption. Controller medications were continued throughout the study, but quick-relief bronchodilators were withheld from 6-8 hr before through 34 hr after dose 1, unless indicated as rescue. RESULTS All airway adverse events (AEs) were of mild or moderate severity. Symptomatic bronchospasm occurred in 53.8% of subjects with asthma after inhaled loxapine and 11.5% after placebo; and in 19.2% of COPD subjects after inhaled loxapine and 11.1% after placebo. Subjects required inhaled albuterol as follows: asthma: 53.8% after inhaled loxapine and 11.5% after placebo; and COPD: 23.1% after inhaled loxapine and 14.8% after placebo. Respiratory signs/symptoms requiring treatment responded to rescue bronchodilator [forced expiratory volume in 1 sec (FEV(1)) return to within 10% of baseline] within 1 hr in 11 of 15 events in asthma subjects and four of seven events in COPD subjects, the remainder by the last spirometry. CONCLUSIONS In subjects with either asthma or COPD, FEV(1) decline and bronchospasm can occur following inhaled loxapine, but more frequently in asthmatic subjects. Most subjects with bronchospasm responded to rescue bronchodilator within 1 hr. No treatment-related serious AE occurred. Although inhaled loxapine is contraindicated in patients with active airways disease per the current approved US labeling, these studies demonstrated that rescue bronchodilator mitigated the symptomatic bronchospasms that may occur in case of inadvertent use.
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Affiliation(s)
- Nicholas Gross
- 1 St. Francis Hospital, Hartford CT, and University Medical Research , Farmington, CT
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Gross N. VI. Die Bezugsfläche der Lösungsgeschwindigkeit für Gips. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1922.57.1.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lagrèze W, Augustynik M, Biermann J, Gross N. Erratum für: Technik und Ergebnisse der transkonjunktivalen Entfernung orbitaler Hämangiome. Klin Monbl Augenheilkd 2015; 233:e1. [DOI: 10.1055/s-0035-1557869] [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: 10/23/2022]
Affiliation(s)
- W. Lagrèze
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - M. Augustynik
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - J. Biermann
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - N. Gross
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
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Lagrèze WA, Augustynik M, Biermann J, Gross N. [Technique and Results for the Transconjunctival Removal of Orbital Haemangiomas]. Klin Monbl Augenheilkd 2015; 233:24-8. [PMID: 26167635 DOI: 10.1055/s-0035-1546112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The cavernous haemangioma (cavernoma) is the most common orbital tumour in adults. Various surgical approaches have been described so far. We prefer a transconjunctival approach and analyse herein how our outcomes compare with those of transcutaneous or transosseous approaches. METHODS A retrospective series of 10 cases was analysed with regard to surgical success and complications. RESULTS The tumour could be completely removed in all cases. In one case, preoperative diplopia disappeared after surgery. Another case suffered from postoperative diplopia, which resolved within two months. Two cases developed a long-lasting partial tonic pupil. CONCLUSION A retrobulbar cavernoma can be safely removed via a transconjunctival approach through shrinkage by coagulation and subsequent cryoextraction.
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Affiliation(s)
- W A Lagrèze
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - M Augustynik
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - J Biermann
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
| | - N Gross
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg
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Affiliation(s)
- Nicholas Gross
- Stritch-Loyola School of Medicine, Maywood, Illinois.,St. Francis Hospital, Hartford, Connecticut
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Gross N. The COPD Pipeline XXVII. Chronic Obstr Pulm Dis 2015; 2:191-194. [PMID: 28848841 PMCID: PMC5556971 DOI: 10.15326/jcopdf.2.2.2015.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Nicholas Gross
- Stritch-Loyola School of Medicine, Chicago, Illinois and St. Francis Hospital, Hartford, Connecticut
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Gross N. The COPD Pipeline, XXVI. Chronic Obstr Pulm Dis 2015; 2:81-84. [PMID: 28848832 PMCID: PMC5556776 DOI: 10.15326/jcopdf.2.1.2014.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Nicholas Gross
- Stritch-Loyola School of Medicine, Chicago, Illinois and St. Francis Hospital, Hartford, Connecticut
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Defferrari R, Mazzocco K, Ambros IM, Ambros PF, Bedwell C, Beiske K, Bénard J, Berbegall AP, Bown N, Combaret V, Couturier J, Erminio G, Gambini C, Garaventa A, Gross N, Haupt R, Kohler J, Jeison M, Lunec J, Marques B, Martinsson T, Noguera R, Parodi S, Schleiermacher G, Tweddle DA, Valent A, Van Roy N, Vicha A, Villamon E, Tonini GP. Influence of segmental chromosome abnormalities on survival in children over the age of 12 months with unresectable localised peripheral neuroblastic tumours without MYCN amplification. Br J Cancer 2014; 112:290-5. [PMID: 25356804 PMCID: PMC4453444 DOI: 10.1038/bjc.2014.557] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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: 05/26/2014] [Revised: 09/22/2014] [Accepted: 10/04/2014] [Indexed: 01/06/2023] Open
Abstract
Background: The prognostic impact of segmental chromosome alterations (SCAs) in children older than 1 year, diagnosed with localised unresectable neuroblastoma (NB) without MYCN amplification enrolled in the European Unresectable Neuroblastoma (EUNB) protocol is still to be clarified, while, for other group of patients, the presence of SCAs is associated with poor prognosis. Methods: To understand the role of SCAs we performed multilocus/pangenomic analysis of 98 tumour samples from patients enrolled in the EUNB protocol. Results: Age at diagnosis was categorised into two groups using 18 months as the age cutoff. Significant difference in the presence of SCAs was seen in tumours of patients between 12 and 18 months and over 18 months of age at diagnosis, respectively (P=0.04). A significant correlation (P=0.03) was observed between number of SCAs per tumour and age. Event-free (EFS) and overall survival (OS) were calculated in both age groups, according to both the presence and number of SCAs. In older patients, a poorer survival was associated with the presence of SCAs (EFS=46% vs 75%, P=0.023; OS=66.8% vs 100%, P=0.003). Moreover, OS of older patients inversely correlated with number of SCAs (P=0.002). Finally, SCAs provided additional prognostic information beyond histoprognosis, as their presence was associated with poorer OS in patients over 18 months with unfavourable International Neuroblastoma Pathology Classification (INPC) histopathology (P=0.018). Conclusions: The presence of SCAs is a negative prognostic marker that impairs outcome of patients over the age of 18 months with localised unresectable NB without MYCN amplification, especially when more than one SCA is present. Moreover, in older patients with unfavourable INPC tumour histoprognosis, the presence of SCAs significantly affects OS.
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Affiliation(s)
- R Defferrari
- Department of Pathology, Istituto Giannina Gaslini, Genova 16148, Italy
| | - K Mazzocco
- Department of Pathology, Istituto Giannina Gaslini, Genova 16148, Italy
| | - I M Ambros
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Vienna 1090, Austria
| | - P F Ambros
- Children's Cancer Research Institute, St Anna Kinderkrebsforschung, Vienna 1090, Austria
| | - C Bedwell
- Northern Genetics Service, Newcastle upon Tyne NEI 3 BZ, UK
| | - K Beiske
- Department of Pathology, Oslo University Hospital Rikshopitalet, Oslo 0424, Norway
| | - J Bénard
- Département de Biologie et de Pathologie Médicales, Gustave Roussy Cancer Campus, Villejuif 94800, France
| | - A P Berbegall
- Department of Pathology, Medical School of Valencia, University of Valencia, Valencia 46010, Spain
| | - N Bown
- Northern Genetics Service, Newcastle upon Tyne NEI 3 BZ, UK
| | - V Combaret
- Laboratoire de Recherche Translationnelle, Centre Léon-Bérard, Lyon 69008, France
| | - J Couturier
- Unité de Génétique Somatique et Cytogénétique, Institut Curie, Paris Cedex 05 75248, France
| | - G Erminio
- Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini, Genova 16148, Italy
| | - C Gambini
- Department of Pathology, Istituto Giannina Gaslini, Genova 16148, Italy
| | - A Garaventa
- Department of Haematology-Oncology, Istituto Giannina Gaslini, Genova 16148, Italy
| | - N Gross
- Pediatric Oncology Research Unit, Lausanne University Hospital (CHUV), Lausanne 1011, Switzerland
| | - R Haupt
- Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini, Genova 16148, Italy
| | - J Kohler
- Department of Paediatric Oncology, Southampton General Hospital, Southampton S016 6YD, UK
| | - M Jeison
- Cancer Cytogenetique and Molecular Cytogenetique Laboratory, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - J Lunec
- Northern Institute for Cancer Research, Newcastle University, Newcastle NE2 4HH, UK
| | - B Marques
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, Lisbon 1649-016, Portugal
| | - T Martinsson
- Department of Clinical Genetics, Göteborg University, Sahlgrenska University Hospital, Göteborg 413 45, Sweden
| | - R Noguera
- Department of Pathology, Medical School of Valencia, University of Valencia, Valencia 46010, Spain
| | - S Parodi
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Genova 16149, Italy
| | - G Schleiermacher
- 1] INSERM U830, Laboratoire de Génétique et Biologie des Cancers, Paris Cedex 05 75248, France [2] Département d'Oncologie Pédiatrique, Institut Curie, Paris Cedex 05 75248, France
| | - D A Tweddle
- Northern Institute for Cancer Research, Newcastle University, Newcastle NE2 4HH, UK
| | - A Valent
- Département de Biologie et de Pathologie Médicales, Gustave Roussy Cancer Campus, Villejuif 94800, France
| | - N Van Roy
- Center for Medical Genetics, Ghent University Hospital, Ghent 9000, Belgium
| | - A Vicha
- Department of Paediatric Haematology and Oncology, Charles University and University Hospital Motol, Prague 15008, Czech Republic
| | - E Villamon
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia 46009, Spain
| | - G P Tonini
- Laboratory of Neuroblastoma, Onco/Haematology Laboratory, University of Padua, Pediatric Research Institute (IRP)-Città della Speranza, Corso Stati Uniti 4, Padova 35127, Italy
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Funk MB, Gross N, Gross S, Hunfeld A, Lohmann A, Guenay S, Hanschmann KM, Keller-Stanislawski B. Thromboembolic events associated with immunoglobulin treatment. Vox Sang 2013; 105:54-64. [DOI: 10.1111/vox.12025] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 12/10/2012] [Accepted: 12/13/2012] [Indexed: 11/26/2022]
Affiliation(s)
- M. B. Funk
- Department of Safety of Medicinal Products and Medical Devices; Paul-Ehrlich-Institut; Langen; Germany
| | - N. Gross
- Department of Immunology; Paul-Ehrlich-Institut; Langen; Germany
| | - S. Gross
- Department of Immunology; Paul-Ehrlich-Institut; Langen; Germany
| | - A. Hunfeld
- Department of Haematology/Transfusion Medicine; Paul-Ehrlich-Institut; Langen; Germany
| | - A. Lohmann
- Department of Safety of Medicinal Products and Medical Devices; Paul-Ehrlich-Institut; Langen; Germany
| | - S. Guenay
- Department of Safety of Medicinal Products and Medical Devices; Paul-Ehrlich-Institut; Langen; Germany
| | - K. M. Hanschmann
- Department of Biostatistics; Paul-Ehrlich-Institut; Langen; Germany
| | - B. Keller-Stanislawski
- Department of Safety of Medicinal Products and Medical Devices; Paul-Ehrlich-Institut; Langen; Germany
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Gross N. Sir Richard Doll, M.D., F.R.S. (1912–2005). Am J Respir Crit Care Med 2012. [DOI: 10.1164/rccm.201211-1982ed] [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: 11/16/2022] Open
Affiliation(s)
- Nicholas Gross
- Strich-Loyola School of MedicineMaywood, IllinoisandSt Francis HospitalHartford, Connecticut
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Confer M, McNall-Knapp R, Krishnan S, Gross N, Keole S. Proton Radiation Therapy for Pediatric Craniopharyngiomas: Initial Results. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1696] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Salm F, Cwiek P, Ghosal A, Lucia Buccarello A, Largey F, Wotzkow C, Höland K, Styp-Rekowska B, Djonov V, Zlobec I, Bodmer N, Gross N, Westermann F, Schäfer SC, Arcaro A. RNA interference screening identifies a novel role for autocrine fibroblast growth factor signaling in neuroblastoma chemoresistance. Oncogene 2012; 32:3944-53. [PMID: 23027129 DOI: 10.1038/onc.2012.416] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 07/19/2012] [Accepted: 07/31/2012] [Indexed: 12/16/2022]
Abstract
Chemotherapeutic drug resistance is one of the major causes for treatment failure in high-risk neuroblastoma (NB), the most common extra cranial solid tumor in children. Poor prognosis is typically associated with MYCN amplification. Here, we utilized a loss-of-function kinome-wide RNA interference screen to identify genes that cause cisplatin sensitization. We identified fibroblast growth factor receptor 2 (FGFR2) as an important determinant of cisplatin resistance. Pharmacological inhibition of FGFR2 confirmed the importance of this kinase in NB chemoresistance. Silencing of FGFR2 sensitized NB cells to cisplatin-induced apoptosis, which was regulated by the downregulation of the anti-apoptotic proteins BCL2 and BCLXL. Mechanistically, FGFR2 was shown to activate protein kinase C-δ to induce BCL2 expression. FGFR2, as well as the ligand fibroblast growth factor-2, were consistently expressed in primary NB and NB cell lines, indicating the presence of an autocrine loop. Expression analysis revealed that FGFR2 correlates with MYCN amplification and with advanced stage disease, demonstrating the clinical relevance of FGFR2 in NB. These findings suggest a novel role for FGFR2 in chemoresistance and provide a rational to combine pharmacological inhibitors against FGFR2 with chemotherapeutic agents for the treatment of NB.
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Affiliation(s)
- F Salm
- Department of Clinical Research, University of Bern, Bern, Switzerland
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