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La Barbera L, Rizzo C, Camarda F, Atzeni F, Miceli G, Molica Colella AB, Franchina V, Giardina A, Corrao S, Provenzano G, Bursi R, Foti R, Dal Bosco Y, Debilio C, Luppino F, Colaci M, Aprile ML, Bentivegna M, Cassarà E, Lo Gullo A, De Andres MI, Guggino G. Effectiveness and safety of filgotinib in rheumatoid arthritis: a real-life multicentre experience. Clin Exp Rheumatol 2024; 42:991-998. [PMID: 38197190 DOI: 10.55563/clinexprheumatol/k78ug3] [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: 07/27/2023] [Accepted: 10/25/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES We investigated the effectiveness and safety of filgotinib in a real-life multicentre cohort of rheumatoid arthritis (RA) patients. METHODS RA patients were evaluated at baseline and after 12 and 24 weeks and were stratified based on previous treatments as biologic disease-modifying anti-rheumatic drug (bDMARD)-naive and bDMARD-insufficient responders (IR). Concomitant usage of methotrexate (MTX) and oral glucocorticoids (GC) was recorded. At each timepoint we recorded disease activity, laboratory parameters and adverse events. RESULTS 126 patients were enrolled. 15.8% were bDMARD-naive (G0), while 84% were bDMARD-IR (G1). In G0, 45% of patients were in monotherapy (G2) and 55% were taken MTX (G3). In G1, 50% of patients were in monotherapy (G4) and 50% used MTX (G5).A significant reduction in all parameters at 12 weeks was observed; in the extension to 24 weeks the significant reduction was maintained for patient global assessment (PGA), examiner global assessment (EGA), visual analogue scale (VAS) pain, VAS fatigue, disease activity score (DAS)28- C-reactive protein (CRP) and CRP values. Filgotinib in monotherapy showed better outcomes in bDMARD-naive patients, with significant differences for patient reported outcomes (PROs) and DAS28-CRP. At 12 weeks, low disease activity (LDA) and remission were achieved in a percentage of 37.2 % and 10.7 % by simplified disease activity index (SDAI), 42.6 % and 5.7 % by clinical disease activity index (CDAI), 26.8 % and 25.2 % by DAS28-CRP, respectively. A significant decrease in steroid dose was evidenced in all patients. We observed a major adverse cardiovascular event in one patient and an increase in transaminase in another. No infections from Herpes Zoster were reported. CONCLUSIONS Our real-world data confirm the effectiveness and safety of filgotinib in the management of RA, especially in bDMARD-naive patients.
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Affiliation(s)
- Lidia La Barbera
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Chiara Rizzo
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Federica Camarda
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Italy
| | - Giovanni Miceli
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Italy
| | | | | | - Annarita Giardina
- Internal Medicine Department iGR, National Relevance Hospital Trust, ARNAS Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Salvatore Corrao
- Internal Medicine Department iGR, National Relevance Hospital Trust, ARNAS Civico, Di Cristina e Benfratelli, Palermo, Italy
| | | | - Roberto Bursi
- Rheumatology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Rosario Foti
- Rheumatology Unit, Vittorio-Emanuele Hospital, Catania, Italy
| | | | - Carmelo Debilio
- Rheumatology Unit, Department of Medicine, Sant'Antonio Abate Hospital, Trapani, Italy
| | - Flavia Luppino
- Rheumatology Unit, Department of Medicine, Sant'Antonio Abate Hospital, Trapani, Italy
| | - Michele Colaci
- Unit of Internal Medicine and Hypertension Centre, Department of Clinical and Experimental Medicine, University of Catania, Cannizzaro Hospital, Catania, Italy
| | - Maria Letizia Aprile
- Unit of Internal Medicine and Hypertension Centre, Department of Clinical and Experimental Medicine, University of Catania, Cannizzaro Hospital, Catania, Italy
| | - Mario Bentivegna
- Integrated Reference Centre of Rheumatology, ASP 7, Scicli Hospital, Ragusa, Italy
| | - Emanuele Cassarà
- Integrated Reference Centre of Rheumatology, ASP 7, Scicli Hospital, Ragusa, Italy
| | - Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS Garibaldi Hospital, Catania, Italy
| | | | - Giuliana Guggino
- Rheumatology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy.
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Paroli M, Becciolini A, Bravi E, Andracco R, Nucera V, Parisi S, Ometto F, Lumetti F, Farina A, Del Medico P, Colina M, Lo Gullo A, Ravagnani V, Scolieri P, Larosa M, Priora M, Visalli E, Addimanda O, Vitetta R, Volpe A, Bezzi A, Girelli F, Molica Colella AB, Caccavale R, Di Donato E, Adorni G, Santilli D, Lucchini G, Arrigoni E, Platè I, Mansueto N, Ianniello A, Fusaro E, Ditto MC, Bruzzese V, Camellino D, Bianchi G, Serale F, Foti R, Amato G, De Lucia F, Dal Bosco Y, Foti R, Reta M, Fiorenza A, Rovera G, Marchetta A, Focherini MC, Mascella F, Bernardi S, Sandri G, Giuggioli D, Salvarani C, Franchina V, Molica Colella F, Ferrero G, Ariani A. Long-Term Retention Rate of Tofacitinib in Rheumatoid Arthritis: An Italian Multicenter Retrospective Cohort Study. Medicina (Kaunas) 2023; 59:1480. [PMID: 37629770 PMCID: PMC10456797 DOI: 10.3390/medicina59081480] [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] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
Background: Tofacitinib (TOFA) was the first Janus kinase inhibitor (JAKi) to be approved for the treatment of rheumatoid arthritis (RA). However, data on the retention rate of TOFA therapy are still far from definitive. Objective: The goal of this study is to add new real-world data on the TOFA retention rate in a cohort of RA patients followed for a long period of time. Methods: A multicenter retrospective study of RA subjects treated with TOFA as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was conducted in 23 Italian tertiary rheumatology centers. The study considered a treatment period of up to 48 months for all included patients. The TOFA retention rate was assessed with the Kaplan-Meier method. Hazard ratios (HRs) for TOFA discontinuation were obtained using Cox regression analysis. Results: We enrolled a total of 213 patients. Data analysis revealed that the TOFA retention rate was 86.5% (95% CI: 81.8-91.5%) at month 12, 78.8% (95% CI: 78.8-85.2%) at month 24, 63.8% (95% CI: 55.1-73.8%) at month 36, and 59.9% (95% CI: 55.1-73.8%) at month 48 after starting treatment. None of the factors analyzed, including the number of previous treatments received, disease activity or duration, presence of rheumatoid factor and/or anti-citrullinated protein antibody, and presence of comorbidities, were predictive of the TOFA retention rate. Safety data were comparable to those reported in the registration studies. Conclusions: TOFA demonstrated a long retention rate in RA in a real-world setting. This result, together with the safety data obtained, underscores that TOFA is a viable alternative for patients who have failed treatment with csDMARD and/or biologic DMARDs (bDMARDs). Further large, long-term observational studies are urgently needed to confirm these results.
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Affiliation(s)
- Marino Paroli
- Department of Clinical, Internist, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Andrea Becciolini
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
| | - Elena Bravi
- Rheumatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (E.B.); (E.A.); (I.P.)
| | - Romina Andracco
- Internal Medicine Unit, Imperia Hospital, 18100 Imperia, Italy; (R.A.); (N.M.)
| | - Valeria Nucera
- Rheumatology Unit, ASL Novara, 28100 Novara, Italy; (V.N.); (A.I.)
| | - Simone Parisi
- Rheumatology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy; (S.P.); (E.F.); (M.C.D.)
| | | | - Federica Lumetti
- Rheumatology Unit, Azienda USL of Modena and AOU Policlinico of Modena, 41100 Modena, Italy;
| | - Antonella Farina
- Internal Medicine Unit, Augusto Murri Hospital, 63900 Fermo, Italy;
| | - Patrizia Del Medico
- Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy;
| | - Matteo Colina
- Rheumatology Unit, Internal Medicine Division, Department of Medicine and Oncology, Santa Maria della Scaletta Hospital, 40026 Imola, Italy;
- Rheumatology Unit, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy
| | | | - Viviana Ravagnani
- Rheumatology Unit, Santa Chiara Hospital APSS—Trento, 38122 Trento, Italy;
| | - Palma Scolieri
- Rheumatology Unit, Nuovo Regina Margherita Hospital, 00154 Roma, Italy; (P.S.); (V.B.)
| | - Maddalena Larosa
- Division of Rheumatology, Department of Medical Specialties, Azienda Sanitaria Locale 3 Genovese, 16132 Genova, Italy; (M.L.); (D.C.); (G.B.)
| | - Marta Priora
- Rheumatology Unit, ASL CN1, 12100 Cuneo, Italy; (M.P.); (F.S.)
| | - Elisa Visalli
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Olga Addimanda
- Rheumatology Unit, AUSL of Bologna—Policlinico Sant’Orsola—AOU—IRCCS of Bologna, 40138 Bologna, Italy; (O.A.); (M.R.)
| | - Rosetta Vitetta
- Unit of Rheumatology, ASL VC Sant’ Andrea Hospital, 13100 Vercelli, Italy; (R.V.); (A.F.)
| | - Alessandro Volpe
- Unit of Rheumatology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy; (A.V.); (A.M.)
| | - Alessandra Bezzi
- Internal Medicine and Rheumatology Unit, AUSL della Romagna—Rimini, 47924 Rimini, Italy; (A.B.); (M.C.F.); (F.M.)
| | - Francesco Girelli
- Rheumatology Unit, G.B. Morgagni—L. Pierantoni Hospital, 47121 Forlì, Italy; (F.G.); (S.B.)
| | | | - Rosalba Caccavale
- Department of Clinical, Internist, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Eleonora Di Donato
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
| | - Giuditta Adorni
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
| | - Daniele Santilli
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
| | - Gianluca Lucchini
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
| | - Eugenio Arrigoni
- Rheumatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (E.B.); (E.A.); (I.P.)
| | - Ilaria Platè
- Rheumatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (E.B.); (E.A.); (I.P.)
| | - Natalia Mansueto
- Internal Medicine Unit, Imperia Hospital, 18100 Imperia, Italy; (R.A.); (N.M.)
| | - Aurora Ianniello
- Rheumatology Unit, ASL Novara, 28100 Novara, Italy; (V.N.); (A.I.)
| | - Enrico Fusaro
- Rheumatology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy; (S.P.); (E.F.); (M.C.D.)
| | - Maria Chiara Ditto
- Rheumatology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy; (S.P.); (E.F.); (M.C.D.)
| | - Vincenzo Bruzzese
- Rheumatology Unit, Nuovo Regina Margherita Hospital, 00154 Roma, Italy; (P.S.); (V.B.)
| | - Dario Camellino
- Division of Rheumatology, Department of Medical Specialties, Azienda Sanitaria Locale 3 Genovese, 16132 Genova, Italy; (M.L.); (D.C.); (G.B.)
| | - Gerolamo Bianchi
- Division of Rheumatology, Department of Medical Specialties, Azienda Sanitaria Locale 3 Genovese, 16132 Genova, Italy; (M.L.); (D.C.); (G.B.)
| | | | - Rosario Foti
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Giorgio Amato
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Francesco De Lucia
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Ylenia Dal Bosco
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Roberta Foti
- Rheumatology Unit, Policlinico San Marco Hospital, 95121 Catania, Italy; (E.V.); (R.F.); (G.A.); (F.D.L.); (Y.D.B.); (R.F.)
| | - Massimo Reta
- Rheumatology Unit, AUSL of Bologna—Policlinico Sant’Orsola—AOU—IRCCS of Bologna, 40138 Bologna, Italy; (O.A.); (M.R.)
| | - Alessia Fiorenza
- Unit of Rheumatology, ASL VC Sant’ Andrea Hospital, 13100 Vercelli, Italy; (R.V.); (A.F.)
| | - Guido Rovera
- Unit of Rheumatology, ASL VC Sant’ Andrea Hospital, 13100 Vercelli, Italy; (R.V.); (A.F.)
| | - Antonio Marchetta
- Unit of Rheumatology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Italy; (A.V.); (A.M.)
| | - Maria Cristina Focherini
- Internal Medicine and Rheumatology Unit, AUSL della Romagna—Rimini, 47924 Rimini, Italy; (A.B.); (M.C.F.); (F.M.)
| | - Fabio Mascella
- Internal Medicine and Rheumatology Unit, AUSL della Romagna—Rimini, 47924 Rimini, Italy; (A.B.); (M.C.F.); (F.M.)
| | - Simone Bernardi
- Rheumatology Unit, G.B. Morgagni—L. Pierantoni Hospital, 47121 Forlì, Italy; (F.G.); (S.B.)
| | - Gilda Sandri
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.S.); (D.G.); (C.S.)
| | - Dilia Giuggioli
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.S.); (D.G.); (C.S.)
| | - Carlo Salvarani
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy; (G.S.); (D.G.); (C.S.)
| | - Veronica Franchina
- Medical Oncology Unit, Azienda Ospedaliera Papardo, 98158 Messina, Italy;
| | | | - Giulio Ferrero
- Unit of Diagnostic and Interventional Radiology, Santa Corona Hospital, 17027 Pietra Ligure, Italy;
| | - Alarico Ariani
- Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy; (A.B.); (E.D.D.); (G.A.); (D.S.); (G.L.); (A.A.)
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Lo Gullo A, Becciolini A, Parisi S, Del Medico P, Farina A, Visalli E, Dal Bosco Y, Molica Colella AB, Lumetti F, Caccavale R, Scolieri P, Andracco R, Girelli F, Bravi E, Colina M, Volpe A, Ianniello A, Ditto MC, Nucera V, Franchina V, Platé I, Di Donato E, Amato G, Salvarani C, Bernardi S, Lucchini G, De Lucia F, Molica Colella F, Santilli D, Mansueto N, Ferrero G, Marchetta A, Arrigoni E, Foti R, Sandri G, Bruzzese V, Paroli M, Fusaro E, Ariani A. Therapeutic Effects of Apremilast on Enthesitis and Dactylitis in Real Clinical Setting: An Italian Multicenter Study. J Clin Med 2023; 12:3892. [PMID: 37373587 DOI: 10.3390/jcm12123892] [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: 04/14/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Enthesitis and dactylitis are difficult-to-treat features of psoriatic arthritis (PsA), leading to disability and affecting quality of life. OBJECTIVE The aim of this study is to evaluate enthesitis (using the Leed enthesitis index (LEI)) and dactylitis at 6 and 12 months in patients treated with apremilast. METHODS Patients affected by PsA from fifteen Italian rheumatological referral centers were screened. The inclusion criteria were: (a) enthesitis or dactylitisphenotype; (b) treatment with apremilast 30 mg bid. Clinical and treatment history, including PsA disease activity, were recorded. Mann-Whitney and chi-squared tests were used to assess the differences between independent groups, and Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. A p-value of <0.05 was considered statistically significant. RESULTS The Eph cohort consisted of 118 patients (median LEI 3); the Dph cohort included 96 patients with a median dactylitis of 1 (IQR 1-2). According to an intention to treat analysis, 25% and 34% of patients with enthesitis achieved remission (i.e., LEI = 0) in T1 and T2. The remission of dactylitis was 47% in T1 and 44% in T2. The per protocol analysis (patients observed for at least 12 months) showed that both dactylitis and LEI significantly improved in T1 (median LEI 1 (IQR 1-3)) and T2 (median LEI 0 (IQR 1-2)). CONCLUSION Eph and Dph PsA patients treated with apremilast experienced a significant improvement in enthesitis and dactylitis activity. After 1 year, enthesitis and dactylitis remission was achieved in more than one-third of patients.
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Affiliation(s)
- Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS "Garibaldi", 95124 Catania, Italy
| | - Andrea Becciolini
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
| | - Simone Parisi
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Patrizia Del Medico
- Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy
| | - Antonella Farina
- Internal Medicine Unit, Ospedale Augusto Murri-Fermo, 63900 Fermo, Italy
| | - Elisa Visalli
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
| | | | | | - Federica Lumetti
- Unit of Rheumatology, Azienda Unità Sanitaria Locale di Modena, 41121 Modena, Italy
| | - Rosalba Caccavale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy
| | - Palma Scolieri
- Unit of Internal Medicine and Rheumatology, ASL Roma 1-Presidio Nuovo Regina Margherita, 00153 Roma, Italy
| | | | - Francesco Girelli
- Internal Medicine Unit, Ospedale "Morgagni-Pierantoni" di Forlì, 47121 Forlì, Italy
| | - Elena Bravi
- Department of Rheumatology, Ospedale "Guglielmo da Saliceto", 29121 Piacenza, Italy
| | - Matteo Colina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-Università di Bologna, 40136 Bologna, Italy
| | - Alessandro Volpe
- Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | | | - Maria Chiara Ditto
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | | | | | - Ilaria Platé
- Department of Rheumatology, Ospedale "Guglielmo da Saliceto", 29121 Piacenza, Italy
| | - Eleonora Di Donato
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
| | - Giorgio Amato
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
| | - Carlo Salvarani
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Simone Bernardi
- Internal Medicine Unit, Ospedale "Morgagni-Pierantoni" di Forlì, 47121 Forlì, Italy
| | - Gianluca Lucchini
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
| | | | | | - Daniele Santilli
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
| | | | | | - Antonio Marchetta
- Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Eugenio Arrigoni
- Department of Rheumatology, Ospedale "Guglielmo da Saliceto", 29121 Piacenza, Italy
| | - Rosario Foti
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
| | - Gilda Sandri
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Vincenzo Bruzzese
- Unit of Internal Medicine and Rheumatology, ASL Roma 1-Presidio Nuovo Regina Margherita, 00153 Roma, Italy
| | - Marino Paroli
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy
| | - Enrico Fusaro
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Alarico Ariani
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
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Franchina V, Stabile S, Cenna R, Mannozzi F, Federici I, Testoni S, Sinno V, Cagnazzo C. ISO 9001:2015 standard implementation in clinical trial centers: An exploratory analysis of benefits and barriers in Italy. Contemp Clin Trials Commun 2023. [DOI: 10.1016/j.conctc.2023.101104] [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: 03/13/2023] Open
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Becciolini A, Parisi S, Del Medico P, Farina A, Visalli E, Molica Colella AB, Lumetti F, Caccavale R, Scolieri P, Andracco R, Girelli F, Bravi E, Colina M, Volpe A, Ianniello A, Ditto MC, Nucera V, Franchina V, Platè I, Donato ED, Amato G, Salvarani C, Bernardi S, Lucchini G, De Lucia F, Molica Colella F, Santilli D, Mansueto N, Ferrero G, Marchetta A, Arrigoni E, Foti R, Sandri G, Bruzzese V, Paroli M, Fusaro E, Ariani A. Predictors of DAPSA Response in Psoriatic Arthritis Patients Treated with Apremilast in a Retrospective Observational Multi-Centric Study. Biomedicines 2023; 11:biomedicines11020433. [PMID: 36830969 PMCID: PMC9953385 DOI: 10.3390/biomedicines11020433] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To date, only a few real-world-setting studies evaluated apremilast effectiveness in psoriatic arthritis (PsA). The aims of this retrospective observational study are to report long-term Disease Activity Index for Psoriatic Arthritis (DAPSA) response of apremilast in PsA patients and to analyze the predictors of clinical response. METHODS All PsA consecutive patients treated with apremilast in fifteen Italian rheumatological referral centers were enrolled. Anamnestic data, treatment history, and PsA disease activity (DAPSA) at baseline, 6 months, and 12 months were recorded. The Mann-Whitney test and chi-squared tests assessed the differences between independent groups, whereas the Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. Logistic regressions verified if there were factors associated with achievement of DAPSA low disease activity or remission at 6 and 12 months. RESULTS DAPSA low disease activity or remission rates at 6 and 12 months were observed, respectively, in 42.7% (n = 125) and 54.9% (n = 161) patients. Baseline DAPSA was inversely associated with the odds of achieving low disease activity or remission at 6 months (odds ratio (OR) 0.841, 95% confidence interval (CI) 0.804-0.879; p < 0.01) and at 12 months (OR 0.911, 95% CI 0.883-0.939; p < 0.01). CONCLUSIONS Almost half of the PsA patients receiving apremilast achieved DAPSA low disease activity or remission at 6 and 12 months. The only factor associated with achievement of low disease activity or remission at both 6 and 12 months was baseline DAPSA.
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Affiliation(s)
- Andrea Becciolini
- Internal Medicine and Rheumatology Unit, Department of Medicine, University Hospital of Parma, 43121 Parma, Italy
| | - Simone Parisi
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliera Universitaria, Città della Salute e della Scienza di Torino, 10121 Turin, Italy
| | - Patrizia Del Medico
- Rheumatology Outpatient Clinic, Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy
| | - Antonella Farina
- Internal Medicine Unit, Rheumatology Outpatient Clinic, Ospedale “A. Murri”, 63900 Fermo, Italy
| | - Elisa Visalli
- Rheumatology Unit, Policlinico San Marco University Hospital of Catania, 95121 Catania, Italy
| | | | - Federica Lumetti
- Rheumatology Unit, Azienda USL of Modena and AOU Policlinico of Modena, 41100 Modena, Italy
| | - Rosalba Caccavale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Palma Scolieri
- Unit of Internal Medicine and Rheumatology, “Nuovo Regina Margherita/S. Spirito” Hospital, ASL Roma 1, 00153 Rome, Italy
| | - Romina Andracco
- Distretto Socio Sanitario ASL 1 Imperiese, 18100 Imperia, Italy
| | - Francesco Girelli
- Rheumatology Service, Internal Medicine Unit, GB Morgagni Hospital, 47121 Forli, Italy
| | - Elena Bravi
- Rheumatology Unit, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Matteo Colina
- Rheumatology Service, Section of Internal Medicine, Department of Medicine and Oncology, Ospedale Santa Maria della Scaletta, 40026 Imola, Italy
- Alma Mater Studiorum, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Alessandro Volpe
- Rheumatology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Bologna, Italy
| | | | - Maria Chiara Ditto
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliera Universitaria, Città della Salute e della Scienza di Torino, 10121 Turin, Italy
| | - Valeria Nucera
- Rheumatology Outpatient Unit, ASL Novara, 28100 Novara, Italy
| | | | - Ilaria Platè
- Rheumatology Unit, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Eleonora Di Donato
- Internal Medicine and Rheumatology Unit, Department of Medicine, University Hospital of Parma, 43121 Parma, Italy
| | - Giorgio Amato
- Rheumatology Unit, Policlinico San Marco University Hospital of Catania, 95121 Catania, Italy
| | - Carlo Salvarani
- Rheumatology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Simone Bernardi
- Rheumatology Service, Internal Medicine Unit, GB Morgagni Hospital, 47121 Forli, Italy
| | - Gianluca Lucchini
- Internal Medicine and Rheumatology Unit, Department of Medicine, University Hospital of Parma, 43121 Parma, Italy
| | - Francesco De Lucia
- Rheumatology Unit, Policlinico San Marco University Hospital of Catania, 95121 Catania, Italy
| | | | - Daniele Santilli
- Internal Medicine and Rheumatology Unit, Department of Medicine, University Hospital of Parma, 43121 Parma, Italy
| | | | - Giulio Ferrero
- Unit of Diagnostic and Interventional Radiology, Santa Corona Hospital, 17027 Pietra Ligure, Italy
| | - Antonio Marchetta
- Rheumatology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Bologna, Italy
| | - Eugenio Arrigoni
- Rheumatology Unit, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Rosario Foti
- Rheumatology Unit, Policlinico San Marco University Hospital of Catania, 95121 Catania, Italy
| | - Gilda Sandri
- Rheumatology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Vincenzo Bruzzese
- Unit of Internal Medicine and Rheumatology, “Nuovo Regina Margherita/S. Spirito” Hospital, ASL Roma 1, 00153 Rome, Italy
| | - Marino Paroli
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Department of General and Specialistic Medicine, Azienda Ospedaliera Universitaria, Città della Salute e della Scienza di Torino, 10121 Turin, Italy
| | - Alarico Ariani
- Internal Medicine and Rheumatology Unit, Department of Medicine, University Hospital of Parma, 43121 Parma, Italy
- Correspondence: ; Tel.: +39-05-2170-4798
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Franchina T, Ficarra G, Fugazzotto D, Bitto A, Magaudda L, Trimarchi F, Di Mauro D, Zarzana M, Cacciola F, Aspria P, Franchina V, Adamo V. EP10.01-019 Rowing Against Cancer: From a Support Project to a Research Program. Perspectives and Challenges of Rowing in Metastatic Lung Cancer Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.896] [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: 11/17/2022]
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Ariani A, Parisi S, Del Medico P, Farina A, Visalli E, Molica Colella A, Lumetti F, Caccavale R, Scolieri P, Andracco R, Girelli F, Bravi E, Colina M, Franchina V, Platé I, DI Donato E, Amato G, Salvarani C, De Lucia F, Santilli D, Arrigoni E, Mozzani F, Foti R, Sandri G, Bruzzese V, Paroli M, Fusaro E, Becciolini A. POS1027 APREMILAST EFFICACY IN REAL WORLD SETTINGS: RESULTS FROM AN ITALIAN MULTI-CENTER OBSERVATIONAL STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1300] [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: 11/03/2022]
Abstract
BackgroundApremilast, an inhibitor of the phosphodiesterase 4, is indicated for Psoriatic Arthritis (PsA) treatment. The 3 years retention rate, an outcome indirectly related to efficacy, observed in clinical trials [1] is 55,5%. A single subsequent real world setting study [2] suggested a lower efficacy as it reported that the six months retention rate was about 57%.ObjectivesThe main aim of this retrospective observational study is the assessment of apremilast 3 years retention rate in a real world PsA patients’ cohort. Moreover, the secondary objective is reporting the reasons of apremilast suspension and the most relevant factor related to treatment persistence.MethodsIn thirteen Italian rheumatological referral centers, all PsA consecutive patients who received apremilast were enrolled. Anamnestic data, treatment history and PsA disease activity (DAPSA) at baseline and after 6 and 12 months were recorded. The Kaplan-Meier curve and the Cox analysis computed the apremilast retention rate and treatment persistence-related risk factors. A p-value < 0.05 was considered statistically significant.ResultsThe three-hundred-twenty-four enrolled patients (median age 60 [InterQuartile Range IQR 52-67] yrs; female prevalence 57,0%) median observation period was 17 [IQR 7-36] months (6848 patients-months). The apremilast retention rate at 6, 12 and 36 months was, respectively, 95%, 86% and 66% (Figure 1). The main discontinuation reasons were: primary inefficacy (40% of interruptions), secondary inefficacy (18%) and gastro-intestinal intolerance (17%%). The oligo-articular onset was the only factor associated to apremilast persistence (Hazard ratio 0.57 IQR 0.34-0.96). Sex, age, and sever comorbidities (cancer, chronic infections etc) were not related to treatment discontinuation. The basal DAPSA (24.1, IQR 18.5-32.0) decreased after 6 and 12 months (respectively 14.5, IQR 10.1-22.6 and 10.5, IQR 8,0-15.2). Remission or minimal disease activity (DAPSA < 15) was achieved after 12 months in 38.0% of patients.ConclusionAlmost two third of PsA patients receiving apremilast were still in treatment after 3 years. The study’s data, confirmed its efficacy and safety profile. Apremilast appear a good treatment choice in patients with oligo articular PsA or burdened by severe comorbidities.References[1]Mease et al. ACR Open Rheumatology (2020)[2]Favalli et al Clin Exp Rheum (2020)Disclosure of InterestsAlarico Ariani Speakers bureau: Zentiva, Consultant of: Boeringher, Amgen, Bristol-Meyers-Squibb, Novartis, Sanofi, Novo Nordisk, Lilly, Janssen, Bruno Farmaceutici, Simone Parisi: None declared, Patrizia Del Medico: None declared, antonella farina: None declared, elisa visalli: None declared, Aldo Molica Colella: None declared, Federica Lumetti Consultant of: Amgen, rosalba caccavale: None declared, Palma Scolieri: None declared, Romina Andracco: None declared, Francesco Girelli: None declared, Elena Bravi: None declared, Matteo Colina: None declared, Veronica Franchina: None declared, Ilaria Platé: None declared, eleonora Di Donato Consultant of: Novartis, Giorgio Amato: None declared, Carlo Salvarani: None declared, Francesco De Lucia: None declared, Daniele Santilli Consultant of: Novartis, eugenio arrigoni: None declared, Flavio Mozzani Consultant of: Novartis, Abbvie, Rosario Foti: None declared, Gilda Sandri: None declared, Vincenzo Bruzzese: None declared, Marino Paroli: None declared, Enrico Fusaro: None declared, Andrea Becciolini: None declared
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Cagnazzo C, Franchina V, Toscano G, Fagioli F, Franchina T, Ricciardi G, Antonuzzo L, Di Costanzo A, Russo A, Cusenza S, Gori S, Marchetti F, Tambaro M, Piccirillo P, Nanni O, Delfanti S, Di Maio M, D'Ascanio F, Adamo V. 1497P Cancer patients’ awareness about clinical research: The ELPIS study preliminary results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.825] [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] Open
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Cagnazzo C, Franchina V, Toscano G, Fagioli F, Franchina T, Ricciardi GRR, Antonuzzo L, Di Costanzo A, Russo A, Cusenza S, Gori S, Marchetti F, Tambaro M, Piccirillo P, Nanni O, Cenna R, Delfanti S, Di Maio M, Dascanio F, Adamo V. Cancer patients’ awareness about clinical research in the era of social media and “fake news”: Preliminary results from ELPIS Study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e24121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24121 Background: Barriers for low recruitment in clinical trials have been classified based on three main sources: physician, patient, system. A primary role is played by a low patient awareness, which often leads to a lack of confidence in science and a substantial inability to estimate the benefits deriving from trial participation, aggravated by the spread of fake news. A prospective observational study was conducted to investigate the views of cancer patients on aspects of clinical research, their expectations, the level of comprehensibility of informed consent and the impact of the fake news phenomenon. Methods: From January 2018, after Ethics Committees approval, the ELPIS study was initiated in 9 Italian Medical Oncology Units. After signing the informed consent, patients were asked to complete a questionnaire, consisting of a set of multiple choice and Likert-score questions. Results: As of January 2021, 115 patients were enrolled, with a balanced sex distribution and a prevalence of subjects older than 55-years (79.8%). Regarding the previous knowledge about clinical research, the average score was 3.9 (range 1-5). The vast majority of respondents (91.3%) had already started experimental therapy and many of them constantly used internet (65.2%) and social networks (34.8%). More than half (53.9%) stated the interview with the physician was sufficient for a full understanding of informed consent. In case of doubt, the majority seeked support in the clinician (39.1%) while very few (1.7%) relied on the web. The average score attributed to doctor-patient relationship was equal to 8.89 (range 1-10). Respondents were quite confident in their ability to independently search for information on their disease, discriminate fake news and identify reliable sites (average score 3.26, 3.27, 3.09 respectively, over a range of 1-5). The scores related to the presumed ability to understand the results of a clinical study and to actively collaborate to produce research were high (average score 4.72 and 4.39 over a range of 1-5). Conclusions: Preliminary data from our research show a good level of patient awareness and a fine ability to understand information, discerning real from fake news. Continuing and implementing the training initiatives of the population in the health sector will certainly contribute to further improvement, hopefully obtaining an even greater involvement of patients in the early phases of research.
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Affiliation(s)
- Celeste Cagnazzo
- Department of Sciences of Public Health and Pediatrics - University of Turin & Division of Pediatric Onco-Hematology, Regina Margherita Hospital, Turin, Italy
| | | | | | - Franca Fagioli
- Department of Sciences of Public Health and Pediatrics - University of Turin & Division of Pediatric Onco-Hematology, Regina Margherita Hospital, Turin, Italy
| | | | | | | | | | - Antonio Russo
- Unit of Medical Oncology-Department of Oncology-AOUP, Palermo, Italy
| | - Stefania Cusenza
- Unit of Medical Oncology-Department of Oncology-AOUP, Palermo, Italy
| | - Stefania Gori
- Oncology Unit, Ospedale Sacro Cuore-don Calabria, Negrar, Italy
| | - Fabiana Marchetti
- Oncology Unit, Ospedale Sacro Cuore-don Calabria, Negrar (VR), Italy
| | - Margherita Tambaro
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Patrizia Piccirillo
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Rosita Cenna
- Division of Pediatric Onco-Hematology, Regina Margherita Hospital, Turin, Italy
| | - Sara Delfanti
- Division of Medical Oncology, SS. Antonio e Biagio General Hospital, Alessandria, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, AO Ordine Mauriziano, Turin, Italy
| | - Fabio Dascanio
- Department of Oncology, University of Turin, AO Ordine Mauriziano, Turin, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit-A.O. Papardo, Messina and Department of Human Pathology University of Messina, Messina, Italy
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Franchina V, Franchina T, Ricciardi G, Adamo V. P39.09 Social Media Support of Lung Cancer Patient Associations During the Lockdown Restrictions in Italy: A Breath of Life During the COVID-19 Pandemic. J Thorac Oncol 2021. [PMCID: PMC8885112 DOI: 10.1016/j.jtho.2021.01.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Franchina V, Cagnazzo C, Di Costanzo A, Arizio F, Frazzetto AME, Gori S, Cenna R, Nicolis F, Procopio G, Adamo V, La Verde N, Nanni O. Patient associations and clinical oncology research: how much does a patient's voice really matter? Expert Rev Pharmacoecon Outcomes Res 2020; 21:433-440. [PMID: 33201731 DOI: 10.1080/14737167.2021.1850274] [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: 10/23/2022]
Abstract
Background: New trends are emerging in clinical research, such as patient empowerment and an active role in influencing health and research ethics. Patients' involvement is considered pivotal by stakeholders and institutions because they can channel the voice of those they represent, empowering their starring role in the different research activities.Objectives: To obtain an overview of the real involvement of Italian patient associations in clinical research.Methods: In January 2019, the Working Group 'Clinical Research Coordinators' of the Italian Association of Medical Oncology spread an online questionnaire consisting of 16 questions on the active involvement of patient associations in clinical research.Results: The involvement in clinical research working groups, in the organization and implementation of specific activities and training initiatives is very limited (21.7% in both cases), as well as the active involvement in the conduct and/or definition of clinical trials (0.3%). Moreover, few associations (15.2%) have joined projects on patient involvement in clinical research in collaboration with other associations.Discussion: Although the current involvement of the associations may have been somewhat underestimated, there is no doubt that much more can be done in terms of training and identification of common objectives between patients and professionals.
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Affiliation(s)
| | - Celeste Cagnazzo
- Unità Di Ricerca E Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città Della Salute E Della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento Di Scienze Della Sanità Pubblica E Pediatriche, Università Degli Studi Di Torino, Turin, Italy
| | | | | | | | - Stefania Gori
- Oncologia, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Rosita Cenna
- Unità Di Ricerca E Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città Della Salute E Della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento Di Scienze Della Sanità Pubblica E Pediatriche, Università Degli Studi Di Torino, Turin, Italy
| | - Fabrizio Nicolis
- Direzione Sanitaria, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Giuseppe Procopio
- Struttura Semplice Oncologia Medica Genitourinaria, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milano, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit, A.O. Papardo Messina, Messina, Italy.,Department of Human Pathology, University of Messina, Messina, Italy
| | - Nicla La Verde
- Oncologia, Ospedale Luigi Sacco - Polo Universitario, Milano, Italy
| | - Oriana Nanni
- Biostatistics and Clinical Trial Unit, Istituto Scientifico Romagnolo per Lo Studio E La Cura Dei Tumori (IRST) Srl, IRCCS, Meldola, Italy
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Adamo V, Ricciardi GRR, Giuffrida D, Scandurra G, Russo A, Blasi L, Spadaro P, Iacono C, Soto Parra HJ, Savarino A, Ferraú F, Zerilli F, Verderame F, Butera A, Santangelo C, Franchina V, Caruso M. Eribulin mesylate use as third-line therapy in patients with metastatic breast cancer (VESPRY): a prospective, multicentre, observational study. Ther Adv Med Oncol 2019; 11:1758835919895755. [PMID: 31903098 PMCID: PMC6923689 DOI: 10.1177/1758835919895755] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 03/29/2019] [Accepted: 11/15/2019] [Indexed: 11/15/2022] Open
Abstract
Background In real-world practice, eribulin mesylate provides significant survival benefit, with a manageable safety profile in heavily pretreated patients with metastatic breast cancer (MBC). Methods In this prospective, open-label, multicentre, observational study we evaluated the effectiveness and tolerability of eribulin as third-line treatment in a homogeneous population. The primary endpoints were the safety profile and response in metastatic sites; secondary endpoints included the response in different subtypes, overall response rate (ORR), progression-free survival (PFS) and overall survival (OS). Results From 2013 to 2016, 118 women were treated in 21 Sicilian institutions; the median age was 58 years (range 29-79), with 69% of patients under 65. The median cycles of eribulin were 5.5 (range 1-26). The most common adverse event was neutropenia (9.3%, 3 cases of grade 3, 4 of grade 4); only 1 case of QT prolongation was reported. Eribulin was effective in controlling metastatic disease in all sites, and it achieved the highest ORR in brain (16%) and liver (14.9%). Median OS was 31.8 months (95% CI 27.9-34.4) and median PFS 5.5 months (95% CI 4.2-6.6). PFS was 5.2 months (95% CI 2.8-8.4) in patients with triple-negative subtype. Median PFS was longer in patients over 65 years (6.1 months, 95% CI 4.4-8.3). In patients who had visceral metastases PFS was 5.5 months (95% CI 95% 3.5-6.6) and OS 33.9 months (95% CI 29.8-40.8). Conclusions Eribulin as third-line treatment shows an acceptable safety profile and a substantial antitumour activity in the treatment of MBC, even in elderly patients and in those with visceral disease.
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Affiliation(s)
- Vincenzo Adamo
- Medical Oncology Unit A.O. Papardo and Department of Human Pathology University of Messina, Contrada Papardo, Messina, Italy
| | | | - Dario Giuffrida
- Department of Medical Oncology, Mediterranean Institute of Oncology, Viagrande, CT, Italy
| | | | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Livio Blasi
- UOC Oncologia Medica, ARNAS Civico, Palermo, Piazza Nicola Leotta, Italy
| | - Pietro Spadaro
- U.O. di Oncologia ed Ematologia, Casa di Cura Villa Salus, Messina, Italy
| | - Carmelo Iacono
- Medical Oncology Department, Ospedale Maria Paterno Arezzo, Ragusa, Italy
| | - Hector J Soto Parra
- Medical Oncology Department, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - Antonino Savarino
- Unità Operativa di Oncologia, Ospedale "Barone Lombardo" di Canicattì, Contrada Giarre, Canicattì, AG, Italy
| | - Francesco Ferraú
- Medical Oncology Department, Ospedale S Vincenzo, Taormina, ME, Italy
| | | | | | | | | | - Veronica Franchina
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology University of Messina, Contrada Papardo, Messina, Italy
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Franchina T, Russo A, Ricciardi G, Franchina V, Adamo V. P2.16-38 Efficacy and Safety of Target Therapy and Immunotherapy in Advanced NSCLC in Elderly: A Systematic Review of Real World Studies. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cagnazzo C, Nanni O, Arizio F, Franchina V, Cenna R, Tabaro G, Vannini F, Procopio G, Gori S, Di Costanzo A. Phase I studies: a test bench for Italian clinical research. Tumori 2019; 106:295-300. [PMID: 31394978 DOI: 10.1177/0300891619868008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The Agenzia Italiana del Farmaco (AIFA) Determination 809/2015 sets all the requirements that clinical units and laboratories must meet in order to conduct phase I studies. Requirements include buildings, equipment, personnel, emergency management, as well as quality requirements defined in a set of standard operating procedures. METHODS In September 2018, the Italian Association of Medical Oncology working group, Clinical Research Coordinator, created an anonymous survey addressed to 51 medical directors of oncologic/hematologic clinical phase I units and all medical directors of generic and transversal units located in Italy and listed at the AIFA website. RESULTS Questionnaires from 24 institutions were collected, 9 previously inspected by competent authorities. All surveyed structures are certified to conduct profit studies and 1 is authorized to include healthy volunteers; 15 units implemented a Clinical Trial Quality Team in order to conduct nonprofit studies. At the time of data collection, a total of 398 proposals for phase I trials have been received, more than 50% coming from 3 institutes. A total of 144 phase I studies were active, with a median of 2.5 (Q1-Q3=0-6) studies for each center and asymmetric distribution of proposals. CONCLUSION The considerable number of proposals received from the interviewed centers indicates that Italy plays an important role in the international pharmaceutical scene, despite bureaucratic procedures that threaten exclusion from decision-making. The AIFA Determination will be an important opportunity to acquire a competitive working approach.
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Affiliation(s)
- Celeste Cagnazzo
- Unità di Ricerca e Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città della Salute e della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Oriana Nanni
- Biostatistics and Clinical Trial Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl, IRCCS, Meldola, Italy
| | | | | | - Rosita Cenna
- Unità di Ricerca e Sviluppo Clinico S.C. Oncoematologia Pediatrica, AOU Città della Salute e della Scienza Presidio Ospedaliero Infantile Regina Margherita, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Gianna Tabaro
- CTO/Direzione Scientifica, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS
| | | | - Giuseppe Procopio
- Struttura Semplice Oncologia Medica Genitourinaria, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Stefania Gori
- Oncologia, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
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Franchina V, Ceravolo F, Franchina T, Ricciardi G, Adamo V. Photography as a therapeutic tool to re-elaborate “cancer” experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx434.022] [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: 11/14/2022] Open
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Adamo V, Ricciardi G, Giuffrida D, Scandurra G, Russo A, Blasi L, Spadaro P, Lucenti A, Soto Parra HJ, Savarino A, Ferraú F, Zerilli F, Verderame F, Butera A, Franchina V, Cottini L, Fedele G, Caruso M. Multicenter study of the evaluation of eribulin (E) use in Sicily in metastatic breast cancer (MBC): A prospective registry (VESPRY trial). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e12565] [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: 11/20/2022] Open
Abstract
e12565 Background: Eribulin Mesylate is a non taxane microtubule dynamics inhibitor, approved for heavily-pretreated MBC patients (pts). Methods: This is a multicenter, prospective, single arm study for E-treatment of third line in pretreated MBC pts, conducted in 14 oncology centers in Sicily. All pts had received two previous chemotherapy regimens for MBC. Pts received E at 1.23 mg/m2 on days 1,8 every 3 weeks until progression. Primary Endpoints: overall response rate (ORR) according to the site of metastases and safety. Secondary objectives: Progression-free survival (PFS) and ORR according to different subtypes. PFS curve was estimated using the Kaplan-Meier method. Multivariable logistic regression model were used to evaluate the associations of each variables with tumor response. ORR was assessed according to RECIST 1.1 and safety with CTCAE v4.0. Results: 122 pts were enrolled and received at least 1 dose of E. Median age was 58 (range 29-79). All received previously anthracycline and taxane based-therapies. Subtypes: Luminal A 69%, Luminal B 7%, HER2 enriched 4% and Triple Negative 20%. The most common metastatic sites were bone and liver; 67% had metastatic disease involving two or more organs. A median of 5 cycles of E (range 1-26) was administrated. 106/122 pts were evaluable for efficacy, all for safety. ORR was 48%. Exploratory subset analysis showed significantly higher ORR in the lung, liver and bone lesions compared to other site of metastases and in HER2 negative pts. Multivariable regression model showed that HER2 positive subtype was correlated with a poor response (odd ratio 6.7, 95% CI 1.2-36.5). The median PFS was 14.7 months (mos) (95% CI 7.2–25.7). Among pts with < 65 and ≥ 65 years, the median PFS was 14.7 and 25.7 mos, respectively. Most common toxicities: G2 diarrhea 1%, asthenia G1 4%, G2 neutropenia 6%, G1 neurotoxicity 5%, QT prolongation 1%, G4 mucositis in only one case. Conclusions: This study showed a significant improved of PFS with E in third line setting and a favorable safety profile compared with results reported in the pivotal trial. Our findings suggest that E has substantial antitumor activity when used early for the treatment for MBC with acceptable safety.
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Affiliation(s)
- Vincenzo Adamo
- Medical Oncology Unit-A.O. Papardo, Messina and Department of Human Pathology University of Messina, Italy, Messina, Italy
| | - Giuseppina Ricciardi
- Medical Oncology Unit-A.O. Papardo, Messina and Department of Human Pathology University of Messina, Italy, Messina, Italy
| | | | | | - Antonio Russo
- Department of Surgical, Oncological, and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Livio Blasi
- UOC Oncologia Medica, ARNAS Civico, Palermo, Italy
| | | | | | - Hector J. Soto Parra
- Medical Oncology, University Hospital Policlinico, Vittorio Emanuele, Catania, Italy
| | | | - Francesco Ferraú
- Medical Oncology Department, Ospedale S Vincenzo, Taormina, Italy
| | | | | | | | - Veronica Franchina
- Medical Oncology Unit A.O. Papardo and Department of Human Pathology University of Messina, Messina, Italy
| | | | - Guido Fedele
- Biostatistic, High Research CRO, Milano, Milano, Italy
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Franchina T, Novello S, Russo A, Gianetta M, Capelletto E, Galetta D, Catino A, Migliorino MR, Ricciardi S, Morgillo F, Della Corte CM, Rocco D, Parra HS, Russo A, Ambrosio F, Franchina V, Adamo V. P1.06-046 Can We Better Manage Advanced NSCLC in the Elderly with the New Therapeutic Agents? Preliminary Analysis of a Real-Life Multicenter Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.910] [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: 10/20/2022]
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Franchina V, Ceravolo F, Franchina T, Ricciardi G, Adamo V. Patient-caregiver relationship in cancer movies of the last ten years: “and the winner is”…the hope! Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.09] [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: 11/13/2022] Open
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Russo A, Franchina T, Picone A, Raiti F, Ricciardi G, Franchina V, Ferraro G, Scimone A, Toscano G, Adamo V. Epidermal Growth Factor Receptor mutational status predicts patterns of metastatic spread in treatment-naïve Adenocarcinomas of the lung. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.44] [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: 11/14/2022] Open
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Adamo V, Ricciardi G, Franchina V, Ferraro G, Caruso M, Bronte G, Banna G, Spadaro P, Savarino A, Iacono C, Soto Parra H, Spada M, Safina V, Blasi L, Zerilli F, Prestifilippo A, Giannitto-Giorgio C, Alberio D, Cottini L, Russo A. Multicenter study of the eValuation of Eribulin (E) use in Sicily in metastatic breast cancer (MBC): A Prospective RegistrY (VESPRY trial). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.57] [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: 11/12/2022] Open
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Adamo V, Ricciardi GRR, Franchina V, Ferraro G, Caruso M, Bronte G, Banna GL, Spadaro P, Savarino A, Iacono C, Soto Parra HJ, Spada M, Safina V, Blasi L, Zerilli F, Prestifilippo A, Giannitto-Giorgio C, Alberio D, Cottini L, Russo A. Multi-istitutional study of the evaluation of eribulin (E) use in Sicily in metastatic breast cancer (MBC): A prospective registry (VESPRY trial). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e12023] [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: 11/20/2022] Open
Affiliation(s)
- Vincenzo Adamo
- Medical Oncology Unit AOOR Papardo-Piemonte, Department of Human Pathology, University of Messina, Messina, Italy
| | | | - Veronica Franchina
- Medical Oncology Unit AOOR Papardo-Piemonte, Department of Human Pathology, University of Messina, Messina, Italy
| | - Giuseppa Ferraro
- Medical Oncology Unit AOOR Papardo-Piemonte, Department of Human Pathology, University of Messina, Messina, Italy
| | | | - Giuseppe Bronte
- Section of Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | | | | | | | - Carmelo Iacono
- Medical Oncology Unit, M. Paternò Hospital, Ragusa, Italy
| | - Hector J. Soto Parra
- Medical Oncology, University Hospital Policlinico, Vittorio Emanuele, Catania, Italy
| | | | | | - Livio Blasi
- UOC Oncologia Medica, ARNAS Civico, Palermo, Italy
| | | | | | | | | | | | - Antonio Russo
- Medical Oncology Unit, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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Russo A, Franchina T, Picone A, Ferraro G, Picciotto M, Zanghì M, Franchina V, Adamo V. Different Metastatic Pattern According to the EGFR Mutational Status in a Cohort of Lung Adenocarcinomas (ADCS): a Single-Institution Report. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv051.03] [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: 11/13/2022] Open
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Caprino L, Borrelli F, Falchetti R, Biader U, Franchina V. A new computerized system for automatic ECG analysis: an application to hypoxic rat ECG's. Comput Biomed Res 1978; 11:195-207. [PMID: 354861 DOI: 10.1016/0010-4809(78)90031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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