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Simmonds WM, Awuku Y, Barrett C, Brand M, Davidson K, Epstein D, Fredericks E, Gabriel S, Grobler S, Gounden C, Katsidzira L, Louw VJ, Naidoo V, Noel C, Ogutu E, Ramonate N, Seabi N, Setshedi M, Van Zyl J, Watermeyer G, Kassianides C. Guidance for the gastrointestinal evaluation and management of iron deficiency in Sub-Saharan Africa. S Afr Med J 2024; 114:e711. [PMID: 38525666 DOI: 10.7196/samj.2024.v114i1b.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Over 30% of the world's population is anaemic, with a significant proportion of these being iron deficient. As iron deficiency (ID) anaemia in men and post-menopausal women is mostly caused by gastrointestinal blood loss or malabsorption, the initial evaluation of a patient with ID anaemia involves referral to a gastroenterologist. The current drive towards patient blood management in sub-Saharan Africa (SSA)prescribes that we regulate not only the use of blood transfusion but also the management of patients in whom the cause of iron loss or inadequate iron absorption is sought. Recommendations have been developed to: (i) aid clinicians in the evaluation of suspected gastrointestinal iron loss and iron malabsorption, and often a combination of these; (ii) improve clinical outcomes for patients with gastrointestinal causes of ID; (iii) provide current, evidence-based, context-specific recommendations for use in the management of ID; and (iv) conserve resources by ensuring rational utilisation of blood and blood products. METHOD Development of the guidance document was facilitated by the Gastroenterology Foundation of Sub-Saharan Africa and the South African Gastroenterology Society. The consensus recommendations are based on a rigorous process involving 21 experts in gastroenterology and haematology in SSA. Following discussion of the scope and purpose of the guidance document among the experts, an initial review of the literature and existing guidelines was undertaken. Thereafter, draft recommendation statements were produced to fulfil the outlined purpose of the guidance document. These were reviewed in a round-table discussion and were subjected to two rounds of anonymised consensus voting by the full committee in an electronic Delphi exercise during 2022 using the online platform, Research Electronic Data Capture. Recommendations were modified by considering feedback from the previous round, and those reaching a consensus of over 80% were incorporated into the final document. Finally, 44 statements in the document were read and approved by all members of the working group. CONCLUSION The recommendations incorporate six areas, namely: general recommendations and practice, Helicobacter pylori, coeliac disease, suspected small bowel bleeding, inflammatory bowel disease, and preoperative care. Implementation of the recommendations is aimed at various levels from individual practitioners to healthcare institutions, departments and regional, district, provincial and national platforms. It is intended that the recommendations spur the development of centre-specific guidelines and that they are integrated with the relevant patient blood management protocols. Integration of the recommendations is intended to promote optimal evaluation and management of patients with ID, regardless of the presence of anaemia.
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Curzen N, Nicholas Z, Stuart B, Wilding S, Hill K, Shambrook J, Eminton Z, Ball D, Barrett C, Johnson L, Nuttall J, Fox K, Connolly D, O'Kane P, Hobson A, Chauhan A, Uren N, Mccann GP, Berry C, Carter J, Roobottom C, Mamas M, Rajani R, Ford I, Douglas P, Hlatky MA. Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial. Eur Heart J 2021; 42:3844-3852. [PMID: 34269376 PMCID: PMC8648068 DOI: 10.1093/eurheartj/ehab444] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/10/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022] Open
Abstract
Aims Fractional flow reserve (FFRCT) using computed tomography coronary angiography (CTCA) determines both the presence of coronary artery disease and vessel-specific ischaemia. We tested whether an evaluation strategy based on FFRCT would improve economic and clinical outcomes compared with standard care. Methods and results Overall, 1400 patients with stable chest pain in 11 centres were randomized to initial testing with CTCA with selective FFRCT (experimental group) or standard clinical care pathways (standard group). The primary endpoint was total cardiac costs at 9 months. Secondary endpoints were angina status, quality of life, major adverse cardiac and cerebrovascular events, and use of invasive coronary angiography. Randomized groups were similar at baseline. Most patients had an initial CTCA: 439 (63%) in the standard group vs. 674 (96%) in the experimental group, 254 of whom (38%) underwent FFRCT. Mean total cardiac costs were higher by £114 (+8%) in the experimental group, with a 95% confidence interval from −£112 (−8%) to +£337 (+23%), though the difference was not significant (P = 0.10). Major adverse cardiac and cerebrovascular events did not differ significantly (10.2% in the experimental group vs. 10.6% in the standard group) and angina and quality of life improved to a similar degree over follow-up in both randomized groups. Invasive angiography was reduced significantly in the experimental group (19% vs. 25%, P = 0.01). Conclusion A strategy of CTCA with selective FFRCT in patients with stable angina did not differ significantly from standard clinical care pathways in cost or clinical outcomes, but did reduce the use of invasive coronary angiography.
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Kafadar AH, Barrett C, Cheung KL. Knowledge and perceptions of Alzheimer's disease in three ethnic groups of younger adults in the United Kingdom. BMC Public Health 2021; 21:1124. [PMID: 34118921 PMCID: PMC8196265 DOI: 10.1186/s12889-021-11231-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a global public health problem with an ageing population. Knowledge is essential to promote early awareness, diagnosis and treatment of AD symptoms. AD knowledge is influenced by many cultural factors including cultural beliefs, attitudes and language barriers. This study aims: (1) to define AD knowledge level and perceptions amongst adults between 18 and 49 years of age in the UK; (2) to compare knowledge and perceptions of AD among three main ethnic groups (Asian, Blacks, and Whites); and (3) to assess potential associations of age, gender, education level, affinity with older people (65 or over), family history and caregiving history with AD knowledge. METHODS Data was collected from 186 participants as a convenience sample of younger adults of three different ethnicities (16.1% Asian, 16.7% Black, 67.2% White), living in the UK, recruited via an online research platform. The majority of the participants were in the 18-34 years age group (87.6%). Demographic characteristics of participants and AD knowledge correlation were assessed by the 30-item Alzheimer's Disease Knowledge Scale (ADKS), comprising 7 content domains. ANOVA/ANCOVA were used to assess differences in AD knowledge by ethnicity, gender, education level, age and affinity with dementia and Alzheimer's patients. RESULTS For AD general knowledge across all respondents only 45.0% answers were correct. No significant differences were found for the total ADKS score between ethnicities in this younger age group, who did not differ in education level. However, there were significant knowledge differences for the ADKS symptom domain score even after controlling for other demographics variables such as gender, education level (p = 0.005). White respondents were more likely to know about AD symptoms than their Black counterparts (p = 0.026). CONCLUSION The study's findings suggest that the AD knowledge level is not adequate for all ethnic groups. Meanwhile, significant differences were observed in symptoms, between ethnic groups, and therefore, differ in their needs regards health communication. The study contributes to an understanding of ethnicity differences in AD knowledge amongst adults from 18 to 49 years of age in the UK and may also provide input into an intervention plan for different ethnicities' information needs.
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Oh Y, Hennessey A, Young L, Yates D, Barrett C. OP0274-PARE EVALUATION OF PATIENT SATISFACTION FOR TELEHEALTH (PHONE AND VIDEO) IN RHEUMATOLOGY OUTPATIENTS DURING COVID-19 PANDEMIC. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Telehealth via phone (TPhone) or video conference (TVideo) in rheumatology has been a topic of interest for many years. Its use was rapidly expanded due to the international public health emergency of coronavirus disease-19 (COVID-19) outbreak in 2020. Australian Medicare Benefits Schedule (MBS) swiftly enabled temporary MBS telehealth items on 13 March 2020, currently extended until 31 March 20211. In the early phase of the COVID-19 pandemic, Antony et al. conducted a single-centre public survey to assess patient perception of rheumatology telehealth. Their results showed that 98.4% of patients consider telehealth acceptable during the pandemic2. It is unclear, however, whether this positive perception persists after patients experience a telehealth. In addition, a survey data in 2019 suggested more than half of Australian rheumatologists work in private practice3. Therefore, inclusion of private patients will better represent patient perception of telehealth.Objectives:The aim of this study was to evaluate patient satisfaction with telehealth during the COVID-19 pandemic. This would determine its feasibility to be integrated in future rheumatology outpatient model.Methods:A questionnaire containing 30 questions was sent to rheumatology patients who attended telehealth appointments at a level 2 public hospital and a local private clinic between April and May 2020. The questionnaires aimed to obtain information on baseline demographics (sex, age, public or private patient, employment status, visual or auditory impairment), appointment details (TPhone or TVideo, usual arrangement for face-to-face (F2F) appointment, cost effectiveness) and appointment satisfaction using a 5-point Likert scale. Descriptive statistical analysis was conducted.Results:The questionnaire was sent to 1452 patients, of which 494 patients responded (34%). Female predominance (77.1%) and a higher proportion of TPhone (79.1%) was seen in the respondents. A majority of patients were existing patients known to the services (90.9%). More than 70% of responses indicated overall satisfaction in specialist care via telehealth, and 88.7% perceived this suitable during a pandemic. Of all respondents, 21.7% were prescribed new medication, and the majority of these patients were confident in taking the new medication after the telehealth appointment. Future acceptability for TPhone was significantly lower in private patients compared to public patients (p= 0.01). Subgroup analysis revealed that higher telehealth satisfaction was associated with needing to take time off work to attend face-to-face appointment (p= 0.02), perception of cost effectiveness (p<0.001) and TVideo (p=0.03).Conclusion:This is the first study which included both public and private rheumatology patients to evaluate patient satisfaction for telehealth during the COVID-19 pandemic. Overall high level of satisfaction was seen in telehealth most notably associated with its cost effectiveness. A higher percentage of patients who had TVideo compared to TPhone were receptive to future telehealth via TVideo, supportive of the importance of visual cues. This in turn will have significant administrative and technological burdens to coordinate in comparison to a F2F or TPhone review. This qualitative study provides valuable insight of patient perception of telehealth, which has the potential to compliment the traditional rheumatology outpatient model of care following the pandemic.References:[1]COVID-19 Temporary MBS Telehealth Services 2020 [Available from: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-TempBB.[2]Antony A, Connelly K, De Silva T, Eades L, Tillett W, Ayoub S, et al. Perspectives of Patients With Rheumatic Diseases in the Early Phase of COVID-19. Arthritis Care & Research. 2020;72(9):1189-95.[3]Association AR. Workforce Survey Exective Summary 2019 2019 [Available from: https://rheumatology.org.au/members/documents/WorkforceSurveyExecutiveSummary-websiteMay2019.pdf.Acknowledgements:University of QueenslandNursing staff at Redcliffe Hospital and Administration officers at Redcliffe & Northside RheumatologyDisclosure of Interests:None declared
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Barrett C, Park SJ, Edmondson L, Monga D. Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy. J Oncol Pharm Pract 2021; 28:577-581. [PMID: 33789524 DOI: 10.1177/10781552211003958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. METHODS This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. RESULTS Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. CONCLUSION In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.
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Barrett C, Cheung KL. Knowledge, socio-cognitive perceptions and the practice of hand hygiene and social distancing during the COVID-19 pandemic: a cross-sectional study of UK university students. BMC Public Health 2021; 21:426. [PMID: 33648486 PMCID: PMC7919985 DOI: 10.1186/s12889-021-10461-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic, social distancing and hand hygiene have been the primary means of reducing transmission in the absence of effective treatments or vaccines, but understanding of their determinants is limited. This study aimed to investigate knowledge and socio-cognitive perceptions, and their associations with such protective behaviours, in UK university students. METHODS A cross-sectional online survey of 293 students was undertaken on 13 May 2020. Survey questions addressed demographics, knowledge of the disease and effectiveness of the protective measures, risk perception, socio-cognitive perceptions (e.g. attitude, social support, and self-efficacy), habit, time factors and trust, as well as the hand hygiene and social distancing behaviours. Multiple linear regression was used to identify the strongest associations of potential determinants with behaviour. RESULTS Participants reported high levels of social distancing with 88.9% answering "Mostly" or "Always" for every activity, but only 42.0% reporting the same for all hand hygiene activities. Knowledge of the effectiveness of each activity in preventing transmission was high, with 90.7% and 93.5% respectively identifying at least 7 of 8 hand hygiene or 9 of 10 social distancing activities correctly. Habit (β = 0.39, p = 0.001) and time factors (β = 0.28, p = 0.001) were the greatest contributors to unique variance in hand hygiene behaviour, followed by ethnicity (β = - 0.13, p = 0.014) and risk perception (β = 0.13, p = 0.016). For social distancing behaviour, the determinants were self-efficacy (β = 0.25, p < 0.001), perceived advantages (β = 0.15, p = 0.022), trust in policy (β = 0.14, p = 0.026) and gender (β = - 0.14, p = 0.016). Regression models explained 40% hand hygiene and 25% social distancing variance. CONCLUSIONS This study indicated that communications about effectiveness of hand hygiene and social distancing behaviours had been effective in terms of knowledge acquisition. However, in the light of likely second waves of COVID-19, attention to maintaining social distancing behaviour and improving hand hygiene behaviour may need to address more difficult areas of changing habits, overcoming time factors and building trust, as well as interventions to increase self-efficacy and address risk perception concerns.
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Barrett C, Stein Z, Hernandez J, Naraparaju R, Schulz U, Tetard L, Raghavan S. Detrimental effects of sand ingression in jet engine ceramic coatings captured with Raman-based 3D rendering. Ann Ital Chir 2021. [DOI: 10.1016/j.jeurceramsoc.2020.09.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ellis J, J B Marks D, Srinivasan N, Barrett C, Hopkins TG, Richards A, Fuhr R, Albayaty M, Coenen M, Liefaard L, Leavens K, Nevin KL, Tang S, Hughes SA, Fortunato L, Edwards K, Cui Y, Anselm R, Delves CJ, Charles E, Feeney M, Webb TM, Brett SJ, Schmidt TS, Stone J, Savage COS, Wisniacki N, Tarzi RM. Depletion of LAG-3 + T Cells Translated to Pharmacology and Improvement in Psoriasis Disease Activity: A Phase I Randomized Study of mAb GSK2831781. Clin Pharmacol Ther 2020; 109:1293-1303. [PMID: 33113155 PMCID: PMC8246744 DOI: 10.1002/cpt.2091] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/11/2020] [Indexed: 12/18/2022]
Abstract
Activated T cells drive a range of immune‐mediated inflammatory diseases. LAG‐3 is transiently expressed on recently activated CD4+ and CD8+ T cells. We describe the engineering and first‐in‐human clinical study (NCT02195349) of GSK2831781 (an afucosylated humanized IgG1 monoclonal antibody enhanced with high affinity for Fc receptors and LAG‐3 and antibody‐dependent cellular cytotoxicity capabilities), which depletes LAG‐3 expressing cells. GSK2831781 was tested in a phase I/Ib, double‐blind, placebo‐controlled clinical study, which randomized 40 healthy participants (part A) and 27 patients with psoriasis (part B) to single doses of GSK2831781 (up to 0.15 and 5 mg/kg, respectively) or placebo. Adverse events were generally balanced across groups, with no safety or tolerability concern identified. LAG‐3+ cell depletion in peripheral blood was observed at doses ≥ 0.15 mg/kg and was dose‐dependent. In biopsies of psoriasis plaques, a reduction in mean group LAG‐3+ and CD3+ T‐cell counts was observed following treatment. Downregulation of proinflammatory genes (IL‐17A, IL‐17F, IFNγ, and S100A12) and upregulation of the epithelial barrier integrity gene, CDHR1, was observed with the 5 mg/kg dose of GSK2831781. Psoriasis disease activity improved up to day 43 at all GSK2831781 doses (0.5, 1.5, and 5 mg/kg) compared with placebo. Depletion of LAG‐3‐expressing activated T cells is a novel approach, and this first clinical study shows that GSK2831781 is pharmacologically active and provides encouraging early evidence of clinical effects in psoriasis, which warrants further investigation in T‐cell‐mediated inflammatory diseases.
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Barrett C, Willcocks LC, Jones RB, Tarzi RM, Henderson RB, Cai G, Gisbert SI, Belson AS, Savage CO. Effect of belimumab on proteinuria and anti-phospholipase A2 receptor autoantibody in primary membranous nephropathy. Nephrol Dial Transplant 2020; 35:599-606. [PMID: 31243451 PMCID: PMC7139214 DOI: 10.1093/ndt/gfz086] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/01/2019] [Indexed: 11/21/2022] Open
Abstract
Background Immunosuppressant drugs reduce proteinuria and anti-phospholipase A2 receptor autoantibodies (PLA2R-Ab) in primary membranous nephropathy (PMN) with varying success and associated toxicities. This study aimed to evaluate the effect of belimumab on proteinuria and PLA2R-Ab in participants with PMN. Methods In this prospective, open-label, experimental medicine study, 14 participants with PMN and persistent nephrotic-range proteinuria received up to 2 years belimumab monotherapy (10 mg/kg, every 4 weeks). Changes in proteinuria (urinary protein:creatinine ratio), PLA2R-Ab, albumin, cholesterol, B-cell subsets and pharmacokinetics were analysed during treatment and up to 6 months after treatment. Results Eleven participants completed to the primary endpoint (Week 28) and nine participants completed the study. In the intention-to-treat population population, baseline proteinuria of 724 mg/mmol [95% confidence interval (CI) 579–906] decreased to 498 mg/mmol (95% CI 383–649) and 130 mg/mmol (95% CI 54–312) at Weeks 28 and 104, respectively, with changes statistically significant from Week 36 (n = 11, P = 0.047). PLA2R-Ab decreased from 174 RU/mL (95% CI 79–384) at baseline to 46 RU/mL (95% CI 16–132) and 4 RU/mL (95% CI 2–6) at Weeks 28 and 104, respectively, becoming statistically significant by Week 12 (n = 13, P = 0.02). Nine participants achieved partial (n = 8) or complete (n = 1) remission. Participants with abnormal albumin and/or cholesterol at baseline gained normal/near normal levels by the last follow-up. Adverse events were consistent with those expected in this population. Conclusions Belimumab treatment in participants with PMN can reduce PLA2R-Ab and subsequently proteinuria, important preludes to remission induction.
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Reungwetwattana T, Gray J, Markovets A, Nogami N, Lee J, Cho B, Chewaskulyong B, Majem M, Peled N, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gray J, Peled N, Markovets A, Nogami N, Lee JS, Cho B, Chewaskulyong B, Majem M, Reungwetwattana T, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Barrett C, Park SJ, Gaertner K, Mao S. The financial impact of physician practice patterns: An analysis of as-needed filgrastim versus prophylactic pegfilgrastim in patients with prostate cancer receiving docetaxel. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6506 Background: Docetaxel improves survival in metastatic prostate cancer. Patients receiving docetaxel are at an intermediate risk of febrile neutropenia (FN). Granulocyte-colony stimulating factor (G-CSF) reduces the incidence of neutropenia and infection. There is no consensus among physicians on G-CSF use with docetaxel in prostate cancer, and physician preference may significantly impact healthcare costs. The purpose of this study is to assess physician practice patterns by comparing efficacy and cost of as-needed filgrastim (ANF) to prophylactic pegfilgrastim (PPF) for neutropenia in patients with prostate cancer receiving docetaxel. Methods: This retrospective cohort study included patients with prostate cancer that received standard docetaxel and G-CSF, either ANF or PPF, from February 2016 to October 2018 at our institution. In the ANF arm, patients with an ANC less than 1000 cells/µL on day 8 of the cycle received filgrastim. In the PPF arm, patients received pegfilgrastim on day 2 for primary prophylaxis. Patient characteristics, chemotherapy dose intensity, delays, and reductions, and incidence of FN were collected. Results: Of the 65 patients included in this study, 32 received ANF and 33 received PPF. Patients in the ANF arm received an average of 6.0 cycles versus 4.8 cycles in the PPF arm (p = 0.013). The completion rate of planned cycles differed, with 93.8% completion in the ANF arm versus 66.7% in the PPF arm (p = 0.001). Average total drug exposure per patient was greater in the ANF arm than the PPF arm (437.5 mg/m2 versus 343.4 mg/m2; p = 0.007). In both groups, there was no significant difference in dose delays or reductions, or incidence of FN. However, there was a significant difference in cost, with an average of $740.26 per cycle per patient for filgrastim, versus $7327.72 per cycle per patient for pegfilgrastim, based on current average wholesale price. Conclusions: In our study, use of ANF was safe, and did not impact planned dose, intensity, or duration when compared to PPF. In addition, the administration of ANF was associated with significant cost savings. Analysis of G-CSF use in patients with prostate cancer receiving docetaxel at our institution has identified an opportunity for substantial healthcare cost savings.
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Alexander K, Barrett C, Dobos K, Cheng P, Liao R, Wheeler M, Liedtke M, Weisshaar D, Witteles R. Contemporary Outcomes in Patients with Cardiac Amyloidosis Undergoing Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cho B, Cheng Y, Zhou C, Ohe Y, Imamura F, Lin MC, Majem M, Shah R, Rukazenkov Y, Todd A, Markovets A, Barrett C, Chmielecki J, Gray J, Ramalingam S. Mechanisms of acquired resistance to first-line osimertinib: Preliminary data from the phase III FLAURA study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy483.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Friedlander M, Rau J, Lee C, Meier W, Lesoin A, Kim JW, Poveda A, Buck M, Scambia G, Shimada M, Hilpert F, King M, Debruyne P, Bologna A, Malander S, Monk B, Petru E, Calvert P, Herzog T, Barrett C, du Bois A. Quality of life in patients with advanced epithelial ovarian cancer (EOC) randomized to maintenance pazopanib or placebo after first-line chemotherapy in the AGO-OVAR 16 trial. Measuring what matters—patient-centered end points in trials of maintenance therapy. Ann Oncol 2018; 29:737-743. [DOI: 10.1093/annonc/mdx796] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sun J, Li Y, Milbury C, Skoletsky J, Burns C, Yip W, Luo J, Dewal N, Johnson A, Gowen K, Tong J, He Y, He J, White J, Roels S, Tsuji A, Truesdell J, Peters E, Gilbert H, Wu C, Schleifman E, Barrett C, Thress K, Jenkins S, Elvin J, Otto G, Lipson D, Ross J, Miller V, Stephens P, Doherty M, Vietz C. P2.02-052 A Clinically-Validated Universal Companion Diagnostic Platform for Cancer Patient Care. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Keane F, Greally M, Harrold E, Barrett C, McCaffrey J. Epithelioid Angiomyolipoma - a case report and review of the literature. IRISH MEDICAL JOURNAL 2017; 110:604. [PMID: 29341516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Herein we present the case of a 43-year-old female in whom a left renal mass was identified incidentally on imaging performed for staging of a newly diagnosed breast carcinoma. The mass was resected and histologic examination and immunohistochemistry confirmed a diagnosis of epithelioid angiomyolipoma.
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Comiskey D, Api A, Barrett C, Ellis G, McNamara C, O'Mahony C, Robison S, Rose J, Safford B, Smith B, Tozer S. Integrating habits and practices data for soaps, cosmetics and air care products into an existing aggregate exposure model. Regul Toxicol Pharmacol 2017; 88:144-156. [DOI: 10.1016/j.yrtph.2017.05.017] [Citation(s) in RCA: 1034] [Impact Index Per Article: 147.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
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Ng C, Rozen G, Biton Y, Leyton-Mange J, Barrett C. P389Direct ultrasound visualization in combination with micropuncture needle reduces vascular access complications in cardiac electrophysiological procedures. Europace 2017. [DOI: 10.1093/ehjci/eux141.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Barrett C, Henderson R, Galwey N, Flint S, Gibson A, Savage C. THU0006 Novel Changes in B and T-Cell Phenotypes with Belimumab in An Autoantibody Mediated Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Oxnard G, Thress K, Alden R, Lawrance R, Paweletz C, Cantarini M, Barrett C, Yang J, Jänne P. 135O_PR: Plasma genotyping for predicting benefit from osimertinib in patients (pts) with advanced NSCLC. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30328-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Yeh T, Jacobs V, Angell H, Geradts J, Hou J, Karakunnel J, Barrett C. 60PD Inhibition of pEGFR in paired tumour biopsies from TKI treatment-naïve EGFR mutant NSCLC patients treated with gefitinib (EGFR inhibitor) or gefitinib in combination with durvalumab (anti-PD-L1). J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30173-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Reddy V, Short S, Barrett C, Washington M, Williams C. BVES is Regulated in Response to Radiation and Influences Intestinal Stem Cell Programs and Recovery After Radiation. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Timms K, Neff C, Morris B, Hodgson D, Orr M, Zhongwu L, Fielding A, Dougherty B, Spencer S, Robertson J, Barrett C, Gutin A, Lanchbury J. 466 Next generation sequencing of BRCA1 and BRCA2 genes in ovarian tumors captures all germline mutations and expands the potential treatment group for the PARP inhibitor olaparib. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30300-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Jarmuz P, Ocali O, Baldwin M, Sakkas D, Barrett C. Success rates of rescue ICSI and analysis of embryo cleavage rates by real time video imaging. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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