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Fung M, Chan M, Chin Koon Siw K, Sabri E, McCurdy J. A148 IMPACT OF EXAMINATION UNDER ANESTHESIA PRIOR TO ANTI-TUMOR NECROSIS FACTOR THERAPY ON FISTULA HEALING FOR PERIANAL CROHN’S DISEASE PATIENTS: A COMPARATIVE COHORT STUDY. J Can Assoc Gastroenterol 2022. [DOI: 10.1093/jcag/gwab049.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Current guidelines recommend a combined approach consisting of an examination under anesthesia (EUA) and anti-TNF therapy for perianal Crohn’s Disease (PCD). However, the impact of this approach on fistula healing and long-term outcomes is unknown.
Aims
To assess the effect of EUA on fistula healing and long term outcomes in patients with perianal Crohn’s disese who are treated with anti-TNF therapy.
Methods
We performed a retrospective, single-center, comparative cohort study between 2009 and 2019. We compared patients with PCD who received EUA prior to anti-TNF therapy (combined therapy) to anti-TNF therapy alone. Our primary outcome was fistula closure by clinical assessment. Secondary outcomes included subsequent local surgery and fecal diversion. Logistic regression and multivariable cox-proportional hazard models adjusted for abscesses, concomitant immunomodulators, and time to anti-TNF initiation were performed.
Results
A total of 155 patients underwent 188 distinct anti-TNF starts: 66 (35%) after an EUA. Patients who underwent an EUA prior to anti-TNF therapy were more likely to have an abscess (50% vs. 15%; p < 0.001) and concomitant immunomodulator usage (64% vs. 50%; p = 0.07). Otherwise, there were no differences between cohorts in age, smoking status, disease duration, and location of luminal disease. There were no significant differences in fistula closure at 3, 6, or 12 months between cohorts overall (Table 1). The results remained consistent in sensitivity analyses that excluded patients with abscesses and prior biologic treatment failure. The results were also similar when defining the combined therapy group as those with setons. After a median follow-up of 4.6 years (IQR, 5.95) patients who underwent an EUA prior to anti-TNF therapy were more likely to require a subsequent EUA (aHR 2.2; 95% CI, 1.3–3.6) (Figure 1) but not fecal diversion (aHR 1.3; 95% CI, 0.45–3.9).
Conclusions
In this single center study, combined therapy (EUA prior to anti-TNF therapy) was not associated with improved clinical outcomes compared with anti-TNF therapy alone. These findings suggest that EUA may not be necessary in every patient with PCD prior to initiation of anti-TNF therapy. Future prospective studies that control for fistula complexity are warranted.
Table 1: Unadjusted rates of fistula closure after anti-TNF therapy comparing patients with and without an exam under anesthesia
Funding Agencies
University of Ottawa Department of Medicine
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Lewis S, Hope A, Chan M, Weiss J, Raziee H, Bezjak A, Cho J, Sun A, Lok B, Raman S, Bissonnette J, Vines D, Giuliani M. FLT-PET/CT in Non-Small Cell Lung Cancer Treated With SBRT- A Pilot Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.10.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chan M, Grossman S. The old tea-bag trick. Br Dent J 2021; 231:603. [PMID: 34824409 DOI: 10.1038/s41415-021-3687-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chan M, Grossman S. Proactive professionals. Br Dent J 2021; 231:532. [PMID: 34772999 DOI: 10.1038/s41415-021-3625-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Urban R, Chow R, Pickles T, Chan M, Livergant J, Gerrie A, Freeman C, Sehn L, Scott D, Villa D, Savage K, Slack G, Lo A. The Impact of Surveillance Imaging After Curative Intent Radiotherapy for Limited Stage Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lui G, Wong CK, Chan M, Chong KC, Wong R, Chu I, Zhang M, Li T, Hui D, Lee N, Chan P. Host inflammatory response is the major marker of severe respiratory syncytial virus infection in older adults. J Infect 2021; 83:686-692. [PMID: 34614399 DOI: 10.1016/j.jinf.2021.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We aim to study the viral kinetics and host inflammatory response of RSV infection in older adults, and their correlation with disease severity. METHODS We performed a prospective observational study in adults with RSV infection. We serially collected nasal-throat swabs for quantification of RSV-A and RSV-B viral load, and peripheral blood samples for measurement of cytokine/chemokine concentrations. The study endpoints were (i) requiring supplemental oxygen therapy, and (ii) non-invasive ventilation, intensive care, or died within 30 days of admission. We performed multivariable logistic regression models to identify independent variables for severe disease. RESULTS We enrolled 71 hospitalized patients and 10 outpatients treated for RSV infection (median age 75 years, 51% male, and 74% with comorbidities). Among hospitalized patients, 61% required supplemental oxygen therapy, and 18% had severe disease requiring non-invasive ventilation or intensive care, or died within 30 days. Inflammatory cytokine/chemokines IL-6, CXCL8/IL-8, CXCL9/MIG and CXCL10/IP-10 increased significantly during the acute phase of illness. IL-6 concentration was independently associated with severe disease after adjusting for confounding factors. RSV viral load was not associated with disease severity throughout the course of illness. CONCLUSION Host inflammatory response is a major marker of severe disease in older adults with RSV infection.
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Bedakihale VM, Bejger M, Belahcene I, Benedetto V, Beniwal D, Benjamin MG, Bennett TF, Bentley JD, BenYaala M, Bergamin F, Berger BK, Bernuzzi S, Bersanetti D, Bertolini A, Betzwieser J, Bhandare R, Bhandari AV, Bhattacharjee D, Bhaumik S, Bidler J, Bilenko IA, Billingsley G, Birney R, Birnholtz O, Biscans S, Bischi M, Biscoveanu S, Bisht A, Biswas B, Bitossi M, Bizouard MA, Blackburn JK, Blackman J, Blair CD, Blair DG, Blair RM, Bobba F, Bode N, Boer M, Bogaert G, Boldrini M, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Bork R, Boschi V, Bose N, Bose S, Bossilkov V, Boudart V, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branch A, Branchesi M, Breschi M, Briant T, Briggs JH, Brillet A, Brinkmann M, Brockill P, Brooks AF, Brooks J, Brown DD, Brunett S, Bruno G, Bruntz R, Bryant J, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buscicchio R, Buskulic D, Cadonati L, Caesar M, Cagnoli G, Cahillane C, Cain HW, Calderón Bustillo J, Callaghan JD, Callister TA, Calloni E, Camp JB, Canepa M, Cannavacciuolo M, Cannon KC, Cao H, Cao J, Cao Z, Capocasa E, Capote E, Carapella G, Carbognani F, Carlin JB, Carney MF, Carpinelli M, Carullo G, Carver TL, Casanueva Diaz J, Casentini C, Castaldi G, Caudill S, Cavaglià M, Cavalier F, Cavalieri R, Cella G, Cerdá-Durán P, Cesarini E, Chaibi W, Chakravarti K, Champion B, Chan CH, Chan C, Chan CL, Chan M, Chandra K, Chanial P, Chao S, Charlton P, Chase EA, Chassande-Mottin E, Chatterjee D, Chaturvedi M, Chatziioannou K, Chen A, Chen C, Chen HY, Chen J, Chen K, Chen X, Chen YB, Chen YR, Chen Z, Cheng H, Cheong CK, Cheung HY, Chia HY, Chiadini F, Chiang CY, Chierici R, Chincarini A, Chiofalo ML, Chiummo A, Cho G, Cho HS, Choate S, Choudhary RK, Choudhary S, Christensen N, Chu H, Chu Q, Chu YK, Chua S, Chung KW, Ciani G, Ciecielag P, Cieślar M, Cifaldi M, Ciobanu AA, Ciolfi R, Cipriano F, Cirone A, Clara F, Clark EN, Clark JA, Clarke L, Clearwater P, Clesse S, Cleva F, Coccia E, Cohadon PF, Cohen DE, Cohen L, Colleoni M, Collette CG, Colpi M, Compton CM, Constancio M, Conti L, Cooper SJ, Corban P, Corbitt TR, Cordero-Carrión I, Corezzi S, Corley KR, Cornish N, Corre D, Corsi A, Cortese S, Costa CA, Cotesta R, Coughlin MW, Coughlin SB, Coulon JP, Countryman ST, Cousins B, Couvares P, Covas PB, Coward DM, Cowart MJ, Coyne DC, Coyne R, Creighton JDE, Creighton TD, Criswell AW, Croquette M, Crowder SG, Cudell JR, Cullen TJ, Cumming A, Cummings R, Cuoco E, Curyło M, Canton TD, Dálya G, Dana A, DaneshgaranBajastani LM, D'Angelo B, Danilishin SL, D'Antonio S, Danzmann K, Darsow-Fromm C, Dasgupta A, Datrier LEH, Dattilo V, Dave I, Davier M, Davies GS, Davis D, Daw EJ, Dean R, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Del Favero V, De Lillo F, De Lillo N, Del Pozzo W, DeMarchi LM, De Matteis F, D'Emilio V, Demos N, Dent T, Depasse A, De Pietri R, De Rosa R, De Rossi C, DeSalvo R, De Simone R, Dhurandhar S, Díaz MC, Diaz-Ortiz M, Didio NA, Dietrich T, Di Fiore L, Di Fronzo C, Di Giorgio C, Di Giovanni F, Di Girolamo T, Di Lieto A, Ding B, Di Pace S, Di Palma I, Di Renzo F, Divakarla AK, Dmitriev A, Doctor Z, D'Onofrio L, Donovan F, Dooley KL, Doravari S, Dorrington I, Drago M, Driggers JC, Drori Y, Du Z, Ducoin JG, Dupej P, Durante O, D'Urso D, Duverne PA, Dwyer SE, Easter PJ, Ebersold M, Eddolls G, Edelman B, Edo TB, Edy O, Effler A, Eguchi S, Eichholz J, Eikenberry SS, Eisenmann M, Eisenstein RA, Ejlli A, Enomoto Y, Errico L, Essick RC, Estellés H, Estevez D, Etienne Z, Etzel T, Evans M, Evans TM, Ewing BE, Fafone V, Fair H, Fairhurst S, Fan X, Farah AM, Farinon S, Farr B, Farr WM, Farrow NW, Fauchon-Jones EJ, Favata M, Fays M, Fazio M, Feicht J, Fejer MM, Feng F, Fenyvesi E, Ferguson DL, Fernandez-Galiana A, Ferrante I, Ferreira TA, Fidecaro F, Figura P, Fiori I, Fishbach M, Fisher RP, Fishner JM, Fittipaldi R, Fiumara V, Flaminio R, Floden E, Flynn E, Fong H, Font JA, Fornal B, Forsyth PWF, Franke A, Frasca S, Frasconi F, Frederick C, Frei Z, Freise A, Frey R, Fritschel P, Frolov VV, Fronzé GG, Fujii Y, Fujikawa Y, Fukunaga M, Fukushima M, Fulda P, Fyffe M, Gabbard HA, Gadre BU, Gaebel SM, Gair JR, Gais J, Galaudage S, Gamba R, Ganapathy D, Ganguly A, Gao D, Gaonkar SG, Garaventa B, García-Núñez C, García-Quirós C, Garufi F, Gateley B, Gaudio S, Gayathri V, Ge G, Gemme G, Gennai A, George J, Gergely L, Gewecke P, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Ghosh S, Ghosh S, Giacomazzo B, Giacoppo L, Giaime JA, Giardina KD, Gibson DR, Gier C, Giesler M, Giri P, Gissi F, Glanzer J, Gleckl AE, Godwin P, Goetz E, Goetz R, Gohlke N, Goncharov B, González G, Gopakumar A, Gosselin M, Gouaty R, Grace B, Grado A, Granata M, Granata V, Grant A, Gras S, Grassia P, Gray C, Gray R, Greco G, Green AC, Green R, Gretarsson AM, Gretarsson EM, Griffith D, Griffiths W, Griggs HL, Grignani G, Grimaldi A, Grimes E, Grimm SJ, Grote H, Grunewald S, Gruning P, Guerrero JG, Guidi GM, Guimaraes AR, Guixé G, Gulati HK, Guo HK, Guo Y, Gupta A, Gupta A, Gupta P, Gustafson EK, Gustafson R, Guzman F, Ha S, Haegel L, Hagiwara A, Haino S, Halim O, Hall ED, Hamilton EZ, Hammond G, Han WB, Haney M, Hanks J, Hanna C, Hannam MD, Hannuksela OA, Hansen H, Hansen TJ, Hanson J, Harder T, Hardwick T, Haris K, Harms J, Harry GM, Harry IW, Hartwig D, Hasegawa K, Haskell B, Hasskew RK, Haster CJ, Hattori K, Haughian K, Hayakawa H, Hayama K, Hayes FJ, Healy J, Heidmann A, Heintze MC, Heinze J, Heinzel J, Heitmann H, Hellman F, Hello P, Helmling-Cornell AF, Hemming G, Hendry M, Heng IS, Hennes E, Hennig J, Hennig MH, Hernandez Vivanco F, Heurs M, Hild S, Hill P, Himemoto Y, Hines AS, Hiranuma Y, Hirata N, Hirose E, Hochheim S, Hofman D, Hohmann JN, Holgado AM, Holland NA, Hollows IJ, Holmes ZJ, Holt K, Holz DE, Hong Z, Hopkins P, Hough J, Howell EJ, Hoy CG, Hoyland D, Hreibi A, Hsieh B, Hsu Y, Huang GZ, Huang HY, Huang P, Huang YC, Huang YJ, Huang YW, Hübner MT, Huddart AD, Huerta EA, Hughey B, Hui DCY, Hui V, Husa S, Huttner SH, Huxford R, Huynh-Dinh T, Ide S, Idzkowski B, Iess A, Ikenoue B, Imam S, Inayoshi K, Inchauspe H, Ingram C, Inoue Y, Intini G, Ioka K, Isi M, Isleif K, Ito K, Itoh Y, Iyer BR, Izumi K, JaberianHamedan V, Jacqmin T, Jadhav SJ, Jadhav SP, James AL, Jan AZ, Jani K, Janssens K, Janthalur NN, Jaranowski P, Jariwala D, Jaume R, Jenkins AC, Jeon C, Jeunon M, Jia W, Jiang J, Jin HB, Johns GR, Jones AW, Jones DI, Jones JD, Jones P, Jones R, Jonker RJG, Ju L, Jung K, Jung P, Junker J, Kaihotsu K, Kajita T, Kakizaki M, Kalaghatgi CV, Kalogera V, Kamai B, Kamiizumi M, Kanda N, Kandhasamy S, Kang G, Kanner JB, Kao Y, Kapadia SJ, Kapasi DP, Karathanasis C, Karki S, Kashyap R, Kasprzack M, Kastaun W, Katsanevas S, Katsavounidis E, Katzman W, Kaur T, Kawabe K, Kawaguchi K, Kawai N, Kawasaki T, Kéfélian F, Keitel D, Key JS, Khadka S, Khalili FY, Khan I, Khan S, Khazanov EA, Khetan N, Khursheed M, Kijbunchoo N, Kim C, Kim JC, Kim J, Kim K, Kim WS, Kim YM, Kimball C, Kimura N, King PJ, Kinley-Hanlon M, Kirchhoff R, Kissel JS, Kita N, Kitazawa H, Kleybolte L, Klimenko S, Knee AM, Knowles TD, Knyazev E, Koch P, Koekoek G, Kojima Y, Kokeyama K, Koley S, Kolitsidou P, Kolstein M, Komori K, Kondrashov V, Kong AKH, Kontos A, Koper N, Korobko M, Kotake K, Kovalam M, Kozak DB, Kozakai C, Kozu R, Kringel V, Krishnendu NV, Królak A, Kuehn G, Kuei F, Kumar A, Kumar P, Kumar R, Kumar R, Kume J, Kuns K, Kuo C, Kuo HS, Kuromiya Y, Kuroyanagi S, Kusayanagi K, Kwak K, Kwang S, Laghi D, Lalande E, Lam TL, Lamberts A, Landry M, Lane BB, Lang RN, Lange J, Lantz B, La Rosa I, Lartaux-Vollard A, Lasky PD, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, Lecoeuche YK, Lee HK, Lee HM, Lee HW, Lee J, Lee K, Lee R, Lehmann J, Lemaître A, Leon E, Leonardi M, Leroy N, Letendre N, Levin Y, Leviton JN, Li AKY, Li B, Li J, Li KL, Li TGF, Li X, Lin CY, Lin FK, Lin FL, Lin HL, Lin LCC, Linde F, Linker SD, Linley JN, Littenberg TB, Liu GC, Liu J, Liu K, Liu X, Llorens-Monteagudo M, Lo RKL, Lockwood A, Lollie ML, London LT, Longo A, Lopez D, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lough JD, Lousto CO, Lovelace G, Lück H, Lumaca D, Lundgren AP, Luo LW, Macas R, MacInnis M, Macleod DM, MacMillan IAO, Macquet A, Magaña Hernandez I, Magaña-Sandoval F, Magazzù C, Magee RM, Maggiore R, Majorana E, Maksimovic I, Maliakal S, Malik A, Man N, Mandic V, Mangano V, Mango JL, Mansell GL, Manske M, Mantovani M, Marchesoni F, Marchio M, Marion F, Mark Z, Márka S, Márka Z, Markakis C, Markosyan AS, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin IW, Martin RM, Martinez M, Martinez V, Martinovic K, Martynov DV, Marx EJ, Masalehdan H, Mason K, Massera E, Masserot A, Massinger TJ, Masso-Reid M, Mastrogiovanni S, Matas A, Mateu-Lucena M, Matichard F, Matiushechkina M, Mavalvala N, McCann JJ, McCarthy R, McClelland DE, McClincy P, McCormick S, McCuller L, McGhee GI, McGuire SC, McIsaac C, McIver J, McManus DJ, McRae T, McWilliams ST, Meacher D, Mehmet M, Mehta AK, Melatos A, Melchor DA, Mendell G, Menendez-Vazquez A, Menoni CS, Mercer RA, Mereni L, Merfeld K, Merilh EL, Merritt JD, Merzougui M, Meshkov S, Messenger C, Messick C, Meyers PM, Meylahn F, Mhaske A, Miani A, Miao H, Michaloliakos I, Michel C, Michimura Y, Middleton H, Milano L, Miller AL, Millhouse M, Mills JC, Milotti E, Milovich-Goff MC, Minazzoli O, Minenkov Y, Mio N, Mir LM, Mishkin A, Mishra C, Mishra T, Mistry T, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Miyakawa O, Miyamoto A, Miyazaki Y, Miyo K, Miyoki S, Mo G, Mogushi K, Mohapatra SRP, Mohite SR, Molina I, Molina-Ruiz M, Mondin M, Montani M, Moore CJ, Moraru D, Morawski F, More A, Moreno C, Moreno G, Mori Y, Morisaki S, Moriwaki Y, Mours B, Mow-Lowry CM, Mozzon S, Muciaccia F, Mukherjee A, Mukherjee D, Mukherjee S, Mukherjee S, Mukund N, Mullavey A, Munch J, Muñiz EA, Murray PG, Musenich R, Nadji SL, Nagano K, Nagano S, Nakamura K, Nakano H, Nakano M, Nakashima R, Nakayama Y, Nardecchia I, Narikawa T, Naticchioni L, Nayak B, Nayak RK, Negishi R, Neil BF, Neilson J, Nelemans G, Nelson TJN, Nery M, 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MHPM, van Remortel N, Vardaro M, Vargas AF, Varma V, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venneberg J, Venugopalan G, Verkindt D, Verma Y, Veske D, Vetrano F, Viceré A, Viets AD, Villa-Ortega V, Vinet JY, Vitale S, Vo T, Vocca H, von Reis ERG, Vorvick C, Vyatchanin SP, Wade LE, Wade M, Wagner KJ, Walet RC, Walker M, Wallace GS, Wallace L, Walsh S, Wang J, Wang JZ, Wang WH, Ward RL, Warner J, Was M, Washimi T, Washington NY, Watchi J, Weaver B, Wei L, Weinert M, Weinstein AJ, Weiss R, Weller CM, Wellmann F, Wen L, Weßels P, Westhouse JW, Wette K, Whelan JT, White DD, Whiting BF, Whittle C, Wilken D, Williams D, Williams MJ, Williamson AR, Willis JL, Willke B, Wilson DJ, Winkler W, Wipf CC, Wlodarczyk T, Woan G, Woehler J, Wofford JK, Wong ICF, Wrangel J, Wu C, Wu DS, Wu H, Wu S, Wysocki DM, Xiao L, Xu WR, Yamada T, Yamamoto H, Yamamoto K, Yamamoto K, Yamamoto T, Yamashita K, Yamazaki R, Yang FW, Yang L, Yang Y, Yang Y, Yang Z, Yap MJ, Yeeles DW, Yelikar AB, Ying M, Yokogawa K, Yokoyama J, Yokozawa T, Yoon A, Yoshioka T, Yu H, Yu H, Yuzurihara H, Zadrożny A, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhan M, Zhang H, Zhang J, Zhang L, Zhang R, Zhang T, Zhao C, Zhao G, Zhao Y, Zhao Y, Zhou Z, Zhu XJ, Zhu ZH, Zucker ME, Zweizig J. Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run. PHYSICAL REVIEW LETTERS 2021; 126:241102. [PMID: 34213926 DOI: 10.1103/physrevd.97.102002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 05/23/2021] [Indexed: 05/21/2023]
Abstract
We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.
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Pfeiffer HP, Pham KA, Phukon KS, Piccinni OJ, Pichot M, Piendibene M, Piergiovanni F, Pierini L, Pierro V, Pillant G, Pilo F, Pinard L, Pinto IM, Piotrzkowski BJ, Piotrzkowski K, Pirello M, Pitkin M, Placidi E, Plastino W, Pluchar C, Poggiani R, Polini E, Pong DYT, Ponrathnam S, Popolizio P, Porter EK, Powell J, Pracchia M, Pradier T, Prajapati AK, Prasai K, Prasanna R, Pratten G, Prestegard T, Principe M, Prodi GA, Prokhorov L, Prosposito P, Prudenzi L, Puecher A, Punturo M, Puosi F, Puppo P, Pürrer M, Qi H, Quetschke V, Quinonez PJ, Quitzow-James R, Raab FJ, Raaijmakers G, Radkins H, Radulesco N, Raffai P, Rail SX, Raja S, Rajan C, Ramirez KE, Ramirez TD, Ramos-Buades A, Rana J, Rapagnani P, Rapol UD, Ratto B, Raymond V, Raza N, Razzano M, Read J, Rees LA, Regimbau T, Rei L, Reid S, Reitze DH, Relton P, Rettegno P, Ricci F, Richardson CJ, Richardson JW, Richardson L, Ricker PM, Riemenschneider G, Riles K, Rizzo M, Robertson NA, Robie R, Robinet F, Rocchi A, Rocha JA, Rodriguez S, Rodriguez-Soto RD, Rolland L, Rollins JG, Roma VJ, Romanelli M, Romano R, Romel CL, Romero A, Romero-Shaw IM, Romie JH, Rose CA, Rosińska D, Rosofsky SG, Ross MP, Rowan S, Rowlinson SJ, Roy S, Roy S, Rozza D, Ruggi P, Ryan K, Sachdev S, Sadecki T, Sadiq J, Sago N, Saito S, Saito Y, Sakai K, Sakai Y, Sakellariadou M, Sakuno Y, Salafia OS, Salconi L, Saleem M, Salemi F, Samajdar A, Sanchez EJ, Sanchez JH, Sanchez LE, Sanchis-Gual N, Sanders JR, Sanuy A, Saravanan TR, Sarin N, Sassolas B, Satari H, Sato S, Sato T, Sauter O, Savage RL, Savant V, Sawada T, Sawant D, Sawant HL, Sayah S, Schaetzl D, Scheel M, Scheuer J, Schindler-Tyka A, Schmidt P, Schnabel R, Schneewind M, Schofield RMS, Schönbeck A, Schulte BW, Schutz BF, Schwartz E, Scott J, Scott SM, Seglar-Arroyo M, Seidel E, Sekiguchi T, Sekiguchi Y, Sellers D, Sengupta AS, Sennett N, Sentenac D, Seo EG, Sequino V, Setyawati Y, Shaffer T, Shahriar MS, Shams B, Shao L, Sharifi S, Sharma A, Sharma P, Shawhan P, Shcheblanov NS, Shen H, Shibagaki S, Shikauchi M, Shimizu R, Shimoda T, Shimode K, Shink R, Shinkai H, Shishido T, Shoda A, Shoemaker DH, Shoemaker DM, Shukla K, ShyamSundar S, Sieniawska M, Sigg D, Singer LP, Singh D, Singh N, Singha A, Sintes AM, Sipala V, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smetana J, Smith JR, Smith RJE, Somala SN, Somiya K, Son EJ, Soni K, Soni S, Sorazu B, Sordini V, Sorrentino F, Sorrentino N, Sotani H, Soulard R, Souradeep T, Sowell E, Spagnuolo V, Spencer AP, Spera M, Srivastava AK, Srivastava V, Staats K, Stachie C, Steer DA, Steinlechner J, Steinlechner S, Stops DJ, Stover M, Strain KA, Strang LC, Stratta G, Strunk A, Sturani R, Stuver AL, Südbeck J, Sudhagar S, Sudhir V, Sugimoto R, Suh HG, Summerscales TZ, Sun H, Sun L, Sunil S, Sur A, Suresh J, Sutton PJ, Suzuki T, Suzuki T, Swinkels BL, Szczepańczyk MJ, Szewczyk P, Tacca M, Tagoshi H, Tait SC, Takahashi H, Takahashi R, Takamori A, Takano S, Takeda H, Takeda M, Talbot C, Tanaka H, Tanaka K, Tanaka K, Tanaka T, Tanaka T, Tanasijczuk AJ, Tanioka S, Tanner DB, Tao D, Tapia A, Tapia San Martin EN, Tapia San Martin EN, Tasson JD, Telada S, Tenorio R, Terkowski L, Test M, Thirugnanasambandam MP, Thomas M, Thomas P, Thompson JE, Thondapu SR, Thorne KA, Thrane E, Tiwari S, Tiwari S, Tiwari V, Toland K, Tolley AE, Tomaru T, Tomigami Y, Tomura T, Tonelli M, Torres-Forné A, Torrie CI, Tosta E Melo I, Töyrä D, Trapananti A, Travasso F, Traylor G, Tringali MC, Tripathee A, Troiano L, Trovato A, Trozzo L, Trudeau RJ, Tsai DS, Tsai D, Tsang KW, Tsang T, Tsao JS, Tse M, Tso R, Tsubono K, Tsuchida S, Tsukada L, Tsuna D, Tsutsui T, Tsuzuki T, Turconi M, Tuyenbayev D, Ubhi AS, Uchikata N, Uchiyama T, Udall RP, Ueda A, Uehara T, Ueno K, Ueshima G, Ugolini D, Unnikrishnan CS, Uraguchi F, Urban AL, Ushiba T, Usman SA, Utina AC, Vahlbruch H, Vajente G, Vajpeyi A, Valdes G, Valentini M, Valsan V, van Bakel N, van Beuzekom M, van den Brand JFJ, Van Den Broeck C, Vander-Hyde DC, van der Schaaf L, van Heijningen JV, van Putten MHPM, van Remortel N, Vardaro M, Vargas AF, Varma V, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venneberg J, Venugopalan G, Verkindt D, Verma Y, Veske D, Vetrano F, Viceré A, Viets AD, Villa-Ortega V, Vinet JY, Vitale S, Vo T, Vocca H, von Reis ERG, Vorvick C, Vyatchanin SP, Wade LE, Wade M, Wagner KJ, Walet RC, Walker M, Wallace GS, Wallace L, Walsh S, Wang J, Wang JZ, Wang WH, Ward RL, Warner J, Was M, Washimi T, Washington NY, Watchi J, Weaver B, Wei L, Weinert M, Weinstein AJ, Weiss R, Weller CM, Wellmann F, Wen L, Weßels P, Westhouse JW, Wette K, Whelan JT, White DD, Whiting BF, Whittle C, Wilken D, Williams D, Williams MJ, Williamson AR, Willis JL, Willke B, Wilson DJ, Winkler W, Wipf CC, Wlodarczyk T, Woan G, Woehler J, Wofford JK, Wong ICF, Wrangel J, Wu C, Wu DS, Wu H, Wu S, Wysocki DM, Xiao L, Xu WR, Yamada T, Yamamoto H, Yamamoto K, Yamamoto K, Yamamoto T, Yamashita K, Yamazaki R, Yang FW, Yang L, Yang Y, Yang Y, Yang Z, Yap MJ, Yeeles DW, Yelikar AB, Ying M, Yokogawa K, Yokoyama J, Yokozawa T, Yoon A, Yoshioka T, Yu H, Yu H, Yuzurihara H, Zadrożny A, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhan M, Zhang H, Zhang J, Zhang L, Zhang R, Zhang T, Zhao C, Zhao G, Zhao Y, Zhao Y, Zhou Z, Zhu XJ, Zhu ZH, Zucker ME, Zweizig J. Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run. PHYSICAL REVIEW LETTERS 2021; 126:241102. [PMID: 34213926 DOI: 10.1103/physrevlett.126.241102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.
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Chahal M, Jiang A, Hayden A, Savage K, Villa D, Scott D, Gerrie A, Lo A, Chan M, Pickles T, Connors J, Sehn L, Freeman C. OUTCOMES AFTER INITIAL REFUSAL OF CURATIVE TREATMENT IN PATIENTS WITH HODGKIN LYMPHOMA IN BRITISH COLUMBIA. Hematol Oncol 2021. [DOI: 10.1002/hon.112_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kandane-Rathnayake R, Louthrenoo W, Hoi A, Golder V, Chen YH, Luo SF, Jan Wu YJ, Lateef A, Cho J, Hamijoyo L, Lau CS, Navarra S, Zamora L, LI Z, An Y, Sockalingam S, Katsumata Y, Harigai M, Hao Y, Zhang Z, Kikuchi J, Takeuchi T, Basnayake B, Goldblatt F, Chan M, Ng K, Bae SC, Oon S, O’neill S, Gibson K, Kumar S, Tugnet N, Tanaka Y, Nikpour M, Morand EF. POS0028 DEFINING THE PREVALENCE OF UNMET NEED IN SLE: DATA FROM A LARGE MULTINATIONAL LONGITUDINAL SLE COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The recent prospectively validated definition of the lupus low disease activity state (LLDAS) allows characterisation of patients not achieving a treatment goal, providing impetus for an analysis of unmet needs in SLE using formal definitions. Other recently described definitions of high disease burden include disease activity over time, high disease activity status (HDAS) episodes, and the combination of high disease activity, serological activity and glucocorticoid (GC) use (HDAS+SA+GC).Objectives:To determine the prevalence of formal categories of unmet need, and the association of these with adverse outcomes, in SLE.Methods:Data from a 13-country longitudinal SLE cohort (ACR/SLICC criteria) were collected between 2013 and 19 using standard templates. Unmet need was defined as (i) patients never attaining LLDAS defined as in Golder et al., 2019 [1], (ii) having persistently active disease (time adjusted mean SLEDAI-2K (AMS) > 4), (iii) ever exhibiting high disease activity status (HDAS; SLEDAI-2K ≥10[2]), or (iv) ever exhibiting all of SLEDAI≥10, serological activity, and glucocorticoid use (HDAS+SA+GC)[3]. Health-related quality of life (HRQoL) was assessed using SF36 (v2) surveys and damage accrual using SLE Damage Index (SDI).Results:3,384 SLE patients were followed for 30,313 visits over median [IQR] 2.4 [0.4, 4.3] years. 53% of all visits were not in LLDAS; 813 patients (24%) never achieved LLDAS during observation. Median AMS was 3.0 [1.4, 4.9] and 34% of patients had AMS > 4 throughout the study. 25% of patients had at least one episode of HDAS, representing 8% of visits. 702 patients (21%) had at least one episode of HDAS+SA+GC, representing 8% of visits. Each of never-LLDAS, AMS>4, ever-HDAS, and ever-HDAS+SA+GC were associated with significantly greater number of physician visits, higher mean glucocorticoid dose, lower HRQoL and higher mortality. 31%, 58% and 83% of never-LLDAS, AMS>4, and ever-HDAS patients respectively were also HDAS+SA+GC on at least one occasion.Conclusion:Data from a multinational longitudinal SLE cohort indicate that unmet need, defined by LLDAS-never, AMS>4, HDAS, or HDAS+SA+GC, is prevalent in SLE, and that these definitions are associated with poor outcomes.References:[1]Golder, V., et al., Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. The Lancet Rheumatology, 2019. 1(2): p. e95-e102.[2]Koelmeyer, R., et al., High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus. Lupus Sci Med, 2020. 7(1).[3]van Vollenhoven, R.F., et al., Belimumab in the treatment of systemic lupus erythematosus: high disease activity predictors of response. Annals of the Rheumatic Diseases, 2012. 71(8): p. 1343-1349.Acknowledgements:The APLC acknowledges all the Data Collectors and Patients for their valuable contributions to research.Disclosure of Interests:Rangi Kandane-Rathnayake: None declared, Worawit Louthrenoo: None declared, Alberta Hoi Consultant of: Abbvie and GSK, Grant/research support from: AstraZeneca, GSK, BMS, Janssen, and Merck Serono, Vera Golder: None declared, Yi-Hsing Chen Speakers bureau: Pfizer, Novartis, Abbvie, Johnson & Johnson, BMS, Roche, Lilly, AstraZeneca, Sanofi, MSD, Guigai, Astellas, Inova Diagnostics, UCB, Agnitio Science Technology, United Biopharma, Thermo Fisher, Consultant of: Pfizer, Novartis, Abbvie, Johnson & Johnson, BMS, Roche, Lilly, AstraZeneca, Sanofi, MSD, Guigai, Astellas, Inova Diagnostics, UCB, Agnitio Science Technology, United Biopharma, Thermo Fisher, Gilead, Grant/research support from: Pfizer, Norvatis, BMS, Abbevie, Johnson & Johnson, Roche, Sanofi, Guigai, Roche, Boehringer Ingelheim, UCB, MSD, Astra-Zeneca, Astellas, Gilead, Shue Fen Luo: None declared, Yeong-Jian Jan Wu Speakers bureau: Pfizer, Lilly, Novartis, Abbvie, Aisha Lateef: None declared, Jiacai Cho: None declared, Laniyati Hamijoyo Speakers bureau: Pfizer, Novartis, Abbot, Chak Sing Lau Shareholder of: Pfizer, Sanofi, and Janssen, Sandra Navarra Speakers bureau: Pfizer, Johnson & Johnson, Novartis, Astellas, Grant/research support from: Astellas, Johnson & Johnson, Leonid Zamora: None declared, Zhanguo Li Speakers bureau: Eli, Lilly, Novartis, GSK, AbbVie, Paid instructor for: Pfizer, Roche, Johnson., Consultant of: Lilly, Pfizer, Grant/research support from: Pfizer, Yuan An: None declared, Sargunan Sockalingam Speakers bureau: Pfizer, Roche, Novartis, Grant/research support from: Roche and Novartis, Yasuhiro Katsumata Speakers bureau: Chugai Pharmaceutical Co., Ltd., Glaxo-Smithkline K.K., and Sanofi K.K., masayoshi harigai Speakers bureau: AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc.,Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd., Consultant of: AbbVie, Boehringer-ingelheim, Bristol Myers Squibb Co., Kissei Pharmaceutical Co.,Ltd. and Teijin Pharma., Grant/research support from: AbbVie Japan GK, Asahi Kasei Corp., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Daiichi-Sankyo, Inc.,Eisai Co., Ltd., Kissei Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., Sekiui Medical, Shionogi & Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd., Yanjie Hao: None declared, Zhuoli Zhang Speakers bureau: Norvatis, GSK, Pfizer, Jun Kikuchi: None declared, Tsutomu Takeuchi Speakers bureau: AbbVie AYUMI Pharmaceutical Corp. Bristol-Myers Squibb Chugai Pharmaceutical Co, Ltd. Daiichi Sankyo Co., Ltd. Eisai Co., Ltd. Eli Lilly Japan, Gilead Sciences, Inc. Mitsubishi-Tanabe Pharma Corp. Pfizer Japan Inc. Sanofi K.K., Consultant of: Astellas Pharma, Inc. Chugai Pharmaceutical Co, Ltd. Eli Lilly Japan, Mitsubishi-Tanabe Pharma Corp., Grant/research support from: AbbVie, Asahikasei Pharma Corp. Chugai Pharmaceutical Co, Ltd. Mitsubishi-Tanabe Pharma Corp. Sanofi K.K., BMDB Basnayake: None declared, Fiona Goldblatt: None declared, Madelynn Chan Speakers bureau: AbbVie, Novartis, Consultant of: Pfizer, Eli-Lilly, Kristine Ng Speakers bureau: Abbvie, Novartis, Janssen, Sang-Cheol Bae: None declared, Shereen Oon: None declared, Sean O’Neill Consultant of: GSK, Kathryn Gibson Speakers bureau: UCB, Consultant of: Novartis, Janssen, Grant/research support from: Novartis, Sunil Kumar: None declared, Nicola Tugnet: None declared, Yoshiya Tanaka Speakers bureau: Daiichi-Sankyo, Eli Lilly, Novartis, YL Biologics, Bristol-Myers, Eisai, Chugai, Abbvie, Astellas, Pfizer, Sanofi, Asahi-kasei, GSK, Mitsubishi-Tanabe, Gilead, Janssen, Grant/research support from: Abbvie, Mitsubishi-Tanabe, Chugai, Asahi-Kasei, Eisai, Takeda, Daiichi-Sankyo, Mandana Nikpour Speakers bureau: Actelion, GSK, Janssen, Pfizer, UCB, Paid instructor for: UCB, Consultant of: Actelion, Boehringer Ingelheim, Certa Therapeutics, Eli Lilly, GSK, Janssen, Pfizer, UCB, Grant/research support from: Actelion, Astra Zeneca, BMS, GSK, Janssen, UCB, Eric F. Morand Speakers bureau: AstraZeneca, Paid instructor for: Eli Lilly, Consultant of: AstraZeneca, Amgen, Biogen, BristolMyersSquibb, Eli Lilly, EMD Serono, Genentech, Janssen, Grant/research support from: AstraZeneca, BristolMyersSquibb, Eli Lilly, EMD Serono, Janssen.
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Fung AS, Graham DM, Chen EX, Stockley TL, Zhang T, Le LW, Albaba H, Pisters KM, Bradbury PA, Trinkaus M, Chan M, Arif S, Zurawska U, Rothenstein J, Zawisza D, Effendi S, Gill S, Sawczak M, Law JH, Leighl NB. A phase I study of binimetinib (MEK 162), a MEK inhibitor, plus carboplatin and pemetrexed chemotherapy in non-squamous non-small cell lung cancer. Lung Cancer 2021; 157:21-29. [PMID: 34052705 DOI: 10.1016/j.lungcan.2021.05.021] [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] [Received: 03/07/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION MEK inhibition is a potential therapeutic strategy in non-small cell lung cancer (NSCLC). This phase I study evaluates the MEK inhibitor binimetinib plus carboplatin and pemetrexed in stage IV non-squamous NSCLC patients (NCT02185690). METHODS A standard 3 + 3 dose-escalation design was used. Binimetinib 30 mg BID (dose level 1 [DL1]) or 45 mg BID (dose level 2 [DL2]) was given with standard doses of carboplatin and pemetrexed using an intermittent dosing schedule. The primary outcome was determination of the recommended phase II dose (RP2D) and safety of binimetinib. Secondary outcomes included efficacy, pharmacokinetics, and an exploratory analysis of response based on mutation subtype. RESULTS Thirteen patients (6 DL1, 7 DL2) were enrolled: 7 KRAS, 5 EGFR, and 1 NRAS mutation. The RP2D was binimetinib 30 mg BID. Eight patients (61.5%) had grade 3/4 adverse events, with dose limiting toxicities in 2 patients at DL2. Twelve patients were evaluated for response, with an investigator-assessed objective response rate (ORR) of 50% (95% CI 21.1%-78.9%; ORR 33.3% by independent-review, IR), and disease control rate 83.3% (95% CI 51.6%-97.9%). Median progression free survival (PFS) was 4.5 months (95% CI 2.6 months-NA), with a 6-month and 12-month PFS rate of 38.5% (95% CI 19.3%-76.5%) and 25.6% (95% CI 8.9%-73.6%), respectively. In an exploratory analysis, KRAS/NRAS-mutated patients had an ORR of 62.5% (ORR 37.5% by IR) vs. 25% in KRAS/NRAS wild-type patients. In MAP2K1-mutated patients, the ORR was 42.8%. CONCLUSION The addition of binimetinib to carboplatin and pemetrexed appears to have manageable toxicity with evidence of activity in advanced non-squamous NSCLC.
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Rabani R, Rasti M, Chan M, Mahomed N, Gandhi R, Viswanathan S. Paradoxical role of IL6 signalling in osteoarthritis. Cytotherapy 2021. [DOI: 10.1016/s1465324921003340] [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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Chan M, Ziyaeyan A, Rasti M, Gabrial S, Kapoor M, Mahomed N, Gandhi R, Viswanathan S. Pro-resolving macrophages as a cell-based therapy in osteoarthritis by adoptive transfer within murine in vivo and human explant ex vivo investigation. Cytotherapy 2021. [DOI: 10.1016/s1465324921004965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pedersen E, Harms P, Zhao L, Andea A, Chan M, Fullen D, Lowe L, Patel R, Durham A. 356 Polypoid melanoma is associated with aggressive histopathological characteristics and poor clinical prognosis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Novak KL, Ma C, Kheirkhahrahimabadi H, heatherington J, Ingram R, Martin M, Panaccione R, Kaplan GG, Devlin S, Seow C, Chan M, Lu C. A173 INNOVATIVE CARE FOR INFLAMMATORY BOWEL DISEASE PATIENTS DURING THE COVID-19 PANDEMIC: USE OF BEDSIDE INTESTINAL ULTRASOUND TO OPTIMIZE MANAGEMENT. J Can Assoc Gastroenterol 2021. [PMCID: PMC7958805 DOI: 10.1093/jcag/gwab002.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background The COVID-19 pandemic has led to significant alterations in the ability to deliver outpatient care to patients with inflammatory bowel disease (IBD) including endoscopic evaluation. This has highlighted the need for alternative, accurate, non-invasive strategies to safely assess disease activity. Aims The aim of this study is to describe the impact of point of care intestinal ultrasound (IUS) in a university-based tertiary care IBD urgent access clinic. Methods We prospectively evaluated a comprehensive care pathway which incorporated outpatient sigmoidoscopy and intestinal ultrasound with the purpose of directing further ambulatory clinical care and avoiding hospitalization or hospital-based investigations including endoscopy during the COVID pandemic for patients with established IBD with symptoms suggestive of a disease flare, or those at high risk of a new diagnosis of IBD. Non-invasive markers C Reactive Protein (CRP) and fecal calprotectin (fCal) were collected where available. Patients were pre-screened for influenza-like illness, as COVID-19 testing was not available for this population during the study period. Substantial management changes were defined as addition of any medications, biologic switch/ optimization, and or referral for surgical consultation. Results Between March 15th and June 30th 2020, a total of 72 patients were seen in the urgent access clinic. All patients were seen within 7 days of referral. The majority were female 57% (41/72) and/ or had Crohn’s disease 65.5% (47/72) (Table 1). Of these, 84.7% (61/72) underwent a substantial management change based on features of active inflammation detected by either IUS alone (53% 38/72) sigmoidoscopy alone (12.5% 9/72) or combination IUS with in-clinic sigmoidoscopy (32% 23/72) in addition to CRP and fCal. Three new diagnoses of IBD were made: one colonic Crohn’s and 2 with ulcerative colitis. One pregnant patient avoided all acute care utilization. Five patients were referred to colorectal surgery for urgent resection including two patients admitted directly for emergent operations. No patients required visits to the emergency department. Furthermore, there have been no unscheduled hospitalizations occurred in this cohort since inception March 23, 2020 til November 15th 2020. Conclusions The implementation of IUS in a centralized, urgent access clinic pathway resulted in efficient and meaningful changes in IBD management while sparing the need for acute care services including ER visits, need for in-hospital endoscopy, and hospitalization. The pandemic highlights the utility of this patient-center tool and supports expansion of wider IUS adoption. Funding Agencies None
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Chan M. SP-0150: Integration of AI and Machine Learning in Radiotherapy QA. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abbott R, Abbott TD, Abraham S, Acernese F, Ackley K, Adams C, Adhikari RX, Adya VB, Affeldt C, Agathos M, Agatsuma K, Aggarwal N, Aguiar OD, Aich A, Aiello L, Ain A, Ajith P, Akcay S, Allen G, Allocca A, Altin PA, Amato A, Anand S, Ananyeva A, Anderson SB, Anderson WG, Angelova SV, Ansoldi S, Antier S, Appert S, Arai K, Araya MC, Areeda JS, Arène M, Arnaud N, Aronson SM, Arun KG, Asali Y, Ascenzi S, Ashton G, Aston SM, Astone P, Aubin F, Aufmuth P, AultONeal K, Austin C, Avendano V, Babak S, Bacon P, Badaracco F, Bader MKM, Bae S, Baer AM, Baird J, Baldaccini F, Ballardin G, Ballmer SW, Bals A, Balsamo A, Baltus G, Banagiri S, Bankar D, Bankar RS, Barayoga JC, Barbieri C, Barish BC, Barker D, Barkett K, Barneo P, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Bartos I, Bassiri R, Basti A, Bawaj M, Bayley JC, Bazzan M, Bécsy B, Bejger M, Belahcene I, Bell AS, Beniwal D, Benjamin MG, Bentley JD, Bergamin F, Berger BK, Bergmann G, Bernuzzi S, Berry CPL, Bersanetti D, Bertolini A, Betzwieser J, Bhandare R, Bhandari AV, Bidler J, Biggs E, Bilenko IA, Billingsley G, Birney R, Birnholtz O, Biscans S, Bischi M, Biscoveanu S, Bisht A, Bissenbayeva G, Bitossi M, Bizouard MA, Blackburn JK, Blackman J, Blair CD, Blair DG, Blair RM, Bobba F, Bode N, Boer M, Boetzel Y, Bogaert G, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Bork R, Boschi V, Bose S, Bossilkov V, Bosveld J, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branchesi M, Brau JE, Breschi M, Briant T, Briggs JH, Brighenti F, Brillet A, Brinkmann M, Brockill P, Brooks AF, Brooks J, Brown DD, Brunett S, Bruno G, Bruntz R, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buscicchio R, Buskulic D, Byer RL, Cabero M, Cadonati L, Cagnoli G, Cahillane C, Calderón Bustillo J, Callaghan JD, Callister TA, Calloni E, Camp JB, Canepa M, Cannon KC, Cao H, Cao J, Carapella G, Carbognani F, Caride S, Carney MF, Carullo G, Casanueva Diaz J, Casentini C, Castañeda J, Caudill S, Cavaglià M, Cavalier F, 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O, Savage RL, Savant V, Sawant D, Sayah S, Schaetzl D, Schale P, Scheel M, Scheuer J, Schmidt P, Schnabel R, Schofield RMS, Schönbeck A, Schreiber E, Schulte BW, Schutz BF, Schwarm O, Schwartz E, Scott J, Scott SM, Seidel E, Sellers D, Sengupta AS, Sennett N, Sentenac D, Sequino V, Sergeev A, Setyawati Y, Shaddock DA, Shaffer T, Sharifi S, Shahriar MS, Sharma A, Sharma P, Shawhan P, Shen H, Shikauchi M, Shink R, Shoemaker DH, Shoemaker DM, Shukla K, ShyamSundar S, Siellez K, Sieniawska M, Sigg D, Singer LP, Singh D, Singh N, Singha A, Singhal A, Sintes AM, Sipala V, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smetana J, Smith JR, Smith RJE, Somala S, Son EJ, Soni S, Sorazu B, Sordini V, Sorrentino F, Souradeep T, Sowell E, Spencer AP, Spera M, Srivastava AK, Srivastava V, Staats K, Stachie C, Standke M, Steer DA, Steinke M, Steinlechner J, Steinlechner S, Steinmeyer D, Stevenson S, Stocks D, Stops DJ, Stover M, Strain KA, Stratta G, Strunk A, Sturani R, Stuver AL, Sudhagar S, Sudhir V, Summerscales TZ, Sun L, Sunil S, Sur A, Suresh J, Sutton PJ, Swinkels BL, Szczepańczyk MJ, Tacca M, Tait SC, Talbot C, Tanasijczuk AJ, Tanner DB, Tao D, Tápai M, Tapia A, Tapia San Martin EN, Tasson JD, Taylor R, Tenorio R, Terkowski L, Thirugnanasambandam MP, Thomas M, Thomas P, Thompson JE, Thondapu SR, Thorne KA, Thrane E, Tinsman CL, Saravanan TR, Tiwari S, Tiwari S, Tiwari V, Toland K, Tonelli M, Tornasi Z, Torres-Forné A, Torrie CI, Tosta E Melo I, Töyrä D, Travasso F, Traylor G, Tringali MC, Tripathee A, Trovato A, Trudeau RJ, Tsang KW, Tse M, Tso R, Tsukada L, Tsuna D, Tsutsui T, Turconi M, Ubhi AS, Udall R, Ueno K, Ugolini D, Unnikrishnan CS, Urban AL, Usman SA, Utina AC, Vahlbruch H, Vajente G, Valdes G, Valentini M, van Bakel N, van Beuzekom M, van den Brand JFJ, Van Den Broeck C, Vander-Hyde DC, van der Schaaf L, Van Heijningen JV, van Veggel AA, Vardaro M, Varma V, Vass S, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venugopalan G, Verkindt D, Veske D, Vetrano F, Viceré A, Viets AD, Vinciguerra S, Vine DJ, Vinet JY, Vitale S, Vivanco FH, Vo T, Vocca H, Vorvick C, Vyatchanin SP, Wade AR, Wade LE, Wade M, Walet R, Walker M, Wallace GS, Wallace L, Walsh S, Wang JZ, Wang S, Wang WH, Ward RL, Warden ZA, Warner J, Was M, Watchi J, Weaver B, Wei LW, Weinert M, Weinstein AJ, Weiss R, Wellmann F, Wen L, Weßels P, Westhouse JW, Wette K, Whelan JT, Whiting BF, Whittle C, Wilken DM, Williams D, Willis JL, Willke B, Winkler W, Wipf CC, Wittel H, Woan G, Woehler J, Wofford JK, Wong ICF, Wright JL, Wu DS, Wysocki DM, Xiao L, Yamamoto H, Yang L, Yang Y, Yang Z, Yap MJ, Yazback M, Yeeles DW, Yu H, Yu H, Yuen SHR, Zadrożny AK, Zadrożny A, Zanolin M, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhao C, Zhao G, Zhou M, Zhou Z, Zhu XJ, Zimmerman AB, Zucker ME, Zweizig J. GW190521: A Binary Black Hole Merger with a Total Mass of 150 M_{⊙}. PHYSICAL REVIEW LETTERS 2020; 125:101102. [PMID: 32955328 DOI: 10.1103/physrevlett.125.101102] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 06/08/2023]
Abstract
On May 21, 2019 at 03:02:29 UTC Advanced LIGO and Advanced Virgo observed a short duration gravitational-wave signal, GW190521, with a three-detector network signal-to-noise ratio of 14.7, and an estimated false-alarm rate of 1 in 4900 yr using a search sensitive to generic transients. If GW190521 is from a quasicircular binary inspiral, then the detected signal is consistent with the merger of two black holes with masses of 85_{-14}^{+21} M_{⊙} and 66_{-18}^{+17} M_{⊙} (90% credible intervals). We infer that the primary black hole mass lies within the gap produced by (pulsational) pair-instability supernova processes, with only a 0.32% probability of being below 65 M_{⊙}. We calculate the mass of the remnant to be 142_{-16}^{+28} M_{⊙}, which can be considered an intermediate mass black hole (IMBH). The luminosity distance of the source is 5.3_{-2.6}^{+2.4} Gpc, corresponding to a redshift of 0.82_{-0.34}^{+0.28}. The inferred rate of mergers similar to GW190521 is 0.13_{-0.11}^{+0.30} Gpc^{-3} yr^{-1}.
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Leung W, Soh TG, Linn YC, Low JGH, Loh J, Chan M, Chng WJ, Koh LP, Poon MLM, Ng KP, Kuick CH, Tan TT, Tan LK, Seng MSF. Rapid production of clinical-grade SARS-CoV-2 specific T cells. ACTA ACUST UNITED AC 2020; 3:e101. [PMID: 32838213 PMCID: PMC7404427 DOI: 10.1002/acg2.101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023]
Abstract
Objectives To determine whether the frequencies of SARS‐CoV‐2‐specific T cells are sufficiently high in the blood of convalescent donors and whether it is technically feasible to manufacture clinical‐grade products overnight for T‐cell therapy and assessment of COVID‐19 immunity. Methods One unit of whole blood or leukapheresis was collected from each donor following standard blood bank practices. The leukocytes were stimulated using overlapping peptides of SARS‐CoV‐2, covering the immunodominant sequence domains of the S protein and the complete sequence of the N and M proteins. Thereafter, functionally reactive cells were enriched overnight using an automated device capturing IFNγ‐secreting cells. Results From 1 × 109 leukocytes, a median of 0.98 × 106 (range 0.56‐2.95) IFNγ + T cells were produced from each of the six donors, suggesting a high frequency of SARS‐CoV‐2 reactive T cells in their blood, even though only one donor had severe COVID‐19 requiring mechanical ventilation whereas the other five donors had minor symptoms. A median of 57% of the enriched T cells were IFNγ+ (range 20%‐74%), with preferential enrichment of CD56+ T cells and effector memory T cells. TCRVβ‐spectratyping confirmed distinctively tall oligoclonal peaks in final products. With just six donors, the probability that a recipient would share at least one HLA allele with one of the donors is >88% among Caucasian, >95% among Chinese, >97% among Malay, and >99% among Indian populations. Conclusions High frequencies of rapid antigen‐reactive T cells were found in convalescent donors, regardless of severity of COVID‐19. The feasibility of clinical‐grade production of SARS‐CoV‐2‐specific T cells overnight for therapeutics and diagnostics is revealed.
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M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, 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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Lamagna C, Chan M, Bagos A, Tai E, Young C, Chen Y, Chou L, Park G, Masuda E, Taylor V. OP0046 TARGETING IRAK1 AND 4 SIGNALING WITH R835, A NOVEL ORAL SMALL MOLECULE INHIBITOR: A POTENTIAL NEW TREATMENT FOR SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by loss of immunological tolerance, hyperactivation of immune cells, proinflammatory cytokine production and, ultimately, end organ damage due to immune complex deposition. Toll-like receptors (TLRs), which are essential to the innate immune response to microbes and other danger signals, play a key role in the pathogenesis of SLE by recognition of self-molecules (1). Interleukin receptor associated kinases (IRAK)1 and 4 are responsible for initiating MyD88-dependent signaling from most TLRs and Interleukin-1 Receptors (IL-1R) and represent attractive targets for the therapeutic treatment of SLE (2). We have identified a potent and selective IRAK1/4 inhibitor, R835, that substantially suppressed the elevation of LPS (TLR4 agonist)-induced serum cytokines in healthy human volunteers in a recently completed phase 1 study.Objectives:The aim of our study was to investigate the effect of IRAK1/4 selective inhibition as potential therapeutic approach for SLE. We evaluated the effect of our clinical candidate R835 on TLR7 signaling and in a mouse model of lupus-like disease.Methods:Human primary dendritic cells and whole blood were stimulated with gardiquimod (TLR7 agonist) to evaluate the effect of R835 on Interferon-alpha (IFN-α) production. R835 was further evaluated for its efficacy on survival and disease progression in lupus-prone NZB/W F1 mice with early or active signs of disease.Results:R835 inhibited TLR7-induced cytokine production in human dendritic cells and whole blood. Given orally to mice, R835 dose-dependently decreased serum IFN-α in response to administration of a TLR7 agonist. Furthermore, treatment of NZB/W F1 lupus-prone mice with R835 reversed the progression of lupus-like disease and the establishment of a pro-inflammatory environment, as demonstrated by decreased levels of proteinuria, blood urea nitrogen and autoantibodies, and reversal of renal pathology.Conclusion:To our knowledge, R835 is the first dual IRAK1/4 inhibitor to enter clinical development and provides an attractive approach to treat a range of autoimmune and rheumatic diseases, including lupus.References:[1]Signals via the Adaptor MyD88 in B cells and DCs Make Distinct and Synergistic Contributions to Immune Activation and Tissue Damage in Lupus. Lino L. Teichmann, Dominik Schenten, Ruslan Medzhitov, Michael Kashgarian, and Mark J. Shlomchik. Immunity. 2013 March 21; 38(3): 528–540.[2]Suppression of IRAK1 or IRAK4 Catalytic Activity, but Not Type 1 IFN Signaling, Prevents Lupus Nephritis in Mice Expressing a Ubiquitin Binding-Defective Mutant of ABIN1. Nanda SK, Lopez-Pelaez M, Arthur JS, Marchesi F, Cohen P. J Immunol. 2016 Dec 1;197(11):4266-4273.Disclosure of Interests:Chrystelle Lamagna Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Meagan Chan Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Art Bagos Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Ernest Tai Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Chi Young Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Yan Chen Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Lu Chou Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Gary Park Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Esteban Masuda Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vanessa Taylor Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals
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Lamagna C, Chan M, Tai E, Siu S, Frances R, Yi S, Young C, Markovtsov V, Chen Y, Chou L, Park G, Masuda E, Taylor V. OP0133 PRECLINICAL EFFICACY OF R835, A NOVEL IRAK1/4 DUAL INHIBITOR, IN RODENT MODELS OF JOINT INFLAMMATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1901] [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:Interleukin receptor associated kinases (IRAK) 1 and 4 are kinases involved in Toll-Like Receptor (TLR) and Interleukin-1 Receptor (IL-1R) signaling pathways, which regulate innate immunity and inflammation. Dysregulation of IRAK1/4 signaling can lead to a variety of inflammatory conditions including rheumatoid and gouty arthritis. As a result, IRAK1/4 are promising therapeutic targets for rheumatic diseases (1). We have identified a potent and selective IRAK1/4 inhibitor, R835, that substantially suppressed the elevation of LPS (TLR4 agonist)-induced serum cytokines in healthy human volunteers in a recently completed phase 1 study.Objectives:The aim of our study was to investigate the effect of IRAK1/4 selective inhibition as a potential therapeutic approach for rheumatological diseases. We evaluated the inhibition by our clinical candidate, R835, on TLR-, IL-1R- and NLRP3 inflammasome-induced cytokine production, as well as in preclinical models of arthritis.Methods:The effect of R835 on TLR- or IL-1R-induced cytokine production was evaluated in vitro using THP-1, human primary endothelial cells and human primary dendritic cells. The activity of R835 on the NLRP3 inflammasome was also tested in vitro using THP-1 cells. The pharmacokinetic-pharmacodynamic relationship of R835 was evaluated in a mouse model of IL-1b-induced cytokine release. Mice were pre-treated orally with vehicle or R835 prior to challenge; serum cytokine and plasma compound levels were determined. The efficacy of IRAK1/4 inhibition by R835 in rodent models of joint inflammation was evaluated in a mouse model monosodium (MSU)-induced peritonitis, in rat model of MSU-induced gouty arthritis and in a rat model of collagen-induced arthritis (CIA).Results:In human cells, R835 blocked proinflammatory cytokine production in response to TLR, IL-1R and NLRP3 inflammasome activation. In mice, R835 dose-dependently decreased serum cytokines in response to administration of IL-1b. Mice pre-treated with R835 demonstrated dose-dependent reductions in MSU crystal-induced serum and peritoneal cytokine levels, as well as neutrophil influx in the peritoneal cavity. Prophylactic and therapeutic treatment with R835 also resulted in significant inhibition of MSU crystal-induced knee edema and pain in a rat model of human gouty arthritis. In the rat model of CIA, R835 blocked both onset and progression of disease, by reducing inflammation, cartilage degeneration and synovial inflammation.Conclusion:R835 is a promising clinical candidate for the treatment of a range of cytokine-driven rheumatological diseases. R835 has proven to have desirable pharmacokinetic properties, was well tolerated and suppressed LPS-induced serum cytokines in healthy volunteers in a recent phase 1 study.References:[1]Bahia M S, Kaur M, Silakari P, Silakari O. Interleukin-1 receptor associated kinase inhibitors: Potential therapeutic agents for inflammatory- and immune-related disorders. Cellular Signalling 27 (2015) 1039–1055.Disclosure of Interests:Chrystelle Lamagna Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Meagan Chan Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Ernest Tai Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Stacey Siu Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Roy Frances Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Sothy Yi Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Chi Young Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vadim Markovtsov Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Yan Chen Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Lu Chou Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Gary Park Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Esteban Masuda Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vanessa Taylor Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals
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Kandane-Rathnayake R, Louthrenoo W, Luo SF, Wu YJ, Chen YH, Golder V, Lateef A, Cho J, Navarra S, Zamora L, Hamijoyo L, Sockalingam S, An Y, Li Z, Katsumata Y, Harigai M, Hao Y, Zhang Z, Chan M, Kikuchi J, Takeuchi T, Goldblatt F, O’neill S, Karyekar C, Lofland JH, Bae SC, Lau CS, Hoi A, Nikpour M, Morand EF. AB0384 MEDICATION USE IN SYSTEMIC LUPUS ERYTHEMATOSUS – DATA FROM A MULTICENTRE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In the absence of evidence-based treatment guidelines, medication use in SLE is highly variable. Low rates of remission and lupus low disease activity state (LLDAS) suggest that suboptimal responses to standard medications, which include glucocorticoids (GC), anti-malarial (AM) drugs and immunosuppressive (IS) agents, are common. Understanding the utility of current medications will facilitate the selection of patients for advanced therapies as they emerge.Objectives:To examine medication use patterns in a large multicentre SLE cohort.Methods:We used 2013-18 data from the Asia Pacific Lupus Collaboration (APLC) cohort in which disease activity (SLEDAI-2K) and medication details were captured at every visit. LLDAS was defined as in Golderet al., 2019 (1). We examined the use of medication (med) categories (GC &/or AM &/or IS) by SLE disease activity and LLDAS at the visit level. Additionally, we performed Cox regression analyses to determine the time-to-discontinuation of meds stratified by SLE disease activity, ranked by time-adjusted mean SLEDAI-2K, and by percent-time spent in LLDAS.Results:We analysed data from 19,804 visits of 2,860 patients. We observed 8 med categories: no meds; GC, AM or IS only; GC+AM; GC+IS; AM+IS and GC+AM+IS (triple therapy). Triple therapy was the most frequent med pattern (32%); single agents were used in 21% of visits and biologicals in only 3%. Among visits where SLEDAI-2K was ≥10, triple therapy was used in 46%, with median [IQR] GC dose 10 [6, 24] mg/day; in contrast, among visits with SLEDAI-2K≤4 triple therapy was used in 28% (p<0.01). Patients in LLDAS received less combination therapy than those who were not in LLDAS.Med persistence (survival analysis) varied widely, with lowest survivals for IS. Patients with time-adjusted mean SLEDAI-2K ≥10 had lower discontinuation of GC and higher discontinuation of IS including azathioprine, leflunomide and cyclosporine (Table 1). In contrast, increased time in LLDAS was associated with reduced discontinuation of AM and azathioprine.GCAMISMPhMPhAAZAMTXCyALEFOverall med survival, days to 25% discontinuation (95%CI)1048(938, 1197)1267(1113, 1428)175(175, 182)387(252, 756)409(350, 476)525(219, 686)268(182, 350)329(190, 524)Univariable associations,HR (95% CI) p-valueDisease activity≤41.001.001.001.001.001.001.001.00>4 & <100.69 (0.56,0.84)p<0.0011.15 (0.92,1.44)0.20.92 (0.80,1.05)0.21.37 (0.78,2.42)0.31.16 (0.97,1.39)0.111.11 (0.72,1.71)0.61.26 (0.90,1.77) 0.181.88 (1.07,3.30) 0.03≥100.65 (0.35,1.21) 0.181.56 (0.94,2.59) 0.080.84 (0.45,1.57)0.61.92 (0.80,4.63)0.142.69 (1.86,3.91) p<0.0011.85 (0.92,3.71) 0.082.66 (1.36,5.21) 0.0041.62 (1.13,2.32)0.009LLDAS<50%1.001.001.001.001.001.001.001.00≥50%1.30 (1.09, 1.55)0.0030.67 (0.54, 0.84)<0.0011.22 (1.08, 1.40)0.0020.83 (0.44,1.57)0.60.83 (0.69, 1.00)0.0540.70 (0.46, 1.07)0.101.29 (0.92, 1.83)0.140.43 (1.5, 1.25)0.12Conclusion:In a large multicentre SLE cohort, most patients were receiving combination treatment. AM treatment survival was high and associated with low disease activity, GC survival was high and associated with high disease activity, while IS survival was low. Patients with high disease activity received more medication combinations but had reduced IS survival. These data suggest ongoing unmet need for improved medications for treatment of SLE.Reference:Golder, V., et al Lancet Rheum. 2019 1(2):e95-102Disclosure of Interests:Rangi Kandane-Rathnayake Grant/research support from: The APLC has received financial (non-restricted educational) grants from AstraZeneca, Bristol Myers Squibb, GlaxoSmithKline, Janssen, EMD Serono, Eli Lilly and UCB for the LLDAS Validation Study., Worawit Louthrenoo: None declared, Shue Fen Luo: None declared, Yeong-Jian Wu Consultant of: Pfizer, Lilly, Novartis, Abbvie, Roche, Speakers bureau: Lilly, Novartis, Yi-Hsing Chen Grant/research support from: Taiwan Ministry of Science and Technology, Taiwan Department of Health, Taichung Veterans General Hospital, National Yang-Ming University, GSK, Pfizer, BMS., Consultant of: Pfizer, Novartis, Abbvie, Johnson & Johnson, BMS, Roche, Lilly, GSK, Astra& Zeneca, Sanofi, MSD, Guigai, Astellas, Inova Diagnostics, UCB, Agnitio Science Technology, United Biopharma, Thermo Fisher, Gilead., Paid instructor for: Pfizer, Novartis, Johnson & Johnson, Roche, Lilly, Astra& Zeneca, Sanofi, Astellas, Agnitio Science Technology, United Biopharma., Speakers bureau: Pfizer, Novartis, Abbvie, Johnson & Johnson, BMS, Roche, Lilly, GSK, Astra& Zeneca, Sanofi, MSD, Guigai, Astellas, Inova Diagnostics, UCB, Agnitio Science Technology, United Biopharma, Thermo Fisher, Gilead., Vera Golder: None declared, Aisha Lateef: None declared, Jiacai Cho: None declared, Sandra Navarra Speakers bureau: Astellas, Novartis, Pfizer, Johnson & Johnson, Abbvie, Leonid Zamora: None declared, Laniyati Hamijoyo Speakers bureau: Pfizer, Novartis, Tanabe, Abbot, Dexa Medica, Roche, Sargunan Sockalingam: None declared, Yuan An: None declared, Zhanguo Li: None declared, Yasuhiro Katsumata: None declared, masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma., Yanjie Hao: None declared, Zhuoli Zhang: None declared, Madelynn Chan: None declared, Jun Kikuchi: None declared, Tsutomu Takeuchi Grant/research support from: Eisai Co., Ltd, Astellas Pharma Inc., AbbVie GK, Asahi Kasei Pharma Corporation, Nippon Kayaku Co., Ltd, Takeda Pharmaceutical Company Ltd, UCB Pharma, Shionogi & Co., Ltd., Mitsubishi-Tanabe Pharma Corp., Daiichi Sankyo Co., Ltd., Chugai Pharmaceutical Co. Ltd., Consultant of: Chugai Pharmaceutical Co Ltd, Astellas Pharma Inc., Eli Lilly Japan KK, Speakers bureau: AbbVie GK, Eisai Co., Ltd, Mitsubishi-Tanabe Pharma Corporation, Chugai Pharmaceutical Co Ltd, Bristol-Myers Squibb Company, AYUMI Pharmaceutical Corp., Eisai Co., Ltd, Daiichi Sankyo Co., Ltd., Gilead Sciences, Inc., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi K.K., Dainippon Sumitomo Co., Ltd., Fiona Goldblatt: None declared, Sean O’Neill: None declared, Chetan Karyekar Shareholder of: Johnson & Johnson, Consultant of: Janssen, Employee of: Janssen Global Services, LLC. Previously, Novartis, Bristol-Myers Squibb, and Abbott Labs., Jennifer H. Lofland Employee of: Janssen, Sang-Cheol Bae: None declared, Chak Sing Lau: None declared, Alberta Hoi: None declared, Mandana Nikpour: None declared, Eric F. Morand Grant/research support from: AstraZeneca, Consultant of: AstraZeneca, Speakers bureau: AstraZeneca
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Walsh RJ, Nickles EP, Li Y, Dharmadhikari B, Koh M, Ho LP, Chan M, Koh LP, Poon MLM, Tan LK, Huang Y, Ang YL, Chong WQ, Asokumaran Y, Loh KS, Soo RA, Lim CM, Schwarz H, Goh BC. Dendritic cell therapy with CD137L-DC-EBV-VAX in locally recurrent or metastatic nasopharyngeal carcinoma (NPC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6535 Background: Epstein-Barr virus (EBV) is associated with non-keratinising (NK) NPC, a disease prevalent in Southeast Asia, and provides a potential target for dendritic cell (DC) vaccine therapy. CD137 ligand (CD137L) expressed on antigen presenting cells costimulates CD137 expressing T cells upon receptor/ligand interaction. CD137L signalling differentiates monocytes to CD137L-DC, a novel type of DC, which are more potent than classical DC in stimulating autologous T cells. Here, we explore the safety and efficacy of autologous CD137L-DC pulsed with EBV peptides spanning Epstein Barr nuclear antigen 1, latent membrane protein 1 (LMP1) and LMP2 (CD137L-DC-EBV-VAX) in patients with locally recurrent or metastatic NPC. Methods: In this single centre, phase I study, eligible patients (pts) with locally recurrent or metastatic NK-NPC and clinical benefit (CB) from their prior treatment (stable disease [SD], partial [PR] or complete response[CR]), underwent apheresis to isolate monocytes which were differentiated to CD137L-DC through CD137L agonist exposure. CD137L-DC were pulsed with EBV antigens during maturation to obtain CD137L-DC-EBV-VAX which was administered intradermally every 2 weeks (w) for up to 7 injections following site preconditioning with Tetanus and Diphtheria vaccine. Results: 14 pts were enrolled of which 2 progressed rapidly and did not begin treatment. Mean age was 58 years. Median lines of prior treatment for metastatic NPC was 1 (range 1-6), the most common being cisplatin and gemcitabine. 9 pts received 7 vaccine doses (range 2-7) with a mean administered cell count of 23.9x106. CB was seen in 5 cases (42%) with 1 PR and 4 SD beyond 1 year. Median progression free survival (mPFS) was 26w (95% CI, 23-43). The lowest PFS (8w) was in a pt with 6 prior lines of treatment including a checkpoint inhibitor. Mean pretreatment neutrophil: lymphocyte ratio (NLR) was 3.4 and a value of less than 3 was associated with prolonged mPFS (42 vs 14w, p = 0.01). Enzyme linked immune absorbent spot (ELISPOT) analysis in 5 pts with CB showed a rise in interferon-γ secreting peripheral T cells prior to the 3rd vaccine versus baseline. Treatment was well tolerated with only 4 cases of grade 1 related adverse events reported, most commonly injection site reaction (3pts). Conclusions: CD137L-DC-EBV-VAX is safe and exhibits promising efficacy when administered following CB from chemotherapy. A rise in activated peripheral blood mononuclear cells after 2 vaccinations in selected patients showing benefit suggests immunological correlates with efficacy. Clinical trial information: NCT03282617 .
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Tan GSE, Ang H, Manauis CM, Chua JM, Gao CQ, Ng FKK, Wong CS, Ng OT, Marimuthu K, Chan M, Leo YS, Vasoo S. Reducing hospital admissions for COVID-19 at a dedicated screening centre in Singapore. Clin Microbiol Infect 2020; 26:1278-1279. [PMID: 32422409 PMCID: PMC7228894 DOI: 10.1016/j.cmi.2020.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 11/15/2022]
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Chan M, Rabani R, Gandhi R, Tian Y, Gaudet I, Viswanathan S. Rapid 48-hour inflammation-resolving polarization of monocytes/macrophages is feasible at larger scale and shows anabolic effect in human osteoarthritic joint explant model. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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