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Lin NU, Pegram MD, Lai C, Lacasia A, Stein A, Yoo B, Perez EA. Abstract OT3-01-04: An open-label, single-arm, phase II study of pertuzumab with high-dose trastuzumab for the treatment of central nervous system progression post-radiotherapy in patients with HER2-positive metastatic breast cancer (PATRICIA). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot3-01-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Central nervous system (CNS) metastases are observed in up to half of patients with HER2-positive metastatic breast cancer (MBC), with incidence likely to continue to rise due to longer survival through improved systemic treatments. While radiotherapy-based approaches can be effective, there are potential short- and long-term toxicities, and patients frequently progress. CNS response to existing systemic therapies has been generally poor, and there is a high unmet need with no approved treatment for CNS metastases in HER2-positive MBC. Combination of the HER2-targeted monoclonal antibodies trastuzumab and pertuzumab provides a more comprehensive blockade of HER2 than either antibody alone, and data from the phase III CLEOPATRA trial suggest that adding pertuzumab to trastuzumab and docetaxel may delay onset of CNS disease. Trastuzumab concentrations in the CNS are increased under conditions of an impaired blood–brain barrier (BBB) and subtherapeutic levels in the CNS may be related to insufficient dosing rather than inability to cross the BBB. The PATRICIA trial is evaluating the addition of pertuzumab with high-dose trastuzumab to a patient's current systemic treatment for HER2-positive MBC patients with CNS progression post-radiotherapy and stable systemic disease.
Study design: In this US-based, phase II, open-label, single-arm study, patients will receive intravenous pertuzumab (840 mg loading dose followed by 420 mg every 3 weeks) in combination with intravenous high-dose trastuzumab (6 mg/kg weekly) in addition to their current systemic therapy (except for ado-trastuzumab emtansine or lapatinib) until disease progression or unacceptable toxicity.
Eligibility criteria: Patients aged ≥18 years with confirmed HER2-positive MBC with new and/or progressive CNS lesions >60 days after whole-brain radiotherapy or stereotactic radiosurgery for CNS metastases, performance status 0–1, and stable systemic disease will be eligible. Patients must have a baseline left ventricular ejection fraction (LVEF) ≥50%, no significant history of cardiac disease or current use of anthracyclines, life expectancy >12 weeks, and not be pregnant or lactating.
Aims: The primary efficacy endpoint will be objective response rate (ORR) in the CNS, assessed by the investigator using RANO–BM criteria. Secondary endpoints will include duration of CNS response, progression-free survival (CNS and/or non-CNS), overall survival, and safety. Pharmacokinetic and patient-reported outcomes will also be evaluated. LVEF will be assessed throughout treatment and follow-up. An interim analysis will be performed when 15 patients have completed 2 cycles, and the study will be stopped if no clinical benefit (complete response, partial response, or stable disease in the CNS) is seen or if two or more patients have congestive heart failure events related to trastuzumab or pertuzumab.
Statistical methods: The recruitment target is 40 patients; with 35 evaluable, the 95% confidence interval around an estimated ORR of 20% will be 8.4–36.9%. The trial opens for accrual in Q3 2015.
Citation Format: Lin NU, Pegram MD, Lai C, Lacasia A, Stein A, Yoo B, Perez EA. An open-label, single-arm, phase II study of pertuzumab with high-dose trastuzumab for the treatment of central nervous system progression post-radiotherapy in patients with HER2-positive metastatic breast cancer (PATRICIA). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-01-04.
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Swain SM, Schneeweiss A, Gianni L, Stein A, McNally V, Heeson S, Portera C, Yoo B, Cortes JC, Baselga J. Abstract P4-14-14: Incidence and management of diarrhea in patients with HER2-positive breast cancer treated with pertuzumab. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-14-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Pertuzumab (P) in combination with trastuzumab (T) and docetaxel (D) is the approved first line SOC in patients with HER2 positive metastatic breast cancer and is approved neoadjuvantly in patients with HER2 positive stage Ib-IIIc breast cancer. Because of its role in heterodimerization with EGFR, P may cause adverse events associated with EGFR antagonists. Diarrhea is the most commonly reported AE due to P. Increased usage of P has generated clinical questions regarding the incidence and management of diarrhea. Here we report safety analyses of diarrhea from three P containing studies.
METHODS: The safety population evaluated in this exploratory analysis included 804 patients from CLEOPATRA, 416 patients from NeoSphere, and 223 from TRYPHAENA. Diarrhea incidence, severity (NCI-CTCAE v3.0), and management in P containing arms were analyzed.
RESULTS: The incidence and management of diarrhea in MBC (Table 1), EBC (Table 2):
CLEOPATRA P+T+D n=408Pla+T+D n=396Incidence of Events n (%)All Grades279 (68)193 (49)≥ Grade 338 (9)20 (5)Median time to 1st event (days) all grades / Interquartile Range (IQR)8 (4,44)23 (6,82)Discontinuation of any study drug8 (0.2)2 (0.6)Treatment n (%)Antidiarrheal treatment164 (40)77 (19)
NeoSphere X4 followed by adjuvant FECx3TRYPHAENANeoadjuvant tx followed by T up to 1 yearT+D n=107P+T+D n=107P+T n=108P+D n=94FEC+P+T x3→P+T+D x3 n=72FEC x3 →P+T+D x3 n=75TCH+P x6 n=76Incidence of Events n (%) (neoadjuvant + adjuvant exposure)All Grades41 (38)55 (51)46 (43)53 (56)46 (64)47 (63)55 (72)≥ Grade 34 (4)7 (7)3 (3)5 (5)3 (4)4 (5)9 (12)Median time to 1st event (days) all grades / Interquartile Range (IQR)7 (4,24)8 (3,26)19 (4,117)6 (3,21)9 (4,30)69 (64,82)6 (3,21)Discontinuation of any study drug0000000Treatment n (%)Antidiarrheal treatment13 (12)23 (22)20 (19)28 (30)23 (32)22 (29)31 (41)pertuzumab(P)+trastuzumab(T)+docetaxel(D) FEC= 5FU, epirubicin, cyclophosphamide TCH= docetaxel,(T)carboplatin(C), trastuzumab(H)
The overall incidence of diarrhea events is greatest in the first cycle containing P: in CLEOPATRA (P+T+D) 43%, in NeoSphere (P+T+D) 34%, (P+T) 21%, and in TRYPHAENA (FEC+P+T→P+T+D) 40%, (FEC→P+T+D c4) 46%, and (TCH+P) 55%. Of patients experiencing diarrhea, the median number of events (all grades) for patients receiving P+T+D in CLEOPATRA and NeoSphere was 2 and 1 respectively, and 2 for patients receiving TCH+P in TRYPHAENA.
CONCLUSIONS:
Diarrhea was common in all P containing arms but events were mostly low grade and occurred more often with the first cycle. Events and management were similar in the EBC and MBC setting. Approximately half of patients required antidiarrheal treatment. However, rates of study drug discontinuation due to diarrhea were low. Studies of treatment associated diarrhea management are planned.
Citation Format: Swain SM, Schneeweiss A, Gianni L, Stein A, McNally V, Heeson S, Portera C, Yoo B, Cortes JC, Baselga J. Incidence and management of diarrhea in patients with HER2-positive breast cancer treated with pertuzumab. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-14-14.
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Park SJ, Jo KW, Yoo B, Lee CK, Kim YG, Yang SK, Byeon JS, Kim KJ, Ye BD, Park SH, Shim TS. Comparison of LTBI treatment regimens for patients receiving anti-tumour necrosis factor therapy. Int J Tuberc Lung Dis 2015; 19:342-8. [PMID: 25686145 DOI: 10.5588/ijtld.14.0554] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A tertiary referral centre in South Korea. OBJECTIVE To compare the completion rates and adverse drug reactions of three latent tuberculous infection (LTBI) treatment regimens for patients receiving anti-tumour necrosis factor (anti-TNF) therapy. DESIGN A total of 408 patients were diagnosed with LTBI before receiving anti-TNF therapy between December 2004 and December 2013. Nine months of isoniazid (9H), 4 months of rifampicin (4H) or 3 months of isoniazid/rifampicin (3HR) were prescribed. The results were analysed retrospectively. RESULTS The mean age of the 408 study subjects was 44 years; 258 (63.2%) were male. The 9H, 4R and 3HR treatment regimens were given to respectively 61 (15.0%), 139 (34.1%) and 208 (51.0%) patients. A total of 362 (88.7%) patients completed the treatment. The treatment completion rate was highest in patients receiving 3HR (94.2%). Of the 408 patients, 54 (13.2%) had one or more adverse drug reactions; their frequency was similar in the three groups. CONCLUSIONS In patients receiving anti-TNF therapy, 3HR seems to be the most acceptable treatment regimen for LTBI, given its high completion rate and acceptable rate of adverse drug reactions.
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Sun D, Yoo B. Effect of tapioca starch addition on rheological, thermal, and gelling properties of rice starch. Lebensm Wiss Technol 2015. [DOI: 10.1016/j.lwt.2015.05.062] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Robert N, Goertz H, Asmar L, Tseng W, Jiao X, Portera C, Yoo B, Patt D, Antao V. 1868 Clinical characteristics, treatment patterns, and outcomes for patients with HER2-positive metastatic breast cancer (MBC) treated with pertuzumab (P) in the first-line in a real-world setting. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30818-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shin K, Park SH, Park W, Baek HJ, Lee YJ, Kang SW, Choe JY, Yoo WH, Park YB, Song JS, Yoo B, Yoo DH, Song Y. SAT0286 Monthly Ibandronate Reduces Bone Loss in Osteopenic Women with Rheumatoid Arthritis Receiving Long-Term Glucocorticoids: A 48-Week Double-Blinded Randomized Placebo-Controlled Investigator-Initiated Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3204] [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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Bae SH, Hong S, Ahn S, Lim DH, Kim YG, Lee CK, Yoo B. AB0613 Predictive Role of Low Vitamin D Levels in Lupus Nephritis Flare. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3245] [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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Hong S, Ahn S, Lim DH, Bae SH, Chang EJ, Lee CK, Yoo B, Kim YG. SAT0051 Protein Phosphatase Magnesium-Dependent 1A Regulates Osteoclast Differentiation Through Modulation of Rank Signaling. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2225] [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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Ahn S, Kim YG, Hong S, Bae SH, Lim DH, Lee CK, Yoo B. FRI0427 Clinical Outcomes of Acute Transverse Myelitis in Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2966] [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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Hong S, Kim YG, Ahn S, Bae SH, Lim DH, Lee CK, Yoo B. AB0612 Clinical Outcomes of Hydronephrosis in Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jung YJ, Lee JY, Jo KW, Yoo B, Lee CK, Kim YG, Yang SK, Byeon JS, Kim KJ, Ye BD, Lee KH, Lee SD, Kim WS, Kim DS, Shim TS. The 'either test positive' strategy for latent tuberculous infection before anti-tumour necrosis factor treatment. Int J Tuberc Lung Dis 2014; 18:428-34. [PMID: 24670697 DOI: 10.5588/ijtld.13.0644] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A ttertiary referral centre in South Korea. OBJECTIVES The 'either test positive' strategy, incorporating both the tuberculin skin test (TST) and the T-SPOT(®).TB(T-SPOT) assay, was evaluated as a novel method for diagnosing latent tuberculous infection (LTBI) before treatment with anti-tumour necrosis factor (TNF) in patients with immune-mediated inflammatory diseases. DESIGN From June 2008 to April 2012, 430 patients received anti-TNF treatment at our institution. TST and T-SPOT were performed simultaneously at baseline. LTBI was defined as a positive TST or a positive T-SPOT result. RESULTS The positivity rates for the TST and T-SPOT assays were respectively 19.1% (82/430) and 44.2% (190/430), yielding an LTBI-positive rate of 48.6% (209/430). LTBI treatment was initiated in 46.0% (198/430) of patients and was completed by 89.4% (177/198). During follow-up (median 884 days), 0.9% (4/430) of the patients developed active tuberculosis (TB). All four TB patients were TST-negative at baseline, although two received LTBI treatment based on the baseline positive T-SPOT assay results. CONCLUSIONS The either test positive strategy is a valid method for diagnosing LTBI before anti-TNF treatment, although it is not clear whether it is superior to other strategies.
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Koo BS, Hong S, Kim YJ, Kim YG, Lee CK, Yoo B. Lupus enteritis: clinical characteristics and predictive factors for recurrence. Lupus 2014; 24:628-32. [PMID: 25391541 DOI: 10.1177/0961203314558858] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 10/01/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To compare the clinical characteristics of lupus enteritis (LE) and non-enteric lupus (non-LE) patients and identify predictors of LE recurrence. METHODS We retrospectively reviewed the medical records of 62 systemic lupus erythematosus (SLE) patients in a tertiary hospital who experienced enteric symptoms and underwent abdominal computed tomography scanning between January 1997 and December 2013. We compared the clinical characteristics between LE and non-LE patients and between recurrent LE and non-recurrent LE cases. RESULTS Out of 62 SLE patients with enteric symptoms, 46 cases (74%) were compatible with LE based on computed tomography findings. The C4 level was decreased in the LE group compared with the non-LE group (9.0 ± 5.6 vs. 12.3 ± 6.2, p = 0.032). Recurrence of LE was observed in 14 patients (28%). Initial involvement at the colon (79% vs. 41%, p = 0.026) and bladder with/without the ureter was more common in the recurrent group (57% vs. 25%, p = 0.048). By multivariate analysis, the hazard ratios of variables associated with recurrence were 4.689 for colon involvement (95% confidence interval: 1.245-17.659, p = 0.0220] and 5.468 for cystitis with/without ureteritis (95% confidence interval: 1.629-18.360, p = 0.006). CONCLUSION Colon and urinary tract involvement in LE patients may be associated with the recurrence of LE.
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Rosen K, Masson O, Li Y, Yoo B. 105: Anoikis of colon carcinoma cells triggered by beta-catenin loss can be enhanced by Tumor Necrosis Factor Receptor 1 antagonists. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Oh J, Choi S, Ku B, Hong S, Kim Y, Koo B, Kim YG, Lee CK, Yoo B. SAT0522 The Association between Uric Acid Level and Urolithiasis on Ultrasonography. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kim Y, Lee EJ, Hong S, Koo B, Seo W, Oh J, Kim YG, Lee CK, Yoo B. AB0500 B-Cell Depleting Therapy for SLE Related Refractory Thrombocytopenia. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3221] [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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Hong S, Lee EJ, Kim Y, Koo B, Chang EJ, Lee EJ, Seo W, Oh J, Kim TH, Kim YG, Lee CK, Yoo B. OP0111 Mechanism of New Bone Formation in Ankylosing Spondylitis: the Role of IL-32 in Osteoblast Differentiation. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2857] [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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Koo B, Hong S, Kim Y, Oh J, Seo W, Kim YG, Lee CK, Yoo B. THU0067 The Incidence of New Onset and Recurrent Uveitis in Ankylosing Spondylitis Patients during TNF Inhibitor Therapy in Korean. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Koo B, Kim Y, Oh J, Hong S, Seo W, Kim YG, Lee CK, Yoo B. SAT0013 Lupus Enteritis: Clinical Characteristics and Risk Factors Associated with Recurrence. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2797] [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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Kim Y, Lee EJ, Hong S, Koo B, Seo W, Oh J, Kim YG, Lee CK, Yoo B. AB0154 Pathogenic Role of Irhom2 in Seropositive Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3199] [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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Kim YJ, Koo BS, So MW, Seo WJ, Kim YG, Lee CK, Yoo B. AB0484 Analysis of factors predictive of survival based on 24 patients with systemic granulomatosis with polyangiitis in korea. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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So M, Koo B, Seo W, Kim YG, Lee CK, Yoo B. SAT0330 Sclerostin concentrations in plasma and synovial fluid inversely correlate with disease severity in knee osteoarthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3276] [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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Koo B, So M, Seo W, Kim YG, Lee CK, Yoo B. THU0267 A randomized controlled trial of the efficacy of incentive spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2232] [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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Heo H, Kim YJ, Koo BS, So MW, Seo WJ, Kim YG, Lee CK, Yoo B. SAT0097 Changes In Bone Mineral Density in Patients with Recent-Onset Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1823] [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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Koo B, So M, Seo W, Kim YG, Lee CK, Yoo B. SAT0123 Reactivation of latent tuberculosis infection and new infection of tuberculosis in patients with anti-tumor necrosis factor therapy for tuberculosis-endemic area. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3070] [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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Jung YJ, Lyu J, Yoo B, Lee CK, Kim YG, Yang SK, Byeon JS, Kim KJ, Ye BD, Lee KH, Lee SD, Kim WS, Kim DS, Shim TS. Combined use of a TST and the T-SPOT®. TB assay for latent tuberculosis infection diagnosis before anti-TNF-α treatment. Int J Tuberc Lung Dis 2012; 16:1300-6. [DOI: 10.5588/ijtld.12.0004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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