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Edgley K, Horne AW, Saunders PTK, Tsanas A. Symptom tracking in endometriosis using digital technologies: Knowns, unknowns, and future prospects. Cell Rep Med 2023; 4:101192. [PMID: 37729869 PMCID: PMC10518625 DOI: 10.1016/j.xcrm.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/12/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023]
Abstract
Endometriosis is a common chronic pain condition with no known cure and limited treatment options. Digital technologies, ranging from smartphone apps to wearable sensors, have shown potential toward facilitating chronic pain assessment and management; however, to date, many of these tools have not been specifically deployed or evaluated in patients with endometriosis-associated pain. Informed by previous studies in related chronic pain conditions, we discuss how digital technologies may be used in endometriosis to facilitate objective, continuous, and holistic symptom tracking. We postulate that these pervasive and increasingly affordable technologies present promising opportunities toward developing decision-support tools assisting healthcare professionals and empowering patients with endometriosis to make better-informed choices about symptom management.
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Affiliation(s)
- Katherine Edgley
- EXPPECT and MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4UU, Scotland, UK.
| | - Andrew W Horne
- EXPPECT and MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4UU, Scotland, UK
| | - Philippa T K Saunders
- Centre for Inflammation Research, University of Edinburgh, Edinburgh EH16 4UU, Scotland, UK
| | - Athanasios Tsanas
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh EH16 4UX, Scotland, UK; Alan Turing Institute, London NW1 2DB, UK
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Corbelli I, Verzina A, Leone De Magistris I, De Vanna G, Eusebi P, Mataluni G, Pisani A, Prudenzano AMP, Trojano M, Delussi M, De Tommaso M, Russo A, Silvestro M, Tedeschi G, Calabresi P, Sarchielli P. Sustained Efficacy, Safety and High Adherence Rate of Onabotulinum Toxin Type A in Chronic Migraine Patients: A Multicentric Prospective Real-Life Study. Toxins (Basel) 2022; 15:toxins15010034. [PMID: 36668854 PMCID: PMC9863104 DOI: 10.3390/toxins15010034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/08/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Guidelines regarding long-term use with onabotulinumtoxinA (onaBT-A) in chronic migraine (CM) prophylaxis are lacking. This multicentric prospective real-life study aimed to assess the efficacy and safety of a long-term treatment. A total of 195 chronic migraine patients were treated with onaBT-A, every 3 months for 5 cycles (Phase 1). In the Phase 2 of the study, depending on response rate, patients were divided into "responders" (R), "partially responders" (PR) and "non-responders" (NR). Then, we proposed to R and PR patients to continue with an additional 12 months of treatment (additional 4 sessions). Response to treatment and adverse events were collected for the entire duration of the study. Of the 195 patients included (females 82.1%, mean age 47.4 ± 12.4), at the end of Phase 1 there were 52.3% of R patients, 17.9% of PR patients, 15.4% of NR patients and 14.4% drop-outs. During Phase 2 of treatment, R patients presented a maintenance of the improvement achieved during the first year of treatment, as well as PR patients. Except for three serious adverse events not related to treatment, all other adverse events were mild or moderate in severity and resolved without sequelae. In the literature, adherence to oral migraine-preventive medications among patients with CM was found to be less than 25%. The results of this prospective real-life multicenter study show efficacy, safety and adherence to a long-term treatment with onaBT-A.
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Affiliation(s)
- Ilenia Corbelli
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
- Correspondence: ; Tel.: +39-075-578-4228; Fax: +39-075-578-4229
| | - Angela Verzina
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
| | - Ilaria Leone De Magistris
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
| | - Gioacchino De Vanna
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
| | - Paolo Eusebi
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
| | - Giorgia Mataluni
- Neurology Unit, Department of Systems Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Antonio Pisani
- Neurology Unit, Department of Systems Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Addolorata Maria Pia Prudenzano
- Headache Center, Neurological Clinic “L. Amaducci”, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70121 Bari, Italy
| | - Maria Trojano
- Headache Center, Neurological Clinic “L. Amaducci”, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70121 Bari, Italy
| | - Marianna Delussi
- Applied Neurophysiology and Pain (ANP) Unit, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Marina De Tommaso
- Applied Neurophysiology and Pain (ANP) Unit, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Marcello Silvestro
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Paolo Calabresi
- The Institute of Neurology, Agostino Gemelli University Policlinic IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Paola Sarchielli
- Neurological Clinic, S. Maria Misericordia Hospital, Department of Medicine, University of Perugia, 06129 Perugia, Italy
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Ezaizi Y, Hasan B, Manini ML, Absah I. Intrapyloric Botulinum Toxin A Injection for Gastroparesis and Functional Upper Gastrointestinal Symptoms in Children: Mayo Clinic Experience, Review of the Literature, and Meta-analysis. Paediatr Drugs 2022; 24:539-545. [PMID: 35768647 DOI: 10.1007/s40272-022-00518-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We aimed to assess the efficacy of intrapyloric botulinum toxin A injection (IPBTI) in children with and without gastroparesis and to perform a meta-analysis and review of the literature. METHODS We retrospectively searched our electronic health records to identify children (aged < 18 years) who underwent an esophagogastroduodenoscopy with IPBTI between 2007 and 2018 for persistent upper gastrointestinal tract symptoms. We included children with and without gastroparesis and excluded children with a history of gastrointestinal surgery, gastrointestinal obstruction, or mucosal disease that could explain their symptoms. A meta-analysis including our study findings was performed. RESULTS We identified 20 children (mean [standard deviation] age, 9.7 [5.8] years; 14 [70%] girls) with upper gastrointestinal symptoms who underwent IPBTI at our institution during the study period. Of the 20 children, 17 (85%) underwent gastric emptying scintigraphy, only nine (53%) of whom had gastroparesis. Response to IPBTI was reported in ten children (50%). Response to IPBTI did not differ by the presence of gastroparesis in included children (p = 0.64). Repeated IPBTI was performed in four children who had a response to the first injection; all four reported no benefit from the second IPBTI. There were no reported complications of IPBTI in our cohort. The meta-analysis indicated that 68% (95% confidence interval 59-78) of patients had a response to IPBTI, regardless of the presence of gastroparesis; 66% (95% confidence interval 53-78) of patients who had gastroparesis had a response to IPBTI. CONCLUSIONS Intrapyloric botulinum toxin A injection is safe in children and can offer transient relief for patients with refractory upper gastrointestinal symptoms with and without gastroparesis.
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Affiliation(s)
- Yamen Ezaizi
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. .,Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. .,Pediatric Gastroenterology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Bashar Hasan
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Mhd Louai Manini
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Imad Absah
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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Minen MT, Jaran J, Boyers T, Corner S. Understanding What People With Migraine Consider to be Important Features of Migraine Tracking: An Analysis of the Utilization of Smartphone‐Based Migraine Tracking With a Free‐Text Feature. Headache 2020; 60:1402-1414. [DOI: 10.1111/head.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/15/2020] [Accepted: 04/27/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Mia T. Minen
- Department of Neurology NYU Langone Health New York NY USA
| | - Jana Jaran
- Department of Neuroscience and Behavior Barnard College New York NY USA
| | - Talia Boyers
- Department of Neuroscience and Behavior Barnard College New York NY USA
| | - Sarah Corner
- Department of Neurology NYU Langone Health New York NY USA
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