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Ranzani A, Castelli F, Di Biagio A, d'Arminio Monforte A, D'Avolio A, Soria A, Bai F, Focà E, Taramasso L, Calcagno A, Bresciani E, Torsello A, Bonfanti P, Lapadula G. Influence of efavirenz and 8-hydroxy-efavirenz plasma levels on cognition and central nervous system side effects. HIV Med 2024; 25:491-497. [PMID: 38104964 DOI: 10.1111/hiv.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To investigate whether efavirenz (EFV) or 8-hydroxy-EFV (8-OH-EFV) plasma levels are associated with neurocognitive impairment and central nervous system (CNS) side effects. METHODS We conducted a cross-sectional analysis to explore the potential links between EFV/8-OH-EFV levels and cognitive performance or CNS-related side effects in patients screened within a randomized trial involving a switch from EFV to rilpivirine. The Mann-Whitney test was employed to compare drug levels in patients with or without cognitive impairment, depression, anxiety, sleep disorder or CNS symptoms. Additionally, Spearman's test was used to assess correlations between drug levels and test scores. RESULTS Among 104 patients, neither EFV nor 8-OH-EFV levels were linked to cognitive impairment, although trends towards higher EFV levels were observed in those with impaired executive function (p = 0.055) and language performances (p = 0.021). On the other hand, elevated 8-OH-EFV levels, but not EFV levels, were associated with more CNS side effects (222 vs. 151 ng/mL, p = 0.027), depressive symptoms (247 vs. 164 ng/mL, p = 0.067) and sleep impairment (247 vs. 164 ng/mL, p = 0.078). Consistently, a trend towards a correlation between EFV levels and lower z-scores in executive function and motor function was observed, while 8-OH-EFV levels, but not EFV levels, were directly correlated with symptom scores. CONCLUSIONS Higher levels of 8-OH-EFV were associated with CNS side effects, while EFV levels were only marginally associated with cognitive performance, thus suggesting that EFV and its metabolite may act differently in determining detrimental neurological effects.
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Affiliation(s)
- Alice Ranzani
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
| | | | | | | | | | | | | | | | | | | | | | | | - Paolo Bonfanti
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
- University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Lapadula
- Fondazione IRCCS "San Gerardo dei Tintori", Monza, Italy
- University of Milano-Bicocca, Milan, Italy
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Rossotti R, Tavelli A, Calzavara D, De Bona A, Muccini C, Moschese D, Caruso E, Soria A, Bossolasco S, Lapadula G, Cernuschi M, Monforte AD. Do we Still Need Eligibility Criteria to Recommend PrEP? Impact of National Prescribing Requirements on Retention in Care and Sexually Transmitted Infections Acquisition. AIDS Behav 2024:10.1007/s10461-024-04320-3. [PMID: 38526636 DOI: 10.1007/s10461-024-04320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
Italian guidelines recommend HIV pre-exposure prophylaxis (PrEP) only upon satisfying strict eligibility criteria. The objective of this study is to evaluate if PrEP candidates attending a community-based service comply with these criteria and whether these prescribing conditions affect retention in care and sexually transmitted infections (STIs) acquisition. A retrospective analysis was performed on PrEP candidates evaluated from January 2019 to June 2022. Data were collected from self-administered questionnaires and clinical files. The population was divided in subjects with 0/1 (0/1 C) and ≥ 2 (≥ 2 C) criteria. Descriptive statistics and non-parametric tests were employed to describe study population. Incidence of PrEP discontinuation and of STIs was estimated per 100 persons-year of follow up (PYFU), and incidence rate ratio (IRR) was calculated. Univariate and multivariable Cox regression analyses were used to evaluate the association strength between PrEP drop out and other variables. The analyses enrolled 659 individuals: 422 individuals were included in 0/1 C, 237 in ≥ 2 C group, respectively. Inconsistent condom use was the most reported prescribing criteria (399 individuals, 60.6%), followed by a previous STI (186 individuals, 28.2%). 0/1 C exhibited lower STIs incidence. PrEP discontinuation was 29% in 0/1 C and 38% in ≥ 2 C (p = 0.031). Cox model revealed that inconsistent condom use was the only prescribing criteria associated to PrEP persistence. The majority of PrEP candidate did not comply with prescribing conditions. Eligibility criteria failed to identify individuals with better retention in care. Our results suggest that Italian guidelines should be updated removing barriers to prescription.
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Affiliation(s)
- Roberto Rossotti
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, Milan, 20162, Italy.
- Milano Checkpoint ETS, Milan, Italy.
| | | | | | - Anna De Bona
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Camilla Muccini
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Moschese
- Milano Checkpoint ETS, Milan, Italy
- Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Alessandro Soria
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Simona Bossolasco
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Lapadula
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimo Cernuschi
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella d'Arminio Monforte
- Milano Checkpoint ETS, Milan, Italy
- ICONA Foundation, Milan, Italy
- School of Medicine, University of Milano, Milan, Italy
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Cañueto J, Muñoz-Couselo E, Cardona-Machado C, Becerril-Andrés S, Martín-Vallejo J, Serra-Guillén C, Soria A, Serrano-Domingo JJ, Ortiz-Velez C, Lostes J, García-Castaño A, Puig S, Fernández de Misa R, Medina J, Aguado C, Ayala de Miguel P, Navarro-Navarro I, Masferrer E, Delgado M, Bellido-Hernández L, Sanmartin O. Efficacy and safety of cemiplimab in the treatment of advanced cutaneous squamous cell carcinoma: A multicentre real-world retrospective study from Spain and systematic review of the published data. J Eur Acad Dermatol Venereol 2024. [PMID: 38308557 DOI: 10.1111/jdv.19821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Affiliation(s)
- J Cañueto
- Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - E Muñoz-Couselo
- Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - C Cardona-Machado
- Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - S Becerril-Andrés
- Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - J Martín-Vallejo
- Departamento de Estadística, Universidad de Salamanca y Unidad de Bioestadistica del IBSAL, Salamanca, Spain
| | - C Serra-Guillén
- Dermatology, Fundación Instituto Valenciano de Oncología (IVO), Valencia, Spain
| | - A Soria
- Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - C Ortiz-Velez
- Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Lostes
- Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A García-Castaño
- Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - S Puig
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, CIBERER, Barcelona, Spain
| | - R Fernández de Misa
- Dermatology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - J Medina
- Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - C Aguado
- Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - E Masferrer
- Dermatology, Hospital Universitari Mútua Terrassa, Barcelona, Spain
| | - M Delgado
- Medical Oncology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - L Bellido-Hernández
- Medical Oncology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - O Sanmartin
- Dermatology, Fundación Instituto Valenciano de Oncología (IVO), Valencia, Spain
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Harrington KJ, Cohen EEW, Soulières D, Dinis J, Licitra L, Ahn MJ, Soria A, Machiels JP, Mach N, Mehra R, Burtness B, Swaby RF, Lin J, Ge J, Lerman N, Tourneau CL. Pembrolizumab versus methotrexate, docetaxel, or cetuximab in recurrent or metastatic head and neck squamous cell carcinoma (KEYNOTE-040): Subgroup analysis by pattern of disease recurrence. Oral Oncol 2023; 147:106587. [PMID: 37925894 DOI: 10.1016/j.oraloncology.2023.106587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND In the phase 3 KEYNOTE-040 study, pembrolizumab prolonged OS versus chemotherapy in previously treated recurrent or metastatic (R/M) HNSCC. We present a post hoc subgroup analysis by disease recurrence pattern: recurrent-only, recurrent and metastatic (recurrent-metastatic), and metastatic-only HNSCC. MATERIALS AND METHODS Patients had HNSCC that progressed during or after platinum-containing treatment for R/M disease or had recurrence or progression within 3-6 months of previous platinum-containing definitive therapy for locally advanced disease. Patients were randomly assigned (1:1) to pembrolizumab 200 mg Q3W or investigator's choice of standards of care (SOC): methotrexate, docetaxel, or cetuximab. Outcomes included OS, PFS, ORR, and DOR. The data cutoff was May 15, 2017. RESULTS There were 125 patients (pembrolizumab, 53; SOC, 72) in the recurrent-only subgroup, 204 in the recurrent-metastatic subgroup (pembrolizumab, 108; SOC, 96), and 166 in the metastatic-only subgroup (pembrolizumab, 86; SOC, 80). The hazard ratio (95% CI) for death for pembrolizumab versus SOC was 0.83 (0.55-1.25) in the recurrent-only, 0.78 (0.58-1.06) in the recurrent-metastatic, and 0.74 (0.52-1.05) in the metastatic-only subgroups. PFS was similar between treatment arms in all subgroups. ORR was 22.6% for pembrolizumab versus 16.7% for SOC in the recurrent-only, 10.2% versus 6.3% in the recurrent-metastatic, and 15.1% versus 8.8% in the metastatic-only subgroups. DOR was numerically longer with pembrolizumab in all subgroups. CONCLUSION Pembrolizumab provided numerically longer OS and durable responses in all subgroups compared with SOC, suggesting that patients with previously treated R/M HNSCC benefit from pembrolizumab regardless of recurrence pattern.
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Affiliation(s)
- K J Harrington
- 105 Cotswold Road, Division of Radiotherapy and Imaging, The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust National Institute of Health Research Biomedical Research Centre, London SM2 5NG, United Kingdom.
| | - E E W Cohen
- 3855 Health Sciences Dr, Department of Medical Oncology, Moores Cancer Center, UC San Diego Health, La Jolla, CA 92093, United States.
| | - D Soulières
- 1560, rue Sherbrooke estx, Department of Hematology and Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, QC H2L 4MN, Canada.
| | - J Dinis
- R Dr. Antonio Bernardino de Almeida Medicina Oncologica Unidade de Investigacao Clinica, Department of Medical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, 4200-072 Porto, Portugal.
| | - L Licitra
- Via Giacomo Venezian, 1, Department of Head and Neck Cancer, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, 20133 Milan, Italy
| | - M-J Ahn
- 81 Irwon-Ro Gangnam, Department of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - A Soria
- Ctra. de Colmenar Viejo km. 9,100, Department of Medical Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - J-P Machiels
- Avenue Hippocrate 10, Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
| | - N Mach
- Rue Gabrielle-Perret-Gentil 4, Clinical Research Unit, Department of Oncology, Hôpitaux Universitaires de Genève, 1205 Geneva, Switzerland
| | - R Mehra
- 22 South Greene Street, Department of Head and Neck Medical Oncology, Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, United States
| | - B Burtness
- 25 York Street PO Box 208028, Yale Cancer Center and Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, United States
| | - R F Swaby
- 90 E Scott Ave, Merck & Co., Inc., Rahway, NJ 07065, United States
| | - J Lin
- 90 E Scott Ave, Merck & Co., Inc., Rahway, NJ 07065, United States
| | - J Ge
- 90 E Scott Ave, Merck & Co., Inc., Rahway, NJ 07065, United States
| | - N Lerman
- 90 E Scott Ave, Merck & Co., Inc., Rahway, NJ 07065, United States
| | - C Le Tourneau
- 26 rue d'Ulm, Department of Drug Development and Innovation (D3i), Institut Curie, Paris-Saclay University, 75005 Paris, France
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Fezzi M, Antolini L, Soria A, Bisi L, Iannuzzi F, Sabbatini F, Rossi M, Limonta S, Rugova A, Columpsi P, Squillace N, Foresti S, Pollastri E, Valsecchi MG, Migliorino GM, Bonfanti P, Lapadula G. Early prone positioning does not improve the outcome of patients with mild pneumonia due to SARS-CoV-2: results from an open-label randomised controlled trial - the EPCoT study. ERJ Open Res 2023; 9:00181-2023. [PMID: 37389899 PMCID: PMC10291725 DOI: 10.1183/23120541.00181-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/20/2023] [Indexed: 07/01/2023] Open
Abstract
Background Prone positioning is routinely used among patients with COVID-19 requiring mechanical ventilation. However, its utility among spontaneously breathing patients is still debated. Methods In an open-label randomised controlled trial, we enrolled patients hospitalised with mild COVID-19 pneumonia, whose arterial oxygen tension to inspiratory oxygen fraction ratio (PaO2/FIO2) was >200 mmHg and who did not require mechanical ventilation or continuous positive airway pressure at hospital admission. Patients were randomised 1:1 to prone positioning on top of standard of care (intervention group) versus standard of care only (controls). The primary composite outcome included death, mechanical ventilation, continuous positive airway pressure and PaO2/FIO2 <200 mmHg; secondary outcomes were oxygen weaning and hospital discharge. Results A total of 61 subjects were enrolled, 29 adjudicated to prone positioning and 32 to the control group. By day 28, 24 out of 61 patients (39.3%) met the primary outcome: 16 because of a PaO2/FIO2 ratio <200 mmHg, five because of the need for continuous positive airway pressure and three because of the need for mechanical ventilation. Three patients died. Using an intention-to-treat approach, 15 out of 29 patients in the prone positioning group versus nine out of 32 controls met the primary outcome, corresponding to a significantly higher risk of progression among those randomised to prone positioning (HR 2.38, 95% CI 1.04-5.43; p=0.040). Using an as-treated approach, which included in the intervention group only patients who maintained prone positioning for ≥3 h·day-1, no significant differences were found between the two groups (HR 1.77, 95% CI 0.79-3.94; p=0.165). Also, we did not find any statistically significant difference in terms of time to oxygen weaning or hospital discharge between study arms in any of the analyses conducted. Conclusions We observed no clinical benefit from prone positioning among spontaneously breathing patients with COVID-19 pneumonia requiring conventional oxygen therapy.
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Affiliation(s)
- Miriam Fezzi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Laura Antolini
- Bicocca Bioinformatics Biostatistics and Bioimaging Center – B4, University of Milano-Bicocca, Milan, Italy
| | - Alessandro Soria
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Luca Bisi
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Francesca Iannuzzi
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Francesca Sabbatini
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Marianna Rossi
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Silvia Limonta
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Alban Rugova
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Paola Columpsi
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Nicola Squillace
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Sergio Foresti
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Ester Pollastri
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging Center – B4, University of Milano-Bicocca, Milan, Italy
| | - Guglielmo Marco Migliorino
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Paolo Bonfanti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Giuseppe Lapadula
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
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Lapadula G, Soria A, Modesti M, Vecchi A, Sabbatini F, Monopoli A, Squillace N, Lungu E, Coloma J, Columpsi P, Cristiano V, Bonfanti P. Behavioural survey and street-based HIV and HCV rapid testing programme among transgender sex workers. Sex Transm Infect 2023; 99:41-46. [PMID: 35351815 DOI: 10.1136/sextrans-2021-055270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/14/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Transgender women sex workers (TGW-SW) are disproportionally affected by HIV and have reduced access to testing. Moreover, information regarding their behaviours and health needs is scarce. METHODS A behavioural survey and a targeted testing programme in prostitution sites were conducted in Milan and Monza areas. The non-profit organisation 'ALA Milano Onlus' and 'San Gerardo' Hospital (Monza) implemented a mobile HIV testing unit involving a TGW peer educator, four physicians, a counsellor, a psychologist and a cultural mediator. All TGW-SW were offered anonymous HIV and hepatitis C virus (HCV) oral testing and asked to fill a questionnaire on sexual habits, drug abuse, and knowledge and attitudes towards HIV and STDs. RESULTS Between May and July 2017, 130 TGW-SW, predominantly migrants, were contacted during 15 street visits; among them, 78 (60%) were interviewed. HIV and HCV testing were accepted by 53 (42%) and 67 (52%) TGW-SW, respectively. Twenty-five (19.8%) subjects who reported already established HIV infection were not retested. Seven patients received a new diagnosis of HIV, while nobody tested positive for HCV. Overall, HIV prevalence was 13.2% (25% including those with already known HIV infection). Recent arrival in Italy and young age were associated with risk of undiagnosed HIV infection. Inconsistent condom use was commonly reported during commercial sex (27%) and with non-commercial partners (64%). Alcohol and cocaine abuse were common problems which facilitated risky behaviours. CONCLUSIONS Oral rapid HIV and HCV testing for TGW-SW in outreach settings were feasible and acceptable and led to a considerable number of new diagnoses. Interventions tailored to TGW-SW, focused on HIV prevention, testing and engagement in care, are fundamental.
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Affiliation(s)
- Giuseppe Lapadula
- School of Medicine, University of Milan-Bicocca, Monza, Italy .,Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | - Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | | | | | - Francesca Sabbatini
- Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | | | - Nicola Squillace
- Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | | | | | - Paola Columpsi
- Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | | | - Paolo Bonfanti
- School of Medicine, University of Milan-Bicocca, Monza, Italy.,Clinic of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
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Vadel J, Bessou A, Blanchon T, Maravic M, Soria A, Launay T, Pouquet M, Younes N, Bizouard G, Bardoulat I. Impact de la crise de COVID-19 sur les consultations pour troubles psychiques en médecine générale en France, en regard de consultations pour maladies chroniques – Analyse de séries temporelles. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Soulieres D, Harrington K, Le Tourneau C, Silva J, Licitra L, Ahn MJ, Soria A, Machiels JP, Mach N, Mehra R, Burtness B, Lin J, Lerman N, Gumuscu B, Cohen E. 658MO Pembrolizumab (pembro) vs standard-of-care (SOC) in previously treated recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC): 6-year follow-up of KEYNOTE-040. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Marquez-Rodas I, Berciano Guerrero M, Muñoz Couselo E, Soria A, Cerezuela-Fuentes P, Manzano Mozo J, Gutierrez Sanz L, Crespo G, Puértolas T, Garcia Castano A, Aguado de la Rosa C, Espinosa E, Majem Tarruella M, López Castro R, Ayala de Miguel P, Medina Martinez J, Fernández Morales L, Bellido Hernández L, Berrocal A, Martín Algarra S. 848P Second-line systemic treatment for patients with advanced melanoma: Results from the prospective real-world study GEM1801. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Soria A, Sánchez Mauriño P, Serrano J, Sequero S, Fra Rodríguez J, Amezcua V, Benítez G, Espinosa E, Aguayo C, García Galindo R, Díaz-Beveridge R, Puértolas T, Cunquero-Tomás A, López Castro R, Crespo G, López P, Gutiérrez Sanz L, Campos B, García L, Cerezuela-Fuentes P. 837P Real-world evidence of encorafenib (E) plus binimetinib (B) in unresectable advanced or metastatic BRAFV600-mut melanoma in Spain (GEM 2002 - BECARE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Muñoz Couselo E, Ortiz Vélez C, Berciano-Guerrero MÁ, Soria A, Cerezuela-Fuentes P, Manzano J, Gutiérrez Sanz L, Crespo G, Puértolas T, García Castaño A, Aguado de la Rosa C, Espinosa E, Majem M, López Castro R, Ayala de Miguel P, Medina Martínez J, Fernández-Morales L, Bellido L, Martín Algarra S, Márquez-Rodas I. 863P Elderly patients (pts) with advanced melanoma: Results from the prospective real-world study GEM1801. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Castagna J, Le Thaï C, Soria A, Barbaud A. Retour d’expérience sur la vaccination anti-Covid-19 des patients étiquetés « à risque allergique ». Revue Française d'Allergologie 2022. [PMCID: PMC9126011 DOI: 10.1016/j.reval.2022.02.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction (contexte de la recherche) Fin décembre 2020, le vaccin anti-Covid-19 à ARNm Comirnaty© de Pfizer-BioNTech a obtenu l’AMM conditionnelle en France. Il était contre-indiqué chez les personnes ayant présenté des manifestations allergiques graves telles que des réactions anaphylactiques par l’HAS, le ministère de la Santé, l’Assurance maladie et l’ANSM. Objectif Évaluer la tolérance de la vaccination avec Comirnaty© chez les patients étiquetés « à risque allergique ». Méthodes Entre le 20 janvier et le 8 avril 2021, les patients étaient adressés via la hot line téléphonique dédiée aux avis vis-à-vis de la vaccination. Les patients « à risque allergique » (avec antécédent d’anaphylaxie à un autre vaccin ou à un médicament par voie injectable) étaient vaccinés sous surveillance allergologique, avec voie d’abord veineux et surveillance rapprochée pendant 2 h. Résultats Au total, 225 patients supposés à haut risque allergique ont été vaccinés (1re dose), 48 hommes et 177 femmes, avec un âge moyen de 73 ans. 98 avaient un terrain atopique (43,6 %). 203 patients avaient des antécédents allergiques suspectés ou prouvés à type d’hypersensibilité immédiate (90,2 %), 16 d’hypersensibilité retardée (7,1 %), 2 avaient une mastocytose systémique indolente sans réaction médicamenteuse spécifique et pour 4 la réaction n’était pas connue. Les molécules en cause étaient en majorité les produits de contraste (32,4 %) ou les antibiotiques (27,5 %). 3 réactions post vaccinales ont été notées sans anaphylaxie de grade II ou plus. Il faut noter que les réactions urticariennes étaient toutes retardées de plus d’1 h ce qui est peu évocateur d’anaphylaxie IgE médiée. 217/225 patients ont eu une 2ème dose (dont 75 dans le service) parmi lesquels 2 ont présenté une réaction non grave non évocatrice d’allergie. Aucune anaphylaxie n’a été rapportée. Conclusions Malgré le petit effectif, lié à une pénurie de vaccin et aux capacités d’accueil limitées, nous n’avons pas observé de réactions anaphylactiques chez les patients « à risque allergique ». Nous avons ainsi pu modifier nos pratiques en limitant les indications de vaccination sous surveillance allergologique. Cette mobilisation d’équipe a été d’une grande aide pour vacciner des patients récusés des centres de vaccination.
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque AM, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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Mazzilli S, Tavoschi L, Soria A, Fornili M, Cocca G, Sebastiani T, Scardina G, Cairone C, Arzilli G, Lapadula G, Ceccarelli L, Cocco N, Bartolotti R, De Vecchi S, Placidi G, Rezzonico L, Baglietto L, Giuliani R, Ranieri R. COVID-19 Infection Among Incarcerated Individuals and Prison Staff in Lombardy, Italy, March 2020 to February 2021. JAMA Netw Open 2022; 5:e224862. [PMID: 35353164 PMCID: PMC8968466 DOI: 10.1001/jamanetworkopen.2022.4862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Owing to infrastructural and population characteristics, the prison setting is at increased risk for transmission of SARS-CoV-2 and for severe clinical outcomes. Because of structural and operational reasons, research in prison settings is challenging and available studies are often monocentric and have limited temporal coverage; broader-based research is necessary. OBJECTIVES To assess the extent and dynamics of the COVID-19 pandemic within the prison system of a large Italian region, Lombardy, and report the infection prevention and control measures implemented. DESIGN, SETTING, AND PARTICIPANTS This repeated cross-sectional study was carried out from March 1, 2020, through February 28, 2021 (first wave, March-June 2020; second wave, October 2020-February 2021) in the prison system of Lombardy, which includes 18 detention facilities for adults. All incarcerated persons and the prison staff of the penitentiary system of the Lombardy region participated in the study. EXPOSURES The main exposures of interest were the weekly average number of incarcerated individuals placed in quarantine in single or shared isolation rooms, the rate of sick leave by symptomatic and asymptomatic prison staff reported to the prison occupational medicine department on a weekly basis, and the level of overcrowding. MAIN OUTCOMES AND MEASURES The primary outcome measures were weekly COVID-19 crude case rates, weekly test positivity rate, and the relative risk of acquiring the infection for prison staff, incarcerated persons, and the general population. RESULTS The study population comprised a mean of 7599 incarcerated individuals and 4591 prison staff. Approximately 5.1% of the prison population were women; demographic characteristics of the prison staff were not available. During the study, COVID-19 occurred in 1564 incarcerated individuals and 661 prison staff. Most of these cases were reported during the second wave (1474 in incarcerated individuals, 529 in prison staff), when stringent measures previously enforced were relaxed. During both epidemic waves, incarcerated individuals and prison staff had a higher relative risk for COVID-19 infection than the general population during both the first wave (incarcerated individuals: 1.30; 95% CI, 1.06-1.58; prison staff: 3.23; 95% CI, 2.74-3.84) and the second wave (incarcerated individuals: 3.91; 95% CI, 3.73-4.09; prison staff: 2.61; 95% CI, 2.41-2.82). CONCLUSIONS AND RELEVANCE The findings of this study suggest that the prison setting was an element of fragility during COVID-19 pandemic, with a high burden of COVID-19 cases among both the incarcerated individuals and prison staff. The prison setting and prison population need to be included and possibly prioritized in the response during epidemic events.
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Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Marco Fornili
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgia Cocca
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Teresa Sebastiani
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Giuditta Scardina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Cristina Cairone
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Lapadula
- Clinic of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Luca Ceccarelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Nicola Cocco
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Raffaella Bartolotti
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Stefano De Vecchi
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Giacomo Placidi
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Leonardo Rezzonico
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ruggero Giuliani
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Roberto Ranieri
- Welfare General Directorate, Lombardy Regional Health Authority, Milan, Italy
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Doan S, Arnould L, Febvay C, Fournié P, Gueudry J, Labalette P, Ouilhon C, Tran THC, Vabres B, Barbarot S, Bouaziz JD, Du-Thanh A, Jachiet M, Seneschal J, Soria A, Staumont-Sallé D, Baudouin C, Mortemousque B. Blépharo-conjonctivites sous dupilumab : recommandations du groupe CEDRE. Dermatite atopique, conjonctivites et dupilumab : quelle prise en charge ? J Fr Ophtalmol 2022; 45:277-287. [DOI: 10.1016/j.jfo.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
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Mille B, Ingen-Housz-Oro S, De Prost N, Voiriot G, Soria A, Tetart F, Bernier C, Morice C, Staumont-Salle D, Dezoteux F. High frequency of eosinophilia and viral reactivation in drug hypersensitivity in patients with severe acute respiratory syndrome coronavirus 2 infection. J Eur Acad Dermatol Venereol 2021; 36:e256-e257. [PMID: 34927763 DOI: 10.1111/jdv.17885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B Mille
- CHU Lille, Service de Dermatologie, Lille, France
| | - S Ingen-Housz-Oro
- AP-HP, Hôpital Henri Mondor, Service de Dermatologie, Créteil, France.,Univ. Paris Est Créteil, Epiderme, Créteil, France
| | - N De Prost
- AP-HP, Hôpital Henri Mondor, Service de Réanimation, Créteil, France
| | - G Voiriot
- AP-HP, Hôpital Tenon, Sorbonne Université, Service de Médecine Intensive Réanimation, Paris, France
| | - A Soria
- AP-HP, Hôpital Tenon, Service de Dermatologie et d'Allergologie, Paris HUEP, Paris, France.,Centre d'immunologie et des Maladies Infectieuses - Paris (Cimi-Paris), INSERM U1135, Paris, France
| | - F Tetart
- CHU Rouen, Centre Erik Satie, Service de Dermatologie, Rouen, France
| | - C Bernier
- CHU Nantes, Service de Dermatologie, Nantes, France
| | - C Morice
- CHU Caen, Service de Dermatologie, Caen, France
| | - D Staumont-Salle
- CHU Lille, Service de Dermatologie, Lille, France.,Univ. Lille, CHU Lille, INSERM 1286, INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - F Dezoteux
- CHU Lille, Service de Dermatologie, Lille, France.,Univ. Lille, CHU Lille, INSERM 1286, INFINITE - Institute for Translational Research in Inflammation, Lille, France
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18
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Valenti L, Pelusi S, Aghemo A, Gritti S, Pasulo L, Bianco C, Iegri C, Cologni G, Degasperi E, D'Ambrosio R, Del Poggio P, Soria A, Puoti M, Carderi I, Pigozzi MG, Carriero C, Spinetti A, Zuccaro V, Memoli M, Giorgini A, Viganò M, Rumi MG, Re T, Spinelli O, Colombo MC, Quirino T, Menzaghi B, Lorini G, Pan A, D'Arminio Monforte A, Buscarini E, Autolitano A, Bonfanti P, Terreni N, Aimo G, Mendeni M, Prati D, Lampertico P, Colombo M, Fagiuoli S. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study. Hepatol Commun 2021; 6:867-877. [PMID: 34811949 PMCID: PMC8948549 DOI: 10.1002/hep4.1851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real‐life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE‐Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow‐up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m2, 1.03‐1.09) and diabetes (OR 2.01 [1.65‐2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35‐0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20‐3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16‐6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11‐0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi‐disciplinary management approach may improve cardiovascular and possibly liver‐related outcomes.
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Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Serena Pelusi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Alessio Aghemo
- Department of Internal Medicine and Hepatology, Humanitas University and Research Hospital, Rozzano, Italy
| | - Sara Gritti
- Fondazione Ricerca Ospedale di Bergamo, Papa Giovanni Hospital, Bergamo, Italy
| | - Luisa Pasulo
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
| | - Cristiana Bianco
- Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Claudia Iegri
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
| | - Giuliana Cologni
- Department of Internal Medicine, Papa Giovanni Hospital, Bergamo, Italy
| | - Elisabetta Degasperi
- Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Roberta D'Ambrosio
- Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Paolo Del Poggio
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Zingonia, Italy
| | - Alessandro Soria
- Division of Infectious Diseases, San Gerardo Hospital-ASST Monza, Monza, Italy
| | - Massimo Puoti
- Department of Infectious Diseases, Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | | | - Canio Carriero
- Department of Infectious Diseases, Spedali Civili Hospital-ASST Brescia, Brescia, Italy
| | - Angiola Spinetti
- Department of Infectious Diseases, Spedali Civili Hospital-ASST Brescia, Brescia, Italy
| | - Valentina Zuccaro
- Department of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy
| | - Massimo Memoli
- Liver Center, San Raffaele Scientific Institute IRCCS, Milano, Italy
| | - Alessia Giorgini
- Department of Gastroenterology and Hepatology, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Mauro Viganò
- Department of Gastroenterology and Hepatology, San Giuseppe Hospital, Milan, Italy
| | - Maria Grazia Rumi
- Department of Gastroenterology and Hepatology, San Giuseppe Hospital, Milan, Italy
| | - Tiziana Re
- Department of Gastroenterology and Hepatology, Legnano Hospital-ASST Milano Ovest, Milan, Italy
| | - Ombretta Spinelli
- Department of Gastroenterology and Hepatology, Lariana Como Hospital, Milan, Italy
| | - Maria Chiara Colombo
- Department of Gastroenterology and Hepatology, Lariana Como Hospital, Milan, Italy
| | - Tiziana Quirino
- Department of Gastroenterology and Hepatology, Busto Arsizio Hospital ASST Valle Olona, Milan, Italy
| | - Barbara Menzaghi
- Department of Gastroenterology and Hepatology, Busto Arsizio Hospital ASST Valle Olona, Milan, Italy
| | - Gianpaolo Lorini
- Department of Gastroenterology and Hepatology, ASST Franciacorta, Milan, Italy
| | - Angelo Pan
- Department of Internal Medicine, Ospedale di Cremona, Cremona, Italy
| | | | | | | | - Paolo Bonfanti
- Division of Infectious Diseases, ASST Lecco, Lecco, Italy
| | | | | | | | - Daniele Prati
- Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Pietro Lampertico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy.,CRC "AM. and A. Migliavacca" Center for Liver Disease, Università degli Studi di Milano, Milano, Italy
| | - Massimo Colombo
- Liver Center, San Raffaele Scientific Institute IRCCS, Milano, Italy
| | - Stefano Fagiuoli
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
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19
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Marniquet ME, Seneschal J, Darrigade AS, Staumont-Sallé D, Jachiet M, Nosbaum A, Tauber M, Abasq C, Ferrier Le Bouedec MC, Droitcourt C, Aubert H, Bernier C, Soria A, Raison-Peyron N, Tétart F, Aubin F, Viguier M, Valois A, Kupfer-Bessaguet I, Goronflot T, Barbarot S. Reasons for Discontinuation of dupilumab in Adult Atopic Dermatitis in Clinical Practice. Br J Dermatol 2021; 186:733-735. [PMID: 34748654 DOI: 10.1111/bjd.20883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
Dupilumab, an anti-IL-4ɑ monoclonal antibody, has shown a positive benefit-risk ratio when treating moderate to severe atopic dermatitis (AD) in clinical studies (1). High persistence on dupilumab has recently been reported in clinical-practice setting with 77% of patients remaining in treatment for 12 months in a retrospective study including 1,963 patients with AD but reasons for discontinuation were not investigated (2).
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Affiliation(s)
| | - J Seneschal
- Dermatologie, Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin disorders, Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000, Bordeaux, France
| | - A-S Darrigade
- Dermatologie, Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin disorders, Univ. Bordeaux, INSERM, BMGIC, U1035, F-33000, Bordeaux, France
| | | | - M Jachiet
- Dermatologie, Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, F-75010, Paris, France
| | - A Nosbaum
- Dermatologie, Hospices Civils de Lyon, Service d'Allergologie et Immunologie clinique, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - M Tauber
- Dermatologie, CHU de Toulouse, Toulouse, France
| | - C Abasq
- Dermatologie, CHU de Brest, Brest, France
| | | | | | - H Aubert
- Dermatologie, CHU de Nantes, Nantes, France
| | - C Bernier
- Dermatologie, CHU de Nantes, Nantes, France
| | - A Soria
- Sorbonne Université, service de Dermatologie et d'Allergologie, Hôpital Tenon, APHP, Paris, France
| | | | - F Tétart
- Dermatologie, CHU de Rouen, Rouen, France
| | - F Aubin
- Dermatologie, CHU de Besançon, Besançon, France
| | - M Viguier
- Dermatologie, Hôpital Robert Debré, CHU de Reims, Reims, France
| | - A Valois
- Dermatologie, Hôpital d'instruction des Armées Sainte Anne, Toulon, France
| | | | - T Goronflot
- Epidemiologie et Biostatistique, CHU de Nantes, Nantes, France
| | - S Barbarot
- Dermatologie, CHU de Nantes, Nantes, France
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20
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Brehon A, Moguelet P, Seta V, Amsler E, Fajac A, Barbaud A, Soria A, Monfort JB. Clinical and histological characteristics during chronic urticaria with dermal neutrophilic infiltrate: Proposal of a diagnostic score. J Eur Acad Dermatol Venereol 2021; 36:e304-e306. [PMID: 34742165 DOI: 10.1111/jdv.17788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- A Brehon
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - P Moguelet
- AP-HP, Service de Pathologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - V Seta
- AP-HP, Service de Dermatologie, Hôpital Cochin, Université de Paris, Paris, 75014, France.,Service de Chirurgie Maxillo-Faciale, Chirurgie Orale et Stomatologie, CHU d'Angers, Angers, France
| | - E Amsler
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - A Fajac
- AP-HP, Service de Pathologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - A Barbaud
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - A Soria
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
| | - J B Monfort
- AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, Paris, 75020, France
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21
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Briand C, Tetart F, Soria A, Staumont-Sallé D, Sterling B, Boralevi F, Castelain Lakkis F, Du-Thanh A, Raison-Peyron N, Chiaverini C. Omalizumab in cold urticaria in children: Retrospective case series of 13 patients, review of the literature. Ann Dermatol Venereol 2021; 148:269-271. [PMID: 34503855 DOI: 10.1016/j.annder.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/21/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Affiliation(s)
- C Briand
- Dermatology Department, Hôpital Archet, Centre Hospitalier Universitaire (CHU) de Nice, 06200 Nice, France.
| | - F Tetart
- Dermatology Department, CHU de Rouen, Service d'allergologie, Centre Erik Satie, CHU, 76000 Rouen, France
| | - A Soria
- Dermatology and Allergy Department, Hôpital Tenon, AP-HP, 75020 Paris, France
| | - D Staumont-Sallé
- Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, 59000 Lille, France
| | - B Sterling
- Dermatology Department, CHU de la Timone, 130005 Marseille, France
| | - F Boralevi
- Paediatric Dermatology Department, Hôpital Pellegrin, CHU, 33300 Bordeaux, France
| | | | - A Du-Thanh
- Dermatology Department, Hôpital Saint Eloi, CHU, 34090 Montpellier, France
| | - N Raison-Peyron
- Dermatology Department, Hôpital Saint Eloi, CHU, 34090 Montpellier, France
| | - C Chiaverini
- Dermatology Department, Hôpital Archet, Centre Hospitalier Universitaire (CHU) de Nice, 06200 Nice, France
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22
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Marquez-Rodas I, Arance A, Berciano Guerrero M, Díaz Beveridge R, Alamo M, Garcia Castaño A, Gonzalez Cao M, Vidal J, Puertolas Hernandez T, Soria A, Aguado de la Rosa C, Sánchez Mauriño P, Valduvieco I, Delgado Rico R, Conde A, Foro P, Prada P, Puertas E, Alvarez Gonzalez A, Berrocal A. 1038MO Intracranial activity of encorafenib and binimetinib followed by radiotherapy in patients with BRAF mutated melanoma and brain metastasis: Preliminary results of the GEM1802/EBRAIN-MEL phase II clinical trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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23
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Garcia Castano A, Muñoz Couselo E, Soria A, Lavernia J, Sanmartin O, Cañueto J, Ayala de Miguel P, Beá Ardébol S, Bellido Hernández L, Fernández-de-Misa Cabrera R, Cunquero-Tomás A, Fernández Franco L, Férnandez-Freire Leal A, Mujika Eizmendi K, Ortiz C, Redondo P, Romero I, Serrano Fernández M, Medina Martínez J. 1061P Safety of cemiplimab for advanced cutaneous squamous cell carcinoma: The Spanish named patient programme. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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24
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Soria A, Lapadula G, Bonfanti P. COVID-19 Mortality and Stress to the Hospital System From High Patient Load. JAMA Intern Med 2021; 181:1134. [PMID: 33843959 DOI: 10.1001/jamainternmed.2021.0599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Lapadula
- Clinic of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Paolo Bonfanti
- Clinic of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
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25
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Squillace N, Bernasconi DP, Lapadula G, Soria A, Sabbatini F, Colella E, Rossi M, Tamburini AM, Leone BE, Brenna A, Malandrin S, Cavallero A, Di Lucia A, Braga M, Bonfanti P. HPV 16 and 18 contribute to development of anal dysplasia in HIV infection irrespective of gender and sexual orientation. HIV Med 2021; 22:860-866. [PMID: 34293254 DOI: 10.1111/hiv.13143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the present study was too investigate prevalence and persistence of human papilloma virus (HPV) and cytological abnormalities (CAs) in the anal swabs of people living with HIV (PLWH): men who have sex with men (MSM), men who have sex with women (MSW) and women (W). METHODS Between March 2010 and January 2019, an anal swab for cytological and HPV genotyping tests was offered to all PLWH attending our clinic. Logistic regression analysis was conducted to identify predictors of infection. RESULTS In all, 354 PLWH were screened: 174 MSM, 90 MSW and 61 W. Prevalence of at least one high-risk (HR) HPV was higher in MSM (91%) and W (85%) than in MSW (77%) (P < 0.05). Cytological abnormalities were found in 21.1% of the entire population. At multivariable regression analysis a lower risk for HPV infection was found for W than for MSM [odds ratio = 0.24 (95% confidence interval: 0.115-0.513)] and for MSW than for MSM [0.37 (0.180-0.773)] and there was a significantly higher risk of CAs in PLWH with HPV 16 and 18 [3.3 (1.04-10.49)]. A total of 175 PLWH (103 MSM, 33 MSW and 26 W) had at least one follow-up visit (T1) after a median (interquartile range) follow-up of 3.6 (2.1-5.7) years. The acquisition rate of HR-HPV was high, with 66.7% of PLWH negative for HR-HPV at T0 who became positive at T1 (P < 0.001). The prevalence of CAs was stable (20.6%). A significant association between CAs at T1 and persistence of HPV-16 and/or 18 was found (P < 0.05). CONCLUSIONS HPV 16 and 18 are associated with the presence and development of CAs irrespective of sexual orientation.
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Affiliation(s)
- Nicola Squillace
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Lapadula
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Alessandro Soria
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Francesca Sabbatini
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Elisa Colella
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Marianna Rossi
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | | | - Biagio Eugenio Leone
- Pathology, Department of Medicine and Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Ambrogio Brenna
- Pathology, Department of Medicine and Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Sergio Malandrin
- Microbiology Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Annalisa Cavallero
- Microbiology Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Adriana Di Lucia
- Department of Surgery, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Marco Braga
- Department of Surgery, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Monza, San Gerardo Hospital, Monza, Italy
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26
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Lapadula G, Bernasconi DP, Soria A, Valsecchi MG, Bonfanti P. Beware of biases in observational studies on anti-spike monoclonal antibodies. Clin Infect Dis 2021; 74:363. [PMID: 34015133 PMCID: PMC9012953 DOI: 10.1093/cid/ciab467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | | | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit, San Gerardo Hospital, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
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27
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Mesia R, Iglesias L, Lambea J, Martínez-Trufero J, Soria A, Taberna M, Trigo J, Chaves M, García-Castaño A, Cruz-Hernández JJ. Correction to: SEOM clinical guidelines for the treatment of head and neck cancer (2020). Clin Transl Oncol 2021; 23:1001. [PMID: 33709222 DOI: 10.1007/s12094-021-02582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- R Mesia
- Institut Català d'Oncologia, Badalona, Spain.
| | - L Iglesias
- Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, 12 de Octubre, Madrid, Spain
| | - J Lambea
- Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - J Martínez-Trufero
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Soria
- Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Taberna
- Institut Català d'Oncologia, Hospitalet de Llobregat, Spain
| | - J Trigo
- Servicio de Oncología Médica, Hospital Clínico Virgen de la Victoria, Málaga, Spain
| | - M Chaves
- Servicio de Oncología Médica, Hospital Virgen de Valme, Seville, Spain
| | - A García-Castaño
- Servicio de Oncología Médica, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - J J Cruz-Hernández
- Servicio de Oncología Médica, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
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28
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Fabbiani M, Lombardi A, Colaneri M, Del Poggio P, Perini P, D'Ambrosio R, Degasperi E, Dibenedetto C, Giorgini A, Pasulo L, Maggiolo F, Castelli F, Brambilla P, Spinelli O, Re T, Lleo A, Rumi M, Uberti-Foppa C, Soria A, Aghemo A, Lampertico P, Baiguera C, Schiavini M, Fagiuoli S, Bruno R. High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV-infected patients treated in a real-life setting. J Viral Hepat 2021; 28:558-568. [PMID: 33306247 DOI: 10.1111/jvh.13454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/21/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
In routine clinical practice, hepatitis C virus-infected patients can prematurely discontinue the prescribed regimen for several reasons. The aim of our study was to investigate sustained virological response (SVR12) rates in patients who prematurely discontinued directly acting antiviral (DAA) regimens and to assess the shortest effective duration of DAA able to lead to SVR12. We retrospectively collected the SVR rates of patients, registered in the NAVIGATORE-Lombardia Network database from January 2015, who discontinued DAAs before the predefined end of treatment. Overall, we included 365 patients, males were the majority (213, 58.4%), mean age was 60.5 years, and 53 (14.5%) patients were HIV-co-infected. Liver cirrhosis was observed in 251 (68.8%) subjects, and the most represented genotypes were 1b (n = 168, 46%) and 3 (n = 59, 16.2%). DAA was discontinued a median of 1 (IQR 1-4) weeks before the predefined EOT, with 164 (44.9%) patients stopping DAAs at least 2 weeks before the planned schedule. In patients with F0-F3 liver fibrosis, lower rates of SVR12 were observed in patients treated for <4 weeks: 50% (n = 2/4) vs. 99.1% (n = 109/110) for ≥4 weeks, p = 0.003. In patients with liver cirrhosis, lower rates of SVR12 were observed in patients treated <8 weeks: 83.3% (n = 25/30) vs. 94.6% (n = 209/221) for ≥8 weeks, p = 0.038. Despite premature discontinuation of DAA, high SVR12 rates were observed in a real-life setting for treatment lasting at least 4 weeks in patients with liver fibrosis F0-F3 and 8 weeks in those with liver cirrhosis. On this basis, feasibility of reducing DAA treatment duration should be explored in randomized clinical trials.
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Affiliation(s)
- Massimiliano Fabbiani
- U.O. Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,UOC Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Andrea Lombardi
- U.O. Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Colaneri
- U.O. Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Paolo Perini
- Divisione di Medicina, Policlinico San Pietro, Bergamo, Italy
| | - Roberta D'Ambrosio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,UOC Gastroenterologia ed Epatologia, CRC 'AM e A Migliavacca' per lo studio e la cura delle malattie del fegato, Milan, Italy
| | - Elisabetta Degasperi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,UOC Gastroenterologia ed Epatologia, CRC 'AM e A Migliavacca' per lo studio e la cura delle malattie del fegato, Milan, Italy
| | - Clara Dibenedetto
- Unità di Epatologia e Gastroenterologia, Ospedale San Paolo, Milan, Italy
| | - Alessia Giorgini
- Unità di Epatologia e Gastroenterologia, Ospedale San Paolo, Milan, Italy
| | - Luisa Pasulo
- Unità di Gastroenterologia, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Franco Maggiolo
- U.O. Malattie Infettive, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Paola Brambilla
- U.O. Malattie Infettive, Istituti Ospitalieri, Cremona, Italy
| | | | - Tiziana Re
- U.O. Malattie Infettive, ASST Ovest Milanese, Legnano, Italy
| | - Ana Lleo
- Medicina Interna ed Epatologia, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Mariagrazia Rumi
- U.O. Epatologia, Ospedale San Giuseppe Multimedica, Università degli Studi di Milano, Milan, Italy
| | - Caterina Uberti-Foppa
- Division of Infectious Diseases, Vita-Salute San Raffaele University Milan, Milan, Italy.,Division of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Soria
- UO Malattie Infettive, Ospedale San Gerardo, ASST Monza, Monza, Italy
| | - Alessio Aghemo
- Medicina Interna ed Epatologia, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Pietro Lampertico
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,UOC Gastroenterologia ed Epatologia, CRC 'AM e A Migliavacca' per lo studio e la cura delle malattie del fegato, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | - Chiara Baiguera
- UO Malattie Infettive, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Monica Schiavini
- Dipartimento di Malattie Infettive, Ospedale Luigi Sacco, Milan, Italy
| | - Stefano Fagiuoli
- Unità di Gastroenterologia, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Raffaele Bruno
- U.O. Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Coppadoro A, Benini A, Fruscio R, Verga L, Mazzola P, Bellelli G, Carbone M, Mulinacci G, Soria A, Noè B, Beck E, Di Sciacca R, Ippolito D, Citerio G, Valsecchi MG, Biondi A, Pesci A, Bonfanti P, Gaudesi D, Bellani G, Foti G. Helmet CPAP to treat hypoxic pneumonia outside the ICU: an observational study during the COVID-19 outbreak. Crit Care 2021; 25:80. [PMID: 33627169 PMCID: PMC7903369 DOI: 10.1186/s13054-021-03502-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/10/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Respiratory failure due to COVID-19 pneumonia is associated with high mortality and may overwhelm health care systems, due to the surge of patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe gas exchange impairment. Helmet is an effective interface to provide continuous positive airway pressure (CPAP) noninvasively. We report data about the usefulness of helmet CPAP during pandemic, either as treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI). METHODS In this observational study we collected data regarding patients failing standard oxygen therapy (i.e., non-rebreathing mask) due to COVID-19 pneumonia treated with a free flow helmet CPAP system. Patients' data were recorded before, at initiation of CPAP treatment and once a day, thereafter. CPAP failure was defined as a composite outcome of intubation or death. RESULTS A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP treatment was successful in 69% of the full treatment and 28% of the DNI patients (P < 0.001). With helmet CPAP, PaO2/FiO2 ratio doubled from about 100 to 200 mmHg (P < 0.001); respiratory rate decreased from 28 [22-32] to 24 [20-29] breaths per minute, P < 0.001). C-reactive protein, time to oxygen mask failure, age, PaO2/FiO2 during CPAP, number of comorbidities were independently associated with CPAP failure. Helmet CPAP was maintained for 6 [3-9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wards. CONCLUSIONS Helmet CPAP treatment is feasible for several days outside the ICU, despite persistent impairment in gas exchange. It was used, without escalating to intubation, in the majority of full treatment patients after standard oxygen therapy failed. DNI patients could benefit from helmet CPAP as rescue therapy to improve survival. TRIAL REGISTRATION NCT04424992.
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Affiliation(s)
- Andrea Coppadoro
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Annalisa Benini
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Robert Fruscio
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Luisa Verga
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Paolo Mazzola
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Giuseppe Bellelli
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Marco Carbone
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Giacomo Mulinacci
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Alessandro Soria
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Beatrice Noè
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Eduardo Beck
- grid.413643.70000 0004 1760 8047ASST Monza, Desio Hospital, Desio, Italy
| | - Riccardo Di Sciacca
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Davide Ippolito
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Giuseppe Citerio
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Maria Grazia Valsecchi
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Andrea Biondi
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Alberto Pesci
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Paolo Bonfanti
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Davide Gaudesi
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Giacomo Bellani
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
| | - Giuseppe Foti
- grid.415025.70000 0004 1756 8604ASST Monza, San Gerardo Hospital, Monza, Italy
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza, MB Italy
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Marcant P, Balayé P, Merhi R, Jendoubi F, Nosbaum A, Raison-Peyron N, Du-Thanh A, Lasek A, Ferrier le Bouedec MC, Tetart F, Valois A, Barbarot S, Soria A, Jachiet M, Staumont-Sallé D. Dupilumab-associated hypereosinophilia in patients treated for moderate-to-severe atopic dermatitis. J Eur Acad Dermatol Venereol 2021; 35:e394-e396. [PMID: 33594731 DOI: 10.1111/jdv.17177] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022]
Affiliation(s)
- P Marcant
- Service de Dermatologie CHU Lille, INFINITE U1286 Inserm, Univ. Lille, Lille, France
| | - P Balayé
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - R Merhi
- Service de Dermatologie, Hôpital Saint André, Centre de Référence des Maladies Rares de la Peau, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - F Jendoubi
- Dermatology and Allergology department, Toulouse University Hospital, Toulouse, France
| | - A Nosbaum
- Allergy and Clinical Immunology Department, Univ Lyon, Lyon Sud University Hospital, Pierre Benite, France
| | - N Raison-Peyron
- Service de Dermatologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - A Du-Thanh
- Service de Dermatologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - A Lasek
- Service de Dermatologie, Hôpital Saint Vincent de Paul, Université Catholique de Lille, Lille, France
| | | | - F Tetart
- Service de Dermatologie, Clinique Dermatologique, CHU de Rouen, Rouen, France
| | - A Valois
- Service de dermatologie, Hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, Toulon, France
| | - S Barbarot
- Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN, INRAE, Nantes, France
| | - A Soria
- Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France
| | - M Jachiet
- Dermatology Department, Université́ Paris Diderot Paris VII, Sorbonne Paris Cité APHP, Saint Louis Hospital, Paris, France
| | - D Staumont-Sallé
- Service de Dermatologie CHU Lille, INFINITE U1286 Inserm, Univ. Lille, Lille, France
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31
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Soria A, Galimberti S, Lapadula G, Visco F, Ardini A, Valsecchi MG, Bonfanti P. The high volume of patients admitted during the SARS-CoV-2 pandemic has an independent harmful impact on in-hospital mortality from COVID-19. PLoS One 2021; 16:e0246170. [PMID: 33507954 PMCID: PMC7842950 DOI: 10.1371/journal.pone.0246170] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/14/2021] [Indexed: 12/22/2022] Open
Abstract
Background During the Coronavirus disease 2019 (COVID-19) pandemic, advanced health systems have come under pressure by the unprecedented high volume of patients needing urgent care. The impact on mortality of this “patients’ burden” has not been determined. Methods and findings Through retrieval of administrative data from a large referral hospital of Northern Italy, we determined Aalen-Johansen cumulative incidence curves to describe the in-hospital mortality, stratified by fixed covariates. Age- and sex-adjusted Cox models were used to quantify the effect on mortality of variables deemed to reflect the stress on the hospital system, namely the time-dependent number of daily admissions and of total hospitalized patients, and the calendar period. Of the 1225 subjects hospitalized for COVID-19 between February 20 and May 13, 283 died (30-day mortality rate 24%) after a median follow-up of 14 days (interquartile range 5–19). Hospitalizations increased progressively until a peak of 465 subjects on March 26, then declined. The risk of death, adjusted for age and sex, increased for a higher number of daily admissions (adjusted hazard ratio [AHR] per an incremental daily admission of 10 patients: 1.13, 95% Confidence Intervals [CI] 1.05–1.22, p = 0.0014), and for a higher total number of hospitalized patients (AHR per an increase of 50 patients in the total number of hospitalized subjects: 1.11, 95%CI 1.04–1.17, p = 0.0004), while was lower for the calendar period after the peak (AHR 0.56, 95%CI 0.43–0.72, p<0.0001). A validation was conducted on a dataset from another hospital where 500 subjects were hospitalized for COVID-19 in the same period. Figures were consistent in terms of impact of daily admissions, daily census, and calendar period on in-hospital mortality. Conclusions The pressure of a high volume of severely ill patients suffering from COVID-19 has a measurable independent impact on in-hospital mortality.
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Affiliation(s)
- Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
- * E-mail:
| | - Stefania Galimberti
- Bicocca Bioinformatics, Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Giuseppe Lapadula
- Clinic of Infectious Diseases, San Gerardo Hospital, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Francesca Visco
- Medical Direction, Edoardo Bassini Hospital, Cinisello Balsamo, Italy
| | - Agata Ardini
- Medical Direction, Edoardo Bassini Hospital, Cinisello Balsamo, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics, Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Paolo Bonfanti
- Clinic of Infectious Diseases, San Gerardo Hospital, School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
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32
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Kurihara F, Milpied B, Ferrier Le Bouëdec M, Raison Peyron N, Morice C, Manciet J, Assier H, Gener G, Giordano Labadie F, Marcant P, Pralong P, Tétard F, Bernier C, Badaoui A, Chasset F, Soria A, Amsler E, Barbaud A. Caractéristiques d’utilisation des huiles essentielles des patients avec un eczéma de contact prouvé aux huiles essentielles et évaluation d’une batterie huile essentielle : étude descriptive du DAG. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hamelin A, Amsler E, Barbaud A, Soria A. Deux cas de prurit cholinergique. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dambricourt V, Oro S, Gaudin O, De Prost N, Soria A, Barbaud A, Bernier C, Bebouelle E, Morice C, Dezoteux F, Staumont-Sallé D. Prise en charge des toxidermies survenant en contexte de COVID-19. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Marcant P, Balayé P, Merhi R, Seneschal J, Tauber M, Jendoubi F, Nosbaum A, Raison-Peyron N, Du-Thanh A, Lasek A, Ferrier le Bouedec MC, Tetart F, Valois A, Lefevre G, Barbarot S, Soria A, Jachiet M, Staumont-Sallé D. Hyperéosinophilie associée au traitement par dupilumab dans la dermatite atopique modérée à sévère : étude rétrospective multicentrique du GREAT. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Iavarone M, D'Ambrosio R, Soria A, Triolo M, Pugliese N, Del Poggio P, Perricone G, Massironi S, Spinetti A, Buscarini E, Viganò M, Carriero C, Fagiuoli S, Aghemo A, Belli LS, Lucà M, Pedaci M, Rimondi A, Rumi MG, Invernizzi P, Bonfanti P, Lampertico P. High rates of 30-day mortality in patients with cirrhosis and COVID-19. J Hepatol 2020; 73:1063-1071. [PMID: 32526252 PMCID: PMC7280108 DOI: 10.1016/j.jhep.2020.06.001] [Citation(s) in RCA: 250] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/27/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Coronavirus disease 2019 (COVID-19) poses a major health threat to healthy individuals and those with comorbidities, but its impact on patients with cirrhosis is currently unknown. Herein, we aimed to evaluate the impact of COVID-19 on the clinical outcome of patients with cirrhosis. METHODS In this multicentre retrospective study, patients with cirrhosis and a confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were enrolled between 1st and 31th March 2020. Clinical and biochemical data at diagnosis of COVID-19 and at the last outpatient visit were obtained through review of medical records. RESULTS Fifty patients with cirrhosis and confirmed SARS-CoV-2 infection were enrolled (age 67 years, 70% men, 38% virus-related, 52% previously compensated cirrhosis). At diagnosis, 64% of patients presented fever, 42% shortness of breath/polypnea, 22% encephalopathy, 96% needed hospitalization or a prolonged stay if already in hospital. Respiratory support was necessary in 71%, 52% received antivirals, 80% heparin. Serum albumin significantly decreased, while bilirubin, creatinine and prothrombin time significantly increased at COVID-19 diagnosis compared to last available data. The proportion of patients with a model for end-stage liver disease (MELD) score ≥15 increased from 13% to 26% (p = 0.037), acute-on-chronic liver failure and de novo acute liver injury occurred in 14 (28%) and 10 patients, respectively. Seventeen patients died after a median of 10 (4-13) days from COVID-19 diagnosis, with a 30-day-mortality rate of 34%. The severity of lung and liver (according to CLIF-C, CLIF-OF and MELD scores) diseases independently predicted mortality. In patients with cirrhosis, mortality was significantly higher in those with COVID-19 than in those hospitalized for bacterial infections. CONCLUSION COVID-19 is associated with liver function deterioration and elevated mortality in patients with cirrhosis. LAY SUMMARY Coronavirus disease 2019 (COVID-19) poses a major health threat to healthy individuals and those with comorbidities. Herein, we assessed its impact on patients with cirrhosis. Infection with COVID-19 was associated with liver function deterioration and elevated mortality in patients with cirrhosis.
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Affiliation(s)
- Massimo Iavarone
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy.
| | - Roberta D'Ambrosio
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy
| | - Alessandro Soria
- Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, University of Milano - Bicocca School of Medicine, Monza, Italy
| | - Michela Triolo
- Gastroenterology 1 - Hepatology & Transplantology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Nicola Pugliese
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Paolo Del Poggio
- UO Gastroenterologia. Policlinico S. Marco, Zingonia-Bergamo, Italy
| | | | - Sara Massironi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Angiola Spinetti
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, Italy
| | - Elisabetta Buscarini
- UOC Gastroenterologia ed Endoscopia Digestiva, ASST Ospedale Maggiore, Crema, Italy
| | - Mauro Viganò
- Division of Hepatology, Ospedale San Giuseppe, Italy
| | - Canio Carriero
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, Italy
| | - Stefano Fagiuoli
- Gastroenterology 1 - Hepatology & Transplantology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Alessio Aghemo
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Luca S Belli
- Hepatology and Gastroenterology Unit, Niguarda Hospital, Milan, Italy
| | - Martina Lucà
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marianna Pedaci
- UOC Gastroenterologia ed Endoscopia Digestiva, ASST Ospedale Maggiore, Crema, Italy; University of Milan, Milan, Italy
| | - Alessandro Rimondi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy; University of Milan, Milan, Italy
| | - Maria Grazia Rumi
- Division of Hepatology, Ospedale San Giuseppe, Italy; University of Milan, Milan, Italy
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Paolo Bonfanti
- Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, University of Milano - Bicocca School of Medicine, Monza, Italy
| | - Pietro Lampertico
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Lapadula G, Bernasconi DP, Bellani G, Soria A, Rona R, Bombino M, Avalli L, Rondelli E, Cortinovis B, Colombo E, Valsecchi MG, Migliorino GM, Bonfanti P, Foti G. Remdesivir Use in Patients Requiring Mechanical Ventilation due to COVID-19. Open Forum Infect Dis 2020; 7:ofaa481. [PMID: 33204761 PMCID: PMC7651598 DOI: 10.1093/ofid/ofaa481] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Abstract
Background Remdesivir has been associated with accelerated recovery of severe coronavirus disease 2019 (COVID-19). However, whether it is also beneficial in patients requiring mechanical ventilation is uncertain. Methods All consecutive intensive care unit (ICU) patients requiring mechanical ventilation due to COVID-19 were enrolled. Univariate and multivariable Cox models were used to explore the possible association between in-hospital death or hospital discharge, considered competing-risk events, and baseline or treatment-related factors, including the use of remdesivir. The rate of extubation and the number of ventilator-free days were also calculated and compared between treatment groups. Results One hundred thirteen patients requiring mechanical ventilation were observed for a median of 31 days of follow-up; 32% died, 69% were extubated, and 66% were discharged alive from the hospital. Among 33 treated with remdesivir (RDV), lower mortality (15.2% vs 38.8%) and higher rates of extubation (88% vs 60%), ventilator-free days (median [interquartile range], 11 [0-16] vs 5 [0-14.5]), and hospital discharge (85% vs 59%) were observed. Using multivariable analysis, RDV was significantly associated with hospital discharge (hazard ratio [HR], 2.25; 95% CI, 1.27-3.97; P = .005) and with a nonsignificantly lower mortality (HR, 0.73; 95% CI, 0.26-2.1; P = .560). RDV was also independently associated with extubation (HR, 2.10; 95% CI, 1.19-3.73; P = .011), which was considered a competing risk to death in the ICU in an additional survival model. Conclusions In our cohort of mechanically ventilated patients, RDV was not associated with a significant reduction of mortality, but it was consistently associated with shorter duration of mechanical ventilation and higher probability of hospital discharge, independent of other risk factors.
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Affiliation(s)
| | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Giacomo Bellani
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | | | - Roberto Rona
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Michela Bombino
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Leonello Avalli
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Egle Rondelli
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | | | - Enrico Colombo
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | | | - Paolo Bonfanti
- Infectious Diseases Unit, San Gerardo Hospital, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Giuseppe Foti
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
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Coppo A, Bellani G, Winterton D, Di Pierro M, Soria A, Faverio P, Cairo M, Mori S, Messinesi G, Contro E, Bonfanti P, Benini A, Valsecchi MG, Antolini L, Foti G. Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study. Lancet Respir Med 2020; 8:765-774. [PMID: 32569585 PMCID: PMC7304954 DOI: 10.1016/s2213-2600(20)30268-x] [Citation(s) in RCA: 312] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic is challenging advanced health systems, which are dealing with an overwhelming number of patients in need of intensive care for respiratory failure, often requiring intubation. Prone positioning in intubated patients is known to reduce mortality in moderate-to-severe acute respiratory distress syndrome. We aimed to investigate feasibility and effect on gas exchange of prone positioning in awake, non-intubated patients with COVID-19-related pneumonia. METHODS In this prospective, feasibility, cohort study, patients aged 18-75 years with a confirmed diagnosis of COVID-19-related pneumonia receiving supplemental oxygen or non-invasive continuous positive airway pressure were recruited from San Gerardo Hospital, Monza, Italy. We collected baseline data on demographics, anthropometrics, arterial blood gas, and ventilation parameters. After baseline data collection, patients were helped into the prone position, which was maintained for a minimum duration of 3 h. Clinical data were re-collected 10 min after prone positioning and 1 h after returning to the supine position. The main study outcome was the variation in oxygenation (partial pressure of oxygen [PaO2]/fractional concentration of oxygen in inspired air [FiO2]) between baseline and resupination, as an index of pulmonary recruitment. This study is registered on ClinicalTrials.gov, NCT04365959, and is now complete. FINDINGS Between March 20 and April 9, 2020, we enrolled 56 patients, of whom 44 (79%) were male; the mean age was 57·4 years (SD 7·4) and the mean BMI was 27·5 kg/m2 (3·7). Prone positioning was feasible (ie, maintained for at least 3 h) in 47 patients (83·9% [95% CI 71·7 to 92·4]). Oxygenation substantially improved from supine to prone positioning (PaO2/FiO2 ratio 180·5 mm Hg [SD 76·6] in supine position vs 285·5 mm Hg [112·9] in prone position; p<0·0001). After resupination, improved oxygenation was maintained in 23 patients (50·0% [95% CI 34·9-65·1]; ie, responders); however, this improvement was on average not significant compared with before prone positioning (PaO2/FiO2 ratio 192·9 mm Hg [100·9] 1 h after resupination; p=0·29). Patients who maintained increased oxygenation had increased levels of inflammatory markers (C-reactive protein: 12·7 mg/L [SD 6·9] in responders vs 8·4 mg/L [6·2] in non-responders; and platelets: 241·1 × 103/μL [101·9] vs 319·8 × 103/μL [120·6]) and shorter time between admission to hospital and prone positioning (2·7 days [SD 2·1] in responders vs 4·6 days [3·7] in non-responders) than did those for whom improved oxygenation was not maintained. 13 (28%) of 46 patients were eventually intubated, seven (30%) of 23 responders and six (26%) of 23 non-responders (p=0·74). Five patients died during follow-up due to underlying disease, unrelated to study procedure. INTERPRETATION Prone positioning was feasible and effective in rapidly ameliorating blood oxygenation in awake patients with COVID-19-related pneumonia requiring oxygen supplementation. The effect was maintained after resupination in half of the patients. Further studies are warranted to ascertain the potential benefit of this technique in improving final respiratory and global outcomes. FUNDING University of Milan-Bicocca.
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Affiliation(s)
- Anna Coppo
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Giacomo Bellani
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.
| | - Dario Winterton
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Michela Di Pierro
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital, Monza, Italy
| | - Paola Faverio
- Respiratory Unit, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Matteo Cairo
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Silvia Mori
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | | | - Ernesto Contro
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | - Paolo Bonfanti
- Clinic of Infectious Diseases, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Annalisa Benini
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy
| | | | - Laura Antolini
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Giuseppe Foti
- Department of Emergency Medicine, San Gerardo Hospital, Monza, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
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Guégan S, Steichen O, Soria A. Literature review of perceptual learning modules in medical education: What can we conclude regarding dermatology? Ann Dermatol Venereol 2020; 148:16-22. [PMID: 32654795 DOI: 10.1016/j.annder.2020.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/08/2019] [Accepted: 01/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Visual pattern recognition is important in many different medical fields, particularly in dermatology. Perceptual learning modules (PLM) are software programs developed to enhance visual pattern recognition through the sequential presentation of images that trainee must quickly diagnose. The aim of this literature review was to determine the scope and effectiveness of PLM in medical education. METHODS We carried out a search of MEDLINE, EMBASE, Web of Science and ERIC from its inception through to July 1, 2017. All articles describing an educational intervention based on perceptual learning in a medical field were included. Two investigators worked independently on study selection and data extraction. RESULTS Of 191 references selected, 5 studies were included in the final analysis: 3 before-after studies and 2 randomized studies comparing 12 to 236 trainees taking PLM with 12 to 316 trainees not taking PLM. Four studies reported a statistically significant increase in diagnostic accuracy (lower error rate) and fluency (shorter response time) following PLM interventions (dermatology, pathology, echocardiography), with long-term persistence of the effect in three studies. CONCLUSION PLM is a promising educational tool to teach pattern recognition that may be used in dermatology and other medical fields to improve diagnostic accuracy and rapidity in daily practice.
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Affiliation(s)
- S Guégan
- Université Paris Descartes, Paris, France; Service de dermatologie, hôpital Cochin, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France.
| | - O Steichen
- Faculté de médecine, Sorbonne universités, Paris, France; Service de médecine interne, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Tenon, Paris, France
| | - A Soria
- Faculté de médecine, Sorbonne universités, Paris, France; Service de dermato-allergologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
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Soria A, Fava M, Bernasconi DP, Lapadula G, Colella E, Valsecchi MG, Migliorino GM, D'Ambrosio R, Landonio S, Schiavini M, Spinetti A, Carriero C, Degasperi E, Cologni G, Gatti F, Viganò P, Hasson H, Uberti-Foppa C, Pasulo L, Baiguera C, Rossotti R, Vinci M, Puoti M, Giorgini A, Menzaghi B, Lombardi A, Pan A, Aghemo A, Grossi PA, Boldizzoni R, Colombo S, Viganò M, Rumi MG, Del Poggio P, Valenti L, Giglio O, De Bona A, d'Arminio Monforte A, Colombo A, Spinelli O, Pigozzi MG, Molteni C, Bonfanti P, Terreni N, Perini P, Capretti A, Bella D, Liani C, Polo S, Aimo G, Pagnucco L, Bhoori S, Centenaro R, Graffeo M, Ciaccio A, Dionigi E, Lazzaroni S, Carderi I, Di Marco M, Rizzardini G, Noventa F, Lampertico P, Fagiuoli S. Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort. Liver Int 2020; 40:769-777. [PMID: 31970845 DOI: 10.1111/liv.14386] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND & AIMS In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. METHODS Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. RESULTS Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P = .065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P = .007) and lower median pretreatment Log10 HCV-RNA (5.87 vs 6.20, P = .001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. CONCLUSIONS In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <<difficult-to-treat>> genotype.
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Affiliation(s)
- Alessandro Soria
- Division of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | - Marco Fava
- Division of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy.,Medical School, University of Milano-Bicocca, Milan, Italy
| | - Davide P Bernasconi
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Lapadula
- Division of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | - Elisa Colella
- Division of Infectious Diseases, San Gerardo Hospital - ASST Monza, Monza, Italy
| | - Maria G Valsecchi
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | - Roberta D'Ambrosio
- Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Simona Landonio
- Infectious Diseases, Ospedale Luigi Sacco - ASST Fatebenefratelli Sacco, Milano, Italy
| | - Monica Schiavini
- Infectious Diseases, Ospedale Luigi Sacco - ASST Fatebenefratelli Sacco, Milano, Italy
| | - Angiola Spinetti
- Infectious Diseases, Spedali Civili - ASST Brescia, Brescia, Italy
| | - Canio Carriero
- Infectious Diseases, Spedali Civili - ASST Brescia, Brescia, Italy
| | - Elisabetta Degasperi
- Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | | | | | - Paolo Viganò
- Ospedale di Legnano - ASST Ovest Milano, Legnano, Italy
| | - Hamid Hasson
- Infectious Diseases, San Raffaele Scientific Institute IRCCS, Milano, Italy
| | | | - Luisa Pasulo
- ASST Papa Giovanni XXIII, Bergamo HCV Network, Bergamo, Italy
| | - Chiara Baiguera
- Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Roberto Rossotti
- Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Maria Vinci
- Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Massimo Puoti
- Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Barbara Menzaghi
- Division of Infectious Diseases, Ospedale di Busto Arsizio - ASST Valle Olona, Busto Arsizio, Italy
| | - Andrea Lombardi
- Infectious Diseases, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy
| | - Angelo Pan
- Division of Infectious Diseases, ASST Cremona, Cremona, Italy
| | - Alessio Aghemo
- Internal Medicine and Hepatology, Humanitas Research Hospital IRCCS and Humanitas University, Rozzano, Italy
| | - Paolo A Grossi
- Ospedale di Circolo e Fondazione Macchi Varese - ASST Sette Laghi, Infectious Diseases, Università dell'Insubria, Varese, Italy
| | | | | | - Mauro Viganò
- Ospedale San Giuseppe, University of Milan, Milano, Italy
| | - Maria G Rumi
- Ospedale San Giuseppe, University of Milan, Milano, Italy
| | | | - Luca Valenti
- Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | | | - Anna De Bona
- Ospedale San Paolo - ASST Santi Paolo e Carlo, Milano, Italy
| | | | | | | | - Marie G Pigozzi
- Infectious Diseases, Spedali Civili - ASST Brescia, Brescia, Italy
| | - Chiara Molteni
- Division of Infectious Diseases, ASST Lecco, Lecco, Italy
| | - Paolo Bonfanti
- Division of Infectious Diseases, ASST Lecco, Lecco, Italy
| | | | - Paolo Perini
- Policlinico San Pietro, Bergamo HCV Network, Ponte San Pietro, Italy
| | - Andrea Capretti
- San Carlo Hospital - ASST Santi Paolo e Carlo, Milano, Italy
| | | | | | | | | | - Layla Pagnucco
- Infectious Diseases, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy
| | - Sherrie Bhoori
- Gastro-Hepato-Pancreatic Surgery and Liver Transplant Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Riccardo Centenaro
- Ospedale di Vizzolo Predabissi - ASST Melegnano e Martesana, Vizzolo Predabissi, Italy
| | - Massimo Graffeo
- UO Gastroenterologia ed Endoscopia Digestiva, Epatologia, Fondazione Ospedaliera Poliambulanza, Rete HCV Brescia, Brescia, Italy
| | - Antonio Ciaccio
- Division of Gastroenterology, San Gerardo Hospital - ASST Monza, Monza, Italy
| | - Elena Dionigi
- Ospedale di Cernusco sul Naviglio - ASST Melegnano e Martesana, Cernusco sul Naviglio, Italy
| | | | | | | | - Giuliano Rizzardini
- Infectious Diseases, Ospedale Luigi Sacco - ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Pietro Lampertico
- Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
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Rossotti R, Tavelli A, Bonora S, Cingolani A, Lo Caputo S, Saracino A, Soria A, Marinaro L, Uberti-Foppa C, Mussini C, Puoti M, d'Arminio Monforte A. Safety and efficacy of daclatasvir at doses other than 60 mg daily in HIV/HCV co-infected subjects: Data from the ICONA/HepaICONA foundation cohorts. Dig Liver Dis 2020; 52:447-451. [PMID: 31959479 DOI: 10.1016/j.dld.2019.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Daclatasvir (DCV) is a HCV NS5A inhibitor whose plasma exposure may be influenced by co-administration with inducers or inhibitors of CYP3A4 such as many antiretrovirals. AIMS Describe the use of different DCV dosages; assess if dose prescription complies with Summaries of Product Characteristics (SmPC); evaluate safety and efficacy of 60 versus 30/90 mg and adequate (i.e. concordant with SmPC) versus incorrect prescriptions. METHODS Retrospective analysis of patients included in ICONA/HepaICONA starting a DCV-including treatment. Incidence rates of liver adverse events (LAE) were calculated; Poisson regression model was used to identify factors associated with LAE. RESULTS 311 patients were included: 250 (80.4%) received DCV at a dosage of 60 mg, 52 (16.7%) 30 mg and 9 (2.9%) 90 mg. An inadequate dosage was used in 18 individuals (5.8%). No difference in SVR was observed (93.8% with 60 mg and 94.2% with 30/90 mg, p = 0.910; 93.5% with adequate and 100% with incorrect dosage, p = 0.277). There were 36 LAE with no differences in the two-paired groups. Decompensated liver disease was a risk factor for LAE (aRR = 2.37; p = 0.034), while HIV RNA < 50 copies/ml resulted protective (aRR = 0.22; p = 0.003). CONCLUSIONS DCV use resulted in high SVR rate regardless of dosage and correctness of prescription.
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Affiliation(s)
- Roberto Rossotti
- Infectious Diseases Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
| | | | - Stefano Bonora
- Department of Medical Sciences, Unit of Infectious Diseases, Amedeo Di Savoia Hospital, University of Turin, Turin, Italy
| | - Antonella Cingolani
- Infectious Diseases Unit, Fondazione Policlinico Universitario A. Gemelli - Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Sergio Lo Caputo
- Clinic of Infectious Diseases, University Hospital Policlinico, University of Bari, Bari, Italy
| | - Annalisa Saracino
- Clinic of Infectious Diseases, University Hospital Policlinico, University of Bari, Bari, Italy
| | - Alessandro Soria
- Clinic of Infectious Diseases, ASST Monza, San Gerardo Hospital, Italy
| | - Letizia Marinaro
- Department of Medical Sciences, Unit of Infectious Diseases, Amedeo Di Savoia Hospital, University of Turin, Turin, Italy
| | | | - Cristina Mussini
- Infectious Disease Unit, University Hospital Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Puoti
- Infectious Diseases Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Marcellin F, Di Beo V, Aumaitre H, Mora M, Wittkop L, Duvivier C, Protopopescu C, Lacombe K, Esterle L, Berenger C, Gilbert C, Bouchaud O, Poizot-Martin I, Sogni P, Salmon-Ceron D, Carrieri P, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Lebrasseur-Longuet D, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar, J M, Paccalin F, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Binois R, Simonet-Lann A, Croisier-Bertin D, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Esterle L, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Tezkratt S, Barré T, Baudoin M, Santos M, Di Beo V, Nishimwe M, Wittkop L. Patient-reported symptoms during direct-acting antiviral treatment: A real-life study in HIV-HCV coinfected patients (ANRS CO13 HEPAVIH). J Hepatol 2020; 72:588-591. [PMID: 31924411 DOI: 10.1016/j.jhep.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de santé publique, F-33000 Bordeaux, France
| | - Claudine Duvivier
- AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, IHU Imagine, Université de Paris, INSERM, U1016, Institut Cochin, CNRS, UMR8104, Paris, France; Institut Pasteur, Medical Center of Institut Pasteur, Necker-Pasteur Infectiology Center, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France; UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Cyril Berenger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Publics Hospitals, Avicenne Hospital, Bobigny, France; Paris 13 Nord University, Bobigny, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U-1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France; Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Doutre MS, Taieb C, Richard MA, Soria A, Amsler E, Hacard F, Augey F, Mathelier-Fusade P. Caractéristiques épidémiologiques de l’urticaire en France. Données de l’étude Objectifs peau. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Degasperi E, Spinetti A, Lombardi A, Landonio S, Rossi MC, Pasulo L, Pozzoni P, Giorgini A, Fabris P, Romano A, Lomonaco L, Puoti M, Vinci M, Gatti F, Carolo G, Zoncada A, Bonfanti P, Russo FP, Aghemo A, Soria A, Centenaro R, Maggiolo F, Rovere P, Pasin F, Paon V, Faggiano G, Vario A, Grossi G, Soffredini R, Carriero C, Paolucci S, Noventa F, Alberti A, Lampertico P, Fagiuoli S. Real-life effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients with previous DAA failure. J Hepatol 2019; 71:1106-1115. [PMID: 31433303 DOI: 10.1016/j.jhep.2019.07.020] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/24/2019] [Accepted: 07/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Sofosbuvir/velpatasivr/voxilaprevir (SOF/VEL/VOX) is approved for retreatment of patients with HCV and a previous failure on direct-acting antivirals (DAAs), however real-life data are limited. The aim of this study was to assess the effectiveness and safety of SOF/VEL/VOX in a real-life setting. METHODS All consecutive patients with HCV receiving SOF/VEL/VOX between May-October 2018 in 27 centers in Northern Italy were enrolled. Bridging fibrosis (F3) and cirrhosis (F4) were diagnosed by liver stiffness measurement: >10 and >13 kPa respectively. Sustained virological response (SVR) was defined as undetectable HCV-RNA 4 (SVR4) or 12 (SVR12) weeks after the end-of-treatment. RESULTS A total of 179 patients were included: median age 57 (18-88) years, 74% males, median HCV-RNA 1,081,817 (482-25,590,000) IU/ml. Fibrosis stage was F0-F2 in 32%, F3 in 21%, F4 in 44%. HCV genotype was 1 in 58% (1b 33%, 1a 24%, 1nc 1%), 2 in 10%, 3 in 23% and 4 in 9%; 82% of patients carried resistance-associated substitutions in the NS3, NS5A or NS5B regions. Patients received SOF/VEL/VOX for 12 weeks, ribavirin was added in 22% of treatment schedules. Undetectable HCV-RNA was achieved by 74% of patients at week 4 and by 99% at week 12. Overall, 162/179 (91%) patients by intention to treat analysis and 162/169 (96%) by per protocol analysis achieved SVR12, respectively; treatment failures included 6 relapsers and 1 virological non-responder. Cirrhosis (p = 0.005) and hepatocellular carcinoma (p = 0.02) were the only predictors of treatment failure. Most frequent adverse events included fatigue (6%), hyperbilirubinemia (6%) and anemia (4%). CONCLUSIONS SOF/VEL/VOX is an effective and safe retreatment for patients with HCV who have failed on a previous DAA course in a real-life setting. LAY SUMMARY This is the largest European real-life study evaluating effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) in a large cohort of consecutive patients with hepatitis C virus infection and a prior direct-acting antiviral failure, who were treated within the NAVIGATORE Lombardia and Veneto Networks, in Italy. This study demonstrated excellent effectiveness (98% and 96% sustained virological response rates at week 4 and 12, respectively) and an optimal safety profile of SOF/VEL/VOX. Cirrhosis and hepatocellular carcinoma onset were the only features associated with treatment failure.
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Affiliation(s)
- Elisabetta Degasperi
- CRC A.M. e A. Migliavacca Center for Liver Diseases, Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
| | - Angiola Spinetti
- Infectious Diseases, ASST Spedali Civili Brescia, Brescia, Italy
| | - Andrea Lombardi
- Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | | | | | - Luisa Pasulo
- Bergamo HCV Network, ASST Papa Giovanni XXIII, Italy
| | | | - Alessia Giorgini
- Gastroenterology and Hepatology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Paolo Fabris
- Infectious Diseases, Santorso Hospital, Vicenza, Italy
| | - Antonietta Romano
- Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy
| | | | - Massimo Puoti
- Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maria Vinci
- Gastroenterology and Hepatology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Federico Gatti
- Hospital Pharmacy, ASST Ovest Milanese, Legnano (MI), Italy
| | - Giada Carolo
- Infectious Diseases, University of Verona, Verona, Italy
| | | | | | - Francesco Paolo Russo
- Gastroenterology and Multivisceral Transplant, University Hospital Padua, Padova, Italy
| | - Alessio Aghemo
- Internal Medicine and Hepatology, IRCCS Humanitas Research Hospital, Humanitas University, Pieve Emanuele (MI), Italy
| | - Alessandro Soria
- Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza (MB), Italy
| | - Riccardo Centenaro
- Internal Medicine, ASST Melegnano Martesana, Vizzolo Predabissi (MI), Italy
| | | | | | - Francesca Pasin
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Veronica Paon
- Internal Medicine, University of Verona, Verona, Italy
| | | | | | - Glenda Grossi
- Internal Medicine, ASST Ovest Milanese, Magenta Hospital (MI), Italy
| | - Roberta Soffredini
- CRC A.M. e A. Migliavacca Center for Liver Diseases, Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Canio Carriero
- Infectious Diseases, ASST Spedali Civili Brescia, Brescia, Italy
| | - Stefania Paolucci
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Alfredo Alberti
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Pietro Lampertico
- CRC A.M. e A. Migliavacca Center for Liver Diseases, Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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Castagna J, Amsler E, Gaouar H, Hamelin A, De Risi-Pugliese T, Kurihara F, Chasset F, Barbaud A, Soria A. Toxidermies et leucémie à tricholeucocytes : une association non fortuite. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Leducq S, Samimi M, Bernier C, Soria A, Amsler E, Staumont-Sallé D, Gabison G, Chosidow O, Bénéton N, Bara C, Grange-Prunier A, Wierzbicka-Hainaut E, Brenaut E, Droitcourt C, Rayson-Peyron N, Bourgoin H, Cornillier H, Machet L, Giraudeau B, Caille A, Maruani A. Efficacité du méthotrexate en adjonction d’un traitement par anti-histaminiques H1 dans le traitement de l’urticaire chronique spontanée sévère réfractaire aux anti-H1 seuls : essai de phase III, randomisé, en double aveugle (NCT01960283). Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Squillace N, Trabattoni D, Muscatello A, Sabbatini F, Maloberti A, Giannattasio C, Masetti M, Fenizia C, Soria A, Clerici M, Gori A, Bandera A. Evaluation of adhesion molecules and immune parameters in HIV-infected patients treated with an atazanavir/ritonavir- compared with a lopinavir/ritonavir-based regimen. J Antimicrob Chemother 2019; 73:2162-2170. [PMID: 29897513 DOI: 10.1093/jac/dky178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 04/16/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives To evaluate changes in pro-atherosclerotic biomarkers and endothelial function in patients initiating two different PI-based regimens as part of ART. Design Prospective randomized 24 week study. Treatment-naive HIV-infected patients with CD4+ T cell count >250 cells/mm3 started PI-based regimens including atazanavir/ritonavir (Group A) or lopinavir/ritonavir (Group B) and were followed up in an observational follow-up study until week 96. Methods The expression of immune activation and adhesion molecules on CD4+ and CD8+ cells and plasma cytokine levels were assessed at weeks 0, 4, 12, 24, 48, 72 and 96. Flow-mediated dilation (FMD), pulse-wave velocity (PWV) and intima-media thickness (IMT) were measured at weeks 0 and 24. Median changes within (signed rank test) and between (Wilcoxon test) arms were calculated. Results Twenty-seven patients were enrolled, of whom 15 were treated with atazanavir/ritonavir and 12 with lopinavir/ritonavir. After 96 weeks of ART, CD25+/CD8+ T cells and plasma concentration of MCP-1/CCL-2 rose whereas CD44+/CD8+ T cells decreased significantly in both groups. Differences between treatments were noted for HLA-DRII+/CD8+, CD44+/CD4+ and CD11a+/CD4+, with significant increases in Group B versus Group A. No differences between groups regarding IMT, PWV and FMD were found at baseline and week 24. Conclusions ART initiation with PI-based regimens led to a decrease in pro-atherosclerotic biomarkers at week 24, which then rebounded at week 96. Lopinavir/ritonavir treatment resulted in an unfavourable modulation of such markers compared with atazanavir/ritonavir treatment.
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Affiliation(s)
- Nicola Squillace
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Francesca Sabbatini
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Alessandro Maloberti
- Cardiology IV, 'A. De Gasperis' Department, ASST Niguarda Ca'Granda, and School of Medicine and Surgery, Milano Bicocca University, Milan, Italy
| | - Cristina Giannattasio
- Cardiology IV, 'A. De Gasperis' Department, ASST Niguarda Ca'Granda, and School of Medicine and Surgery, Milano Bicocca University, Milan, Italy
| | - Michela Masetti
- Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy
| | - Claudio Fenizia
- Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
| | - Alessandro Soria
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Alessandra Bandera
- Infectious Diseases Clinic, Azienda Socio Sanitaria Territoriale di Monza, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
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49
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Jachiet M, Nosbaum A, Staumont-Sallé D, Seneschal J, Viguier M, Soria A, Barbaud A, Carriou AC, Chuffart-Delplanque M, Darrigade AS, Fite C, de Masson A, Bagot M, Chevret S, Bouaziz JD. Low cardiovascular risk and poor quality of life associated with tobacco use and skin infections in adult atopic dermatitis: result of a French multicenter study. J Eur Acad Dermatol Venereol 2019; 33:e451-e453. [PMID: 31273834 DOI: 10.1111/jdv.15774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Jachiet
- Service de Dermatologie et Vénérologie, Hôpital Saint Louis, AP-HP, Paris, France
| | - A Nosbaum
- Service D'allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - D Staumont-Sallé
- Service de Dermatologie et vénérologie, CHU Lille, Lille, France.,Inserm U995 - LIRIC - Lille Inflammation Research International Center, Univ. Lille, Lille, France
| | - J Seneschal
- Service de Dermatologie et Dermatologie Pédiatrique, Centre de Référence des maladies rares de la peau, Hôpital saint André, CHU de Bordeaux, Bordeaux, France
| | - M Viguier
- Service de Dermatologie et Vénérologie, Hôpital Robert Debré, CHU de Reims, Reims, France
| | - A Soria
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, AP-HP, Paris, France.,Department of Dermatology and Allergology, Tenon Hospital, Paris, France
| | - A Barbaud
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, AP-HP, Paris, France.,Department of Dermatology and Allergology, Tenon Hospital, Paris, France
| | - A-C Carriou
- Service de Dermatologie et vénérologie, CHU de Rennes, Reims, France
| | - M Chuffart-Delplanque
- Service de Dermatologie et vénérologie, CHU Lille, Lille, France.,Inserm U995 - LIRIC - Lille Inflammation Research International Center, Univ. Lille, Lille, France
| | - A-S Darrigade
- Service de Dermatologie et Dermatologie Pédiatrique, Centre de Référence des maladies rares de la peau, Hôpital saint André, CHU de Bordeaux, Bordeaux, France
| | - C Fite
- Service de Dermatologie, Groupe Hospitalier Paris-Saint-Joseph, Paris, France
| | - A de Masson
- Service de Dermatologie et Vénérologie, Hôpital Saint Louis, AP-HP, Paris, France
| | - M Bagot
- Service de Dermatologie et Vénérologie, Hôpital Saint Louis, AP-HP, Paris, France
| | - S Chevret
- Service de Biostatistique et Information Médicale, UMR1153, equipe ECSTRRA, Inserm, Université Paris Diderot, Paris, France
| | - J-D Bouaziz
- Service de Dermatologie et Vénérologie, Hôpital Saint Louis, AP-HP, Paris, France
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50
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Capetti AF, De Socio GV, Cossu MV, Sterrantino G, Cenderello G, Cattelan A, Baldin GM, Soria A, Riccardi N, Niero FP, Celesia BM, Barbarini G, Rusconi S, Rizzardini G. Durability of dolutegravir plus boosted darunavir as salvage or simplification of salvage regimens in HIV-1 infected, highly treatment-experienced subjects. HIV Clin Trials 2019; 19:242-248. [PMID: 30890064 DOI: 10.1080/15284336.2018.1550290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dolutegravir (DTG) plus boosted darunavir (bDRV) is a compact, adherence-friendly salvage regimen with the highest genetic barrier to HIV-1 resistance. OBJECTIVE Aim of the present study is to assess the long term (96-week) safety and efficacy of DTG + bDRV in a of multidrug-experienced HIV-1 infected patients, simplifying or building rescue regimens. METHODS All HIV-1-infected subjects from eleven Italian centers switched to DTG + bDRV between March 2014 and September 2015 were included and followed for minimum 96 weeks. RESULTS The cohort comprises 130 subjects, switched from 42 different, complex or at least twice-daily regimens, mainly for simplification (44.6%), viral failure (30.0%) or toxicity (16.6%). At baseline 118 had documented resistance to 1-5 antiretroviral classes and 12 lacked genotypic results either for historical reasons or for problems with primer annealing; 52 (40%) had uncontrolled viral replication, three above 500.000 copies/mL. At week 96 two showed ≥50 HIV-1 RNA copies/mL, 23 had 1-49 copies/mL and 101 had no virus detected. The proportion of subjects presenting abnormal values at baseline significantly decreased for serum glucose, creatinine, AST, total cholesterol and triglycerides. CONCLUSIONS These long-term data confirm the reliability of the two-drug regimen consisting of bDRV plus DTG in salvage settings in HIV-1 infection.
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Affiliation(s)
- Amedeo F Capetti
- a 1st Division of Infectious Diseases , ASST Fatebenefratelli-Sacco , Milano , Italy
| | - Giuseppe V De Socio
- b Infectious Diseases Clinic , Azienda Ospedaliero-Universitaria di Perugia , Perugia , Italy
| | - Maria V Cossu
- a 1st Division of Infectious Diseases , ASST Fatebenefratelli-Sacco , Milano , Italy
| | | | | | - Annamaria Cattelan
- e Infectious and Tropical Diseases , Azienda Ospedaliera-Universitaria di Padova , Padova , Italy
| | - Gian M Baldin
- f 2nd Division of Infectious Diseases , Università Cattolica del Sacro Cuore , Roma , Italy
| | - Alessandro Soria
- g Clinic of Infectious Diseases, San Gerardo Hospital, ASST Monza , University of Milano-Bicocca , Milan , Italy
| | - Niccolò Riccardi
- h Infectious Diseases Clinic , "San Martino" Hospital , Genova , Italy
| | - Fosca P Niero
- a 1st Division of Infectious Diseases , ASST Fatebenefratelli-Sacco , Milano , Italy
| | - Benedetto M Celesia
- i Infectious Diseases Unit , University of Catania, ARNAS (Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione) Garibaldi , Catania , Italy
| | - Giorgio Barbarini
- j 2nd Division of Infectious Diseases , "Policlinico San Matteo" Hospital , Pavia , Italy
| | - Stefano Rusconi
- k Infectious Diseases Unit, DIBIC Luigi Sacco , University of Milano , Milan , Italy
| | - Giuliano Rizzardini
- a 1st Division of Infectious Diseases , ASST Fatebenefratelli-Sacco , Milano , Italy.,l School of Clinical Medicine, Faculty of Health Sciences , Whitwaterstrand University , Johannesburg , South Africa
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