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Zahr N, Urien S, Llopis B, Noé G, Tissot N, Bihan K, Junot H, Marin C, Mansour B, Luyt CE, Bleibtreu A, Funck-Brentano C. Total and Unbound Pharmacokinetics of Cefiderocol in Critically Ill Patients. Pharmaceutics 2022; 14:pharmaceutics14122786. [PMID: 36559279 PMCID: PMC9784526 DOI: 10.3390/pharmaceutics14122786] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Cefiderocol is a siderophore cephalosporin antibiotic active against Gram-negative bacteria, including extended-spectrum beta-lactamase and carbapenemase-producing strains. The pharmacokinetics of cefiderocol has been studied in healthy subjects and particularly in phase II and III studies. This retrospective study investigated intravenous cefiderocol population pharmacokinetics in adult patients treated by cefiderocol. METHODS We studied 55 consecutive patients hospitalized in an intensive care unit. Cefiderocol plasma samples were obtained on different occasions during treatment. Plasma concentration was assayed using mass spectrometry. Data analysis was performed using a non-linear mixed-effect approach via Monolix 2020R1. RESULTS A total of 205 plasma samples were obtained from 55 patients. Eighty percent of patients received cefiderocol for ventilator-associated pneumonia due to carbapenem-resistant Pseudomonas aeruginosa infection. Cefiderocol concentration time-courses were best fit to a two-compartment open model with first-order elimination. Elimination clearance was positively related to renal function (estimated by the CKD formula). Adding albumin plasma binding in the model significantly improved the model assuming a ~40% unbound drug fraction given a ~40 g/L albuminemia. The final model included CKD plus cefiderocol plasma binding effects. Fat-free mass was better than total body weight to influence, via the allometric rule, clearance and volume terms, but this effect was negligible. The final clearance based on free circulating drug (CLU) for a typical patient, CKD = 90, was 7.38 L/h [relative standard error, RSE, 22%] with a between-subject variability of 0.47 [RSE 10%] (exponential distribution). CONCLUSION This study showed that albumin binding and CKD effects were significant predictors of unbound and total plasma cefiderocol concentrations. Our results indicate that individual adjustment of cefiderocol can be used to reach high minimum inhibitory concentrations based on an estimation of unbound drug concentration and optimize therapeutic efficacy.
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Affiliation(s)
- Noël Zahr
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
- Correspondence:
| | - Saik Urien
- Unité de Recherche Clinique, Hôpital Necker-Enfants Malades, AP-HP, 75015 Paris, France
| | - Benoit Llopis
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Gaëlle Noé
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Nadine Tissot
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Kevin Bihan
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Helga Junot
- Pharmacy Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne Université, 75013 Paris, France
| | - Clémence Marin
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Bochra Mansour
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
| | - Charles-Edouard Luyt
- Service de Médecine Intensive Réanimation, Institut de Cardiologie, AP-HP Sorbonne-Université, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Alexandre Bleibtreu
- Service de Maladies Infectieuses et Tropicales, Pitié-Salpêtrière Hospital, AP-HP Sorbonne Université, 75013 Paris, France
| | - Christian Funck-Brentano
- Pharmacokinetics and Therapeutic Drug Monitoring Unit, Department of Pharmacology, Pitié-Salpêtrière Hospital, Inserm, CIC-1901, UMR-S 1166, AP-HP Sorbonne Université, 75013 Paris, France
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Llopis B, Bleibtreu A, Schlemmer D, Robidou P, Paccoud O, Tissot N, Noé G, Junot H, Luyt CÉ, Funck-Brentano C, Zahr N. Simple and accurate quantitative analysis of cefiderocol and ceftobiprole in human plasma using liquid chromatography-isotope dilution tandem mass spectrometry: interest for their therapeutic drug monitoring and pharmacokinetic studies. Clin Chem Lab Med 2021; 59:1800-1810. [PMID: 34243226 DOI: 10.1515/cclm-2021-0423] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/21/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Cefiderocol and ceftobiprole are new generation cephalosporin antibiotics that exhibit high inter-individual plasma concentration variability that potentially impact their efficacy or toxicity. The aim of this study was to develop and validate a selective, simple, and fast UPLC-MS/MS method for simultaneous quantification of cefiderocol and ceftobiprole in human plasma to enable their therapeutic drug monitoring (TDM) and support PK and PK/PD studies, in particular in critically ill patients. METHODS After a simple and fast single-step protein precipitation, cefiderocol and ceftobiprole were separated on a Waters Acquity UPLC BEH C18 column by linear gradient elution; with subsequent detection by Shimadzu MS 8060 triple quadrupole tandem mass spectrometer in a positive ionization mode. RESULTS Analysis time was 5 min per run. The analytical performance of the method in terms of specificity, sensitivity, linearity, precision, accuracy, matrix effect (ME), extraction recovery (ER), limit of quantification, dilution integrity, and stability of analytes under different conditions met all criteria for a bioanalytical method for the quantification of drugs. The calibration curves were linear over the range of 1-200 mg/L for cefiderocol and 0.5-100 mg/L for ceftobiprole with a linear regression coefficient above 0.995 for both. CONCLUSIONS A simple, fast, and selective liquid chroma-tography-tandem mass spectrometry method was developed and validated for the simultaneous quantification of cefiderocol and ceftobiprole. This new method was successfully applied to the measurement of plasma concentration of cefiderocol and ceftobiprole in critically ill patients and showed good performance for their therapeutic monitoring and optimizing antibiotic therapy.
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Affiliation(s)
- Benoit Llopis
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
- AP-HP. Sorbonne Université, Laboratoire de suivi thérapeutique pharmacologique spécialisé, Paris, France
| | - Alexandre Bleibtreu
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - Dimitri Schlemmer
- AP-HP. Sorbonne Université, Laboratoire de suivi thérapeutique pharmacologique spécialisé, Paris, France
| | - Pascal Robidou
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
| | - Olivier Paccoud
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - Nadine Tissot
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
- AP-HP. Sorbonne Université, Laboratoire de suivi thérapeutique pharmacologique spécialisé, Paris, France
| | - Gaëlle Noé
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
- AP-HP. Sorbonne Université, Laboratoire de suivi thérapeutique pharmacologique spécialisé, Paris, France
| | - Helga Junot
- AP-HP. Sorbonne Université, Pharmacy Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Charles-Édouard Luyt
- AP-HP. Sorbonne Université, Service de Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne-Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Christian Funck-Brentano
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
| | - Noël Zahr
- AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Pharmacokinetics and Therapeutic Drug Monitoring Unit, UMR-S 1166, Paris, France
- AP-HP. Sorbonne Université, Laboratoire de suivi thérapeutique pharmacologique spécialisé, Paris, France
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Zahr N, Urien S, Aubry A, Chauvin C, Comets E, Llopis B, Tissot N, Noe G, Fourniols E, Jaureguiberry S, Bleibtreu A, Funck-Brentano C. Ciprofloxacin population pharmacokinetics during long-term treatment of osteoarticular infections. J Antimicrob Chemother 2021; 76:2906-2913. [PMID: 34363656 DOI: 10.1093/jac/dkab275] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ciprofloxacin is an antibiotic used in osteoarticular infections owing to its very good bone penetration. Very few pharmacokinetic data are available in this population. OBJECTIVES To investigate oral ciprofloxacin population pharmacokinetics in adult patients treated for osteoarticular infections and propose guidance for more effective dosing. METHODS A retrospective population-pharmacokinetic analysis was performed on 92 consecutive hospitalized patients in the orthopaedic department. Ciprofloxacin plasma samples were obtained on one or two occasions during treatment. Plasma concentration was measured using ultra-performance liquid chromatography system coupled with tandem mass spectrometry. Data analysis was performed using a non-linear mixed-effect approach via Monolix 2019R2. RESULTS A total of 397 plasma samples were obtained with 11.5% and 41.6% of patients being below the therapeutic target for Gram-negative and staphylococcal infections, respectively. Ciprofloxacin pharmacokinetics were best described by a two-compartment model with a first-order absorption. Ciprofloxacin apparent plasma clearances and volumes of distribution were dependent on patients' fat-free mass according to the allometric rule. Elimination clearance was also positively related to renal function through the modification of diet in renal disease equation (MDRD) and rifampicin co-administration. When patients are co-treated with rifampicin, ciprofloxacin dosage should be increased by 50% to 60%. CONCLUSIONS This study showed that free-fat mass was a better size predictor than total body weight for ciprofloxacin clearance and volumes terms. Moreover, both MDRD and rifampicin status were significant predictors of individual ciprofloxacin clearance. Our study suggests that individual adjustment of ciprofloxacin dose in osteoarticular infections with less-susceptible bacteria might be indicated to reach required efficacy targets.
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Affiliation(s)
- Noël Zahr
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France.,AP-HP, Sorbonne Université, Pharmacokinetics and Therapeutic Drug Monitoring Unit, Laboratoire de Suivi Thérapeutique Pharmacologique Spécialisé, F-75013 Paris, France
| | - Saik Urien
- 3AP-HP, Université de Paris, Cochin Hospital, Department of Pediatric and Perinatal Pharmacology, Paris, France
| | - Alexandra Aubry
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, 75013 Paris, France.,Laboratoire de Bactériologie-Hygiène, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, 75651 Paris cedex 13, France
| | - Charlotte Chauvin
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France
| | | | - Benoit Llopis
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France
| | - Nadine Tissot
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France
| | - Gaëlle Noe
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France
| | - Eric Fourniols
- AP-HP, Pitié-Salpêtrière Hospital, Department of Orthopedia, Paris, France
| | - Stéphane Jaureguiberry
- AP-HP, Paris Saclay Université, Inserm 1018 Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Bicêtre Hospital, Service de Maladies Infectieuses et Tropicales, Kremlin Bicêtre, France
| | - Alexandre Bleibtreu
- AP-HP, Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - Christian Funck-Brentano
- AP-HP, Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital; INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université Médecine, F-75013 Paris, France
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Llopis B, Robidou P, Tissot N, Pinna B, Gougis P, Aubart FC, Campedel L, Abbar B, Weil DR, Uzunov M, Gligorov J, Salem JE, Funck-Brentano C, Zahr N. Development and clinical validation of a simple and fast UPLC-ESI-MS/MS method for simultaneous quantification of nine kinase inhibitors and two antiandrogen drugs in human plasma: Interest for their therapeutic drug monitoring. J Pharm Biomed Anal 2021; 197:113968. [PMID: 33618135 DOI: 10.1016/j.jpba.2021.113968] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/23/2020] [Revised: 01/04/2021] [Accepted: 02/09/2021] [Indexed: 12/15/2022]
Abstract
Kinase inhibitors (KIs) and antiandrogen drugs (AAs) are oral anticancer drugs with narrow therapeutic index that exhibit high inter- and intra-individual variability. We describe here a UPLC-MS/MS method for the simultaneous quantification of nine KIs: cobimetinib, dasatinib, ibrutinib, imatinib, nilotinib, palbociclib, ruxolitinib, sorafenib and vemurafenib; two active metabolites of them: N-desmethyl imatinib, N-oxide sorafenib; and two AAs: abiraterone and enzalutamide; with short pre-treatment and run time in order to be easily used in clinical practice for their therapeutic drug monitoring (TDM) and facilitating pharmacokinetics and pharmacokinetics/pharmacodynamics studies. Plasma samples were prepared by a single-step protein precipitation. Analytes were separated on a Waters Acquity UPLC® T3 HSS C18 column by non-linear gradient elution; with subsequent detection by Xevo® TQD triple quadrupole tandem mass spectrometer in a positive ionization mode. Analysis time was 2.8 min per run, and all analytes eluted within 1.46-1.97 minutes. The analytical performance of the method in terms of specificity, sensitivity, linearity, precision, accuracy, matrix effect, extraction recovery, limit of quantification, dilution integrity and stability of analytes under different conditions met all criteria for a bioanalytical method for the quantification of drugs. The calibration curves were linear over the range of 1-500 ng/mL for abiraterone, dasatinib and ibrutinib; 5-500 ng/mL for cobimetinib and palbociclib; 10-5,000 ng/mL for imatinib, N-desmethyl imatinib, nilotinib, sorafenib, N-oxide sorafenib and ruxolitinib; 100-50,000 ng/mL for enzalutamide and 100-100,000 ng/mL for vemurafenib with coefficient of correlation above 0.995 for all analytes. This novel method was successfully applied to TDM in clinical practice.
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Affiliation(s)
- Benoit Llopis
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Pascal Robidou
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Nadine Tissot
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Bruno Pinna
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Paul Gougis
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, institut universitaire de cancérologie, département d'oncologie médicale, CLIP2, Galilée Paris, France
| | - Fleur Cohen Aubart
- AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Service de Médecine Interne 2, Centre National de Référence Maladies Systémiques Rares et Histiocytoses, Paris, France
| | - Luca Campedel
- AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, institut universitaire de cancérologie, département d'oncologie médicale, CLIP2, Galilée Paris, France
| | - Baptiste Abbar
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Damien Roos Weil
- AP-HP Sorbonne Université, Service d'Hématologie Clinique, Pitié-Salpêtrière Hospital, Paris, France
| | - Madalina Uzunov
- AP-HP Sorbonne Université, Service d'Hématologie Clinique, Pitié-Salpêtrière Hospital, Paris, France
| | - Joseph Gligorov
- Institut Universitaire de Cancérologie, AP-HP Sorbonne Université, INSERM U-938, CLIP(2) Galilée, Tenon Hospital, Medical Oncology Department, Paris, France
| | - Joe-Elie Salem
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Christian Funck-Brentano
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France
| | - Noël Zahr
- AP-HP.Sorbonne Université, Department of Pharmacology and Clinical Investigation Center (CIC-1901), Pitié-Salpêtrière Hospital, INSERM, CIC-1901 and UMR-S 1166, Sorbonne Université, Faculty of Medicine Sorbonne Université, Faculty of Medicine, Paris, France.
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Zahr N, Urien S, Llopis B, Pourcher V, Paccoud O, Bleibtreu A, Mayaux J, Gandjbakhch E, Hekimian G, Combes A, Benveniste O, Saadoun D, Allenbach Y, Pinna B, Cacoub P, Funck-Brentano C, Salem JE. Pharmacokinetics and pharmacodynamics of hydroxychloroquine in hospitalized patients with COVID-19. Therapie 2021; 76:285-295. [PMID: 33558079 PMCID: PMC7842207 DOI: 10.1016/j.therap.2021.01.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/17/2020] [Revised: 01/03/2021] [Accepted: 01/22/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hydroxychloroquine (HCQ) dosage required to reach circulating levels that inhibit SARS-Cov-2 are extrapolated from pharmacokinetic data in non-COVID-19 patients. METHODS We performed a population-pharmacokinetic analysis from 104 consecutive COVID-19 hospitalized patients (31 in intensive care units, 73 in medical wards, n=149 samples). Plasma HCQ concentration were measured using high performance liquid chromatography with fluorometric detection. Modelling used Monolix-2019R2. RESULTS HCQ doses ranged from 200 to 800mg/day administered for 1 to 11days and median HCQ plasma concentration was 151ng/mL. Among the tested covariates, only bodyweight influenced elimination oral clearance (CL) and apparent volume of distribution (Vd). CL/F (F for unknown bioavailability) and Vd/F (relative standard-error, %) estimates were 45.9L/h (21.2) and 6690L (16.1). The derived elimination half-life (t1/2) was 102h. These parameters in COVID-19 differed from those reported in patients with lupus, where CL/F, Vd/F and t1/2 are reported to be 68L/h, 2440 L and 19.5h, respectively. Within 72h of HCQ initiation, only 16/104 (15.4%) COVID-19 patients had HCQ plasma levels above the in vitro half maximal effective concentration of HCQ against SARS-CoV-2 (240ng/mL). HCQ did not influence inflammation status (assessed by C-reactive protein) or SARS-CoV-2 viral clearance (assessed by real-time reverse transcription-PCR nasopharyngeal swabs). CONCLUSION The interindividual variability of HCQ pharmacokinetic parameters in severe COVID-19 patients was important and differed from that previously reported in non-COVID-19 patients. Loading doses of 1600mg HCQ followed by 600mg daily doses are needed to reach concentrations relevant to SARS-CoV-2 inhibition within 72hours in≥60% (95% confidence interval: 49.5-69.0%) of COVID-19 patients.
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Affiliation(s)
- Noël Zahr
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology and Clinical Investigation Center, INSERM, CIC-1901, Sorbonne Université, Faculty of Medicine, 75013 Paris, France.
| | - Saik Urien
- AP-HP, Université de Paris, INSERM, Cochin Hospital, Department of Pediatric and Perinatal Pharmacology, 75014 Paris, France
| | - Benoit Llopis
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology and Clinical Investigation Center, INSERM, CIC-1901, Sorbonne Université, Faculty of Medicine, 75013 Paris, France
| | - Valérie Pourcher
- AP-HP, Sorbonne Université, INSERM 1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, 75013 Paris, France
| | - Olivier Paccoud
- AP-HP, Sorbonne Université, INSERM 1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, 75013 Paris, France
| | - Alexandre Bleibtreu
- AP-HP, Sorbonne Université, INSERM 1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Pitié-Salpêtrière Hospital, Service de Maladies Infectieuses et Tropicales, 75013 Paris, France
| | - Julien Mayaux
- AP-HP, Sorbonne Université, Service de Pneumologie, Médecine intensive - Réanimation (Département "R3S"), Groupe Hospitalier Universitaire Pitié-Salpêtrière-Charles-Foix, 75013 Paris, France
| | - Estelle Gandjbakhch
- AP-HP, Sorbonne Université, Service de Cardiologie, Groupe Hospitalier Universitaire Pitié-Salpêtrière-Charles-Foix, 75013 Paris, France
| | - Guillaume Hekimian
- AP-HP, Sorbonne Université, Médecine intensive-Réanimation Médicale Groupe Hospitalier Universitaire Pitié-Salpêtrière-Charles-Foix, 75013 Paris, France
| | - Alain Combes
- AP-HP, Sorbonne Université, Médecine intensive-Réanimation Médicale Groupe Hospitalier Universitaire Pitié-Salpêtrière-Charles-Foix, 75013 Paris, France
| | - Olivier Benveniste
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, 75013 Paris, France
| | - David Saadoun
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, 75013 Paris, France
| | - Yves Allenbach
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, 75013 Paris, France
| | - Bruno Pinna
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology and Clinical Investigation Center, INSERM, CIC-1901, Sorbonne Université, Faculty of Medicine, 75013 Paris, France
| | - Patrice Cacoub
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, 75013 Paris, France
| | - Christian Funck-Brentano
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology and Clinical Investigation Center, INSERM, CIC-1901, Sorbonne Université, Faculty of Medicine, 75013 Paris, France
| | - Joe-Elie Salem
- AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Pharmacology and Clinical Investigation Center, INSERM, CIC-1901, Sorbonne Université, Faculty of Medicine, 75013 Paris, France
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Ferrer MD, Martí-Bonmatí L, Belloch V, Moreno F, Martínez-Rodrigo J, Galant J, Llopis B. [Diagnostic effectiveness of CT and MR in local staging of renal tumors]. Actas Urol Esp 1993; 17:434-41. [PMID: 8368117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The aim of this paper is to study the pre-operative staging of renal tumours, comparing CT and MR, and the imaging criteria used, examining the diagnostic efficacy for each of them. Thirty-four tumours were obtained from 29 patients. All cases were studied with CT and MR. To measure diagnostic efficacy, both for each technique and the criteria used in 2 different readings, a diagnostic performance curve (DPC) is calculated. Neither CT nor MR show infiltration of renal capsule. With regard to perinephritic fat, fascia and adjacent organ invasion, both techniques lead to overstaging, mainly CT. When applying more conservative reading criteria, the results are much improved, specially in relation to CT, although results with MR continue to be more favourable. MR is better to study vascular invasion, providing no false results. Of 22 tumours undergoing surgery, first option was the correct staging in 14 tumour with CT and in 16 with MR. When selecting the best imaging technique to stage renal tumours, MR allows a better and simpler radiologic reading. Nevertheless, considering the high correlation between CT and MR, CT can be used more reliably in institutions where no easy access to a MR unit is available. Both CT and MR overstage renal tumours.
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Affiliation(s)
- M D Ferrer
- Servicios de Diagnóstico por la Imagen, Hospital Doctor Peset, Valencia
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7
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Abstract
Carcinoma of prostatic ducts is a rare clinical feature. We have reviewed 398 histories of patients with histologic diagnosis of prostatic carcinoma and found 10 patients with the ductal variety (2.51%). Four had pure ductal transitional cell carcinoma, 5 had mixed acinar adenocarcinoma plus ductal transitional cell carcinoma, and the last one had mixed acinar and ductal adenocarcinoma. Age, symptoms, physical findings, and imaging diagnoses were similar to those of acinar carcinoma. Rectal examination disclosed hard prostate in 9 patients. The metastatic way depended on the histologic elements present in each patient. Cystoscopy showed a malignant-resembling image in 4 cases. The mean survival (23 months) was lower than that of patients with acinar carcinoma. Early diagnosis and radical surgery still are the only way to increase the expectation of life of patients affected by this pathology.
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8
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Llopis B, Günthner S, Picurelli L, Iranzo S, Moreno F, Ferrer J. [Penoscrotal gangrene: our series of cases]. Actas Urol Esp 1991; 15:40-2. [PMID: 2058440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ten cases of penoscrotal gangrene seen in our department over the last 8 years are presented. In 80% of patients causative factors of the gangrenous process were demonstrated and were equally distributed between urology and colorectal pathologies. The most commonly associated pathology was diabetes mellitus affecting up to 50% of our patients. Two or more germs were isolated from the necrotic-purulent material for cultures, mainly E. coli (90%) and Proteus mirabilis (50%) as aerobic organisms, and Bacteroides fragilis (40%) in the anaerobic group. Despite emergency surgical therapy and high doses of broad spectrum antibiotics, mortality in our series was about 20%.
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Affiliation(s)
- B Llopis
- Servicio de Urología, Hospital Dr. Peset, Valencia
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9
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Navalón P, Llopis B, Picurelli L, Martínez G, Ferrer J. [Surgical treatment of urinary stress incontinence in women]. Actas Urol Esp 1990; 14:271-3. [PMID: 2264490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Long-term results obtained in 54 surgical procedures to correct effort urinary incontinence performed in 49 patients with this pathology are reviewed. One group was treated with suprapubic urethrovesical suspension with the Marshall-Marchetti-Krantz technique; the other group with endoscopic suspension of the neck of the bladder, with the Stamey technique and the third group with sling techniques. The authors conclude that any of the surgical techniques achieving a correct reposition of urethrovesical anatomy, rising the posterior urethra to its primitive anatomical bed, obtain a similar success rate.
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Affiliation(s)
- P Navalón
- Servicio de Urología, Hospital Doctor Peset, Valencia
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10
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Abstract
To study the efficacy, specificity and sensitivity of ultrasonography, cytology and phospholipid/fatty acid quotient (PL/FA) in the detection of recurrences in patients with superficial bladder cancer we performed these three examinations simultaneously with cystoscopy. In over 405 cystoscopies, 348 were negative and 57 were positive for tumor. Sensitivity, the most important parameter, was 73% for the three examinations together. Each method separately had the following sensitivity: ultrasound 26%; cytology 14%, and PL/FA 47%. Considering that there were only 15 false-negatives, with this follow-up scheme we save the patient from a lot of cystoscopies, avoiding their inherent morbidity.
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11
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Abstract
Following some reports concerning the possible influence of ABO blood groups on constitutional types and different features of human pathology, we have investigated if there are relationships between ABO blood groups and bladder tumors. Our findings show that tumoral behavior in patients with bladder carcinoma and blood group O has a tendency to an increased aggressivity with higher tumoral grade and more relapses than what is seen in tumors of patients with A blood group. Although this difference is not statistically significant, we believe that blood group ABO should be considered as a constitutional prognostic factor in bladder carcinoma and further investigations in this field are needed.
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Affiliation(s)
- B Llopis
- Division of Urology and Haematology, La Fé Hospital, Valencia, Spain
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12
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Vera-Donoso CD, Llopis B, Oliver F, Gallego J, Ruiz J, Vidal J, Jiménez Cruz JF. Selective chemoprophylaxis guided by multifactorial analysis in superficial bladder cancer. Eur Urol 1990; 17:219-22. [PMID: 2112473 DOI: 10.1159/000464042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
One hundred and five patients with superficial bladder cancer (60 primary and 45 recurrent tumors) entered a prospective chemoprophylaxis trial after transurethral resection of the tumor. The drug for chemoprophylaxis was chosen by a computer which received the tumor data and analyzed them through a previous program of recurrence risk factors (multivariant analysis). In comparison with the aleatory selection of the drug, this statistical computerized choice has diminished the recurrence index (from 8 to 3) and increased the interval free of disease (from 70 to 83.5 months) in this group of patients.
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13
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Domínguez C, Broseta E, Boronat F, Llopis B, Martínez R, Jiménez-Cruz JF. [Disseminated renal adenocarcinoma. Developmental study]. ARCH ESP UROL 1989; 42:863-6. [PMID: 2624487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A study was undertaken on 57 patients diagnosed as having disseminated renal adenocarcinoma. The interval between the onset of symptomatology and diagnosis ranged from 1 to 48 months. The tumor frequently metastasized to lungs and bone. To evaluate survival, this patient population was divided into two groups: those who underwent nephrectomy, 17 patients (9 patients also underwent lymphadenectomy), and those who were put on drug therapy alone. No significant difference was observed with respect to survival for both patient groups.
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14
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Llopis B, Navalón P, Picurelli L, Domingo ML, Martínez G, Ferrer J. [Percutaneous nephrostomy as a technic for emergency drainage: review of cases]. ARCH ESP UROL 1989; 42:897-9. [PMID: 2624490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Percutaneous nephrostomy (PCN) is currently one of the procedures of choice for emergency drainage of the upper urinary tract. Moreover, it permits morphologic and functional diagnostic possibilities as well as a wide variety of new and frequently definitive therapeutic procedures. We report on 58 PCN procedures performed in 55 patients from May 1983 to February 1989. PCN was indicated for complicated or uncomplicated uni- or bilateral supravesical obstruction, with infection and/or azotemia. All patients submitted to PCN for complicated obstruction with infection and/or azotemia showed a marked clinical and analytical improvement. Apart from resolving this emergency, it reduced the morbidity and mortality rate of subsequent surgical treatment of the underlying cause of obstruction because patient status was markedly improved. The major complications, retroperitoneal hematoma and sepsis, were rare. We frequently observed that the catheter had come out or become obstructed in our series. PCN affords the following advantages: it can be performed with local anesthesia; it is a simple technique; there are no absolute contraindications; its morbidity and mortality rates are low; and, it can be easily converted into a permanent procedure. In our view, all the foregoing advantages, as well as its therapeutic and morphologic and functional diagnostic possibilities, make PCN one of the procedures of choice in emergency treatment of upper urinary tract obstruction.
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15
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Picurelli L, Llopis B, Navalón P, Leal M, San Juan C, Moral A, Ferrer Roda J. [Calcification and contamination as complications in the use of double-J catheters: incidence and correlation]. Actas Urol Esp 1989; 13:375-7. [PMID: 2596357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We present a series of cases of complex renal lithiasis, in which we carried out temporary internal urinary bypassing, prior to extracorporeal lithotripsy, by means of the retrograde insertion of a double-J urethral catheter, studying the time of stay, the presence or not of contamination in the catheter and its relationship with the calcifications found in them. We also carried out a metabolic-functional study of each patient, determining the urinary pH and the serum and urinary calcium, phosphorous and uric acid concentrations, and observing their possible influence on the above-mentioned complications. Of the 25 catheters studied, we observed calcification in 11 cases (44%). In these we observed urealytic germs (Proteus and Pseudomonas), without finding modifications of urinary pH. We observed no relationship between the calcium deposits and serum and urinary calcium, phosphorous and uric acid concentration.
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16
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Gallego J, Jiménez Cruz JF, Gobernado M, Llopis B, Vidal J, Server G, Ruiz JL, David Vera C. [Aztreonam versus tobramycin in acute pyelonephritis. A comparative study]. ARCH ESP UROL 1989; 42:116-9. [PMID: 2660754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We performed a comparative study between the monobactam antibiotic aztreonam and the aminoglycoside tobramycin in patients diagnosed as having acute pyelonephritis. The respective doses were 1 gr. IM daily for 7 days, and 100 mgr. IM q 12 h for the same period of time. Clinically, 100% of uncomplicated acute pyelonephritis and 87.5% of complicated infections cured with aztreonam. Tobramycin achieved an 80% cure rate for both types of infections. Microbiologically aztreonam was effective in all uncomplicated acute pyelonephritis, and in 69.56% of the complicated cases (overall microbiological cure rate = 78.7%). The therapeutic failures were ascribable to infections from S. faecalis, an organism naturally resistant to aztreonam. Thus, the microbiological cure rate was 84.2% in complicated pyelonephritis from organisms sensitive to this antimicrobial. The microbiological cure rate for tobramycin was 70% in acute uncomplicated, and 80% in complicated infections. We observed a good clinical and biological tolerance to both antimicrobials. No side effects were observed. Serum and blood biochemical analyses, and coagulation tests revealed no changes.
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17
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Broseta E, Boronat F, Domínguez C, Vidal J, Llopis B, Jiménez-Cruz JF. [Modification of the echographic pattern of carcinoma of the prostate treated with Lh-rh agonists]. ARCH ESP UROL 1989; 42:125-8. [PMID: 2660756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We present the results of a study undertaken to assess the echo patterns and prostate size in 13 patients with prostatic carcinoma treated with Lh-rh agonists. The study revealed a gradual reduction of the anteroposterior and transverse diameters. After 12 months, these were 28% and 22% of their respective initial values. Furthermore, the prostatic echo patterns changed significantly in 66% of the patients, and infiltration of the seminal vesicle improved or became stable in 50%. These findings suggest that transrectal ultrasonography may be useful in the follow up of prostatic carcinoma patients receiving hormone therapy.
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18
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Picurelli L, Llopis B, Navalón P, Sanjuan C, Ferrer Roda J. [Kidney pelvis calcification around a double-J ureteral catheter which was impossible to extract. Apropos of a case]. Actas Urol Esp 1989; 13:142-3. [PMID: 2728942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We present a case of pyelorenal calcification on double-J ureteral catheter, which made endoscopic extraction impossible. We review the literature and describe the incidence, methods of diagnosis and treatment of this complication, as well as the means used to avoid it.
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19
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Llopis B, Vera-Donoso CD, Gallego J, Boronat F, Jiménez-Cruz JF. Immunoprophylaxis with Calmette-Guérin bacillus in recurrent superficial bladder tumors. Eur Urol 1989; 16:28-30. [PMID: 2714314 DOI: 10.1159/000471524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
26 patients with superficial bladder cancer underwent complete removal of tumors by transurethral resection and entered a prospective trial of immunoprophylaxis with Calmette-Guérin bacillus (BCG). The entire group had recurrent tumors that failed to respond to previous prophylaxis with thiotepa (13 patients) or other drugs (13 patients). Intravesical administration of BCG reduced the recurrence index and increased the disease-free interval. Side effects were mild and well tolerated. BCG seems to be effective in the prophylaxis of superficial bladder tumor recurrence after the failure of other drugs.
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Affiliation(s)
- B Llopis
- Service of Urology, La Fe Hospital, Valencia, Spain
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20
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Oliver F, Llopis B, Vera C, Domínguez C, Vidal J, Gallego J, Jiménez JF. [Directed chemotherapy in superficial carcinoma of the bladder conditioned by the knowledge of recurrence factors]. Actas Urol Esp 1989; 13:41-3. [PMID: 2496584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A retrospective study of 56 patients (23 primary and 36 relapsing) with superficial vesical carcinoma and treated with transurethral resection and directed chemoprophylaxis was done. Directed chemoprophylaxis is define as a specific type of adjuvant therapy where the drug is determined by a previous study with multivariant analysis of the relapse risk factors of a group of 385 cases, where the chemotherapeutic agent was also a variable. The drug is specified by the data introduced in a microprocessor program. Such chemoprophylactic approach has achieved a marked reduction in the relapse rate and increased the disease-free interval from 8 to 3 and from 70 to 83.5 respectively, with regard to the free drug choice approach.
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21
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Oliver F, Llopis B, Domínguez C, Vera C, Jiménez JF. [Renal trauma. Our diagnostic and therapeutic approach]. Actas Urol Esp 1988; 12:549-57. [PMID: 3232562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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22
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Oliver F, Llopis B, Vera C, Iranzo S, Broseta E, Moreno B, Jiménez JF. [New protocol in the follow-up of superficial bladder carcinoma]. Actas Urol Esp 1988; 12:415-8. [PMID: 3064563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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23
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Oliver F, Llopis B, Vera C, Domínguez C, Vidal J, Gallego J, Jiménez JF. [Directed chemotherapy in superficial carcinoma conditioned by the knowledge of relapse factors]. Actas Urol Esp 1988; 12:419-23. [PMID: 3218579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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24
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Abstract
Five cases of malignant fibrous histiocytoma located in the retroperitoneum are reported. Paraneoplastic syndrome, abdominal mass, tendency to local recurrence, laborious therapy and poor prognosis are the clinical characteristics of this tumor. Accuracy of actual diagnosis is evaluated and pathological features are analyzed.
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25
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Vera-Donoso CD, Llopis B, Oliver F, Alonso M, Montalar J, Jiménez JF. [Asynchronous bilateral testicular teratocarcinoma]. Actas Urol Esp 1987; 11:621-3. [PMID: 3330910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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26
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Llopis B, Sánchez A, Boronat F, Gallego J, Moreno B, Alonso M, Martínez R, Vera CD, Jiménez JF. [Prognostic factors and risk of recurrence in a series of 385 patients with superficial bladder carcinoma treated with thiotepa, adriamycin or cisplatin]. ARCH ESP UROL 1987; 40:159-64. [PMID: 3113347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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27
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Boronat F, Domínguez C, Alonso M, Llopis B, Gallego J, Jiménez-Cruz JF. [Value of intracavitary echography in the study of non-urologic pelvic pathology]. Actas Urol Esp 1987; 11:1-6. [PMID: 3554905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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28
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Llopis B, Gallego J, Bretó M, Martínez M, Valls F, Boronat F, Mompó JA, Jiménez JF. [Urinary lipids and bladder carcinoma. A new biological marker]. Actas Urol Esp 1986; 10:429-32. [PMID: 3825642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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29
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Oliver F, Llopis B, Gallego J, Alonso M, Martínez R, Iranzo S, Jiménez JF. [Treatment of intractable bladder hemorrhage]. Actas Urol Esp 1986; 10:459-62. [PMID: 3825648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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30
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Boronat F, Gallego J, Llopis B, Valls F, Martínez-Agulló E, Martínez R, Jiménez-Cruz JF. [Intracavitary echography of the prostate]. Actas Urol Esp 1986; 10:399-406. [PMID: 2435112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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31
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Boronat F, Llopis B, Gallego J, Oliver F, Domínguez C, Jiménez-Cruz JF. [Transurethral echography of the bladder. 3: Control of tumor resection]. Actas Urol Esp 1986; 10:347-50. [PMID: 3548234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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32
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Boronat F, Gallego J, Alonso M, Martínez R, Llopis B, Jiménez-Cruz JF. [Transurethral echography of the bladder. I. Normal morphology and non-tumor changes in the wall]. Actas Urol Esp 1986; 10:335-40. [PMID: 3548232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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33
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Boronat F, Fernández J, Llopis B, Gallego J, Iranzo S, Jiménez-Cruz JF. [Transurethral echography of the bladder. 2: Diagnosis and tumor staging]. Actas Urol Esp 1986; 10:341-6. [PMID: 3548233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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34
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Llopis B, Gallego J, Boronat F, Moreno B, Mompó JA, Jiménez JF. [Comparative study of thiotepa, adriamycin and cisplatin in the prophylaxis of recurrence of superficial bladder carcinoma in a group of 217 patients]. Actas Urol Esp 1986; 10:225-30. [PMID: 3092589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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35
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Llopis B, Iranzo S, Boronat F, Gallego J, Moreno B, Mompó JA, Alonso M, Jiménez JF. [The renal adenoma-adenocarcinoma dilemma]. Actas Urol Esp 1986; 10:255-8. [PMID: 3751711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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36
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Mompó JA, Alonso M, Boronat F, Llopis B, Jiménez Cruz JF. [Retroperitoneal abscess secondary to pancreatitis. Diagnostic considerations]. Actas Urol Esp 1986; 10:275-6. [PMID: 3751714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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37
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Llopis B, Gallego J, Jiménez JF. [Life expectancy for the Spanish population: formulas, a table and a microcomputer program]. Actas Urol Esp 1986; 10:153-4. [PMID: 3755564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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38
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Llopis B, Alonso M, Valls F, Moreno B, Boronat F, Gallego J, Iranzo S, Oliver F, Jiménez JF. [Secondary tumors of the penis]. Actas Urol Esp 1986; 10:167-70. [PMID: 3739785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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39
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Iranzo S, Llopis B, Froufe A, Alonso M, Boronat F, Moreno B, Oliver F, Gallego J, Jiménez Cruz JF. [Renal adenoma or adenocarcinoma?]. ARCH ESP UROL 1986; 39:190-4. [PMID: 3729559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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40
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Llopis B, Gallego J, Mompó JA, Boronat F, Alonso M, Moreno B, Jiménez JF. Crossed chemoprophylaxis assay between adriamycin and cis-platinum in recurrent superficial bladder tumor. Eur Urol 1986; 12:253-6. [PMID: 3091370 DOI: 10.1159/000472630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Of 146 patients with superficial bladder carcinoma, 66 (35 primary and 31 recurrent from failure of thiotepa chemoprophylaxis) relapsed following transurethral resection (TUR) and chemotherapy with adriamycin or cis-platinum. A new TUR was carried out. In case of progression in the number of tumors, size, stage or grade, treatment was begun with the other drug. If the tumor had the same characteristics, treatment was continued with the same drug. In both the primary and recurrent tumors with or without progression, cis-platinum controlled the tumor better than adriamycin, rescuing it from the latter and obtaining a recurrence index and disease-free interval as with cis-platinum alone. These results are more conclusive in primary tumors.
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41
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Iranzo S, Llopis B, Alonso M, Moreno B, Boronat F, Oliver F, Jiménez Cruz JF. [Diverticulum of the anterior urethra in the adult male. Presentation of a case]. ARCH ESP UROL 1985; 38:593-5. [PMID: 3938634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Mompo JA, Boronat F, Alonso M, Oliver F, Llopis B, Jiménez-Cruz JF. [Urinary diversion in anuria of tumor origin]. Actas Urol Esp 1985; 9:409-14. [PMID: 2421550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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43
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Gallego J, Llopis B, Boronat F, Martínez E, Jiménez JF. [Anterior vesical elongation in paraplegia]. ARCH ESP UROL 1985; 38:479-83. [PMID: 4083929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Llopis B, Mompón JA, Boronat F, Jiménez JF. [Bladder malacoplakia and renal carcinoma]. Actas Urol Esp 1985; 9:99-102. [PMID: 4013853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Llopis B, Gallego J, Mompó JA, Boronat F, Jiménez JF. Thiotepa versus adriamycin versus cis-platinum in the intravesical prophylaxis of superficial bladder tumors. Eur Urol 1985; 11:73-8. [PMID: 3924624 DOI: 10.1159/000472459] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A study was performed on 184 patients with superficial bladder cancer (pTa, pT1), 92 with primary and 92 recurrent tumors. After TUR of all visible lesions, endovesical chemotherapy with thiotepa, adriamycin or cis-platinum was started on the 15th and 30th days following surgery. There were no statistically significant differences between any of the three chemotherapies at the doses and intervals mentioned. Only cis-platinum has proven to be more effective in primary high grade tumor.
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Llopis B, Gallego J, Cruz M, Martínez M, Mompó JA, Jiménez JF. Urinary lipids in vesical carcinoma: a new biological marker. Preliminary study. Eur Urol 1985; 11:121-6. [PMID: 4006999 DOI: 10.1159/000472469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We have determined urinary lipids by thin-layer chromatography in 40 patients with bladder tumors, and have evaluated their modification following tumor removal and their predictive value in terms of the presence or absence of recurrences. The results obtained were compared with those of a control group without tumoral pathology (14 patients) and 11 cases with bacterial infection of the urinary tract. There is a marked difference between the lipidogram of the tumoral group of patients and the controls (p less than 0.005), especially in the phospholipid to fatty acid (PL/FA) relationship, with a specificity of 100% and a sensitivity of 80%. With regard to recurrences, in non-recurrent cases the PL/FA value remained high in relation to the initial value (p less than 0.005), whereas in the recurrent cases the value rose to 'tumoral limits'. Macrohematuria and urinary infection modify the lipidogram, resulting in values similar to the tumoral cases. Their absence is therefore essential in order to evaluate the results. The urinary lipidogram appears to be a possible biological marker for bladder tumors.
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Oliver F, Llopis B, Guillén M, Mompó JA, Jiménez Cruz JF. [Solitary cerebral metastasis of transitional carcinoma of the bladder: apropos of a case]. ARCH ESP UROL 1984; 37:533-6. [PMID: 6524976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Boronat F, Fernández J, Llopis B, Mompo JA, Gallego J, Jiménez-Cruz JF. [Transitional carcinoma of the renal pelvis in a young man]. Actas Urol Esp 1984; 8:407-10. [PMID: 6524488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Boronat F, Llopis B, Fernández J, Alonso M, Gallego J, Jiménez-Cruz JF. [Diagnosis of bladder pathology by endocavitary echography]. Actas Urol Esp 1984; 8:385-90. [PMID: 6395645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Boronat F, Llopis B, Mompó JA, Moreno B, Valls F, Jiménez-Cruz JF. [Possibilities of endocavitary echography in the exploration of the prostate and seminal vesicles]. Actas Urol Esp 1984; 8:301-8. [PMID: 6207710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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