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Poliseno M, Mazzitelli M, Narducci A, Ferrara SM, Resnati C, Gervasoni C, Cattelan AM, Lo Caputo S. Doravirine Plus Integrase Strand Transfer Inhibitors as a 2-Drug Treatment-Switch Strategy in People Living with HIV: The Real-Life DORINI Multicentric Cohort Study. J Acquir Immune Defic Syndr 2023; 94:235-243. [PMID: 37757865 DOI: 10.1097/qai.0000000000003248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/20/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Few data are available about the efficacy, durability, and tolerability of doravirine (DOR) + integrase strand inhibitors (INI) as a switching strategy among antiretroviral therapy (ART)-experienced people living with HIV (PLWH). SETTING Retrospective, multicenter cohort study investigating the durability, efficacy, and tolerability of 2 off-label drug associations of DOR + INI among ART-experienced PLWH. METHODS The study included PLWH who switched to DOR combined with either raltegravir (RAL) or dolutegravir (DTG) between June 1, 2020, and December 31, 2021, with at least 1 follow-up (FU) visit. Virologic, biometric, and metabolic parameters were evaluated at baseline (T0) and at 1-3 (T1), 6 (T2), and 12 (T3) months. Univariate and multivariate survival analyses assessed the 28-week probability of persistence on the regimens. Patient satisfaction was measured using the HIV Treatment Satisfaction Questionnaire. RESULTS Ninety-five PLWH were included, 52 in DOR + RAL and 43 in DOR + DTG. Six treatment discontinuations were reported during a mean of 37 (±17) weeks of FU (incidence of 2.7 × 1000 person-weeks FU). Only 2 were the result of virological failure without resistance mutations. DOR + DTG demonstrated significantly higher 28-week persistence than DOR + RAL (HR 1.90, 95% CI: 1.24-2.90, log-rank: P = 0.003). Weight, waist circumference, and fasting lipids reduced considerably at T3 vs T0. Overall, high satisfaction with the new treatment was reported, particularly in the DOR + RAL (68 (64-72)/72), compared with the DOR + DTG group (58 (50-65)/72, P < 0.001). CONCLUSIONS Our experience revealed few treatment discontinuations, improved metabolic parameters, and high patient satisfaction among ART-experienced PLWH switching to DOR combined with INI, irrespective of the specific INI used.
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Affiliation(s)
- Mariacristina Poliseno
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | - Arianna Narducci
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Sergio Maria Ferrara
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Chiara Resnati
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and
| | - Cristina Gervasoni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Anna Maria Cattelan
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | - Sergio Lo Caputo
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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2
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Cataldi M, Celentano C, Bencivenga L, Arcopinto M, Resnati C, Manes A, Dodani L, Comnes L, Vander Stichele R, Kalra D, Rengo G, Giallauria F, Trama U, Ferrara N, Cittadini A, Taglialatela M. Identification of Drugs Acting as Perpetrators in Common Drug Interactions in a Cohort of Geriatric Patients from Southern Italy and Analysis of the Gene Polymorphisms That Affect Their Interacting Potential. Geriatrics (Basel) 2023; 8:84. [PMID: 37736884 PMCID: PMC10514861 DOI: 10.3390/geriatrics8050084] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Pharmacogenomic factors affect the susceptibility to drug-drug interactions (DDI). We identified drug interaction perpetrators among the drugs prescribed to a cohort of 290 older adults and analysed the prevalence of gene polymorphisms that can increase their interacting potential. We also pinpointed clinical decision support systems (CDSSs) that incorporate pharmacogenomic factors in DDI risk evaluation. METHODS Perpetrator drugs were identified using the Drug Interactions Flockhart Table, the DRUGBANK website, and the Mayo Clinic Pharmacogenomics Association Table. Allelic variants affecting their activity were identified with the PharmVar, PharmGKB, dbSNP, ensembl and 1000 genome databases. RESULTS Amiodarone, amlodipine, atorvastatin, digoxin, esomperazole, omeprazole, pantoprazole, simvastatin and rosuvastatin were perpetrator drugs prescribed to >5% of our patients. Few allelic variants affecting their perpetrator activity showed a prevalence >2% in the European population: CYP3A4/5*22, *1G, *3, CYP2C9*2 and *3, CYP2C19*17 and *2, CYP2D6*4, *41, *5, *10 and *9 and SLC1B1*15 and *5. Few commercial CDSS include pharmacogenomic factors in DDI-risk evaluation and none of them was designed for use in older adults. CONCLUSIONS We provided a list of the allelic variants influencing the activity of drug perpetrators in older adults which should be included in pharmacogenomics-oriented CDSSs to be used in geriatric medicine.
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Affiliation(s)
- Mauro Cataldi
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
| | - Camilla Celentano
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
| | - Leonardo Bencivenga
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Cité de la Santé, Place Lange, 31300 Toulouse, France
| | - Michele Arcopinto
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
| | - Chiara Resnati
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
| | - Annalaura Manes
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
| | - Loreta Dodani
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
| | - Lucia Comnes
- Datawizard, Via Salaria 719a, 00138 Rome, Italy;
| | - Robert Vander Stichele
- Heymans Institute of Pharmacology, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium; (R.V.S.); (D.K.)
- European Institute for Innovation through Health Data, c/o Department Medical Informatics and Statistics, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Dipak Kalra
- Heymans Institute of Pharmacology, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium; (R.V.S.); (D.K.)
- European Institute for Innovation through Health Data, c/o Department Medical Informatics and Statistics, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
- Istituti Clinici Scientifici—ICS Maugeri S.p.A., Via Bagni Vecchi 1, 82037 Telese, Italy
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
| | - Ugo Trama
- General Directorate for Health Protection and Coordination of the Regional Health System, Regione Campania, Centro Direzionale Is. C3, 80132 Naples, Italy;
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
- Istituti Clinici Scientifici—ICS Maugeri S.p.A., Via Bagni Vecchi 1, 82037 Telese, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (L.B.); (M.A.); (G.R.); (F.G.); (N.F.); (A.C.)
| | - Maurizio Taglialatela
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (C.R.); (A.M.); (L.D.); (M.T.)
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Cattaneo D, Bernacchia D, Beltrami M, Resnati C, Meraviglia P, Gervasoni C. When the absence of an interaction can become clinically relevant. AIDS 2021; 35:1327-1328. [PMID: 34076620 DOI: 10.1097/qad.0000000000002878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dario Cattaneo
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic
- Unit of Clinical Pharmacology
| | - Dario Bernacchia
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Martina Beltrami
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | | | - Paola Meraviglia
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Cristina Gervasoni
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
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4
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Cataldi M, Citro V, Resnati C, Manco F, Tarantino G. New Avenues for Treatment and Prevention of Drug-Induced Steatosis and Steatohepatitis: Much More Than Antioxidants. Adv Ther 2021; 38:2094-2113. [PMID: 33761100 PMCID: PMC8107075 DOI: 10.1007/s12325-021-01669-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/11/2021] [Indexed: 12/12/2022]
Abstract
Drug-induced lipid accumulation in the liver may induce two clinically relevant conditions, drug-induced steatosis (DIS) and drug-induced steatohepatitis (DISH). The list of drugs that may cause DIS or DISH is long and heterogeneous and includes therapeutically relevant molecules that cannot be easily replaced by less hepatotoxic medicines, therefore making specific strategies necessary for DIS/DISH prevention or treatment. For years, the only available tools to achieve these goals have been antioxidant drugs and free radical scavengers, which counteract drug-induced mitochondrial dysfunction but, unfortunately, have only limited efficacy. In the present review we illustrate how in vitro preclinical research unraveled new key players in the pathogenesis of specific forms of DISH, and how, in a few cases, proof of concept of the beneficial effects of their pharmacological modulation has been obtained in vivo in animal models of this condition. The key issue emerging from these studies is that, in selected cases, liver toxicity depends on mechanisms unrelated to those responsible for the desired, primary pharmacological effects of the toxic drug and, therefore, specific strategies can be designed to overcome steatogenicity without making the drug ineffective. In particular, the hepatotoxic drug could be given in combination with a second molecule intended to selectively antagonize its liver toxicity whilst, ideally, potentiating its desired pharmacological activity. Although most of the evidence that we discuss is from in vitro or animal models and will need to be further explored and validated in humans, it highlights new avenues to be pursued in order to improve the safety of steatogenic drugs.
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Grasso A, Resnati C, Lanza A, Berrino L, Villani R. Toxicovigilance during COVID-19: attention to poisoning related to disinfection. Minerva Anestesiol 2020; 87:251-252. [PMID: 33319952 DOI: 10.23736/s0375-9393.20.15010-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anna Grasso
- Poison Center, A. Cardarelli Hospital, Naples, Italy -
| | - Chiara Resnati
- Poison Center, A. Cardarelli Hospital, Naples, Italy.,Department of Experimental Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Anna Lanza
- Poison Center, A. Cardarelli Hospital, Naples, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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Cattaneo D, Baldelli S, Resnati C, Giacomelli A, Meraviglia P, Minisci D, Astuti N, Ridolfo A, De Socio GV, Clementi E, Galli M, Gervasoni C. Evaluation of the concentrations of psychotropic drugs in HIV-infected versus HIV-negative patients: Potential implications for clinical practice. World J Biol Psychiatry 2020; 21:651-657. [PMID: 30058430 DOI: 10.1080/15622975.2018.1500032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 12/20/2022]
Abstract
Objectives: The management of psychiatric illness in HIV-infected patients is clinically challenging because of the risk of potential drug-drug interactions. Here, we aimed to measure the antidepressant and/or antipsychotic drug concentrations in HIV-infected patients during routine outpatient visits.Methods: Six hundred HIV-infected patients were screened during the first 15 months after the introduction of our outpatient polytherapy management service in a search for subjects treated with psychotropic drugs for at least 3 months. The distribution of psychotropic drug concentrations in HIV-infected patients was compared with that observed in a control group of HIV-negative patients monitored over the same period.Results: The search identified 82 HIV-infected patients concomitantly receiving antiretroviral and psychotropic drug treatment, 55% of whom had plasma psychotropic drug concentrations that were below minimum effective levels. The same result was found in only 26% of the samples taken from HIV-negative patients. These results were not affected by patients' gender, age, adherence to therapies or drug-drug interactions.Conclusions: A higher rate of sub-therapeutic antidepressant and/or antipsychotic drugs concentrations were found in HIV-infected patients. The creation of multidiscliplinary specialist teams may contribute to improving the management of such complex patients.
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Affiliation(s)
- Dario Cattaneo
- Gestione Ambulatoriale Politerapie (GAP) outpatient clinic, ASST Fatebenefratelli Sacco, Milan, Italy.,Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Sara Baldelli
- Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Chiara Resnati
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Paola Meraviglia
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Davide Minisci
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Noemi Astuti
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Annalisa Ridolfo
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuseppe V De Socio
- Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria di Perugia, Perugia, Italy
| | - Emilio Clementi
- Clinical Pharmacology Unit, Consiglio Nazionale delle Ricerche Institute of Neuroscience, Department of Biomedical and Clinical Sciences, Sacco University Hospital, Università degli Studi di Milano, Milan, Italy.,E. Medea Scientific Institute, Bosisio Parini, Italy
| | - Massimo Galli
- Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cristina Gervasoni
- Gestione Ambulatoriale Politerapie (GAP) outpatient clinic, ASST Fatebenefratelli Sacco, Milan, Italy.,Department of Infectious Disease, ASST Fatebenefratelli Sacco, Milan, Italy
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Daolio A, Scilabra P, Di Pietro ME, Resnati C, Rissanen K, Resnati G. Binding motif of ebselen in solution: chalcogen and hydrogen bonds team up. NEW J CHEM 2020. [DOI: 10.1039/d0nj04647g] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Ebselen, a compound active against SARS-CoV-2, forms a bifurcated supramolecular synthon thanks to chalcogen bond and hydrogen bond cooperation.
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Affiliation(s)
- Andrea Daolio
- Department of Chemistry
- Materials
- Chemical Engineering “Giulio Natta”
- Milano I-20131
- Italy
| | - Patrick Scilabra
- Department of Chemistry
- Materials
- Chemical Engineering “Giulio Natta”
- Milano I-20131
- Italy
| | | | - Chiara Resnati
- Recidency Program Clinical Pharmacology & Toxicology
- Università degli Studi della Campania “Luigi Vanvitelli”
- Napoli I-80138
- Italy
| | - Kari Rissanen
- Department Chemistry
- University of Jyväskylä
- Jyväskylä
- Finland
| | - Giuseppe Resnati
- Department of Chemistry
- Materials
- Chemical Engineering “Giulio Natta”
- Milano I-20131
- Italy
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Cattaneo D, Fossati A, Resnati C, Galli M, Gervasoni C. Generics for the Treatment of Hepatitis C in Monoinfected and HIV-coinfected Patients: Pros and Cons. AIDS Rev 2017; 19:167-172. [PMID: 28926562] [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: 06/07/2023]
Abstract
The treatment of hepatitis C virus in monoinfected and HIV-coinfected patients has greatly changed over recent years as a result of the introduction of direct-acting antiviral agents (DAAs), which have revolutionized clinical outcomes and led to sustained virological response rates above 90-95%. The discovery of new molecules and the subsequent competition between pharmaceutical companies, together with the negotiated price policies pursued by many national health systems, have led to a gradual reduction in the cost of DAAs, and expand their use to an increasing number of patients, including those with mild liver damage. However, the cost of branded DAAs is still too high for many developing countries, and many patients are still left without therapy. In this context, the availability of generic DAAs certainly provides a major opportunity for further cost savings in industrialized countries and will ensure broader access to treatment elsewhere. However, their more widespread use must not lead to a reduction in pharmaceutical quality because this could result in serious clinical consequences, including high rat failures, and selection of drug resistance. It is therefore essential that all generic formulations of DAAs are pre-qualified by the World Health Organization, and that real-life studies are carried out to verify their pharmacokinetic bioequivalence (ideally in patients, and not just in healthy volunteers) and clinical effectiveness. In this regard, lessons from expanding access programs in the HIV field would be very helpful.
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Affiliation(s)
- Dario Cattaneo
- Department of Laboratory Medicine, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Alessandro Fossati
- Department of Cardiovascular Surgery, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Chiara Resnati
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Massimo Galli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
| | - Cristina Gervasoni
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy
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Cataneo D, Fossati A, Resnati C, Galli M, Gervasoni C. Generics for the Treatment of Hepatitis C in Monoinfected And HIV-Coinfected Patients: Pros and Cons. AIDS Rev 2017. [DOI: 10.24875/aidsrev.m17000002] [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: 11/17/2022]
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10
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Falvella FS, Ricci E, Cheli S, Resnati C, Cozzi V, Cattaneo D, Gervasoni C, Clementi E, Galli M, Riva A. Pharmacogenetics-based optimisation of atazanavir treatment: potential role of new genetic predictors. Drug Metab Pers Ther 2017; 32:115-117. [PMID: 28599374 DOI: 10.1515/dmpt-2017-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 03/01/2017] [Indexed: 06/07/2023]
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11
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Gervasoni C, Resnati C, Formenti T, Fossati A, Minisci D, Meraviglia P, Cattaneo D. The relevance of drug–drug interactions in clinical practice: the case of concomitant boosted protease inhibitors plus alpha1-blocker administration. Antivir Ther 2017; 23:467-469. [DOI: 10.3851/imp3214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
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Riva A, Invernizzi A, Resnati C, Micheli V, Cattaneo D, Gervasoni C. Elvitegravir/cobicistat-associated toxic optical neuropathy in an HIV-infected patient: a call for caution? Antivir Ther 2016; 22:453-455. [PMID: 27328632 DOI: 10.3851/imp3058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Abstract
Ocular toxicity may not only be caused by medication overdoses and drug-drug interactions, but also by chronic administration of medications at recommended doses. We describe a case of an HIV-infected patient who experienced significant and sustained bilateral visual loss 2 months after starting treatment with elvitegravir/cobicistat/tenofovir/emtricitabine. Given the absence of any evidence of tenofovir- or emtricitabine-induced optical neuropathy after several years of clinical use, the antiretroviral therapy was promptly changed to tenofovir/emtricitabine plus atazanavir/ritonavir, which led to a progressive improvement in visual acuity. However, visual evoked potentials never returned to normal amplitudes. This is the first report of toxic optical neuropathy associated with the use of elvitegravir/cobicistat. It is imperative to recognize any signs of possible eye toxicity as rapidly as possible, and refer affected patients to an ophthalmologist promptly because early detection and the withdrawal of the offending agent are crucial in reversing this adverse ocular event.
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Affiliation(s)
- Agostino Riva
- 3rd Division of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco University Hospital, Milan, Italy
| | - Chiara Resnati
- 3rd Division of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy
| | - Valeria Micheli
- Clinical Microbiology, Virology and Diagnosis of Bioemergency, Luigi Sacco University Hospital, Milan, Italy
| | - Dario Cattaneo
- Unit of Clinical Pharmacology, Luigi Sacco University Hospital, Milan, Italy
| | - Cristina Gervasoni
- 3rd Division of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy
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Pezzani MD, Resnati C, Di Cristo V, Riva A, Gervasoni C. Abacavir-induced liver toxicity. Braz J Infect Dis 2016; 20:502-4. [PMID: 27054757 PMCID: PMC9425524 DOI: 10.1016/j.bjid.2016.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/08/2016] [Accepted: 03/13/2016] [Indexed: 12/04/2022] Open
Abstract
Abacavir-induced liver toxicity is a rare event almost exclusively occurring in HLA B*5701-positive patients. Herein, we report one case of abnormal liver function tests occurring in a young HLA B*5701-negative woman on a stable nevirapine-based regimen with no history of liver problems or alcohol abuse after switching to abacavir from tenofovir. We also investigated the reasons for abacavir discontinuation in a cohort of patients treated with abacavir-lamivudine-nevirapine.
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Affiliation(s)
- Maria Diletta Pezzani
- Università di Milano, Luigi Sacco University Hospital, Department of Biomedical and Clinical Sciences L. Sacco, Milan, Italy
| | - Chiara Resnati
- Università di Milano, Luigi Sacco University Hospital, Department of Biomedical and Clinical Sciences L. Sacco, Milan, Italy
| | - Valentina Di Cristo
- Università di Milano, Luigi Sacco University Hospital, Department of Biomedical and Clinical Sciences L. Sacco, Milan, Italy
| | - Agostino Riva
- Università di Milano, Luigi Sacco University Hospital, Department of Infectious Diseases, Milan, Italy
| | - Cristina Gervasoni
- Università di Milano, Luigi Sacco University Hospital, Department of Infectious Diseases, Milan, Italy.
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Cattaneo D, Sollima S, Charbe N, Resnati C, Clementi E, Gervasoni C. Suspected pharmacokinetic interaction between raltegravir and the 3D regimen of ombitasvir, dasabuvir and paritaprevir/ritonavir in an HIV-HCV liver transplant recipient. Eur J Clin Pharmacol 2015; 72:365-7. [PMID: 26362279 DOI: 10.1007/s00228-015-1936-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Dario Cattaneo
- Unit of Clinical Pharmacology, L. Sacco University Hospital, Milan, Italy
| | - Salvatore Sollima
- Department of Infectious Diseases, Luigi Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy
| | - Nitin Charbe
- Unit of Clinical Pharmacology, L. Sacco University Hospital, Milan, Italy
| | - Chiara Resnati
- Department of Infectious Diseases, Luigi Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy
| | - Emilio Clementi
- Clinical Pharmacology Unit, CNR Institute of Neuroscience, Dept Biomedical and Clinical Sciences, L. Sacco University Hospital, Università di Milano, 20157, Milan, Italy
- Scientific Institute IRCCS E. Medea, 23842, Bosisio Parini, Italy
| | - Cristina Gervasoni
- Department of Infectious Diseases, Luigi Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
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