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Nozawa K, Terada M, Onishi M, Ozaki Y, Takano T, Fakhouri W, Novick D, Haro JM, Faris LH, Kawaguchi T, Tanizawa Y, Tsurutani J. Real-world treatment patterns and outcomes of abemaciclib for the treatment of HR + , HER2- metastatic breast cancer patients in Japan. Breast Cancer 2023:10.1007/s12282-023-01461-6. [PMID: 37217763 DOI: 10.1007/s12282-023-01461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/08/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION This study described, in routine clinical practice in Japan, the patient characteristics, treatment patterns, and outcomes of female patients with HR + /HER2- metastatic breast cancer (MBC) who started abemaciclib treatment. METHODS Clinical charts were reviewed for patients starting abemaciclib in 12/2018-08/2021 with a minimum of 3 months follow-up data post-abemaciclib initiation regardless of abemaciclib discontinuation. Patient characteristics, treatment patterns, and tumor response were descriptively summarized. Kaplan-Meier curves estimated progression-free survival (PFS). RESULTS 200 patients from 14 institutions were included. At abemaciclib initiation, median age was 59 years, and the Eastern Cooperative Oncology Group performance status score was 0/1/2 for 102/68/5 patients (58.3/38.9/2.9%), respectively. Most had an abemaciclib starting dose of 150 mg (92.5%). The percentage of patients receiving abemaciclib as 1st, 2nd, or 3rd line treatment was 31.5%, 25.8%, and 25.2%, respectively. The most frequent endocrine therapy drugs used with abemaciclib were fulvestrant (59%) and aromatase inhibitors (40%). Evaluation of tumor response was available for 171 patients, 30.4% of whom had complete/partial response. Median PFS was 13.0 months (95% CI 10.1-15.8 months). CONCLUSIONS In a routine clinical practice setting in Japan, patients with HR + , HER2- MBC appear to benefit from abemaciclib treatment in terms of treatment response and median PFS, with the results broadly reflecting the evidence demonstrated in clinical trials.
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Affiliation(s)
- K Nozawa
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Terada
- Department of Breast Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - M Onishi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Ozaki
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Takano
- Department of Breast Medical Oncology, Breast Oncology Center, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - W Fakhouri
- Eli Lilly and Company, Indianapolis, IN, USA
| | - D Novick
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - L H Faris
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - T Kawaguchi
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Y Tanizawa
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan.
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Rajan N, Wei A, Cheng R, Novick D, Szende A, Baik R, Colman S. PCN106 Treatment Patterns and Health Resource Utilization in Patients with Hepatocellular Cancer (HCC) Following Failure of Sorafenib in Real World Setting in Taiwan. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Baig A, Loya M, Novick D, Shah S. Abstract No. 530 The role of chest radiographs post computed tomography–guided lung biopsy with gelatinous foam slurry: is it necessary? J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Novick D, Torres T, Laredo F. PCN31 BURDEN OF DISEASE FOR ADVANCED BREAST CANCER IN MEXICO. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Goren A, Novick D, Barros BR, Laks J, Dueñas H, Kahle-Wrobleski K. Impact of Caregiving for Patients with Alzheimer's Disease and Dementia on Psychiatric and Clinical Comorbidities in Brazil. Value Health 2014; 17:A402. [PMID: 27200965 DOI: 10.1016/j.jval.2014.08.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Goren
- Kantar Health, New York, NY, USA
| | - D Novick
- Eli Lilly and Company, Windlesham, UK
| | - B R Barros
- Eli Lilly do Brasil Ltda, São Paulo, Brazil
| | - J Laks
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
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Gorbounova VA, Bychkov MB, Vladimirova LY, Levchenko EV, Karpenko TD, Mamontov OY, Burmistrov V, Novick D, Rajan N, Sholokhova E, Solovyenko Y, Tjulandin SA. Characteristics of Patients with Pleural Mesothelioma in the Russian Federation. Value Health 2014; 17:A617. [PMID: 27202164 DOI: 10.1016/j.jval.2014.08.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V A Gorbounova
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - M B Bychkov
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - L Y Vladimirova
- Rostov Scientific Research Oncological Institute, Rostov-on-Don, Russia
| | - E V Levchenko
- N. N. Petrov Research Oncology Institute, Saint-Petersburg, Russia
| | - T D Karpenko
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - O Y Mamontov
- N. N. Petrov Research Oncology Institute, Saint-Petersburg, Russia
| | | | - D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | - N Rajan
- Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia
| | | | | | - S A Tjulandin
- N. N. Blokhin Russian Cancer Research Center, Moscow, Russia
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Novick D, Montgomery W, Treuer T, Aguado J, Kraemer S, Haro JM. Comparative Effectiveness in Terms of Treatment Discontinuation of Orodispersable Versus. Standard Oral Olanzapine Tablets in Non-Adherent Patients: Results from a 1-Year European Outpatient Observational Study. Value Health 2014; 17:A766. [PMID: 27202812 DOI: 10.1016/j.jval.2014.08.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | - W Montgomery
- Eli Lilly Australia Pty Ltd,, West Ryde, Australia
| | - T Treuer
- Eli Lilly & Company, Budapest, Hungary
| | - J Aguado
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - S Kraemer
- Eli Lilly and Company Ltd, Bad Homburg, Germany
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Jihyung Hong J, Montgomery W, Dueñas H, Elfatarany G, Haro JM. Predictors Pf Remission in the Treatment of Depression in the Middle East: Real-World Evidence From A 6-Month Prospective Observational Study. Value Health 2014; 17:A454. [PMID: 27201258 DOI: 10.1016/j.jval.2014.08.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | | | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
| | - G Elfatarany
- Eli Lilly & Company, Saudi, Riyadh, Saudi Arabia
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Montgomery W, Treuer T, Aguado J, Kraemer S, Haro JM. Relationship of Insight with Medication Adherence and the Impact on Outcomes in Patients with Schizophrenia and Bipolar Disorder: Results From A 1-Year European Outpatient Observational Study. Value Health 2014; 17:A455. [PMID: 27201259 DOI: 10.1016/j.jval.2014.08.1243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | - T Treuer
- Eli Lilly & Company, Budapest, Hungary
| | - J Aguado
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - S Kraemer
- Eli Lilly and Company Ltd, Bad Homburg, Germany
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Novick D, Montgomery W, Aguado J, Dueñas H, Haro JM. Symtomatic Factors in Patients With Major Depressive Disorder (MDD): Results from an Observational Study. Value Health 2014; 17:A543. [PMID: 27201753 DOI: 10.1016/j.jval.2014.08.1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D Novick
- Eli Lilly Holdings Limited, Windlesham, UK
| | | | - J Aguado
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - H Dueñas
- Eli Lilly de Mexico, Mexico City, Mexico
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Peng X, Sun P, Novick D, Andrews J, Sun S. Real-world comparison of health care utilization between duloxetine and pregabalin initiators with fibromyalgia. J Pain Res 2014; 7:37-46. [PMID: 24470771 PMCID: PMC3891762 DOI: 10.2147/jpr.s51636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/23/2022] Open
Abstract
Objectives To compare health care utilization of duloxetine initiators and pregabalin initiators among fibromyalgia patients in a real-world setting. Methods A retrospective cohort study was conducted based on a US national commercial health claims database (2006–2009). Fibromyalgia patients who initiated duloxetine or pregabalin in 2008, aged 18–64 years, and who maintained continuous health insurance coverage 1 year before and 1 year after initiation were assigned to duloxetine or pregabalin cohorts on the basis of their initiated agent. Patients who had pill coverage of the agents over the course of 90 days preceding the initiation were excluded. The two comparative cohorts were constructed using propensity score greedy match methods. Descriptive analysis and paired t-test were performed to compare health care utilization rates in the postinitiation year and the changes of these rates from the preinitiation year to the postinitiation year. Results Both matched cohorts (n=1,265 pairs) had a similar mean initiation age (49–50 years), percentage of women (87%–88%), and prevalence of baseline comorbid conditions (neuropathic pain other than diabetic peripheral neuropathic pain, low back pain, cardiovascular disease, hypertension, headache or migraine, and osteoarthritis). In the preinitiation year, both cohorts had similar inpatient, outpatient, and medication utilization rates (inpatient, 15.7%–16.1%; outpatient, 100.0%; medication, 97.9%–98.7%). The utilization rates diverged in the postinitiation year, with the pregabalin cohort using more fibromyalgia-related inpatient care (3.2% versus 2.2%; P<0.05), any inpatient care (19.3% versus 16.8%; P<0.05), and fibromyalgia-related outpatient care (62.1% versus 51.8%; P<0.05). From the preinitiation period to the postinitiation period, the duloxetine cohort experienced decreases in certain utilization rates, whereas the pregabalin cohort had increases (percentage of patients with a fibromyalgia-related admission, −1.2% versus 0.4% [P<0.01]; number of fibromyalgia-related outpatient claims, −1.7 versus 4.7 [P<0.01]). Conclusion Fibromyalgia patients initiating pregabalin tended to consume more fibromyalgia-related inpatient and outpatient care in the first postinitiation year, whereas fibromyalgia patients initiating duloxetine tended to have lower utilization rates of fibromyalgia-related inpatient care in the postinitiation year than in the preinitiation year.
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Affiliation(s)
- X Peng
- Eli Lilly and Company, Indianapolis, IN, USA
| | - P Sun
- Kailo Research Group, Indianapolis, IN, USA
| | - D Novick
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J Andrews
- Eli Lilly and Company, Indianapolis, IN, USA
| | - S Sun
- Kailo Research Group, Indianapolis, IN, USA
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Novick D, Montgomery W, Moneta V, Peng X, Brugnoli R, Haro J. EPA-1087 - Treatment patterns in asian patients with a major depressive episode. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Drucker I, Klajman A, Revel M, Manor Y, Ben-Efraim S, Novick D. Interleukin-6 and interleukin-6 receptor secretion by chronic lymphatic leukaemia and normal B lymphocytes: effect of PMA and PWM. Mediators Inflamm 2012; 6:147-53. [PMID: 18472849 PMCID: PMC2365853 DOI: 10.1080/09629359791857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) were detected in supernatants of cultures of B chronic lymphatic leukaemia (CLL) lymphocytes. Phorbol-12-myristate 13 acetate (PMA) caused a decrease in the levels of IL-6 in 14 out of 16 cultures and an increase in levels of sIL6R in all 15 cases. The effect of pokeweed mitogen (PWM) was variable and not significant. The levels of IL-6 were below the detection limit (60 pg/ml) in sera of 13 CLL patients whereas sIL-6R was detected (13 ng/ml to 97 ng/ml) in the 13 sera. IL6 was not detected in cultures of unstimulated or stimulated with PMA or PWM normal human B cells. Levels of sIL-6R were minimal in cultures of normal B lymphocytes and were increased in PMA stimulated cultures. The results are consistent with the view that B-CLL cells produce spontaneously IL-6 which could act in an autocrine fashion to cause shedding of surface IL-6R and account for the correlation found between serum levels of sIL-6R and B-CLL lymphocyte numbers. The fall in levels of IL-6 in PMA stimulated CLL cultures might express masking or degradation of IL-6 after combination with the receptor.
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Affiliation(s)
- I Drucker
- Laboratory for Clinical Immunology Meir Hospital Kfar-Saba 44281 Israel
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Haro JM, Reed C, Gonzalez-Pinto A, Novick D, Bertsch J, Vieta E. 2-Year course of bipolar disorder type I patients in outpatient care: factors associated with remission and functional recovery. Eur Neuropsychopharmacol 2011; 21:287-93. [PMID: 20956071 DOI: 10.1016/j.euroneuro.2010.08.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 07/10/2010] [Accepted: 08/08/2010] [Indexed: 11/29/2022]
Abstract
EMBLEM is a 2-year, prospective, observational study that enrolled patients initiating/changing oral treatment for an acute manic/mixed episode. This paper analysed remission and functional recovery in 1656 patients who entered the 2-year long-term phase. Cox models identified variables significantly associated with achieving remission and functional recovery at 2years. Of these patients, 64% achieved remission and 34% achieved functional recovery. Patients with a higher CGI-BP overall score at baseline, who had depressive episodes in the year before inclusion and who had poor social functioning (work or social impairment, not living independently or without a spouse/partner) were less likely to achieve remission or recovery. Prescription of typical antipsychotics and prescription of antidepressants at the first visit of the long-term treatment phase (12weeks) were independent predictors of lower remission and recovery rates. In conclusion, functional recovery occurred in approximately half of those who achieved remission. Impairment of work and social functioning was consistently associated with lower remission and recovery rates.
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Affiliation(s)
- J M Haro
- Parc Sanitari Sant Joan De Deu-SSM, Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.
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González-Pinto A, Reed C, Novick D, Bertsch J, Haro JM. Assessment of medication adherence in a cohort of patients with bipolar disorder. Pharmacopsychiatry 2010; 43:263-70. [PMID: 20842617 DOI: 10.1055/s-0030-1263169] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study aimed to identify factors associated with medication adherence in bipolar disorder (BPD) patients. METHODS EMBLEM is a 2-year, prospective, observational study on the outcomes of BPD patients initiating or changing treatment for a manic/mixed episode. Data were collected at baseline, during the first 12 weeks of treatment (acute phase) and up to 24 months of follow-up (maintenance phase). Adherence was assessed by investigators at every visit. Repeated measures logistic regression analyses identified variables associated with adherence. RESULTS Of 1,831 patients included in the analysis, 76.6% were adherent and 23.4% were non-adherent with their BPD medication during the maintenance phase. Patients were more likely to be adherent if they had insight into their illness at week 12. Patients were less likely to be adherent if they had cannabis abuse/dependence during the acute phase, work impairment or higher CGI hallucinations/delusions at baseline DISCUSSION Psychotic symptoms, poor insight, cannabis abuse/dependence and work impairment are negatively related to medication adherence during maintenance therapy of bipolar disorder. Patients with these characteristics may need a different therapeutic approach.
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Affiliation(s)
- A González-Pinto
- CIBERSAM Stanley International Mood Disorders Research Centre, Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain.
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Ascher-Svanum H, Peng X, Montgomery W, Faries DE, Lawson AH, Witte MM, Novick D, Jemiai N, Perrin E, McDonnell DP. Assessing the infrequent oral supplementation of olanzapine long-acting injection in the treatment of schizophrenia. Eur Psychiatry 2010; 26:313-9. [PMID: 20621454 DOI: 10.1016/j.eurpsy.2010.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 02/08/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Adding another antipsychotic to a treatment regimen was previously used in evaluating the medication's efficacy. Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics. This post-hoc analysis assessed supplementation of olanzapine long-acting injection (olanzapine-LAI) with oral olanzapine. SUBJECTS AND METHODS We used 12 months of data from an open-label, single-arm extension study of patients with schizophrenia or schizoaffective disorder (N=931) treated with olanzapine-LAI. The prevalence, duration, time to first supplementation, and best predictors of oral supplementation were assessed. RESULTS Oral supplementation occurred in 21% of patients for a median of 31 days with mean modal dose of 10.8 mg/day. Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients (47 vs. 97 days, p<0.001). Best predictors of oral supplementation included a more severe illness profile at baseline, lower olanzapine-LAI dose prior to oral supplementation, supervised living arrangements, and being African-American. CONCLUSION Supplementation of olanzapine-LAI appears to be infrequent, of relatively short duration, and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse.
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Affiliation(s)
- H Ascher-Svanum
- Lilly Corporate Center, DC 4133, Eli Lilly and Company, Indianapolis, IN 46285, USA.
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Hong J, Novick D, Haro J, Knapp M. PW01-181 - Economic consequences of medication nonadherence in the treatment of schizophrenia: 36-month results from the SOHO (schizophrenia outpatient health outcomes) study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Novick D, Brugnoli R, Haro J, Rossi A, Bortolomasi M, Frediani S, Borgherini G. PW01-254 - Risk factors for suicide in the observational schizophrenia outpatient health outcomes (SOHO) study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Novick D, Ascher-Svanum H, Zhu B, Brnabic A, Stauffer V, Peng X, Karagianis J, Perrin E. The Number Needed to Treat for All-Cause Medication Discontinuation in the Treatment of Schizophrenia: Consistency Across World Geographies and Study Designs. Pharmacopsychiatry 2009; 43:81-5. [DOI: 10.1055/s-0029-1242816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Karagianis J, Novick D, Pecenak J, Haro JM, Dossenbach M, Treuer T, Montgomery W, Walton R, Lowry AJ. Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO): baseline characteristics of pan-regional observational data from more than 17,000 patients. Int J Clin Pract 2009; 63:1578-88. [PMID: 19780867 DOI: 10.1111/j.1742-1241.2009.02191.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) patient population at study entry, focusing on illness burden and prescribing practices across regions. METHODS The SOHO study was a 3-year, prospective, observational study designed to assess costs and outcomes associated with antipsychotic use in outpatients initiating or changing antipsychotic (with an emphasis on olanzapine compared with other antipsychotics). SOHO was conducted in 10 European countries and 27 other countries as Intercontinental SOHO (IC-SOHO). Data from all countries have been pooled to produce the W-SOHO dataset. MAIN OUTCOMES MEASURES Clinical Global Impression-Schizophrenia (CGI-SCH) severity scores, psychotropic medication use, adverse events, social interaction, housing and employment status, self-perceived health state (EuroQoL EQ-5D scale and Visual Analogue Scale, EQ-VAS), and reasons for initiation/change of antipsychotic. RESULTS The W-SOHO database comprises 17,384 patients from six regions; East Asia (n = 1223), Central and Eastern Europe (n = 2175), Northern Europe (n = 4291), Southern Europe (n = 5788), Latin America (n = 2566), North Africa and the Middle East (n = 1341). Overall, patients were 38 +/- 13 years old (mean +/- SD), moderately ill (mean CGI-SCH overall score of 4.4 +/- 1.0) with a median duration of illness of 7 years (interquartile range 1-16 years); 43% were female, 10% were receiving antipsychotic medication for the first time. Adverse events were prevalent across all regions; on average, 50% (range 41-59%) of patients taking antipsychotics exhibited extrapyramidal symptoms at baseline, and 62% (34-67%) of patients reported sexual dysfunction in the previous month. On average, only 19% (16-23%) of patients were in paid employment and as many as 69% were living in dependent housing. CONCLUSIONS Despite inherent diversity in these patients and the health care systems supporting them, there are striking cross-regional similarities in baseline characteristics for most measures. Not all countries are represented; regional comparisons may not be valid outside of the countries studied.
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Affiliation(s)
- J Karagianis
- Clinical Research, Eli Lilly Canada Inc., Toronto, ON, Canada M1N 2E8.
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Novick D, Gonzalez-Pinto A, Haro JM, Bertsch J, Reed C, Perrin E, Tohen M. Translation of Randomised Controlled Trial Findings into Clinical Practice: Comparison of Olanzapine and Valproate in the EMBLEM Study. Pharmacopsychiatry 2009; 42:145-52. [DOI: 10.1055/s-0028-1128115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Suarez D, Haro JM, Novick D, Perrin E, Ochoa S, Naber D. Reasons and Outcomes of Olanzapine Dose Adjustments in the Outpatient Treatment of Schizophrenia. Pharmacopsychiatry 2009; 42:135-40. [PMID: 19585391 DOI: 10.1055/s-0028-1112127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Novick D, Suarez D, Haro J, Haddad P. Adherence with Antipsychotic Treatment Medication in Outpatients with Schizophrenia: 36- Month Results from the Schizophrenia Outpatients Health Outcomes (soho) Study. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71250-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Objective:To assess frequency and baseline factors associated with adherence with antipsychotic medication during long-term treatment in outpatients with schizophrenia.Methods:SOHO is a 3-year, prospective, observational study that included 10 972 patients changing or starting a new antipsychotic medication Treatment adherence during 4 weeks prior to the visit was assessed at each visit by participating psychiatrists as:•the patient has not been prescribed medication;•the patient almost always adheres;•the patient adheres half of the time; and•the patient never adheres to antipsychotic medication.Logistic regression models were fitted to analyze the baseline factors associated to compliance during follow-up.Results:6731 patients with at most one missing visit were analysed. Data from the missing visit were imputed from the previous visit; 71.2% were considered to be adherent and 28.8% non-adherent over the 3-year follow-up period. the strongest predictor of medication adherence during follow-up was adherence at baseline (OR = 4.01, 95% CI: 3.46-4.64). other baseline predictors of adherence included not using antipsychotics in the previous 4 weeks, receiving treatment for first time, being socially active, and a higher body mass index. Baseline predictors of non-adherence were alcohol dependence, substance abuse, hospitalisation in previous 6 months, living independently housing and having hostile behaviours.Conclusions:Alcohol dependence, substance abuse and living independently were associated with non-adherence. Previous adherence, being socially active and receiving medication for the first time was associated with better adherence. Limitation: medication adherence was assessed by the psychiatrist through a single item question.
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Lambert M, Naber D, Schacht A, Wagner T, Hundemer HP, Karow A, Huber CG, Suarez D, Haro JM, Novick D, Dittmann RW, Schimmelmann BG. Rates and predictors of remission and recovery during 3 years in 392 never-treated patients with schizophrenia. Acta Psychiatr Scand 2008; 118:220-9. [PMID: 18699954 DOI: 10.1111/j.1600-0447.2008.01213.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Few studies have prospectively examined remission and recovery as well as their predictors in schizophrenia simultaneously. Aims of the study were to identify remission and recovery rates as well as their predictors in schizophrenia. METHOD 392 never-treated patients with schizophrenia were assessed over 3 years. Combined remission and recovery required concurrent achievement of symptomatic and functional remission as well as adequate quality of life for at least 6 and 24 months respectively. Predictors were analysed using stepwise logistic regression models. RESULTS At 3 years, remission rates for symptoms, functioning and subjective wellbeing were 60.3%, 45.4% and 57.0%; recovery rates were 51.7%, 35.0% and 44.3%. Of those, 28.1% were in combined remission and 17.1% in combined recovery. Predictors mainly included the baseline functional status and early remission within the first 3 months. CONCLUSION The proportion of patients who met combined remission or recovery criteria is low. Early treatment adaptations in case of early non-remission are mandatory.
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Affiliation(s)
- M Lambert
- Psychosis Early Detection and Intervention Centre, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Novick D, Elbirt D, Dinarello CA, Rubinstein M, Sthoeger ZM. Interleukin-18 binding protein in the sera of patients with Wegener's granulomatosis. J Clin Immunol 2008; 29:38-45. [PMID: 18594952 DOI: 10.1007/s10875-008-9217-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 06/05/2008] [Indexed: 12/24/2022]
Abstract
INTRODUCTION In the present study, we examined the levels of the pro-inflammatory cytokine IL-18 and its natural inhibitor, the IL-18 binding protein (IL-18BP), in sera of Wegener's granulomatosis (WG) patients at various stages of the disease. PATIENTS AND METHODS Sera from eight consecutive biopsy-proven systemic WG patients (four men and four women; age at diagnosis 58.4 +/- 13.8 years) were obtained longitudinally with a follow-up period of 55.2 +/- 30 months. Sera obtained from 50 healthy subjects were used as controls. RESULTS AND DISCUSSION Serum levels of IL-18, IL-18BP, and free IL-18 obtained during an active phase of the disease (Birmingham Vasculitis Activity Score, BVAS > 10) were more than twofold higher than levels in the same patients during inactive disease stages (BVAS < 5; P < 0.002; P < 0.006, and P < 0.03 for IL-18, IL-18BP, and free IL-18, respectively). During inactive stages, the levels of these markers were comparable to those of healthy controls. The elevated levels of IL-18 and IL-18BP in sera during active stages of disease suggest a possible role in the pathogenesis and course of the WG. CONCLUSION Despite the elevated IL-18BP levels during active disease, free IL-18 remained higher than in the inactive disease stages, suggesting a potential benefit of administration of exogenous IL-18BP as a novel therapeutic approach for active WG.
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Affiliation(s)
- D Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel.
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Haro JM, Novick D, Suarez D, Ochoa S, Roca M. Predictors of the course of illness in outpatients with schizophrenia: a prospective three year study. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1287-92. [PMID: 18502012 DOI: 10.1016/j.pnpbp.2008.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Revised: 03/25/2008] [Accepted: 04/02/2008] [Indexed: 11/25/2022]
Abstract
The course of schizophrenia includes a combination of periods of remission and relapse. Previous studies focused on simple dichotomous outcomes and did not take into account the complexity of the course. Using data from a large 3-year follow-up study of schizophrenia, we described the different courses of schizophrenia. Of the 5950 patients with complete 3-year data, 38.7% never achieved remission (prolonged course), 15.7% achieved remission but relapsed and 45.7% achieved and maintained remission (persistent remission). Females, patients with better social functioning at baseline (living independently, in paid employment, socially active or having a spouse or partner) and with a shorter duration of illness had a more favourable course. Patients prescribed risperidone, quetiapine or depot typicals at the baseline visit were more likely to have a prolonged course than patients who started olanzapine. The results show that description of the long-term outcome of schizophrenia cannot be summarized with just one outcome variable.
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Affiliation(s)
- J M Haro
- Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, CIBER-SAM, Spain.
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Haro JM, Ciudad A, Alonso J, Bousoño M, Suárez D, Novick D, Gilaberte I. [Remission and relapse in the outpatient treatment of patients with schizophrenia. Outcomes at 3 years]. Actas Esp Psiquiatr 2008; 36:187-196. [PMID: 18461495] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Three year data collected in the frame of the SOHO study within Spain were used to evaluate antipsychotic treatment outcomes by analyzing remission and relapse as well as the factors influencing them. METHODS The SOHO was a prospective, long-term, observational study of the outcomes of schizophrenia treatment in ambulatoty who initiated therapy or who changed to a new antipsychotic drug performed in 10 European countries, with a focus on olanzapine. This article reports the attainment of international schizophrenia clinical remission and relapse criteria and the associated correlates in these patients. RESULTS AND CONCLUSIONS A total of 2,020 patients were recruited in Spain. Almost 2/3 (60.1%) of the patients met the criteria for clinical remission. Factors that influence the likelihood of remission were identified, such as gender, baseline clinical and/or functional status, time since treatment initiation, treatment with olanzapine versus oral typical antipsychotics, duration of treatment, gender or the need for concomitant anxiolytics. Relapse occurred in 18.7% of patients. Treatment with quetiapine or the prescription of anticholinergics was associated with a greater risk of relapse. CONCLUSIONS These results highlight some prognostic factors of the course of schizophrenia and underscore the importance of the antipsychotic choice and its maintenance to achieve favorable long-term clinical outcomes in routine practice.
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Affiliation(s)
- J M Haro
- Fundacion San Juan de Dios, Barcelona, Spain.
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Schuepbach D, Novick D, Haro J, Reed C, Boeker H, Noda S, Angst J, Hell D. Determinants of Voluntary vs. Involuntary Admission in Bipolar Disorder and the Impact of Adherence. Pharmacopsychiatry 2008; 41:29-36. [DOI: 10.1055/s-2007-993213] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Neff GW, Kemmer N, Zacharias VC, Kaiser T, Duncan C, McHenry R, Jonas M, Novick D, Williamson C, Hess K, Thomas M, Buell J. Analysis of hospitalizations comparing rifaximin versus lactulose in the management of hepatic encephalopathy. Transplant Proc 2007; 38:3552-5. [PMID: 17175328 DOI: 10.1016/j.transproceed.2006.10.107] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [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: 06/30/2006] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Patients with end-stage liver disease often develop hepatic encephalopathy. The loss in cognitive abilities results in marked economic loss to the patient and health care community. We report hospital admission rates and economic impact of patients with end-stage liver disease suffering from hepatic encephalopathy. METHODS The medical records were reviewed involving liver transplant patients started on lactulose or rifaximin therapy after presenting with stage 2 hepatic encephalopathy from January 2004 to November 2005. Information collected included demographics, hospitalizations required for hepatic encephalopathy, economic data, and Model for End-stage Liver Disease (MELD) score. RESULTS Thirty-nine patients met study criteria: 24 patients treated with lactulose (group one) and 15 with rifaximin (group two). Group one included 18 men and six women of mean age 48 (range 39 to 58), average MELD 14 (range 10 to 19). Group two included 10 men and five women of mean age 47 (range 42 to 58), average MELD 15 (range 10 to 19). Group one patients required 19 hospitalizations overall: three patients with three hospitalizations, four patients with two hospitalizations, and two patients required one hospitalization. Total drug cost per month was 50 dollars(group one) and 620 dollars(group two). The average annual cost of hospitalization, emergency room visit, and drug per patient treated was 13,284.96 dollars for a total of 318,839 dollars (range 5005 dollars to 26,255 dollars, including drug cost and hospital care). Group two required three hospitalizations, all three with one visit. The average annual cost of hospitalization, emergency room visit, and drug per patient treated was 7958.13 dollars for a total of 119,372 dollars (range 6005 dollars to 19,255 dollars, including drug cost and hospital care). The total cost of therapy per patient per year was 13,285 dollars (group one) versus 7958 dollars (group two). The average length of stay was shorter in group two [3.5 days (range 3 to 4)] versus group 1 [5.0 days (range 3 to 10); P < .0001]. CONCLUSION These pilot data demonstrate the marked difference in economic costs for the treatment of hepatic encephalopathy. The results also show that in comparative groups, the economic gains are quickly lost when using lactulose.
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Affiliation(s)
- G W Neff
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio 45267-0595, USA.
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Neumayr G, Ludwiczek O, Hoertnagl H, Pfister R, Mitterbauer G, Moschen A, Novick D, Rubinstein M, Tilg H. The Impact of Prolonged Strenuous Endurance Exercise on Interleukin 18 and Interleukin 18 Binding Protein in Recreational Cyclists. Int J Sports Med 2005; 26:836-40. [PMID: 16320167 DOI: 10.1055/s-2005-837466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/25/2022]
Abstract
Interleukin 18 (IL-18) is an important pro-inflammatory cytokine in the early phase of human immune response to microbial infections. The influence of strenuous exercise on the intrinsic balance of IL-18 and its endogenous antagonist IL-18 binding protein (IL-18 BP) is unknown, but could be of major relevance for the athlete's immune function empirically and epidemiologically proven to be altered after exhaustive exertion. To study the effect of strenuous marathon cycling on the interaction of IL-18 and IL-18 BP we investigated 37 male, healthy, and well-trained amateur cyclists participating in the Otztaler Radmarathon in Tyrol (distance: 230 km; cumulative altitude difference: 5500 m). IL-18 was measured by a commercially available ELISA-Kit and IL-18 BP by a novel IL-18 BP ELISA method. Free, unbound IL-18 was calculated according to a standard equation. The mean plasma level of IL-18 was 142.27 +/- 21.85 pg/ml pre-race, remained nearly unchanged (124.35 +/- 13.16 pg/ml; p = 1.0) immediately after competition (mean race time 9 h 38 min), but declined significantly 24 h afterward (62.92 +/- 6.80 pg/ml; p = 0.002). The plasma levels of IL-18 BP increased considerably immediately after and kept on rising for the following 24 h (pre-race: 1.51 +/- 0.20 ng/ml; immediately post-race: 3.84 +/- 0.26 ng/ml, p < 0.001; 24 h post-race: 4.33 +/- 0.42 ng/ml, p < 0.001). Therefore, the calculated free IL-18 was 122.06 +/- 16.79 pg/ml pre-race, declined to 82.86 +/- 8.59 (p = 0.05) immediately post-race and to 39.17 +/- 3.76 pg/ml 24 h post-race (p < 0.001). The respective percentages of this post-exercise reduction in free IL-18 plasma levels were 32 % and 68 %. The present study reveals an exercise-induced significant decline in free IL-18 accompanied by an immediate up-regulation of IL-18 BP and decreased IL-18 in marathon cyclists. This down-regulation of free IL-18 may (i) limit the magnitude and duration of a too excessive inflammatory response to the exercise-induced tissue damage and (ii) on the other hand contribute to the elevated susceptibility to infection in athletes undergoing exhaustive exercise.
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Affiliation(s)
- G Neumayr
- Institute of Sports Medicine, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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Lambert M, Haro JM, Novick D, Edgell ET, Kennedy L, Ratcliffe M, Naber D. Olanzapine vs. other antipsychotics in actual out-patient settings: six months tolerability results from the European Schizophrenia Out-patient Health Outcomes study. Acta Psychiatr Scand 2005; 111:232-43. [PMID: 15701108 DOI: 10.1111/j.1600-0447.2004.00451.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The European Schizophrenia Out-patient Health Outcomes study is an observational study investigating treatment in schizophrenia. We report treatment-emergent adverse events during the first 6 months of treatment. METHOD The rate of extrapyramidal symptoms (EPS), anticholinergic use, weight gain and sexual related dysfunctions were assessed in 8,400 out-patients. RESULTS Patients typical antipsychotics and risperidone experienced significantly more EPS and anticholinergic use than patients in the clozapine, olanzapine, and quetiapine cohorts. Patients treated with amisulpride, typical antipsychotics and risperidone were significantly more likely to have sexual related dysfunctions and/or amenorrhea. Increases in weight and body mass index occurred in all cohorts, but were significantly greater in the olanzapine and clozapine cohorts. CONCLUSION Patients treated with olanzapine, quetiapine and clozapine had better tolerability outcomes regarding EPS and sexual related dysfunctions compared with patients receiving risperidone, amisulpride and typicals. Patients treated with olanzapine and clozapine had higher weight increases than patients treated with risperidone, quetiapine and typicals.
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Affiliation(s)
- M Lambert
- Centre for Psychosocial Medicine, Department for Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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Haro JM, Edgell ET, Novick D, Alonso J, Kennedy L, Jones PB, Ratcliffe M, Breier A. Effectiveness of antipsychotic treatment for schizophrenia: 6-month results of the Pan-European Schizophrenia Outpatient Health Outcomes (SOHO) study. Acta Psychiatr Scand 2005; 111:220-31. [PMID: 15701107 DOI: 10.1111/j.1600-0447.2004.00450.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To present the 6-month outcomes associated with antipsychotic treatment of patients participating in the Schizophrenia Outpatient Health Outcomes (SOHO) study. METHOD SOHO is a 3-year, prospective, observational study of the health outcomes associated with antipsychotic treatment in 10 European countries. The study included over 10,000 out-patients who were initiating or changing their antipsychotic medication. RESULTS Clinical Global Impression (CGI)-severity and quality of life (QOL) scores improved in all treatment cohorts. There was a higher response in the CGI-overall symptoms and in the CGI-schizophrenia positive, negative, cognitive and depressive symptom scales in the olanzapine (Olz) and clozapine (Cloz) cohorts compared with other treatment cohorts. Changes were associated with an improvement in QOL. CONCLUSION Patients starting Olz and Cloz tend to have better outcomes at 6 months than patients who start other antipsychotics in actual out-patient clinical practice. The results should be interpreted conservatively because of the non-randomized study design.
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Affiliation(s)
- J M Haro
- Sant Joan de Déu-Serveis de Salut Mental, Sant Boi, Barcelona, Spain.
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Ciudad A, Prieto L, Olivares JM, Montejo AL, Ros S, Novick D. [The European schizophrenia outpatient health outcomes (SOHO) study: baseline findings of the Spanish sample]. Actas Esp Psiquiatr 2004; 32:227-35. [PMID: 15232752] [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] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
INTRODUCTION To describe the baseline findings and study population of the Spanish sample of the Schizophrenia Outpatient Health Outcomes (SOHO) Study. METHOD The SOHO study is an ongoing, large, prospective, long-term observational study of schizophrenia treatment in 10 European countries. The study population consists of outpatients who initiate therapy or change to a new antipsychotic. RESULTS A total of 86 investigators enrolled 2,020 in Spain (10,972 patients in Europe). 64 % of patients were men and the mean age was 38.7 years. The Spanish SOHO study sample had considerable functional impairment at baseline. The main reason for change of therapy was lack effectiveness followed by intolerability. Patients included in the study and those receiving their first antipsychotic for schizophrenia are most likely to receive an atypical agent. CONCLUSION The Spanish SOHO study population appears to represent the Spanish outpatients with schizophrenia in whom a treatment decision is required. Baseline findings reflect Spanish clinical practice with respect to patients treated with individual antipsychotics.
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Affiliation(s)
- A Ciudad
- Departamento de Investigación Clínica, Eli Lilly & Co., Alcobendas, Madrid.
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Karow A, Ritzhaupt A, Roesch F, Novick D, Naber D, Dittmann RW. Association of clinical and non-clinical factors with subjective well-being – data of the SOHO study. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Naber D, Krausz M, Novick D, Czekalla J. Antipsychotic treatment in schizophrenic patients. 6-month data of the 3-year European observational study of health outcomes (SOHO). Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-827087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cyranowski JM, Frank E, Winter E, Rucci P, Novick D, Pilkonis P, Fagiolini A, Swartz HA, Houck P, Kupfer DJ. Personality pathology and outcome in recurrently depressed women over 2 years of maintenance interpersonal psychotherapy. Psychol Med 2004; 34:659-669. [PMID: 15099420 DOI: 10.1017/s0033291703001661] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Empirical data on the impact of personality pathology on acute treatment outcome for depression are mixed, in part because of challenges posed by assessing trait-like personality patterns while patients are in an active mood episode. To our knowledge, no previous study has examined the effect of personality pathology on maintenance treatment outcome. By maintenance treatment we refer to long-term treatment provided to prevent depression recurrence among remitted patients. METHOD Structured Clinical Interviews for the DSM-III-R Personality Disorders (SCID-II) were obtained on a sample of 125 recurrently depressed women following sustained remission of the acute mood episode and prior to entering maintenance treatment. SCID-II interviews were then repeated following 1 and 2 years of maintenance interpersonal psychotherapy. RESULTS At the pre-maintenance assessment, 21.6% of the sample met SCID-II personality disorder criteria. Co-morbid personality pathology was related to an earlier age of onset, more previous depressive episodes, and a greater need for adjunctive pharmacotherapy to achieve remission of the acute mood episode. Co-morbid personality pathology predicted both higher rates of depression recurrence and a shorter time to recurrence over the 2-year course of maintenance treatment. Notably, among those patients who remained depression-free, continuous levels of personality pathology steadily declined over the 2-year course of maintenance therapy. CONCLUSIONS Results highlight the need for early and effective intervention of both episodic mood disorder and inter-episode interpersonal dysfunction inherent to the personality disorders. Future maintenance treatment trials are needed to clarify the relationship between episodic mood disorder and personality function over time.
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Affiliation(s)
- J M Cyranowski
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Lonnemann G, Novick D, Rubinstein M, Dinarello CA. Interleukin-18, interleukin-18 binding protein and impaired production of interferon-gamma in chronic renal failure. Clin Nephrol 2004; 60:327-34. [PMID: 14640238 DOI: 10.5414/cnp60327] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [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: 11/18/2022] Open
Abstract
UNLABELLED Uremia is associated with suppressed cellular immune responses, manifested, in part, by impaired interferon-gamma (IFNgamma) production. We investigated the influence of kidney function on plasma levels of interleukin-18 binding protein (IL-18BP), the naturally occurring inhibitor of IL-18. METHODS Plasma levels of IL-18, IL-18BP and IFNgamma were measured by specific immunoassays in patients with normal kidney function (NKF, n = 29), in patients with chronic renal insufficiency (CRI, n = 29), and in patients on hemodialysis (HD, n = 40). In addition, Staphylococcus epidermidis-induced production of IFNgamma and IL-18 in whole blood cultures was determined in 12 patients on HD and compared to production in 9 controls with NKF. RESULTS Plasma IL-18 (mean +/- SEM) in NKF was 17.9 +/- 3.6 pg/ml, in CR142.6 +/- 7.0 pg/ml (p < 0.01), and in HD 93.5 +/- 13.6 pg/ml (p < 0.001). The level of IL-18BP in NKF was 3.4 +/- 0.4 ng/ml, in CRI 7.5 +/- 0.7 ng/ml (p < 0.001), and in HD 13.1 +/- 0.8 ng/ml (p < 0.001). Plasma IL-18BP was inversely correlated with creatinine clearance (correlation coefficient: -0.7479). The level of free IL-18 was calculated in NKF to be 13.8 +/- 3.3 pg/ml, in CRI 23.6 +/- 3.9 pg/ml (not significant), and in HD 39.6 +/- 5.9 pg/ml (p < 0.001). Stimulated whole blood production of IFNgamma in NKF was 185 +/- 74 pg/10(6) mononuclear cells (PBMC), but suppressed in HD to 27.3 +/- 16 pg/10(6) PBMC (p < 0.05). CONCLUSION In uremia, retention of IL-18BP does not suffice to neutralize most of the concomitantly raised levels of total IL-18 resulting in elevated levels of free IL-18. Nevertheless, IFNgamma production in whole blood is reduced in patients on HD. Therefore, suppression of IFNgamma production in uremia may be due to inhibitors of IFNgamma production other than IL-18BP.
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Affiliation(s)
- G Lonnemann
- Gemeinschaftspraxis Nephrologie/Dialyse, Langenhagen, Germany.
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Haro JM, Kamath SA, Ochoa S, Novick D, Rele K, Fargas A, Rodríguez MJ, Rele R, Orta J, Kharbeng A, Araya S, Gervin M, Alonso J, Mavreas V, Lavrentzou E, Liontos N, Gregor K, Jones PB. The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand Suppl 2003:16-23. [PMID: 12755850 DOI: 10.1034/j.1600-0447.107.s416.5.x] [Citation(s) in RCA: 433] [Impact Index Per Article: 20.6] [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: 11/23/2022]
Abstract
OBJECTIVE To describe the development and validation of the Clinical Global Impression-Schizophrenia (CGI-SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. METHOD The CGI-SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter-rater reliability, all patients were assessed by two clinicians. RESULTS Symptoms were assessed in 114 patients. Correlation coefficients between the CGI-SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). CONCLUSION The CGI-SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.
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Affiliation(s)
- J M Haro
- Research and Development Unit, Sant Joan de Déu-SSM, Sant Boi, Barcelona, Spain.
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Prieto L, Novick D, Sacristán JA, Edgell ET, Alonso J. A Rasch model analysis to test the cross-cultural validity of the EuroQoL-5D in the Schizophrenia Outpatient Health Outcomes Study. Acta Psychiatr Scand Suppl 2003:24-9. [PMID: 12755851 DOI: 10.1034/j.1600-0447.107.s416.6.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [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: 11/23/2022]
Abstract
OBJECTIVE To investigate the pan-European, cross-cultural validity of the EuroQol-5D (EQ-5D) for assessing quality of life in the Schizophrenia Outpatient Health Outcomes (SOHO) Study. METHOD The EQ-5D items investigated were mobility, self-care, usual activities, pain/discomfort and anxiety/depression. A Rasch rating scale model (a form of differential item functioning) was used to identify invariance of item calibrations for the 10 European countries participating in the SOHO study. RESULTS There was general congruence in the EQ-5D item calibration pattern. The rank of average EQ-5D item calibrations was similar for all countries except Denmark. Denmark showed slight misfits for mobility and pain/discomfort. CONCLUSION The EQ-5D is an appropriate measure of health-related quality of life across European countries and translations.
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Affiliation(s)
- L Prieto
- Clinical Research Department, Eli Lilly & Co, Alcobendas, Spain.
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Knapp M, Novick D, Genkeer L, Curran CM, McDaid D. Financing health care in Europe: context for the Schizophrenia Outpatient Health Outcomes Study. Acta Psychiatr Scand Suppl 2003:30-40. [PMID: 12755852 DOI: 10.1034/j.1600-0447.107.s416.1.x] [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: 11/23/2022]
Abstract
OBJECTIVE Exploration of the implications for mental health care of the health care funding environment in Europe, as context for the Schizophrenia Outpatient Health Outcomes (SOHO) Study. METHOD Data on health care financing for individual countries were sourced by review of the literature and personal communication with European country representatives. RESULTS The main and complementary sources of health care finance are presented for the 10 European countries participating in the SOHO study. CONCLUSION A mixture of tax and social insurance funding mechanisms dominate general health care funding in Europe. These mechanisms in principle promote equity in access to all health care interventions, including those for mental health. However, current resource allocation to mental health care may not reflect fully the impact of mental health disorders. Further work is now under way to examine the contribution of non-health sectors (such as social welfare) to the funding and provision of services.
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Affiliation(s)
- M Knapp
- Personal Social Services Research Unit, LSE Health and Social Care, London School of Economics, London, UK.
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Pignatti P, Ciapponi L, Galle P, Hansen MB, Massa M, Meazza C, Paonessa G, Novick D, Ciliberto G, Martini A, De Benedetti F. High circulating levels of biologically inactive IL-6/SIL-6 receptor complexes in systemic juvenile idiopathic arthritis: evidence for serum factors interfering with the binding to gp130. Clin Exp Immunol 2003; 131:355-63. [PMID: 12562400 PMCID: PMC1808632 DOI: 10.1046/j.1365-2249.2003.02052.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/20/2022] Open
Abstract
We previously demonstrated that high levels of IL-6/sIL-6R complexes are present in sera of patients with systemic juvenile idiopathic arthritis (s-JIA) and that the amount of IL-6 estimated in the IL-6/sIL-6R complexes is markedly higher than that measured by the B9 assay. Here, we show that two additional bioassays, employing human myeloma XG-1 cells and human hepatoma Hep3B cells, detected serum IL-6 levels similar to those measured by the B9 assay and approximately 10-fold lower than the IL-6 levels estimated to be present in the IL-6/sIL-6R complex. Using an assay for the measurement of the amount of circulating IL-6 complexed with the sIL-6R and available for binding to gp130 (gp130 binding activity), we show that the IL-6/gp130 binding activity is similar to that detected by the bioassays and again significantly lower than that estimated to be present in the IL-6/sIL-6R complex. Addition of recombinant human IL-6 (rhIL-6) to sera of patients or controls results in a markedly lower increase in the gp130 binding activity in patients than in controls. Moreover, sera from s-JIA patients inhibited in a dose dependent manner the gp130 binding activity assay. These results show that sera from patients with s-JIA contain a factor, or factors, that inhibit(s) the binding of the IL-6/sIL-6R complex to gp130. This inhibitory activity does not appear to be due to soluble gp130, C-reactive protein or autoantibodies to IL-6.
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Affiliation(s)
- P Pignatti
- Paediatria Generale e Reumatologia, IRCCS Policlinico San Matteo, Pavia, Italy
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Kaser A, Novick D, Rubinstein M, Siegmund B, Enrich B, Koch RO, Vogel W, Kim SH, Dinarello CA, Tilg H. Interferon-alpha induces interleukin-18 binding protein in chronic hepatitis C patients. Clin Exp Immunol 2002; 129:332-8. [PMID: 12165091 PMCID: PMC1906434 DOI: 10.1046/j.1365-2249.2002.01911.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Interleukin-18 (IL-18), derived from macrophages and Kupffer cells, is the central pro-inflammatory cytokine leading to experimental liver failure. IL-18 binding protein (IL-18BP) is a circulating protein that binds IL-18 and neutralizes its activity. Since IL-18 production is increased in chronic HCV infection, we asked whether IFN-alpha might act on the IL-18/IL-18BP system in HCV patients. IL-18BP, total and free IL-18 plasma levels were determined in 13 HCV patients receiving 1 x 107 IU IFN-alpha subcutaneously daily for 28 days. The in vitro effects of IFN-alpha on macrophage IL-18BP and IL-18 were studied by enzyme-linked immunosorbent assays and Northern analysis. IFN-alpha administration increased IL-18BP plasma levels 3.24 fold 24 h after institution of therapy, resulting in a 67.4% reduction of free IL-18. Total IL-18 levels decreased from day +24 on. In vitro, IFN-alpha diminished IL-18 release from macrophages of healthy volunteers and chronic HCV patients. On top of its inhibitory effects on IL-1 and TNF-alpha release, IFN-alpha also exerts its anti-inflammatory action in vivo by induction of IL-18BP. These anti-inflammatory properties might account - together with its antiviral action - for its clinical efficacy in chronic hepatitis C.
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Affiliation(s)
- A Kaser
- Division of Gastroenterology and Hepatology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria
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Haro J, Edgell E, Frewer P, Novick D, Lothgren M. Baseline results from SOHO: a pan-European, observational study. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80654-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Edgell E, Frewer P, Haro J, Novick D, Lothgren M. Olanzapine or risperidone treatment initiation: SOHO Study Results. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Novick D, Eshhar Z, Fischer DG, Friedlander J, Rubinstein M. Monoclonal antibodies to human interferon-gamma: production, affinity purification and radioimmunoassay. EMBO J 2002; 2:1527-30. [PMID: 11892806 PMCID: PMC555317 DOI: 10.1002/j.1460-2075.1983.tb01618.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [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: 11/06/2022] Open
Abstract
Human interferon-gamma (IFN-gamma) purified to electrophoretic homogeneity by a cation exchange h.p.l.c., was used for the development of monoclonal antibodies. Following immunization, spleen lymphocytes of two mice showing the highest binding and neutralizing titers were isolated, fused with NSO mouse myeloma cells and cloned. The screening of hybridomas was based on precipitation of the immune complexes with a second antibody and recovery of the biological activity of IFN-gamma from the precipitate. Twenty nine independent hybridomas secreting antibodies specific to IFN-gamma were obtained. Twelve out of these 29 hybridomas produced antibodies that neutralized the antiviral activity of pure as well as crude IFN-gamma. Moreover, IFN-gamma obtained by various induction procedures was neutralized as well, indicating that these various IFN-gamma subtypes are immunologically cross-reactive. Immune precipitation of partially purified 125I-labelled IFN-gamma by several monoclonal antibodies revealed two protein bands of 26,000 and 21,000 daltons. Immunoaffinity chromatography of IFN-gamma gave a 50-fold purification to a specific activity > or = 4 x 10(7) units/mg. Two of the monoclonal antibodies were found suitable for a sensitive and rapid double antibody solid-phase radioimmunoassay, allowing the detection of IFN-gamma at concentrations of at least 4 ng/ml (150 units/ml) within 8 h.
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Affiliation(s)
- D Novick
- Department of Virology, The Weizmann Institute of Science, Rehovot, Israel
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Abstract
Voluntary user fees in hospitals in Buenos Aires, which operate outside official controls, have not featured in other studies of health care in Argentina. After providing a historical overview of different hospital funding sources, the authors focus on the activity of cooperadoras--the organizations responsible for levying voluntary fees. Using detailed data from two case-study hospitals and more general financial sources, they assess the importance of these fees, identifying sharp variations between different hospitals, serious problems of under-reporting, and potential abuses. The authors also examine the means by which fees are levied and the degree of coercion involved. Voluntary fees are not a particularly successful funding strategy: the income they generate is variable; they are almost entirely unregulated; and they sometimes conflict with other, more legitimate funding sources. Most importantly, their voluntaristic aspect is largely notional: most patients are heavily pressured to make payments. The main motivation for continuing with voluntary fees is to avoid the political fallout that would probably result from introduction of a formal user fees policy.
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Affiliation(s)
- P Lloyd-Sherlock
- School of Development Studies, University of East Anglia, Norwich, England.
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Zecchina G, Novick D, Rubinstein M, Barak V, Dinarello C, Nagler A. Interleukin-18 binding protein in acute graft versus host disease and engraftment following allogeneic peripheral blood stem cell transplants. J Hematother Stem Cell Res 2001; 10:769-76. [PMID: 11798503 DOI: 10.1089/152581601317210863] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Dysregulation of the cytokine network plays an important role in graft-versus-host disease (GVHD). Interleukin-18 (IL-18) is an obligatory cytokine for interferon-gamma (IFN-gamma) production and IFN-gamma and sIFN-gammaR are elevated in patients with GVHD. Because IL-18 binding protein (IL-18BP) is an inhibitor of IL-18-mediated IFN-gamma production, we evaluated IL-18BP levels in patients undergoing allogeneic peripheral blood stem cell transplantation (PBSCT). IL-18BP levels were assessed in 14 patients on day -10 (before conditioning), on the day of transplant, on the day of engraftment, and during transplant-related complications. A comparison of the kinetics of IL-18BP and soluble(s) IL-6R, sIFN-gammaR, IL-18 serum levels was performed. IL-18BP levels were assessed by specific monoclonal antibodies in a double-sandwich enzyme-linked immunosorbent assay (ELISA). In all patients IL-18BP levels decreased during conditioning and increased in parallel with engraftment (p < 0.05). Accordingly, during rejection, IL-18BP serum levels remained low and similar to pretransplant levels. The mean elevation of IL-18BP detected in association to acute GVHD was significantly higher in comparison to normal engraftment (p < 0.05). A correlation between IL-18BP, sIFNgammaR, and sIL-6R serum levels was found in all patients. No correlation between IL-18 and IL-18BP serum levels was found in patients undergoing uneventful PBSCT and rejection, whereas a marked increase in both IL-18 and IL-18BP levels was detected during acute GVHD (p < 0.01). Our data suggest that the dysregulation of IL-18 and IL-18BP may be important in the pathophysiology of transplant-related complications. Furthermore, because preliminary data from our group show that IL-18 blockage ameliorates GVHD in murine models, it is inferred that these cytokines may represent potential targets in the development of new therapeutic strategies in acute GVHD.
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Affiliation(s)
- G Zecchina
- Department of Scienze Cliniche e Biologiche Universitá di Torino, Italy
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Abstract
UNLABELLED During the last three decades, we have witnessed dramatic improvements in both the psychosocial and pharmacological treatments of affective disorders. Administered in concert with the new medications advances in pharmacology have produced, disorder-specific psychosocial treatments have further improved the prognosis and course of bipolar and unipolar disorder. METHODS We review our research on unipolar and bipolar disorder and their treatment, in particular interpersonal psychotherapy (IPT) and modifications thereof. RESULTS We provide empirical evidence that IPT is an efficacious acute and maintenance treatment for affective disorders. Our cumulative research and clinical experience suggest that interpersonal relations and circadian and social rhythms influence affective illnesses and that psychotherapy may aid in normalizing problems in these areas for patients with affective illnesses. CONCLUSIONS Despite the excitement generated by the recent progress in research on mental disorders and their treatment, we are yet to fulfill the promise that the explosion of knowledge about targeted pharmacotherapies or psychotherapies would seem to offer. To move our field forward, we must continue to apply scientific rigor and thought to understanding the suitability of current nomenclatures, the impact of comorbid psychiatric and medical illnesses and symptoms on the manifestation and treatment of affective disorders, and the practicality of widespread utilization of new treatments.
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Affiliation(s)
- E Frank
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
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Stuyt RJ, Netea MG, Kim SH, Novick D, Rubinstein M, Kullberg BJ, Van der Meer JW, Dinarello CA. Differential roles of interleukin-18 (IL-18) and IL12 for induction of gamma interferon by staphylococcal cell wall components and superantigens. Infect Immun 2001; 69:5025-30. [PMID: 11447182 PMCID: PMC98596 DOI: 10.1128/iai.69.8.5025-5030.2001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The roles of endogenous cytokines induced by either intact staphylococcal microorganisms or staphylococcal exotoxins were examined using human whole-blood cultures. To accomplish this, interleukin-18 binding protein (IL-18BP) and tumor necrosis factor binding protein (TNFbp) were used to neutralize IL-18 and TNF, respectively, whereas an anti-IL-12 monoclonal antibody was used to neutralize IL-12 and the IL-1 receptor antagonist (IL-1Ra) was used to block IL-1 receptors. Heat-killed Staphylococcus epidermidis and Staphylococcus aureus, as well as the staphylococcal superantigens toxic shock syndrome toxin-1 (TSST-1) and staphylococcus enterotoxin B (SEB) induced gamma interferon (IFN-gamma) production. Staphylococcus spp.-induced production of IFN-gamma required the presence of endogenous IL-18, IL-12, and TNF. In contrast, TSST-1-induced IFN-gamma was not significantly reduced in the presence of IL-18BP, anti-IL-12 antibodies, IL-1Ra, or anti-TNFbp. SEB-induced IFN-gamma was significantly inhibited only by anti-IL-12 antibodies, indicating that endogenous IL-18, IL-1, and TNF are not required for SEB-induced IFN-gamma. In conclusion, the mechanisms of IFN-gamma stimulation by intact staphylococcal microorganisms and by exotoxins differ, and this is likely due to the different receptors which are triggered on the cell membranes. In contrast to its role in the interactions between staphylococci and host cells, IL-18 does not appear to play a major role in superantigen-induced IFN-gamma.
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Affiliation(s)
- R J Stuyt
- Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USA
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Novick D, Schwartsburd B, Pinkus R, Suissa D, Belzer I, Sthoeger Z, Keane WF, Chvatchko Y, Kim SH, Fantuzzi G, Dinarello CA, Rubinstein M. A novel IL-18BP ELISA shows elevated serum IL-18BP in sepsis and extensive decrease of free IL-18. Cytokine 2001; 14:334-42. [PMID: 11497494 DOI: 10.1006/cyto.2001.0914] [Citation(s) in RCA: 210] [Impact Index Per Article: 9.1] [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: 11/22/2022]
Abstract
IL-18 binding protein (IL-18BP) is a circulating antagonist of the proinflammatory Th1 cytokine IL-18. It effectively blocks IL-18 by forming a 1:1 high affinity (Kd=400 pM) complex, exhibiting a very low dissociation rate. We have developed a sandwich ELISA for IL-18BPa and determined its limit of detection (62 pg/ml). Interference by IL-18 and related cytokines, as well as cross reactivity with other IL-18BP isoforms (b, c, and d) were determined. Using this ELISA, we measured serum IL-18BPa in large cohorts of healthy individuals and in septic patients. Serum IL-18BPa in healthy individuals was 2.15+/-0.15 ng/ml (range 0.5-7 ng/ml). In sepsis, the level rose to 21.9+/-1.44 ng/ml (range 4-132 ng/ml). Total IL-18 was measured in the same sera by an electrochemiluminescence assay and free IL-18 was calculated based on the mass action law. Total IL-18 was low in healthy individuals (64+/-17 pg/ml) and most of it ( approximately 85%) was in its free form. Total IL-18 and IL-18BPa were both elevated in sepsis patients upon admission (1.5+/-0.4 ng/ml and 28.6+/-4.5 ng/ml, respectively). At these levels, most of the IL-18 is bound to IL-18BPa, however the remaining free IL-18 is still higher than in healthy individuals. We conclude that IL-18BPa considerably inhibits circulating IL-18 in sepsis. Yet, exogenous administration of IL-18BPa may further reduce circulating IL-18 activity.
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Affiliation(s)
- D Novick
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, 76100, Israel
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