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De Vincentis A, D'Amato D, Cristoferi L, Gerussi A, Malinverno F, Lleo A, Colapietro F, Marra F, Galli A, Fiorini C, Coco B, Brunetto M, Niro GA, Cotugno R, Saitta C, Cozzolongo R, Losito F, Giannini EG, Labanca S, Marzioni M, Marconi G, Morgando A, Pellicano R, Vanni E, Cazzagon N, Floreani A, Chessa L, Morelli O, Muratori L, Pellicelli A, Pompili M, Ponziani F, Tortora A, Rosina F, Russello M, Cannavò M, Simone L, Storato S, Viganò M, Abenavoli L, D'Antò M, De Gasperi E, Distefano M, Scifo G, Zolfino T, Calvaruso V, Cuccorese G, Palitti VP, Sacco R, Bertino G, Frazzetto E, Alvaro D, Mulinacci G, Palermo A, Scaravaglio M, Terracciani F, Galati G, Ronca V, Zuin M, Claar E, Izzi A, Picardi A, Invernizzi P, Vespasiani‐Gentilucci U, Carbone M. Predictors of serious adverse events and non-response in cirrhotic patients with primary biliary cholangitis treated with obeticholic acid. Liver Int 2022; 42:2453-2465. [PMID: 35932095 PMCID: PMC9804305 DOI: 10.1111/liv.15386] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/24/2022] [Accepted: 06/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND & AIMS Obeticholic acid (OCA) has recently been restricted in patients with primary biliary cholangitis (PBC) with "advanced cirrhosis" because of its narrow therapeutic index. We aimed to better define the predicting factors of hepatic serious adverse events (SAEs) and non-response in cirrhotic patients undergoing OCA therapy. METHODS Safety and efficacy of treatment were evaluated in a cohort of consecutive PBC cirrhotic patients started with OCA. OCA response was evaluated according to the Poise criteria. Risk factors for hepatic SAEs and non-response were reported as risk ratios (RR) with 95% confidence intervals (CIs). RESULTS One hundred PBC cirrhotics were included, 97 Child-Pugh class A and 3 class B. Thirty-one had oesophageal varices and 5 had a history of ascites. Thirty-three per cent and 32% of patients achieved a biochemical response at 6 and 12 months respectively. Male sex (adjusted-RR 1.75, 95%CI 1.42-2.12), INR (1.37, 1.00-1.87), Child-Pugh score (1.79, 1.28-2.50), MELD (1.17, 1.04-1.30) and bilirubin (1.83, 1.11-3.01) were independently associated with non-response to OCA. Twenty-two patients discontinued OCA within 12 months: 10 for pruritus, 9 for hepatic SAEs (5 for jaundice and/or ascitic decompensation; 4 for upper digestive bleeding). INR (adjusted-RR 1.91, 95%CI 1.10-3.36), lower albumin levels (0.18, 0.06-0.51), Child-Pugh score (2.43, 1.50-4.04), history of ascites (3.5, 1.85-6.5) and bilirubin (1.30, 1.05-1.56), were associated with hepatic SAEs. A total bilirubin≥1.4 mg/dl at baseline was the most accurate biochemical predictor of hepatic SAEs under OCA. CONCLUSIONS An accurate baseline assessment is crucial to select cirrhotic patients who can benefit from OCA. Although OCA is effective in one third of cirrhotics, bilirubin level ≥1.4 mg/dl should discourage from its use.
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Affiliation(s)
| | - Daphne D'Amato
- Gastroenterology Unit, Città della salute e della scienzaTurinItaly
| | - Laura Cristoferi
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Alessio Gerussi
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Federica Malinverno
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Ana Lleo
- Internal Medicine and Hepatology, Humanitas Clinical and Research Center IRCCSHumanitas UniversityMilanItaly
| | - Francesca Colapietro
- Internal Medicine and Hepatology, Humanitas Clinical and Research Center IRCCSHumanitas UniversityMilanItaly
| | - Fabio Marra
- Internal Medicine and Hepatology Unit, Department of Experimental and Clinical MedicineUniversity of FirenzeFirenzeItaly
| | - Andrea Galli
- Department of Experimental and Clinical Biochemical SciencesUniversity of FlorenceFlorenceItaly
| | - Cecilia Fiorini
- Department of Experimental and Clinical Biochemical SciencesUniversity of FlorenceFlorenceItaly
| | - Barbara Coco
- Hepatology Unit, University Hospital of PisaPisaItaly
| | | | - Grazia Anna Niro
- Gastroenterology Unit, Fondazione Casa Sollievo Della Sofferenza IRCCSSan Giovanni RotondoItaly
| | - Rosa Cotugno
- Gastroenterology Unit, Fondazione Casa Sollievo Della Sofferenza IRCCSSan Giovanni RotondoItaly
| | - Carlo Saitta
- Division of Medicine and HepatologyUniversity Hospital of Messina “Policlinico G. Martino”MessinaItaly
| | - Raffaele Cozzolongo
- Gastroenterology UnitNational Institute of Gastroenterology “S de Bellis” Research HospitalCastellana GrotteItaly
| | - Francesco Losito
- Gastroenterology UnitNational Institute of Gastroenterology “S de Bellis” Research HospitalCastellana GrotteItaly
| | - Edoardo Giovanni Giannini
- Gastroenterology Unit, Department of Internal MedicineUniversity of Genova, IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | - Sara Labanca
- Gastroenterology Unit, Department of Internal MedicineUniversity of Genova, IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | - Marco Marzioni
- Clinic of Gastroenterology and HepatologyUniversità Politecnica delle MarcheAnconaItaly
| | - Giulia Marconi
- Clinic of Gastroenterology and HepatologyUniversità Politecnica delle MarcheAnconaItaly
| | - Anna Morgando
- Gastroenterology Unit, Città della salute e della scienzaTurinItaly
| | | | - Ester Vanni
- Gastroenterology Unit, Città della salute e della scienzaTurinItaly
| | - Nora Cazzagon
- Gastroenterology Unit, Department of Surgery, Oncology and GastroenterologyPadua University HospitalPaduaItaly
| | - Annarosa Floreani
- Gastroenterology Unit, Department of Surgery, Oncology and GastroenterologyPadua University HospitalPaduaItaly
| | - Luchino Chessa
- Liver Unit, University Hospital of CagliariCagliariItaly
| | - Olivia Morelli
- Clinic of Gastroenterology and Hepatology, Department of MedicineUniversità degli Studi di PerugiaPerugiaItaly
| | - Luigi Muratori
- DIMEC Università di Bologna, Policlinico di Sant'OrsolaBolognaItaly
| | | | - Maurizio Pompili
- Internal Medicine and Hepatology Unit, Policlinico GemelliSapienza UniversityRomeItaly
| | - Francesca Ponziani
- Internal Medicine and Hepatology Unit, Policlinico GemelliSapienza UniversityRomeItaly
| | - Annalisa Tortora
- Internal Medicine and Hepatology Unit, Policlinico GemelliSapienza UniversityRomeItaly
| | | | | | | | - Loredana Simone
- Department of GastroenterologyUniversity Hospital Sant'AnnaFerraraItaly
| | - Silvia Storato
- IRCCS Sacro Cuore Institute Don Calabria, GastroenterologyNegrarItaly
| | - Mauro Viganò
- Hepatology Unit, San Giuseppe HospitalMilanItaly
| | - Ludovico Abenavoli
- Department of Health SciencesUniversity “Magna Graecia” of CatanzaroItaly
| | - Maria D'Antò
- Hepatology Unit, Santa Maria delle Grazie HospitalPozzuoliItaly
| | - Elisabetta De Gasperi
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico – Division of Gastroenterology and Hepatology – CRC “A.M. and A. Migliavacca” Center for Liver DiseaseMilanItaly
| | - Marco Distefano
- Department of Infectious DiseasesUmberto I HospitalSyracuseItaly
| | - Gaetano Scifo
- Department of Infectious DiseasesUmberto I HospitalSyracuseItaly
| | - Teresa Zolfino
- Department of GastroenterologyBrotzu HospitalCagliariItaly
| | | | | | | | | | - Gaetano Bertino
- Gastroenterology and Hepatology UnitUniversity Hospital Policlinico Vittorio EmanueleCataniaItaly
| | - Evelise Frazzetto
- Gastroenterology and Hepatology UnitUniversity Hospital Policlinico Vittorio EmanueleCataniaItaly
| | - Domenico Alvaro
- Department of Translational and Precision MedicineUniversity La SapienzaRomeItaly
| | - Giacomo Mulinacci
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Andrea Palermo
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Miki Scaravaglio
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | | | - Giovanni Galati
- Internal Medicine and HepatologyUniversity Campus Bio‐Medico of RomeRomeItaly
| | - Vincenzo Ronca
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | - Massimo Zuin
- Liver and Gastroenterology Unit, Department of Health SciencesUniversita’ degli Studi di MilanoMilanItaly,ASST Santi Paolo e CarloUniversity Hospital San PaoloMilanItaly
| | | | - Antonio Izzi
- Department of Infectious DiseasesD. Cotugno HospitalNapoliItaly
| | - Antonio Picardi
- Internal Medicine and HepatologyUniversity Campus Bio‐Medico of RomeRomeItaly
| | - Pietro Invernizzi
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
| | | | - Marco Carbone
- Division of Gastroenterology, Centre for Autoimmune Liver Diseases, Department of Medicine and SurgeryUniversity of Milano‐Bicocca, European Reference Network on Hepatological Diseases (ERN RARE‐LIVER), San Gerardo HospitalMonzaItaly
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Giorelli M, Altomare S, Aniello MS, Leone R, Liuzzi D, Plasmati I, Sardaro M, Superbo M, Mennea G, Fioretto N, Guglielmi G, Balzano R, Scarabino T, Cuccorese G, Cialdella F, Campobasso G, Barbara M. Lemierre's syndrome complicated by cerebral venous sinus thrombosis: A life threatening and rare disease successfully treated with empiric antimicrobial therapy and conservative approach. Intractable Rare Dis Res 2022; 11:37-39. [PMID: 35261851 PMCID: PMC8898395 DOI: 10.5582/irdr.2021.01142] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/23/2022] [Accepted: 02/06/2022] [Indexed: 11/05/2022] Open
Abstract
Lemierre's syndrome (LS) is a "forgotten" condition characterized by septic thrombophlebitis of the jugular vein that follows an otolaryngological infection. Fusobacterium necrophorum is the aetiological agent responsible for the syndrome in adolescents and young adults whereas in older people even common bacteria are involved. Complications arise from spreading of septic emboli distally, i.e. to the brain, lungs, bones and internal organs everywhere in the body. We report a middle-aged woman who presented with headache and bilateral sixth cranial nerve palsy following a sphenoidal sinusitis and left mastoiditis. Imaging revealed thrombotic involvement of the left internal jugular vein as well as of several cerebral venous sinuses thrombosis (CVT). Currently, precise management protocols of LS with CVT complication do not exist although a combination of macrolides and second or third-generation cephalosporins, as well as anti-coagulants represent the mainstream of therapeutics. Surgical drainage is associated to remove septic foci but is burdened by severe complications and side effects. Complete recovery was achieved following pharmacological treatment in our patient. This report adds further evidence that LS complicated by CVT may be effectively treated adopting a conservative approach thus avoiding surgical drainage and severe complications.
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Affiliation(s)
- Maurizio Giorelli
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
- Address correspondence to:Maurizio Giorelli, Operative Unit of Neurology, "Dimiccoli" General Hospital, Viale Ippocrate 11, Barletta 76121, Italy. E-mail:
| | - Sergio Altomare
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
| | | | - Ruggiero Leone
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Daniele Liuzzi
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
| | | | - Michele Sardaro
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Maria Superbo
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Giuseppe Mennea
- Operative Unit of Internal Medicine, "Bonomo" General Hospital, Andria, Italy
| | - Nicola Fioretto
- Operative Unit of Radiology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Giuseppe Guglielmi
- Operative Unit of Radiology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Rosario Balzano
- Operative Unit of Radiology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Tommaso Scarabino
- Operative Unit of Radiology, "Bonomo" General Hospital, Andria, Italy
| | - Giuseppe Cuccorese
- Operative Unit of Internal Medicine, "Dimiccoli" General Hospital, Barletta, Italy
| | - Francesca Cialdella
- Operative Unit of Otorhinolaryngology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Giuseppe Campobasso
- Operative Unit of Otorhinolaryngology, "Dimiccoli" General Hospital, Barletta, Italy
| | - Michele Barbara
- Operative Unit of Otorhinolaryngology, "Dimiccoli" General Hospital, Barletta, Italy
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3
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Mangia A, Piazzolla V, Giannelli A, Visaggi E, Minerva N, Palmieri V, Carraturo I, Potenza D, Napoli N, Lauletta G, Tagarielli V, Santoro R, Piccigallo E, De Gioia S, Chimenti A, Cuccorese G, Metrangolo A, Mazzola M, Agostinacchio E, Mennea G, Sabbà C, Cela M, Copetti M, Losappio R. Correction: SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience. PLoS One 2019; 14:e0223287. [PMID: 31553772 PMCID: PMC6760782 DOI: 10.1371/journal.pone.0223287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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4
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Mangia A, Piazzolla V, Giannelli A, Visaggi E, Minerva N, Palmieri V, Carraturo I, Potenza D, Napoli N, Lauletta G, Tagarielli V, Santoro R, Piccigallo E, De Gioia S, Chimenti A, Cuccorese G, Metrangolo A, Mazzola M, Agostinacchio E, Mennea G, Sabbà C, Cela M, Copetti M, Losappio R. SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience. PLoS One 2019; 14:e0215783. [PMID: 31091254 PMCID: PMC6519817 DOI: 10.1371/journal.pone.0215783] [Citation(s) in RCA: 18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/08/2019] [Indexed: 12/22/2022] Open
Abstract
Background and objectives The pangenotypic single tablet regimen of NS5B inhibitor sofobuvir (SOF) and NS5A inhibitor velpatasvir (VEL) is advised for 12 weeks in HCV-infected patients including those with compensated cirrhosis. Addition of ribavirin (RBV) may be considered in genotype 3 (GT3) with compensated and is recommended in decompensated cirrhosis. Real-life results with SOF/VEL are limited. To evaluate efficacy and safety in a large real-world-cohort including patients with different GTs and various fibrosis stages. Design In total, 1429 patients were treated with SOF/VEL 400/100 mg for 12 weeks in the Puglia registry between June 2017 and May 2018. 1319 (92.3%) reached week 12 post-treatment (SVR12) at the moment. Only 41 received RBV. Diagnosis of cirrhosis was based on transient elastography and/or APRI or FIB-4 scores. Sensitivity analysis in the population including all patients except non virological failure was conducted. Primary efficacy endpoint was the percentage of patients with SVR12. Results Patients’ mean age was 63.8 years, 42.3% had GT1. The majority were naïve and 735 (55.5%) F0/F2. Of the remaining 587, 282 had cirrhosis. SVR12 was 98.5%, 98.0% in GT1, 99.4% in GT2, 97.1% in GT3, 100% in GT4. Overall, SVR12 by sensitivity analysis was 99.4%; 99.7% among F0-F1. Among 218 PWID, SVR12 was 94.5%. Discontinuation rates were 3.7% among PWID and 0.7% among non-PWID (p = 0.004). Conclusions SOF/VEL treatment of chronic HCV infection reaches very high cure rates in a variety of patients; including those with F0/F1 and PWID.
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Affiliation(s)
- Alessandra Mangia
- Liver Unit, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
- * E-mail:
| | - Valeria Piazzolla
- Liver Unit, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Anna Giannelli
- Infectious Diseases Unit, Presidio Ospedaliero “Vittorio Emanuele II”, Bisceglie, Italy
| | | | - Nicola Minerva
- Internal Medicine “Ospedale Caduti in Guerra”, Canosa, Italy
| | | | | | - Domenico Potenza
- Interventional Ultrasound Unit, Ospedale “A. Perrino”, Brindisi, Italy
| | - Nicola Napoli
- Internal Medicine “C. Frugoni” University of Bari, Bari, Italy
| | | | | | - Rosanna Santoro
- Liver Unit, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | - Ernesto Piccigallo
- Gastroenterology Division Ospedale “S. de Bellis” Castellana Grotte, Italy
| | | | - Angelo Chimenti
- Infectious Diseases Ospedale “SS Annunziata”, Taranto, Italy
| | | | | | - Michele Mazzola
- Infectious Diseases Unit, Presidio Ospedaliero “Vittorio Emanuele II”, Bisceglie, Italy
| | | | | | - Carlo Sabbà
- Gastroenterology “Ospedali Riuniti”, Foggia, Italy
| | - Marina Cela
- Geriatric Unit, Department of interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Massimiliano Copetti
- Biostatistics Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Ruggiero Losappio
- Infectious Diseases Unit, Presidio Ospedaliero “Vittorio Emanuele II”, Bisceglie, Italy
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5
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Ippolito AM, Milella M, Messina V, Conti F, Cozzolongo R, Morisco F, Brancaccio G, Barone M, Santantonio T, Masetti C, Tundo P, Smedile A, Carretta V, Gatti P, Termite AP, Valvano MR, Bruno G, Fabrizio C, Andreone P, Zappimbulso M, Gaeta GB, Napoli N, Fontanella L, Lauletta G, Cuccorese G, Metrangolo A, Francavilla R, Ciracì E, Rizzo S, Andriulli A. HCV clearance after direct-acting antivirals in patients with cirrhosis by stages of liver impairment: The ITAL-C network study. Dig Liver Dis 2017; 49:1022-1028. [PMID: 28487083 DOI: 10.1016/j.dld.2017.03.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sustained virological response (SVR12) rates at 12 weeks after treatment for HCV-infected patients with decompensated cirrhosis are used when referring to those with moderate functional impairment, while few data are available for those with more severe impairment. The use of the cirrhosis staging system proposed by D'Amico might provide new insights on timing for antiviral therapy. METHODS We investigated efficacy (SVR12), safety, and post-treatment variations in clinical and laboratory parameters in 2612 patients with advanced fibrosis (n=575) or cirrhosis (n=2037). Cirrhosis was in the compensated phase (without/with varices) or had previously been in the decompensated stage. Different direct-acting antiviral (DAA) regimens were administered in accordance with scientific guidelines. RESULTS The SVR12 rate was 97.6% in patients with advanced fibrosis. For patients with cirrhosis, the rate was 96.5% in stage 1, 95.1% in stage 2, 100% in stage 3, 95.7% in stage 4, and 93.6% in stage 5. These rates were independent of gender, age, HCV genotype, and treatment schedule. Positive changes in biochemical parameters and CPT classes following therapy were evident in compensated and previously decompensated patients. CONCLUSION Our findings support the use of DAAs in patients with advanced cirrhosis (stages 3-5) who are at greatest risk and have the most to gain from therapy.
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Affiliation(s)
- Antonio Massimo Ippolito
- Division of Gastroenterology, "Casa Sollievo Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Italy.
| | - Michele Milella
- Clinics of Infectious Diseases, University of Bari, Bari, Italy
| | - Vincenzo Messina
- Infectious and Tropical Diseases Unit, S. Anna and S. Sebastiano Hospital, Caserta, Italy
| | - Fabio Conti
- Centre for the Study of Hepatitis, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Raffaele Cozzolongo
- Division of Gastroenterology, "De Bellis" Hospital, IRCCS, Castellana Grotte, Italy
| | - Filomena Morisco
- Division of Gastroenterology, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | | | - Michele Barone
- Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Italy
| | | | - Chiara Masetti
- Hepatology and Liver Transplantation Unit, University of Tor Vergata, Rome, Italy
| | - Paolo Tundo
- Division of Infectious Diseases, "S. Caterina Novella" Hospital, Galatina, Italy
| | - Antonina Smedile
- Department of Medical Sciences, University of Turin and Department of Gastroenterology and Hepatology, Azienda Ospedaliera Città della Salute e della Scienza, Turin, Italy
| | - Vito Carretta
- Liver Unit, Department of Internal Medicine, Hospital of Venosa, Venosa, Italy
| | - Pietro Gatti
- Internal Medicine, Hospital of Ostuni, Ostuni, Italy
| | | | - Maria Rosa Valvano
- Division of Gastroenterology, "Casa Sollievo Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Giuseppe Bruno
- Clinics of Infectious Diseases, University of Bari, Bari, Italy
| | | | - Pietro Andreone
- Centre for the Study of Hepatitis, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Marianna Zappimbulso
- Division of Gastroenterology, "De Bellis" Hospital, IRCCS, Castellana Grotte, Italy
| | | | - Nicola Napoli
- Clinica Medica "C. Frugoni", University of Bari, Bari, Italy
| | - Luca Fontanella
- Centre for Liver Disease, Fatebenefratelli Hospital, Naples, Italy
| | | | - Giuseppe Cuccorese
- Division of Internal Medicine, "Monsignor Di Miccoli" Hospital, Barletta, Italy
| | | | | | | | - Salvatore Rizzo
- Division of Internal Medicine, Hospital of Martina Franca, Martina Franca, Italy
| | - Angelo Andriulli
- Division of Gastroenterology, "Casa Sollievo Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Italy
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6
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Mottola L, Cenderello G, Piazzolla VA, Forte P, Carretta V, Mecenate F, Brancaccio G, Minisini R, Zuin M, Terreni N, Monti M, Colombo AE, Nosotti L, Minerva N, Luzzitelli I, Kostandini A, Cuccorese G, Russello M, Santoro R, Mangia A. Interleukin-28B genetic variants in untreated Italian HCV-infected patients: a multicentre study. Liver Int 2015; 35:482-8. [PMID: 25039676 DOI: 10.1111/liv.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/26/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Different prevalence of favourable IL28BCC genotype have been reported in studies performed in different countries around the world. Data on distribution of IL28B genotypes in healthy Italian subjects are lacking. METHODS Studies on prospectively collected untreated chronic HCV-infected Italian patients led to conflicting results. To investigate the prevalence of IL28B genotypes in untreated HCV-infected patients and in subjects able to clear HCV, and to compare them to the prevalence registered in healthy Italian controls. To evaluate IL28B prevalence across different HCV genotypes. RESULTS IL28BCC was observed in 30.9% of chronic HCV patients, in 71.0% of subjects able to clear HCV infection and in 41.6% of the Italian controls. The frequency of IL28BCC was higher in HCV genotype 2 and 3 than in 1 (38.3 vs. 28.2) (P = 0.02). Levels of ALT higher in IL28BCC than in non-CC were observed regardless of HCV genotypes (P = 0.0014). CONCLUSIONS IL28BCC frequencies progressively decline from subjects with spontaneous HCV clearance to normal non-infected subjects and to chronically infected. This study suggests that patients with IL28BCC, if genotype 1, are able to clear HCV more often than if genotype 2 and 3 infected, and that CC genotype is associated with higher grade of necro-inflammation.
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Affiliation(s)
- Leonardo Mottola
- Liver Unit, Hospital 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
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Mangia A, Cenderello G, Orlandini A, Piazzolla V, Picciotto A, Zuin M, Ciancio A, Brancaccio G, Forte P, Carretta V, Zignego AL, Minerva N, Brindicci G, Marignani M, Baroni GS, Bertino G, Cuccorese G, Mottola L, Ripoli M, Pirisi M. Individualized treatment of genotype 1 naïve patients: an Italian multicenter field practice experience. PLoS One 2014; 9:e110284. [PMID: 25340799 PMCID: PMC4207756 DOI: 10.1371/journal.pone.0110284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/15/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Triple therapy including Telaprevir or Boceprevir still represents in many European countries the standard of care for patients with Hepatitis C Virus genotype 1 infection. The number of patients who received this treatment resulted generally lower than expected. We investigated, among naïve patients, number and characteristics of treatment candidates who were started on triple or dual therapy in comparison to those who were deferred. PATIENTS AND METHODS 621 naïve treatment candidates were prospectively evaluated at each center. Factors associated with decision to defer or treat with dual or triple therapy were investigated by univariate and multivariate analyses. Rates of Sustained Virological Response and safety profile were analysed. RESULTS Of candidates to treatment, 33% did not received it. It was mostly due to high risk of Interferon-induced decompensation. Of 397 patients who were started on treatment, 266 (67%) received triple, 131 dual. Among patient receiving treatment, unfavorable IL28B, severe liver damage and higher albumin were independently associated with the physician decision to administer triple therapy. Sustained Virological Response after dual therapy was 66.4%, after triple 73.7% (p = 0.14). 142 patients received Telaprevir. The choice of Telaprevir-based therapy was associated with higher Body Mass Index and advanced liver disease. Sustained Virological Response rates were 71.1% after Telaprevir and 76.6% after Boceprevir. CONCLUSIONS Individualizing treatment with available regimens allows to maximize Sustained Virological Response and to reduce the number of patients who remain untreated. High proportion of patients with severe liver damage urgently need Interferon free treatment.
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Affiliation(s)
- Alessandra Mangia
- Hospital IRCCS “Casa Sollievo della Sofferenza”, Liver Unit, San Giovanni Rotondo, Italy
| | | | | | - Valeria Piazzolla
- Hospital IRCCS “Casa Sollievo della Sofferenza”, Liver Unit, San Giovanni Rotondo, Italy
| | - Antonio Picciotto
- University of Genova, Department of Internal Medicine, Gastroenterology Unit, Genova, Italy
| | - Massimo Zuin
- “S. Paolo” Hospital, University of Milan, Department of Medicine, Milan, Italy
| | - Alessia Ciancio
- AOU “San Giovanni Battista” - Molinette, Department of Medical Sciences, Torino, Italy
| | | | - Paolo Forte
- “G. Careggi” Hospital, Department of Gastroenterology, Florence, Italy
| | | | - Anna Linda Zignego
- University of Milan, Department of Experimental and Clinical Medicine, Milan, Italy
| | - Nicola Minerva
- Hospital of Canosa, Department of Internal Medicine, Canosa, Italy
| | | | | | | | | | - Giuseppe Cuccorese
- “R. Dimiccoli” Hospital, Department of Gaastroenterology, Barletta, Italy
| | - Leonardo Mottola
- Hospital IRCCS “Casa Sollievo della Sofferenza”, Liver Unit, San Giovanni Rotondo, Italy
| | - Maria Ripoli
- Hospital IRCCS “Casa Sollievo della Sofferenza”, Liver Unit, San Giovanni Rotondo, Italy
| | - Mario Pirisi
- Università degli Studi del Piemonte Orientale, Department of Internal Medicine, Novara, Italy
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Tursi A, Modeo ME, Cascella AM, Cuccorese G, Spinazzola AM, Miglietta A. [Scombroid syndrome with severe and prolonged cardiovascular involvement]. Recenti Prog Med 2001; 92:537-9. [PMID: 11552310] [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: 02/21/2023]
Abstract
Scombroid poisoning is a form of ichthyosarcotoxism caused by eating spoiled fish, mainly of the scombroid family. Inappropriate storage of these fish can lead to the decarboxylation of histidine in the flesh to histamine by enterobacteria. The symptoms of histamine poisoning mimic those of an IgE-mediated food allergy, as well as flushing, headache, diarrhea and palpitations. However, in some cases, the scombroid poisoning can be characterized by very serious symptoms, as well as cardiovascular compromission. We describe two cases of scombroid poisoning with severe hypotension requiring continuous intravenous dopamine with resolution of symptoms only several hours later.
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Affiliation(s)
- A Tursi
- Divisione di Medicina Interna, ospedale Umberto I, Barletta.
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Tursi A, Modeo ME, Cuccorese G, Cascella AM, Spinazzola AM, Miglietta A. [Pancytopenia caused by ticlopidine treated with filgrastim. Description of a case]. Recenti Prog Med 2000; 91:511-2. [PMID: 11072739] [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: 02/18/2023]
Abstract
Ticlopidine is an antiplatelet agent that is used to reduce the occurrence of atherothrombotic arterial events, but it can sometime cause severe haematological side-effects. We describe the case of a 79-year old woman suffering from ischaemic cardiopathy and chronic cerebral vasculopathy treated with ticlopidine, who developed a rare pancytopenia on the 26th day of ticlopidine treatment. The patient was successful treated with intravenous antibiotics and with filgrastim, with complete reversion of the pancytopenia.
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Affiliation(s)
- A Tursi
- Divisione di Medicina, Ospedale Civile Umberto I, Barletta
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Cuccorese G, Tursi A, Spinazzola AM, Modeo ME, Miglietta A. Biochemical and virological changes in serum of nonresponder or relapser chronic hepatitis C patients retreated with interferon and ribavirin followed by interferon alone. Am J Gastroenterol 2000; 95:2399-400. [PMID: 11007262 DOI: 10.1111/j.1572-0241.2000.02353.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Lapadula G, Muolo P, Semeraro F, Covelli M, Brindicci D, Cuccorese G, Francavilla A, Pipitone V. Esophageal motility disorders in the rheumatic diseases: a review of 150 patients. Clin Exp Rheumatol 1994; 12:515-21. [PMID: 7842532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Rheumatic diseases are a group of systemic disorders that may be concurrent with Raynaud's phenomenon and involvement of the internal organs, in particular the esophagus. Esophageal motor abnormalities have been widely described in systemic sclerosis, but have not frequently been reported in other diseases. In the present study we have examined the prevalence and pattern of esophageal motility disorders in different rheumatic diseases. METHODS Esophageal manometry was performed on 150 patients, 21 males and 129 females, suffering from different rheumatic diseases (SSc, RA, SLE, MCTD, undifferentiated CTD, or DM/PM) and on 30 healthy controls. RESULTS Functional involvement of the esophagus was demonstrated in all the rheumatic diseases considered, although at varying percentages. The frequencies of the functional abnormalities differed when each disease was considered separately. In SSc patients abnormalities were found more frequently in the lower esophageal sphincter (81.8%) and in the esophageal body (84.8%); data for the DM/PM and MCTD patients broadly overlapped. On the contrary, in SLE the lower sphincter appeared to be less (or even not at all) impaired, while the most specific disorder was an isolated abnormal peristalsis. RP did not always correlate with manometric changes in all of the groups studied. CONCLUSIONS Three conclusions derive from our study: i) motor disorders affecting the esophagus were not only found in SSc, but also in all forms of non-lupus CTD; ii) the simultaneous involvement of the esophageal body and the lower esophageal sphincter is discriminant between non-lupus CTD and SLE; and iii) RP may be regarded as a condition pathogenetically unrelated to manometrically detected esophageal motor abnormalities.
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Affiliation(s)
- G Lapadula
- Department of Rheumatology, University of Bari, Italy
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