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Nunes J, Fettem S, Tahri S, Macke L, Chourak H, Barateau A, Lafond C, de Crevoisier R, Bessieres I, Marage L, Acosta O. PO-1611 Evaluation of synthetic-CT generated from prostate MRI (0.35T) with a 2D+ Pix2Pix method. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03575-7] [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: 10/18/2022]
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Phimphasone-Brady P, Chiao J, Karamsetti L, Sieja A, Johnson R, Macke L, Lum H, Lee R, Farro S, Loeb D, Schifeling C, Huebschmann AG. Clinician and staff perspectives on potential disparities introduced by the rapid implementation of telehealth services during COVID-19: a mixed-methods analysis. Transl Behav Med 2021; 11:1339-1347. [PMID: 34132810 PMCID: PMC8344776 DOI: 10.1093/tbm/ibab060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic has rapidly altered ambulatory health care delivery and may have worsened disparities in health care access. To assess the telehealth implementation experiences of ambulatory personnel in different disciplines and their perspectives on potential telehealth disparities, and to make recommendations for more equitable telehealth delivery. We used a convergent parallel mixed-methods design. Clinic managers from geriatric medicine, internal medicine, and psychiatry e-mailed a survey to clinicians and staff regarding experiences with telehealth care delivery. Quantitative survey responses were analyzed with Fisher's Exact tests. Qualitative responses were coded thematically. Recommendations were categorized by type of implementation strategy. Quantitative and qualitative findings on telehealth disparities were merged in a joint data display. Respondents (n = 147, 57% response rate) were distributed across three specialties: 66% internal medicine, 19% psychiatry, and 14% geriatric medicine. Prior to 2020, 77% of clinicians had never delivered telehealth services. By Spring 2020, 78% reported conducting more than half of clinic visits by telehealth. Among clinicians, 52% agreed/strongly agreed that rapid telehealth implementation exacerbated access to care disparities to: older adult patients, those with limited internet access, and those needing interpretation services. Staff expressed similar difficulties with telehealth set-up especially for these patients. To improve telehealth equity, clinicians recommended to: (i) change infrastructure; (ii) train and educate stakeholders; and (iii) support clinicians. Clinicians and staff reported specific subpopulations had challenges in accessing telehealth visits. To avoid perpetuating telehealth access disparities, further co-discovery of equitable implementation strategies with patients and clinics are urgently needed.
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Affiliation(s)
| | - J Chiao
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - L Karamsetti
- Department of Psychiatry, University of Colorado, Aurora, CO, USA
| | - A Sieja
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - R Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - L Macke
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - H Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - R Lee
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - S Farro
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - D Loeb
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - C Schifeling
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - A G Huebschmann
- Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO, USA
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von Richter O, Skerjanec A, Afonso M, Sanguino Heinrich S, Poetzl J, Woehling H, Velinova M, Koch A, Kollins D, Macke L, Wuerth G. GP2015, a proposed etanercept biosimilar: Pharmacokinetic similarity to its reference product and comparison of its autoinjector device with prefilled syringes. Br J Clin Pharmacol 2016; 83:732-741. [PMID: 27790726 PMCID: PMC5346872 DOI: 10.1111/bcp.13170] [Citation(s) in RCA: 28] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/14/2016] [Accepted: 10/23/2016] [Indexed: 01/25/2023] Open
Abstract
Aims To assess pharmacokinetics (PK) and safety of GP2015, a proposed etanercept biosimilar, in two studies: comparison with etanercept originator (ETN, bioequivalence study) and comparison of GP2015 administered via an autoinjector (AI) or prefilled syringes (PFS, delivery study). Methods Both studies were randomized, two‐sequence, two‐period, crossover studies conducted in healthy male subjects. In the bioequivalence study, subjects were randomized to receive a single 50 mg subcutaneous (s.c.) injection of GP2015 or ETN. In the delivery study, subjects were randomized to receive a single 50 mg s.c. injection of GP2015 via AI or PFS. Following a wash‐out period of 35 days, subjects in the bioequivalence study received single 50 mg s.c. injection of GP2015 or ETN, and subjects in the delivery study received single 50 mg s.c. injection of GP2015 via AI or PFS. Results The geometric mean ratios (90% confidence interval) of GP2015/ETN for Cmax (1.11 [1.05–1.17]), AUC0–tlast (0.98 [0.94–1.02]) and AUC0–inf (0.96 [0.93–1.00]) were within the predefined bioequivalence range of 0.80–1.25. The geometric mean ratios (90% confidence interval) of AI/PFS for Cmax (1.01 [0.94–1.08]), AUC0–tlast (1.01 [0.95–1.07]) and AUC0–inf (1.01 [0.96–1.07]) were also within the range 0.80–1.25. No new safety issues were reported. Three subjects had low titres of non‐neutralising anti‐drug antibodies during a follow‐up visit in the bioequivalence study. Conclusions The PK of GP2015 was similar to ETN, demonstrating bioequivalence. The safety profile of GP2015 was consistent with previous reports for ETN. The GP2015 AI provided equivalent dosing and tolerability to the GP2015 PFS.
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Affiliation(s)
- Oliver von Richter
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - Andrej Skerjanec
- Global Clinical Development, Biopharmaceuticals, Sandoz AG, Basel, Switzerland
| | - Miguel Afonso
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | | | - Johann Poetzl
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - Heike Woehling
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | | | - Annelize Koch
- PAREXEL Early Phase Clinical Unit, Northwick Park Hospital, Harrow, UK
| | - Dmitrij Kollins
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - Lars Macke
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - Guido Wuerth
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
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Afonso M, Kollins D, Macke L, Woehling H, Wuerth G. THU0144 Pharmacokinetics and Safety of GP2015, A Proposed Etanercept Biosimilar, Administered Subcutaneously by An Autoinjector or Prefilled Syringe in Healthy Male Subjects. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Garritsen HS, Macke L, Meyring W, Hannig H, Pägelow U, Wörmann B, Geffers R, Dittmar KE, Lindenmaier W. Efficient generation of clinical-grade genetically modified dendritic cells for presentation of multiple tumor-associated proteins. Transfusion 2010; 50:831-42. [DOI: 10.1111/j.1537-2995.2009.02519.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Dittmar KEJ, Simann M, Zghoul N, Schön O, Meyring W, Hannig H, Macke L, Dirks WG, Miller K, Garritsen HSP, Lindenmaier W. Quality of Cell Products: Authenticity, Identity, Genomic Stability and Status of Differentiation. ACTA ACUST UNITED AC 2010; 37:57-64. [PMID: 20737047 DOI: 10.1159/000284401] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 09/28/2009] [Indexed: 11/19/2022]
Abstract
Cellular therapies that either use modifications of a patient's own cells or allogeneic cell lines are becoming in vogue. Besides the technical issues of optimal isolation, cultivation and modification, quality control of the generated cellular products are increasingly being considered to be more important. This is not only relevant for the cell's therapeutic application but also for cell science in general. Recent changes in editorial policies of respected journals, which now require proof of authenticity when cell lines are used, demonstrate that the subject of the present paper is not a virtual problem at all. In this article we provide 2 examples of contaminated cell lines followed by a review of the recent developments used to verify cell lines, stem cells and modifications of autologous cells. With relative simple techniques one can now prove the authenticity and the quality of the cellular material of interest and therefore improve the scientific basis for the development of cells for therapeutic applications. The future of advanced cellular therapies will require production and characterization of cells under GMP and GLP conditions, which include proof of identity, safety and functionality and absence of contamination.
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Affiliation(s)
- Kurt E J Dittmar
- Department of Molecular Biotechnology, Helmholtz Centre for Infection Research (HZI) Braunschweig, Braunschweig, Germany
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Macke L, Garritsen HSP, Meyring W, Hannig H, Pägelow U, Wörmann B, Piechaczek C, Geffers R, Rohde M, Lindenmaier W, Dittmar KEJ. Evaluating maturation and genetic modification of human dendritic cells in a new polyolefin cell culture bag system. Transfusion 2009; 50:843-55. [PMID: 20003054 DOI: 10.1111/j.1537-2995.2009.02520.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Dendritic cells (DCs) are applied worldwide in several clinical studies of immune therapy of malignancies, autoimmune diseases, and transplantations. Most legislative bodies are demanding high standards for cultivation and transduction of cells. Closed-cell cultivating systems like cell culture bags would simplify and greatly improve the ability to reach these cultivation standards. We investigated if a new polyolefin cell culture bag enables maturation and adenoviral modification of human DCs in a closed system and compare the results with standard polystyrene flasks. STUDY DESIGN AND METHODS Mononuclear cells were isolated from HLA-A*0201-positive blood donors by leukapheresis. A commercially available separation system (CliniMACS, Miltenyi Biotec) was used to isolate monocytes by positive selection using CD14-specific immunomagnetic beads. The essentially homogenous starting cell population was cultivated in the presence of granulocyte-macrophage-colony-stimulating factor and interleukin-4 in a closed-bag system in parallel to the standard flask cultivation system. Genetic modification was performed on Day 4. After induction of maturation on Day 5, mature DCs could be harvested and cryopreserved on Day 7. During the cultivation period comparative quality control was performed using flow cytometry, gene expression profiling, and functional assays. RESULTS Both flasks and bags generated mature genetically modified DCs in similar yields. Surface membrane markers, expression profiles, and functional testing results were comparable. The use of a closed-bag system facilitated clinical applicability of genetically modified DCs. CONCLUSIONS The polyolefin bag-based culture system yields DCs qualitatively and quantitatively comparable to the standard flask preparation. All steps including cryopreservation can be performed in a closed system facilitating standardized, safe, and reproducible preparation of therapeutic cells.
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Affiliation(s)
- Lars Macke
- Department of Molecular Biotechnology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
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