1
|
Hess G, Dreyling M, Oberic L, Gine E, Luigi Zinzani P, Linton K, Vilmar A, Jerkeman M, Chen JMH, Ohler A, Stilgenbauer S, Thieblemont C, Lambert J, Ruggero Zilioli V, Sancho JM, Jimenez Ubieto A, Fischer L, Eyre TA, Keeping S, Park JE, Wu JJ, Siddiqi R, Reitan J, Wade S, Salles G. Real-world experience among patients with relapsed/refractory mantle cell lymphoma after Bruton tyrosine kinase inhibitor failure in Europe: The SCHOLAR-2 retrospective chart review study. Br J Haematol 2023; 202:749-759. [PMID: 36257914 PMCID: PMC10812379 DOI: 10.1111/bjh.18519] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Received: 06/14/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022]
Abstract
Mantle cell lymphoma (MCL) after relapse is associated with poor prognosis. No standard of care exists and available evidence for treatments is limited, particularly in patients who fail Bruton tyrosine kinase inhibitor (BTKi) therapy. This multicentre retrospective chart review study, SCHOLAR-2, addresses this knowledge gap and reports on data collected from 240 patients with relapsed/refractory MCL in Europe who were treated with BTKi-based therapy between July 2012 and July 2018, and had experienced disease progression while on BTKi therapy or discontinued BTKi therapy due to intolerance. The median overall survival (OS) from initiation of first BTKi therapy was 14.6 months (95% confidence interval [CI] 11.6-20.0) in the overall cohort, 5.5 months (95% CI 3.9-8.2) in 91 patients without post-BTKi therapy, and 23.8 months (95% CI 18.9-30.1) in 149 patients who received post-BTKi therapy (excluding chimeric antigen receptor T-cell treatment). In the latter group, patients received a median of one (range, one to seven) line of post-BTKi therapy, with lenalidomide-containing regimens and bendamustine plus rituximab being the most frequently administered; the median OS from initiation of first post-BTKi therapy was 9.7 months (95% CI 6.3-12.7). These results provide a benchmark for survival in patients with R/R MCL receiving salvage therapy after BTKi failure.
Collapse
Affiliation(s)
- Georg Hess
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | | | - Eva Gine
- GELTAMO, Hematology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia “Seràgnoli”, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Kim Linton
- The Manchester Cancer Research Center, Manchester, United Kingdom
| | | | - Mats Jerkeman
- Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden
| | | | - Anke Ohler
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | | | - Jonathan Lambert
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Juan-Manuel Sancho
- GELTAMO, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Luca Fischer
- Medizinische Klinik III, LMU Klinikum, Munich, Germany
| | | | | | | | | | | | | | - Sally Wade
- Wade Outcomes Research & Consulting, Salt Lake City, USA
| | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| |
Collapse
|
2
|
Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT, Timmerman JM, Holmes H, Jaglowski S, Flinn IW, McSweeney PA, Miklos DB, Pagel JM, Kersten MJ, Bouabdallah K, Khanal R, Topp MS, Houot R, Beitinjaneh A, Peng W, Fang X, Shen RR, Siddiqi R, Kloos I, Reagan PM. Three-Year Follow-Up of KTE-X19 in Patients With Relapsed/Refractory Mantle Cell Lymphoma, Including High-Risk Subgroups, in the ZUMA-2 Study. J Clin Oncol 2023; 41:555-567. [PMID: 35658525 PMCID: PMC9870225 DOI: 10.1200/jco.21.02370] [Citation(s) in RCA: 75] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Brexucabtagene autoleucel (KTE-X19) autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is approved for the treatment of relapsed/refractory mantle cell lymphoma (MCL). Outcomes after a 3-year follow-up in the pivotal ZUMA-2 study of KTE-X19 in relapsed/refractory MCL are reported, including for subgroups by prior therapy (bendamustine and type of Bruton tyrosine kinase inhibitor [BTKi]) or high-risk characteristics. METHODS Patients with relapsed/refractory MCL (one to five prior therapies, including prior BTKi exposure) received a single infusion of KTE-X19 (2 × 106 CAR T cells/kg). RESULTS After a median follow-up of 35.6 months, the objective response rate among all 68 treated patients was 91% (95% CI, 81.8 to 96.7) with 68% complete responses (95% CI, 55.2 to 78.5); medians for duration of response, progression-free survival, and overall survival were 28.2 months (95% CI, 13.5 to 47.1), 25.8 months (95% CI, 9.6 to 47.6), and 46.6 months (95% CI, 24.9 to not estimable), respectively. Post hoc analyses showed that objective response rates and ongoing response rates were consistent among prespecified subgroups by prior BTKi exposure or high-risk characteristics. In an exploratory analysis, patients with prior bendamustine benefited from KTE-X19, but showed a trend toward attenuated T-cell functionality, with more impact of bendamustine given within 6 versus 12 months of leukapheresis. Late-onset toxicities were infrequent; only 3% of treatment-emergent adverse events of interest in ZUMA-2 occurred during this longer follow-up period. Translational assessments revealed associations with long-term benefits of KTE-X19 including high-peak CAR T-cell expansion in responders and the predictive value of minimal residual disease for relapse. CONCLUSION These data, representing the longest follow-up of CAR T-cell therapy in patients with MCL to date, suggest that KTE-X19 induced durable long-term responses with manageable safety in patients with relapsed/refractory MCL and may also benefit those with high-risk characteristics.
Collapse
Affiliation(s)
- Michael Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX,Michael Wang, MD, Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; Twitter: @michaelwangmd; e-mail:
| | | | - Andre Goy
- John Theurer Cancer Center, Hackensack University, Hackensack, NJ
| | | | | | | | | | | | | | - Ian W. Flinn
- Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN
| | | | | | | | - Marie José Kersten
- Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands, on behalf of HOVON/LLPC
| | - Krimo Bouabdallah
- CHU Bordeaux, Service d’Hématologie et thérapie Cellulaire, Bordeaux, France
| | | | - Max S. Topp
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Roch Houot
- CHU Rennes, Université Rennes, INSERM & EFS, Rennes, France
| | | | | | - Xiang Fang
- Kite, a Gilead Company, Santa Monica, CA
| | | | | | | | | |
Collapse
|
3
|
Wang M, Munoz J, Goy A, Locke FL, Jacobson CA, Hill BT, Timmerman J, Holmes H, Flinn IW, Miklos DB, Pagel JM, Kersten MJ, Houot R, Beitinjaneh A, Peng W, Fang X, Shen R, Siddiqi R, Kloos I, Reagan PM. Three-year follow-up of outcomes with KTE-X19 in patients with relapsed/refractory mantle cell lymphoma in ZUMA-2. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7518] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
Abstract
7518 Background: Brexucabtagene autoleucel (KTE-X19) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for the treatment of patients (pts) with relapsed/refractory (R/R) mantle cell lymphoma (MCL). In ZUMA-2, a 93% objective response rate (ORR; 67% complete response [CR] rate) was reported with KTE-X19 in pts with R/R MCL (median follow-up: 12.3 mo; 60 efficacy-evaluable pts; Wang et al. N Engl J Med. 2020). Here, we present updated outcomes with 2 years of additional follow-up. Methods: Adult pts (≥18 years) with R/R MCL underwent leukapheresis and conditioning chemotherapy followed by a single infusion of KTE-X19. Minimal residual disease (MRD) was an exploratory endpoint (sensitivity 10-5) evaluated in peripheral blood using next-generation sequencing. Updated results are reported for all 68 treated pts. Results: After 35.6 mo median follow-up, the ORR (CR + partial response) was 91% (95% CI, 81.8-96.7), with a 68% CR rate (95% CI, 55.2-78.5). The median duration of response (DOR) was 28.2 mo (95% CI, 13.5-47.1), with 25 of 68 treated pts (37%) still in ongoing response (all CR) at data cutoff. Late relapse > 24 mo post-infusion was infrequent (n = 3). The medians for progression-free survival (PFS) and overall survival (OS) were 25.8 mo (95% CI, 9.6-47.6) and 46.6 mo (95% CI, 24.9-not estimable), respectively. MRD was analyzed in 29 pts total; 24 of 29 were MRD-negative at mo 1, and 15 of 19 with available data were MRD-negative at mo 6. At data cutoff, the medians for DOR, PFS, and OS in the 15 MRD-negative pts were all not reached, vs 6.1, 7.1, and 27.0 mo, in the 4 MRD-positive pts, respectively. MRD-negative status at mo 1, 3, and 6 was associated with durable response, with 55%, 71%, and 69% of MRD-negative pts at those timepoints remaining in ongoing CR at data cutoff. Circulating tumor DNA analysis of MRD at mo 3 and 6 was predictive of relapse (AUC 0.80 and 0.75, respectively). No new safety signals were observed. Only 3% of treatment-emergent adverse events (AEs) of interest occurred since the primary report. The most frequent Grade ≥3 AE was neutropenia (1 [1%] Grade 3; 7 [10%] Grade 4). Two pts had KTE-X19-related Grade 3 serious infections: pneumonia and upper respiratory tract infection (n = 1); influenza (n = 1). There were no new cytokine release syndrome AEs and 1 new serious neurologic AE of Grade 3 encephalopathy (13.0 mo post-infusion) that was considered not related to study treatment. Three new Grade 5 AEs occurred, none of which were considered related to study treatment: Salmonella bacteremia (24.9 mo post-infusion), myelodysplastic syndrome (25.2 mo post-infusion), and acute myeloid leukemia (37.5 mo post-infusion). Conclusions: These data represent the longest follow-up of CAR T-cell therapy in pts with MCL to date and suggest that KTE-X19 induces durable long-term responses with manageable safety and low late relapse potential in R/R MCL. Clinical trial information: NCT02601313.
Collapse
Affiliation(s)
- Michael Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Andre Goy
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
| | | | | | | | - John Timmerman
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | | | - Ian W. Flinn
- Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN
| | | | | | | | - Roch Houot
- CHU Rennes, Université Rennes, INSERM & EFS, Rennes, France
| | | | | | - Xiang Fang
- Kite, a Gilead Company, Santa Monica, CA
| | - Rhine Shen
- Kite, a Gilead Company, Santa Monica, CA
| | | | | | | |
Collapse
|
4
|
Petersohn S, Salles G, Wang M, Wu J, Wade SW, Simons CL, Bennison C, Siddiqi R, Peng W, Kloos I, Castaigne G, Hess G. Cost-effectiveness analysis of KTE-X19 CAR T therapy versus real-world standard of care in patients with relapsed/refractory mantle cell lymphoma post BTKi in England. J Med Econ 2022; 25:730-740. [PMID: 35611697 DOI: 10.1080/13696998.2022.2079317] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS The objective of this study is to estimate the cost-effectiveness of KTE-X19 versus standard of care (SoC) in the treatment of patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL) post-Bruton tyrosine kinase inhibitor (BTKi) treatment from a UK healthcare perspective. MATERIALS AND METHODS A three-state partitioned survival model (pre-progression, post-progression and death) with a cycle length of one month was used to extrapolate progression-free and overall survival over a lifetime horizon. Population inputs along with KTE-X19 (brexucabtagene autoleucel) efficacy and safety data were derived from the single-arm trial ZUMA-2 (NCT02601313). The composition of SoC was informed by a literature-based meta-analysis, SoC efficacy data were obtained from the SCHOLAR-2 real-world study. Survival was modelled using standard parametric curves for SoC and a mixture-cure methodology for KTE-X19. It was assumed that patients whose disease had not progressed after five years experienced long-term remission. Costs, resource use and utility, and adverse event disutility inputs were obtained from published literature and publicly available data sources. An annual discount rate of 3.5% was applied to costs and health outcomes. Modelled outcomes for KTE-X19 and SoC included expected life years (LY), quality-adjusted life years (QALY) and total costs. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. RESULTS Estimated median survival was 5.96 years for KTE-X19 and 1.38 for SoC. Discounted LYs, QALYs and lifetime costs were 8.27, 5.99 and £385,765 for KTE-X19 versus 1.98, 1.48 and £79,742 for SoC, respectively. The KTE-X19 versus SoC cost per QALY was £67,713 and the cost per LY was £48,645. Influential scenario analyses use alternative KTE-X19 survival curves and discount rates, and shorter time horizons. CONCLUSION Considering the survival and quality of life benefits compared to SoC, KTE-X19 for R/R MCL appears as a cost-effective treatment in the real-world UK setting.
Collapse
Affiliation(s)
| | - Gilles Salles
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, United States
| | - Michael Wang
- Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Jim Wu
- Kite, a Gilead Company, Santa Monica, United States
| | - Sally W Wade
- Wade Outcomes Research and Consulting, Salt Lake City, United States
| | | | | | | | - Weimin Peng
- Kite, a Gilead Company, Santa Monica, United States
| | - Ioana Kloos
- Kite, a Gilead Company, Santa Monica, United States
| | | | - Georg Hess
- Department of Hematology, Oncology and Pneumology University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
5
|
Mohiuddin H, Siddiqi R, Aijaz P. Pesticide poisoning in Pakistan: the need for public health reforms. Public Health 2016; 141:185. [PMID: 27931997 DOI: 10.1016/j.puhe.2016.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/14/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
Affiliation(s)
- H Mohiuddin
- Dow Medical College, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi 74200, Pakistan.
| | - R Siddiqi
- Dow Medical College, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi 74200, Pakistan
| | - P Aijaz
- Dow Medical College, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi 74200, Pakistan
| |
Collapse
|
6
|
Naz S, Siddiqi R, Sheikh H, Sayeed S. Corrigendum to “Deterioration of olive, corn and soybean oils due to air, light, heat and deep-frying” [Food Res. Int. 38 (2005) 127–134]. Food Res Int 2013. [DOI: 10.1016/j.foodres.2012.12.014] [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: 10/27/2022]
|
7
|
Goudie S, Dreyer S, Siddiqi R. Modified mattress suture. Ann R Coll Surg Engl 2012. [PMID: 22943246 PMCID: PMC3954391 DOI: 10.1308/003588412x13373405385214k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
8
|
Goudie S, Dreyer S, Siddiqi R. Modified mattress suture. Ann R Coll Surg Engl 2012; 94:366. [DOI: 10.1308/rcsann.2012.94.5.366] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
9
|
|
10
|
Abstract
AIM To evaluate whether previous isotretinoin use induces permanent, measurable, and clinically significant abnormalities in night vision such that flying is precluded, and whether potential military and civilian commercial aviators should be screened routinely. METHODS A retrospective, non-interventional, consecutive case series of 47 individuals with a confirmed history of oral isotretinoin use were compared to 20 age and sex matched controls. RESULTS 47 individuals (44 males and three females), age range 17-33, underwent Goldmann-Weekers dark adaptation (DA) and standard electroretinogram (ERG) according to ISCEV protocols. 34 patients showed no abnormality in any parameters. Two patients had abnormal DA and ERGs. The mean scotopic ERG b wave amplitude of the isotretinoin group was 496.5 microV (SD 51.3 microV) compared with 501.7 microV (62.3.1 microV) among the controls. The group mean a:b ratio was 0.55 (0.04) compared to 0.69 (0.08) in the controls. CONCLUSION Previous use of isotretinoin may have caused retinal toxicity in two subjects and laboratory evidence of night blindness in 11 further subjects. One subject had subclinical changes remaining in the ERG 96 months after cessation of isotretinoin. This may justify the directed use of electrophysiological screening in professions that are night vision critical.
Collapse
Affiliation(s)
- S P Mollan
- Birmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham B18 7QH, UK.
| | | | | | | | | | | |
Collapse
|
11
|
Patil BB, Mowatt L, Ho S, Scott RA, Siddiqi R. Asymptomatic bilateral simultaneous rhegmatogenous retinal detachments. Eye (Lond) 2004; 19:820-1; author reply 821-2. [PMID: 15375368 DOI: 10.1038/sj.eye.6701659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
12
|
Affiliation(s)
- R Siddiqi
- Weill Medical College of Cornell University, New York, NY 10021, USA.
| | | |
Collapse
|
13
|
|
14
|
Hany OE, Siddiqi R, Khan MA. Growth response of Listeria monocytogenes NCTC 7973 in two different media at four incubation temperatures. Ann Acad Med Singap 1993; 22:300-2. [PMID: 8373108] [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: 01/30/2023]
Abstract
Listeria monocytogenes NCTC 7973 was cultivated in tryptose phosphate broth (TPB) and tryptone soya broth (TSB) at four different temperatures: 4 degrees, 20 degrees, 30 degrees and 37 degrees C. Cells grown in TSB at 20 degrees C displayed maximum absorbance over cells grown in TPB at the same temperature. Moreover, this observation was further confirmed by dry mass determination and viable count. We determined that cells grown in TSB at 20 degrees C exhibited significant enhanced growth as compared to cells grown in TPB at the same temperature, hence TSB was found to be the medium of choice for maximum biomass production.
Collapse
Affiliation(s)
- O E Hany
- Department of Microbiology, University of Karachi, Pakistan
| | | | | |
Collapse
|
15
|
Abstract
Different serovars of Listeria monocytogenes grew well in a chemically defined medium. Sixteen amino acids were tested for the growth of L. monocytogenes. Most strains required cystine, valine, isoleucine, and leucine. Phenylalanine was a stimulatory growth factor for all six strains of Listeria. Whilst tryptophan was essentially required by NCTC 7973, LM and C-286 and stimulatory for 4155 and C-294, none of the strains did exhibit requirements of asparagine, glutamine, proline, histidine and tyrosine as essential/stimulatory growth factor.
Collapse
Affiliation(s)
- R Siddiqi
- Department of Microbiology, University of Karachi, Pakistan
| | | |
Collapse
|
16
|
Brodsky MA, Allen BJ, Bessen M, Luckett CR, Siddiqi R, Henry WL. Beta-blocker therapy in patients with ventricular tachyarrhythmias in the setting of left ventricular dysfunction. Am Heart J 1988; 115:799-808. [PMID: 2895576 DOI: 10.1016/0002-8703(88)90882-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [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: 01/03/2023]
Abstract
Although several studies suggest beta blockers (BB) are effective in suppressing ventricular arrhythmias, less is known about their role in the treatment of patients with ventricular tachyarrhythmias associated with impaired left ventricular function. To assess the tolerance and efficacy of these agents, 32 patients presenting with either ventricular fibrillation (18) or sustained ventricular tachycardia (14) were studied during BB therapy. Left ventricular dysfunction (mean ejection fraction 29%) was present as a consequence of coronary artery disease (26) or cardiomyopathy (6). Baseline arrhythmia assessment revealed recurrent ventricular tachycardia in all patients. Antiarrhythmic drug therapy including BB was guided by programmed stimulation (10), exercise testing (8), ambulatory monitoring (12), or was given empirically (2). Beta blockers were well tolerated, as measured by exercise duration, which improved significantly, and by long-term maintenance, which continued in 23 of 32 (72%) patients. Over a mean follow-up of 668 days, patients treated with BB had a relatively low incidence of both sudden (3%) and nonsudden (9%) death. Thus, BB can be effective and well tolerated adjunct therapy in patients with a history of ventricular tachyarrhythmias in the setting of impaired left ventricular function.
Collapse
Affiliation(s)
- M A Brodsky
- Division of Cardiology, University of California, Irvine Medical Center, Orange 92668
| | | | | | | | | | | |
Collapse
|
17
|
Au PK, Bhandari AK, Bream R, Schreck D, Siddiqi R, Rahimtoola SH. Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia. J Am Coll Cardiol 1987; 9:389-97. [PMID: 2433319 DOI: 10.1016/s0735-1097(87)80394-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The proarrhythmic effects of class IA antiarrhythmic drugs were prospectively evaluated during programmed ventricular stimulation in 24 consecutive patients with frequent ventricular premature beats whose baseline study, performed while no antiarrhythmic drugs were being taken, showed no inducible sustained ventricular arrhythmias. No patient had nonsustained (greater than 5 beats) or sustained ventricular tachycardia by history or baseline 24 hour ambulatory electrocardiographic monitoring. Sequential stimulation studies using up to three extra-stimuli were performed after administration of procainamide, quinidine and disopyramide on different days. Proarrhythmic response was defined as induction of one or more of the following: sustained monomorphic ventricular tachycardia; sustained polymorphic ventricular tachycardia; ventricular fibrillation; reproducibly inducible nonsustained monomorphic ventricular tachycardia. During 55 antiarrhythmic drug trials (24 of procainamide, 21 of quinidine, 10 of disopyramide) in the 24 patients, 6 patients had a proarrhythmic response: sustained monomorphic ventricular tachycardia in 3, ventricular fibrillation in 2, nonsustained monomorphic ventricular tachycardia in 1. Thus, 11% of drug trials resulted in a proarrhythmic response and 25% of patients had a proarrhythmic response to one of the drugs tested. A proarrhythmic response to one drug did not predict a similar response to another drug of the same class. The 6 patients with a proarrhythmic response did not differ significantly from the other 18 patients with regard to underlying heart disease, electrocardiographic or baseline 24 hour ambulatory electrocardiographic characteristics; however, they did have a higher incidence of digoxin usage (p less than 0.02), a shorter baseline right ventricular effective refractory period (p less than 0.01) and a smaller increment in effective refractory period during antiarrhythmic drug testing (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
18
|
Siddiqi R, Khan MA. Vitamin and nitrogen base requirements for Listeria monocytogenes and haemolysin production. Zentralbl Bakteriol Mikrobiol Hyg A Med Mikrobiol Infekt Parasitol 1982; 253:225-35. [PMID: 6819739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A complete chemically defined medium is described for the growth of different serovars of Listeria monocytogenes. The medium supported rapid, luxuriant and transferable growth. At the same time haemolysin production was induced to the same extent as in tryptose phosphate broth. Riboflavin and calcium-pantothenate were essential for the growth of all six strains tested. Biotin, pyridoxal-hydrochloride and p-aminobenzoic acid were either essential or stimulatory to all strains. Most strains did not require folic acid, thiamin, nicotinic acid and inositol, but they were stimulatory for some strains. Adenine was essential for two strains (NCTC 7973, 5214 m) while cytosine exhibited an inhibitory effect on the growth of all the strains.
Collapse
|
19
|
Afzal M, Ziaur-Rehman, Hussain F, Siddiqi R. A survey of blood groups. J PAK MED ASSOC 1977; 27:426-8. [PMID: 417200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A survey was conducted to investigate into the frequency of different blood groups in Punjab. A total of 1415 persons were included in this survey. The slide method was used for determination of ABO and AB blood groups as well as Rh factor. The frequency of blood group A was 21.20%; B, 36.16%; AB, 9.05% and O, 34.14%. Distribution of blood groups among various castes revealed the incidence of blood group A, 13.57% to 30%; B, 28.125% to 50%; O, 16.67% to 40%; and AB, zero to 25%. Only 2.76% cases were found to be Rh negative. Rh negative frequency was much higher in Baluchs, Awans and Gujjars than Rajputs, Jats and Arains.
Collapse
|
20
|
Nawaz M, Siddiqi R. Normal pH of blood, total serum proteins and cholesterol in serum of female buffaloes. Nord Vet Med 1974; 26:211-4. [PMID: 4830566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
21
|
|