1
|
Shih JH, Albert PS, Fine J, Liu D. An imputation approach for a time-to-event analysis subject to missing outcomes due to noncoverage in disease registries. Biostatistics 2023; 25:117-133. [PMID: 36534828 PMCID: PMC10939403 DOI: 10.1093/biostatistics/kxac049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 11/29/2022] [Accepted: 12/04/2022] [Indexed: 12/17/2023] Open
Abstract
Disease incidence data in a national-based cohort study would ideally be obtained through a national disease registry. Unfortunately, no such registry currently exists in the United States. Instead, the results from individual state registries need to be combined to ascertain certain disease diagnoses in the United States. The National Cancer Institute has initiated a program to assemble all state registries to provide a complete assessment of all cancers in the United States. Unfortunately, not all registries have agreed to participate. In this article, we develop an imputation-based approach that uses self-reported cancer diagnosis from longitudinally collected questionnaires to impute cancer incidence not covered by the combined registry. We propose a two-step procedure, where in the first step a mover-stayer model is used to impute a participant's registry coverage status when it is only reported at the time of the questionnaires given at 10-year intervals and the time of the last-alive vital status and death. In the second step, we propose a semiparametric working model, fit using an imputed coverage area sample identified from the mover-stayer model, to impute registry-based survival outcomes for participants in areas not covered by the registry. The simulation studies show the approach performs well as compared with alternative ad hoc approaches for dealing with this problem. We illustrate the methodology with an analysis that links the United States Radiologic Technologists study cohort with the combined registry that includes 32 of the 50 states.
Collapse
Affiliation(s)
- Joanna H Shih
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Paul S Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Jason Fine
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Danping Liu
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| |
Collapse
|
2
|
Vyzhga Y, Hentgen V, Caorsi R, Wittkowski H, Hofer M, Ruperto N, Lainka E, Theodoropoulou K, Foell D, Mosci E, Gattorno M. Breaking down the fences among registries on autoinflammatory diseases: the E-Merge project. Orphanet J Rare Dis 2023; 18:191. [PMID: 37461074 DOI: 10.1186/s13023-023-02812-4] [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] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Among the various numbers of different autoinflammatory diseases (AIDs), the absolute majority of them remains rare, with a single representative in large populations. This project, endorsed by PRES, supported by the EMERGE fellowship program, and performed in line with the Metadata registry for the ERN RITA (MeRITA), has the objective of performing a data synchronization attempt of the most relevant research questions regarding clinical features, diagnostic strategies, and optimal management of autoinflammatory diseases. RESULTS An analysis of three large European registries: Eurofever, JIR-cohort and AID-Net, with a total coverage of 7825 patients from 278 participating centers from different countries, was performed in the context of epidemiological and clinical data merging. The data collected and evaluated in the registries does not cover only pediatric patients, but also adults with newly diagnosed AIDs. General aspects of the existing epidemiological data have been discussed in the context of patient global distribution, potential diagnostic delays, access to genetic testing, and the availability of the treatment. CONCLUSIONS In general, the results indicate a great potential for upcoming collaborative work using existing data in cohorts that enhance the quality of medical care performed for patients with autoinflammatory diseases.
Collapse
Affiliation(s)
- Y Vyzhga
- National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
| | - V Hentgen
- Department for Pediatrics, National Referral Centre of Auto-Inflammatory Diseases and Inflammatory Amyloidosis - CEREMAIA, Versailles Hospital, Le Chesnay, Paris, France
| | - R Caorsi
- Centre for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - H Wittkowski
- Department of Pediatric Rheumatology and Immunology, University Hospital Munster, Münster, Germany
| | - M Hofer
- Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- University Hospital of Geneva, Geneva, Switzerland
| | - N Ruperto
- Gaslini Trial Centre, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - E Lainka
- Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany
| | - K Theodoropoulou
- Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - D Foell
- Department of Pediatric Rheumatology and Immunology, University Hospital Munster, Münster, Germany
| | - E Mosci
- Gaslini Trial Centre, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M Gattorno
- Centre for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| |
Collapse
|
3
|
Bergman MJ, Zueger P, Patel J, Saffore CD, Topuria I, Cavanaugh C, Fang S, Clewell J, Ogdie A. Clinical and Economic Benefit of Achieving Disease Control in Psoriatic Arthritis and Ankylosing Spondylitis: A Retrospective Analysis from the OM1 Registry. Rheumatol Ther 2023; 10:187-199. [PMID: 36333490 PMCID: PMC9931970 DOI: 10.1007/s40744-022-00504-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is limited evidence on the clinical and economic benefit of achieving disease control in psoriatic arthritis (PsA) and ankylosing spondylitis (AS), thus we aimed to assess the impact of disease control on healthcare resource use (HCRU) and direct medical costs among US patients with PsA or AS over 1 year. METHODS Data were derived from the US OM1 PsA/AS registries (PsA: 1/2013-12/2020; AS: 01/2013-4/2021) and the Optum Insight Clinformatics® Data Mart to identify adult patients with PsA or AS. Two cohorts were created: with disease control and without disease control. Disease control was defined as modified Disease Activity Index for Psoriatic Arthritis (DAPSA28) ≤ 4 for PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 4 for AS. Outcomes were all-cause inpatient, outpatient, and emergency department (ED) visits and associated costs over a 1-year follow-up period. Mean costs per person per year (PPPY) were assessed descriptively and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated for the likelihood of HCRU by logistic regression. RESULTS The study included 1235 PsA (with disease control: N = 217; without: N = 1018) and 581 AS patients (with disease control: N = 342; without: N = 239). Patients without disease control were more likely to have an inpatient (aOR [95% CI]; PsA: 3.0 [0.9, 10.1]; AS: 7.7 [2.3, 25.1]) or ED (PsA: 1.6 [0.6, 4.2]; AS: 3.5 [1.5, 8.3]) visit than those with disease control. Those without disease control, vs. those with disease control, had greater PPPY costs associated with inpatient (PsA: $1550 vs. $443), outpatient (PsA: $1789 vs. $1327; AS: $2498 vs. $2023), and ED (PsA: $114 vs. $57; AS: $316 vs. $50) visits. CONCLUSIONS Findings from this study demonstrate lower disease activity among patients with PsA and AS is associated with less HCRU and lower costs over the following year.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Alexis Ogdie
- University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
4
|
Ostrosky-Zeichner L, Nguyen MH, Bubalo J, Alexander BD, Miceli MH, Pappas PG, Jiang J, Song Y, Thompson GR 3rd. Multicenter Registry of Patients Receiving Systemic Mold-Active Triazoles for the Management of Invasive Fungal Infections. Infect Dis Ther 2022. [PMID: 35716251 DOI: 10.1007/s40121-022-00661-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/19/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction ‘Real-world’ data for mold-active triazoles (MATs) in the treatment of invasive fungal infections (IFIs) are lacking. This study evaluated usage of MATs in a disease registry for the management of IFIs. Methods Data were collected for this multicenter, observational, prospective study from 55 US centers, between March 2017 and April 2020. Eligible patients received isavuconazole, posaconazole, or voriconazole as MAT monotherapy (one MAT) or multiple/sequenced MAT therapy (more than one MAT) for prophylaxis or treatment. Patients were enrolled within 60 days of MAT initiation. The primary objective was to characterize patients receiving a MAT and their patterns of therapy. The full analysis set (FAS) included eligible patients for the relevant enrollment protocol, and the safety analysis set (SAF) included patients who received ≥ 1 MAT dose. Results Overall, 2009 patients were enrolled in the SAF. The FAS comprised 1993 patients (510 isavuconazole; 540 posaconazole; 491 voriconazole; 452 multiple/sequenced MAT therapies); 816 and 1177 received treatment and prophylaxis at study index/enrollment, respectively. Around half (57.8%) of patients were male, and median age was 59 years. Among patients with IFIs during the study, the most common pathogens were Aspergillus fumigatus in the isavuconazole (18.2% [10/55]) and voriconazole (25.5% [12/47]) groups and Candida glabrata in the posaconazole group (20.9% [9/43]); the lungs were the most common infection site (58.2% [166/285]). Most patients were maintained on MAT monotherapy (77.3% [1541/1993]), and 79.4% (1520/1915) completed their MAT therapies. A complete/partial clinical response was reported in 59.1% (591/1001) of patients with a clinical response assessment. Breakthrough IFIs were reported in 7.1% (73/1030) of prophylaxis patients. Adverse drug reactions (ADRs) were reported in 14.7% (296/2009) of patients (3.9% [20/514] isavuconazole; 11.3% [62/547] posaconazole; 14.2% [70/494] voriconazole). Conclusions In this ‘real-world’ study, most patients remained on their initial therapy and completed their MAT therapy. Over half of patients receiving MATs for IFIs had a successful response, and most receiving prophylaxis did not develop breakthrough IFIs. ADRs were uncommon. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00661-5.
Collapse
|
5
|
Lazem M, Hooman N, Sheikhtaheri A. Development and pilot implementation of Iranian Hemolytic Uremic Syndrome Registry. Orphanet J Rare Dis 2022; 17:228. [PMID: 35710568 PMCID: PMC9205084 DOI: 10.1186/s13023-022-02376-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 06/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Patients with Hemolytic Uremic Syndrome (HUS) face late diagnosis and lack of appropriate treatment because of a lack of knowledge and experience in this field. A prerequisite for such knowledge is the development of research infrastructures such as a registry system. Therefore, this study aimed to develop and describe the HUS registry in accordance with the Iranian health system and implement its software system. Methods We first interviewed 10 pediatric nephrologists and after analyzing the interviews, we identified the features and requirements and the data related to HUS. Then, during two rounds of the Delphi technique (the first round with 23 participants and the second round with 18 participants), the model of this registry was finalized based on the agreement of at least 75% of specialists. At the next step, based on the agreed requirements, IRI.HUS.Reg (Iranian Hemolytic Uremic Syndrome Registry) software was developed and implemented in a pediatric hospital. Results We classified 369 meaning units of interviews in 41 codes and 7 final themes including purposes of the registry (10 codes), inclusion criteria (7 codes), data collection method (4 codes), data quality control (6 codes), data sources (4 codes), data analysis (3 codes) and software features (7 codes). These 7 feature groups (67 subgroups) and 12 data classes (138 data elements) include demographic data, referrals, examinations, clinical signs, causes, laboratory tests, medical histories, paraclinical measures, treatments, outcomes, patient’s status at discharge, and follow-up data were reviewed by the Delphi panelists, and finally, 64 features and 131 data elements were accepted by at least 78% agreement. Then, we developed and implemented a registry software system in a hospital. Conclusion We implemented IRI.HUS.Reg based on related features, 12 data classes agreed by specialists, literature review, and comparison with other existing registries. Therefore, the data collected in this registry can be compared with other data from existing registries in other countries. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02376-9.
Collapse
Affiliation(s)
- Mina Lazem
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Nakysa Hooman
- Aliasghar Clinical Research Development Center (AACRDC), Aliasghar Children Hospital, Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
6
|
Abello V, Mantilla WA, Idrobo H, Sossa CL, Salazar LA, Pena A, Herrera JM, Guerrero P, Espinosa D, Quintero-Vega GE, Munevar I, Galvez K, Henao A, Gómez R, Saavedra JD, Gaviria LM, Osuna M, Mateos MV. Real-World Evidence of Epidemiology and Clinical Outcomes in Multiple Myeloma, Findings from the Registry of Hemato-Oncologic Malignancies in Colombia, Observational Study. Clin Lymphoma Myeloma Leuk 2022; 22:e405-e413. [PMID: 35042679 DOI: 10.1016/j.clml.2021.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/01/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION/BACKGROUND Multiple Myeloma (MM) is a plasma cell derived clonal disorder that represents around 1% of all newly diagnosed neoplasms. Limited data regarding MM treatment in Latin America is available, and access to novel agents for a substantial portion of the population is limited by their high costs. MATERIALS (OR PATIENTS) AND METHODS RENEHOC is a bidirectional (retrospective and prospective) multicenter observational registry of hematological malignancies in Colombia. MM patients included up to July 2020 were analyzed on this report. RESULTS 890 are reported with a median follow-up of 18 months (IQR: 7-42 months). Patients were classified by age group (≤ or > 65 years). Median age at diagnosis was 67 years (IQR: 59-75 years) and 47.1% of patients were women. 709 patients (79.6%) received Bortezomib-based schemes as part of the first line. Two hundred and fifty-two patients (28.3%) were consolidated with Autologous Stem Cell Transplantation (ASCT) in first-line. ASCT consolidation and age were the main independent factors influencing outcomes; in the non-ASCT cohort, 5-year overall survival was 48.7% (CI 41.8-55.2) compared to 80.7% (CI 73-86.4) in ASCT patients. CONCLUSION This data depicts the reality of MM in Colombia, which likely reflects other Latin American countries, where access barriers to diagnosis and treatment are echoed in advanced stage diagnosis and a low rate of transplants. These seem to negatively impact survival despite the availability of most novel drugs approved for this disease. Thus, emphasizing the paradox that prevails in most of the region: availability without equitable access.
Collapse
Affiliation(s)
- Virginia Abello
- Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Clínica del Country, Bogotá, Colombia.
| | | | - Henry Idrobo
- Universidad del Valle, Centro Médico Julián Coronel, Calí, Colombia
| | - Claudia Lucia Sossa
- Universidad Autónoma de Bucaramanga, Clínica Foscal, Centro de hematología PROTEHOS, Bucaramanga, Colombia
| | - Luis Antonio Salazar
- Universidad Autónoma de Bucaramanga, Clínica Foscal, Centro de hematología PROTEHOS, Bucaramanga, Colombia
| | - Angela Pena
- Universidad Autónoma de Bucaramanga, Clínica Foscal, Centro de hematología PROTEHOS, Bucaramanga, Colombia
| | | | | | - Daniel Espinosa
- Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
| | - Guillermo Enrique Quintero-Vega
- Universidad de los Andes, Fundación Santa Fe de Bogotá, Servicios Médicos de Hematología y Cardiología SAS, Bogotá, Colombia
| | - Isabel Munevar
- Fundación Cardioinfantil, Hospital Militar, Bogotá, Colombia
| | | | | | | | | | | | | | - María Victoria Mateos
- Hospital Universitario de Salamanca, Centro de Investigación del Cáncer de Salamanca, Salamanca, España
| |
Collapse
|
7
|
Muenzer J, Botha J, Harmatz P, Giugliani R, Kampmann C, Burton BK. Evaluation of the long-term treatment effects of intravenous idursulfase in patients with mucopolysaccharidosis II (MPS II) using statistical modeling: data from the Hunter Outcome Survey (HOS). Orphanet J Rare Dis 2021; 16:456. [PMID: 34717704 PMCID: PMC8557006 DOI: 10.1186/s13023-021-02052-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 02/24/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mucopolysaccharidosis II (MPS II; Hunter syndrome) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. Enzyme replacement therapy (ERT) with intravenous (IV) idursulfase can stabilize or improve many somatic manifestations, but there remains a need for further analysis of long-term treatment outcomes. Using data from patients with MPS II enrolled in the Hunter Outcome Survey (HOS), mixed modeling was performed to evaluate and predict the effects of IV idursulfase treatment on selected clinical parameters for up to 8 years following treatment start. The modeling population comprised male patients followed prospectively in HOS who had received IV idursulfase for at least 5 years and who had data available for two or more time points (at least one post-ERT). Age at ERT start and time since ERT start were included as covariates. RESULTS In total, 481 patients were eligible for inclusion in at least one model. At 8 years post-ERT start, improvement from baseline was predicted for each age group (< 18 months, 18 months to < 5 years and ≥ 5 years at treatment start) in the following parameters: mean urinary glycosaminoglycan levels (percentage changes of > -75% in each group), mean left ventricular mass index (decreases of ~ 1 g/m2) and mean palpable liver size (decreases of > 2 cm). Improvements in mean 6-min walk test distance (increase of > 50 m) and stabilization in percent predicted forced vital capacity and forced expiratory volume in 1 s (decreases of ~ 4 and ~ 9 percentage points, respectively) at 8 years post-ERT start were predicted for patients aged ≥ 5 years at ERT start (these assessments are unsuitable for patients aged < 5 years). Predicted changes over time were similar across the three age groups; however, overall outcomes were most favorable in children aged < 18 months at ERT start. CONCLUSIONS These findings suggest that the previously reported positive effects of IV idursulfase on the somatic manifestations of MPS II are predicted to be maintained for at least 8 years following ERT initiation and highlight the value of statistical modeling to predict long-term treatment outcomes in patients with rare diseases.
Collapse
Affiliation(s)
- Joseph Muenzer
- University of North Carolina at Chapel Hill, 101 Manning Drive CB# 7487, Medical School Wing E Room 117, Chapel Hill, NC 27599-7487 USA
| | - Jaco Botha
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - Paul Harmatz
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA USA
| | - Roberto Giugliani
- Department of Genetics, UFRGS, Medical Genetics Service, HCPA, and INAGEMP, Porto Alegre, Brazil
| | | | - Barbara K. Burton
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| |
Collapse
|
8
|
Gorini F, Coi A, Mezzasalma L, Baldacci S, Pierini A, Santoro M. Survival of patients with rare diseases: a population-based study in Tuscany (Italy). Orphanet J Rare Dis 2021; 16:275. [PMID: 34127030 PMCID: PMC8201697 DOI: 10.1186/s13023-021-01907-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Rare diseases (RDs) encompass a heterogeneous group of life-threatening or chronically debilitating conditions that individually affect a small number of subjects but overall represent a major public health issue globally. There are still limited data on RD burden due to the paucity of large population-based epidemiological studies. The aim of this research was to provide survival estimates of patients with a RD residing in Tuscany, Italy. Methods Cases collected in the Rare Diseases Registry of Tuscany with diagnosis between 1st January 2000 and 31th December 2018 were linked to the regional health databases in order to retrieve information on mortality of all subjects. Survival at 1, 5 and 10 years from diagnosis with 95% confidence intervals (CI) was estimated by sex, age class, nosological group and subgroup using the Kaplan–Meier method. The effect of sex, age and period of diagnosis (years 2000–2009 or 2010–2018) on survival was estimated using Cox proportional hazards regression. Results Survival at 1, 5 and 10 years from diagnosis was 97.3%, 88.8% and 80.8%, respectively. Respiratory diseases and peripheral and central nervous system disorders were characterized by the lowest survival at 5 and 10 years. Despite a modest higher prevalence of RDs among females (54.0% of the total), male cases had a significant increased risk of death (hazard ratio, HR 1.48, 95% CI 1.38–1.58). Cases diagnosed during 2010–2018 period had a risk of death significantly lower than those diagnosed during 2000–2009 (HR 0.81, 95% CI 0.82–0.96), especially for immune system disorders (HR 0.48, 95% CI 0.26–0.87), circulatory system diseases (HR 0.61, 95% CI 0.45–0.84) and diseases of the musculoskeletal system and connective tissue (HR 0.64, 95% CI 0.49–0.84). Conclusions An earlier diagnosis as well as the improvement in the efficacy of treatment resulted in a decreased risk of death over the years for specific RDs. The linkage between a population-based registry and other regional databases exploited in this study provides a large and accurate mass of data capable of estimating patients’ life-expectancy and increasing knowledge on the collective burden of RDs. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01907-0.
Collapse
Affiliation(s)
- Francesca Gorini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy.
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy
| | - Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy
| | - Silvia Baldacci
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, via Moruzzi 1, 56124, Pisa, Italy
| |
Collapse
|
9
|
Coi A, Barsotti S, Santoro M, Almerigogna F, Bargagli E, Caproni M, Emmi G, Frediani B, Guiducci S, Matucci Cerinic M, Mosca M, Parronchi P, Prediletto R, Selvi E, Simonini G, Tavoni AG, Bianchi F, Pierini A. Epidemiology of systemic sclerosis: a multi-database population-based study in Tuscany (Italy). Orphanet J Rare Dis 2021; 16:90. [PMID: 33596949 PMCID: PMC7890847 DOI: 10.1186/s13023-021-01733-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/30/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022] Open
Abstract
Background Systemic Sclerosis (SSc) is a chronic autoimmune disease with a complex pathogenesis that includes vascular injury, abnormal immune activation, and tissue fibrosis. We provided a complete epidemiological characterization of SSc in the Tuscany region (Italy), considering prevalence and incidence, survival, comorbidities and drug prescriptions, by using a multi-database population-based approach. Cases of SSc diagnosed between 1st January 2003 and 31st December 2017 among residents in Tuscany were collected from the population-based Rare Diseases Registry of Tuscany. All cases were linked to regional health and demographic databases to obtain information about vital statistics, principal causes of hospitalization, complications and comorbidities, and drug prescriptions. Results The prevalence of SSc in Tuscany population resulted to be 22.2 per 100,000, with the highest prevalence observed for the cases aged ≥ 65 years (33.2 per 100,000, CI 95% 29.6–37.3). In females, SSc was predominant (86.7% on the total) with an overall sex ratio F/M of 6.5. Nevertheless, males presented a more severe disease, with a lower survival and significant differences in respiratory complications and metabolic comorbidities. Complications and comorbidities such as pulmonary involvement (HR = 1.66, CI 95% 1.17–2.35), congestive heart failure (HR = 2.76, CI 95% 1.80–4.25), subarachnoid and intracerebral haemorrhage (HR = 2.33, CI 95% 1.21–4.48) and malignant neoplasms (HR = 1.63, CI 95% 1.06–2.52), were significantly associated to a lower survival, also after adjustment for age, sex and other SSc-related complications. Disease-modifying antirheumatic drugs, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors were the drugs with the more increasing prevalence of use in the 2008–2017 period. Conclusions The multi-database approach is important in the investigation of rare diseases where it is often difficult to provide accurate epidemiological indicators. A population-based registry can be exploited in synergy with health databases, to provide evidence related to disease outcomes and therapies and to assess the burden of disease, relying on a large cohort of cases. Building an integrated archive of data from multiple databases linking a cohort of patients to their comorbidities, clinical outcomes and survival, is important both in terms of treatment and prevention.
Collapse
Affiliation(s)
- Alessio Coi
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.
| | - Simone Barsotti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Santoro
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Fabio Almerigogna
- Immunoallergology Unit, , Careggi University Hospital, Florence, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Marzia Caproni
- Rare Dermatological Diseases Unit, USL Toscana Centro, Firenze, Italy.,ERN-SKIN Diseases Centre, Department of Health Sciences, University of Florence, Firenze, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, "Le Scotte" Hospital, Siena, Italy
| | - Serena Guiducci
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Marco Matucci Cerinic
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Renato Prediletto
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Enrico Selvi
- Rheumatology Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Gabriele Simonini
- Rheumatology Unit, A. Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Antonio Gaetano Tavoni
- Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| |
Collapse
|
10
|
Zarei J, Dastoorpoor M, Jamshidnezhad A, Cheraghi M, Sheikhtaheri A. Regional COVID-19 registry in Khuzestan, Iran: A study protocol and lessons learned from a pilot implementation. Inform Med Unlocked 2021; 23:100520. [PMID: 33495736 PMCID: PMC7816600 DOI: 10.1016/j.imu.2021.100520] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 10/03/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 02/08/2023] Open
Abstract
Disease registry systems provide a strong information infrastructure for decision-making and research. The purpose of this study is to describe the implementation method and protocol of the COVID-19 registry in Khuzestan province, Iran. We established a steering committee and formulated the purposes of the registry. Then, based on reviewing the literature, and expert panels, the minimum data set, the data collection forms and the web-based software were developed. Data collection is done retrospectively through Hospital Information Systems, Medical Care Monitoring Center system (MCMC), Management of Communicable Disease Prevention and Control system (MCDPC) as well as, patients' records. For prospective data collection, the data collection forms are compiled with patients' medical records by the medical staff and are then entered into the registry system. We collect patients' administrative and demographic data, history and physical examinations, test and imaging results, disease progression, treatment, outcomes, and follow-ups of the confirmed and suspected inpatients and outpatients. From April 20 to December 5, 2020, the data of 4,812 confirmed cases and 7,113 suspected cases were collected from two COVID-19 referral hospitals. Based on our experience, recording information along with providing care for patients and putting patients' data registration in the medical staff's routine, structuring data, having a flexible technical team and rapid software development for multiple and continuous updates, automating data collection by connecting the registry to existing information systems and having different incentives, the registration process can be strengthened.
Collapse
Affiliation(s)
- Javad Zarei
- Health Information Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Jamshidnezhad
- Health Information Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Cheraghi
- Social Determinant of Health Research Center, Department of Public Health, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Sheikhtaheri
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Khayamzadeh M, Aliakbari F, Zolghadr Z, Emadeddin M, Ahadi M, Akbari M, Abedi AR, Nematollahi S, Hosseini J. Five-Year Survival Rate of Bladder Cancer in Iran during 2001-2007. Iran J Pathol 2020; 16:69-74. [PMID: 33391383 PMCID: PMC7691705 DOI: 10.30699/ijp.2020.118375.2287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/22/2020] [Indexed: 01/03/2023]
Abstract
Background & Objective: Bladder cancer is the fourth most common cancer in men and the most common cancer in women, comprising 8% of all males and 3% of female tumors. The present study aimed to estimate the five-year survival rates of bladder cancer in Iran. Methods: Information on 3,337 registered cases of bladder cancer was obtained from the Office of National Cancer Registry in the Ministry of Health and Medical Education (MOH & ME). A telephone survey was conducted to gather additional information, such as survival status, demographic, and clinical profile. Kaplan–Meier estimates of five-year survival rates were calculated according to the age of diagnosis, gender, pathological type, and provincial pole. Results and Conclusion: Overall five-year survival rate was 77%. According to the pathologic type, five-year survival rates were 81%, 66%, 81%, 42%, 77%, and 82% in low-grade urothelial carcinoma, high-grade urothelial carcinoma, adenocarcinoma, undifferentiated carcinomas, Squamous Cell Carcinomas (SCCs), and other tumors, respectively. Additionally, those tumors were 93%, 88%, 81%, 64%, and 44% among patients whose average ages at diagnosis were < 50, 50–59, 60–59, 70–79, and > 80 years old, respectively. Our study revealed that age and histological type were the major prognostic factors for survival in patients with bladder cancer. Therefore, given the histologic features of the tumor and patients with advanced age, a continuous screening would be highly warranted.
Collapse
Affiliation(s)
- Maryam Khayamzadeh
- Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshte Aliakbari
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Zolghadr
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Emadeddin
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Ahadi
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Reza Abedi
- Urology Department, Shohada-ye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Nematollahi
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalil Hosseini
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
FitzGerald JM, Tran TN, Alacqua M, Altraja A, Backer V, Bjermer L, Bjornsdottir U, Bourdin A, Brusselle G, Bulathsinhala L, Busby J, Canonica GW, Carter V, Chaudhry I, Cho YS, Christoff G, Cosio BG, Costello RW, Eleangovan N, Gibson PG, Heaney LG, Heffler E, Hew M, Hosseini N, Iwanaga T, Jackson DJ, Jones R, Koh MS, Le T, Lehtimäki L, Ludviksdottir D, Maitland-van der Zee AH, Menzies-Gow A, Murray RB, Papadopoulos NG, Perez-de-Llano L, Peters M, Pfeffer PE, Popov TA, Porsbjerg CM, Price CA, Rhee CK, Sadatsafavi M, Tohda Y, Wang E, Wechsler ME, Zangrilli J, Price DB. International severe asthma registry (ISAR): protocol for a global registry. BMC Med Res Methodol 2020; 20:212. [PMID: 32819285 PMCID: PMC7439682 DOI: 10.1186/s12874-020-01065-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Severe asthma exerts a disproportionately heavy burden on patients and health care. Due to the heterogeneity of the severe asthma population, many patients need to be evaluated to understand the clinical features and outcomes of severe asthma in order to facilitate personalised and targeted care. The International Severe Asthma Registry (ISAR) is a multi-country registry project initiated to aid in this endeavour. Methods ISAR is a multi-disciplinary initiative benefitting from the combined experience of the ISAR Steering Committee (ISC; comprising 47 clinicians and researchers across 29 countries, who have a special interest and/or experience in severe asthma management or establishment and maintenance of severe asthma registries) in collaboration with scientists and experts in database management and communication. Patients (≥18 years old) receiving treatment according to the 2018 definitions of the Global Initiative for Asthma (GINA) Step 5 or uncontrolled on GINA Step 4 treatment will be included. Data will be collected on a core set of 95 variables identified using the Delphi method. Participating registries will agree to provide access to and share standardised anonymous patient-level data with ISAR. ISAR is a registered data source on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance. ISAR’s collaborators include Optimum Patient Care, the Respiratory Effectiveness Group (REG) and AstraZeneca. ISAR is overseen by the ISC, REG, the Anonymised Data Ethics & Protocol Transparency Committee and the ISAR operational committee, ensuring the conduct of ethical, clinically relevant research that brings value to all key stakeholders. Conclusions ISAR aims to offer a rich source of real-life data for scientific research to understand and improve disease burden, treatment patterns and patient outcomes in severe asthma. Furthermore, the registry will provide an international platform for research collaboration in respiratory medicine, with the overarching aim of improving primary and secondary care of adults with severe asthma globally.
Collapse
Affiliation(s)
| | | | | | - Alan Altraja
- Department of Pulmonary Medicine, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Vibeke Backer
- Center of Physical Activity Research, Rigshospitalet and Copenhagen University, Copenhagen, Denmark
| | - Leif Bjermer
- Department of Respiratory Medicine & Allergology, Skåne University Hospital, Lund, Sweden
| | | | - Arnaud Bourdin
- Department of Respiratory Diseases, Montpellier University Hospitals, Hopital Arnaud de Villeneuve and PhyMed Exp (INSERM U 1046, CNRS UMR9214), Universite de Montpellier, Montpellier, France
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Departments of Epidemiology and Respiratory Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - John Busby
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Giorgio W Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Milan, Italy.,SANI-Severe Asthma Network Italy, Milan, Italy
| | | | | | - You Sook Cho
- Division of Allergy, Department of Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - George Christoff
- Faculty of Public Health, Medical University - Sofia, Sofia, Bulgaria
| | - Borja G Cosio
- Son Espases University Hospital-IdISBa-Ciberes, Mallorca, Spain
| | - Richard W Costello
- Clinical Research Centre, Smurfit Building Beaumont Hospital and Department of Respiratory Medicine, RCSI, Dublin, Ireland
| | | | - Peter G Gibson
- Australasian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, Australia.,Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton Heights, Australia
| | - Liam G Heaney
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Enrico Heffler
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Milan, Italy.,SANI-Severe Asthma Network Italy, Milan, Italy
| | - Mark Hew
- Alfred Health & Monash University, Melbourne, Australia
| | | | - Takashi Iwanaga
- Department of Respiratory Medicine & Allergology, Faculty of Medicine, Kindai University Hospital, Ōsakasayama, Japan
| | - David J Jackson
- Guy's & St Thomas' NHS Trust and King's College London, London, UK
| | - Rupert Jones
- Faculty of Medicine & Dentistry, University of Plymouth, Plymouth, UK
| | - Mariko S Koh
- Department of Respiratory & Critical Care Medicine, Singapore General Hospital and Duke-National University Singapore Medical School, Singapore, Singapore
| | - Thao Le
- Optimum Patient Care, Cambridge, UK
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Dora Ludviksdottir
- Department of Respiratory Medicine, Faculty of Medicine, Landspitali University Hospital and University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | - Paul E Pfeffer
- UK Severe Asthma Network, Barts Health NHS Trust and Queen Mary University of London, London, UK
| | - Todor A Popov
- University Hospital "Sv. Ivan Rilski", Sofia, Bulgaria
| | | | | | - Chin K Rhee
- The Catholic University of Korea, Seoul, South Korea
| | - Mohsen Sadatsafavi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Yuji Tohda
- Department of Respiratory Medicine & Allergology, Faculty of Medicine, Kindai University Hospital, Ōsakasayama, Japan
| | - Eileen Wang
- Division of Allergy & Clinical Immunology, Department of Medicine, National Jewish Health and Division of Allergy & Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, Denver and Aurora, CO, USA
| | - Michael E Wechsler
- Division of Pulmonary, Critical Care and Sleep Medicine, Asthma Program, National Jewish Health, Denver, USA
| | | | - David B Price
- Optimum Patient Care, Cambridge, UK. .,Observational and Pragmatic Research Institute, Singapore, Singapore. .,Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
| |
Collapse
|
13
|
Papa R, Cant A, Klein C, Little MA, Wulffraat NM, Gattorno M, Ruperto N. Towards European harmonisation of healthcare for patients with rare immune disorders: outcome from the ERN RITA registries survey. Orphanet J Rare Dis 2020; 15:33. [PMID: 32000824 PMCID: PMC6993334 DOI: 10.1186/s13023-020-1308-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
The Rare Immunodeficiency, AutoInflammatory and AutoImmune Disease (RITA) network is a European Research Network (ERN) that brings together the leading centres for rare immune disorders. On April 2018 an online survey was sent to all RITA members in order to facilitate the harmonization of data collection in rare immune disorders registries. Currently, as many as 52 different registries collect data on rare immune disorders, of whom 30 (58%) are dedicated primarily to autoimmune diseases, 15 (29%) to primary immunodeficiencies and 12 (23%) to autoinflammatory disorders. Improving data on patient safety, outcome, and quality of life measures is warranted to unfold the full potential of RITA registries.
Collapse
Affiliation(s)
- Riccardo Papa
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Andrew Cant
- Great North Children's Hospital & Institute for Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Mark A Little
- Trinity Health Kidney Centre, Tallaght University Hospital, Dublin, Ireland
| | - Nico M Wulffraat
- Department of Pediatrics, Section Pediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Centrum Utrecht, Utrecht, Netherlands
| | - Marco Gattorno
- Centre for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Nicolino Ruperto
- UOSID Centro Trial, PRINTO, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
| | | |
Collapse
|
14
|
Li Y, Chen B, Gao X, Hu N, Huang M, Ran Z, Liu Z, Zhong J, Zou D, Wu X, Ren J, Sheng J, Zheng P, Wang H, Chen M, Chen J, Xi P, Lu J, Handel M, Liu Y, Fan H, Qian J. Current diagnosis and management of Crohn's disease in China: results from a multicenter prospective disease registry. BMC Gastroenterol 2019; 19:145. [PMID: 31420025 PMCID: PMC6697932 DOI: 10.1186/s12876-019-1057-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022] Open
Abstract
Background This study aimed to understand the disease characteristics and treatment outcomes of Crohn’s disease (CD) in a real-world setting in China. Methods In this prospective, non-interventional, multicenter disease registry, adults (≥18 years) with existing and newly diagnosed CD were recruited from 14 medical centers across China from January 2015 to January 2017. The study consisted of the enrollment and follow-up periods, of 12 months each. Demographic, clinical characteristics, diagnostic duration and management of CD at enrollment were evaluated. Logistic regression analysis and stepwise multivariate logistic regression analysis used to assess the relationship between the risk factors and CD. Results Of 504 enrolled patients, 499 (99.0%) were eligible for analysis. The mean (SD) age at study enrollment was 32.3 (11.43) years and the majority (69.7%) of participants were male. In the past 15 years, a sustained decrease of the period of time in the diagnosis of CD was observed, at about 39.4 (24.11) months in 2010, which decreased to 3.1 (2.13) months in 2015. The most common presenting symptoms of CD included abdominal pain (78.0%), diarrhea (58.1%), weight loss (52.9%) and fever (30.1%). Oral ulcer (19.4%) and arthritis (9.8%) were the most common extra-intestinal manifestations. Non-stricturing non-penetrating (B1) (49.9%) behavior and ileocolonic involvement (L3) (56.2%) location were more frequent. Perianal disease was observed in 29.1% of the patients. Around 23.8% (119/499) patients had CD-related surgery other than perianal disease surgery. Older age at enrollment, longer disease course, complicated disease behavior and absence of perianal disease were all surgery risk factors (p < 0.05). The most common medications was immunomodulators (e.g., azathioprine) (41.5%), anti-TNFα agents (32.9%) and aminosalicylates (20.6%). The mean (SD) Crohn’s Disease Active Index (CDAI) score was 159.1 (91.45) and almost half of the patients (49.1%, 81/165) were in remission. Conclusions This study demonstrated the CD-disease characteristics, risk factors of CD-related surgery and perianal disease, and treatment strategies in a real-world setting in China and may help in developing programs to diagnose and manage patients with CD. Electronic supplementary material The online version of this article (10.1186/s12876-019-1057-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yue Li
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Baili Chen
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiang Gao
- The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Naizhong Hu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Meifang Huang
- Zhongnan Hospital of Wu Han University, Wuhan, China
| | - Zhihua Ran
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhanju Liu
- Shanghai Tenth Peoples Hospital of Tongji University, Shanghai, China
| | - Jie Zhong
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Duowu Zou
- Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoping Wu
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianlin Ren
- Zhongshan Hospital, Xiamen University, Xiamen, China
| | | | - Ping Zheng
- Dongfang Hospital of Tongji University, Shanghai, China
| | - Huahong Wang
- Peking University First Hospital, Beijing, China
| | - Minhu Chen
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junrong Chen
- The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peng Xi
- Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, China
| | - Jiajia Lu
- Johnson & Johnson (China) Investment Ltd. Janssen China R&D Center, Beijing, China
| | | | | | - Hua Fan
- Medical Affairs, Takeda China, Shanghai, China
| | - Jiaming Qian
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
15
|
Movahedi M, Cesta A, Li X, Bombardier C; OBRI Investigators. Collection of antirheumatic medication data from both patients and rheumatologists shows strong agreement in a real-world clinical cohort: the Ontario Best Practices Research Initiative-a rheumatoid arthritis cohort. J Clin Epidemiol 2019; 114:95-103. [PMID: 31226411 DOI: 10.1016/j.jclinepi.2019.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/31/2019] [Accepted: 06/10/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The objective of the study was to examine the agreement between patient- and rheumatologist-reported antirheumatic medication (ARM) use in the Ontario Best Practices Research Initiative. STUDY DESIGN AND SETTING We included adult patients who enrolled on or after September 1st 2010 and compared ARM use where rheumatologist visits and interviews occurred within 60 days of each other. Kappa statistic was used to measure agreement. We calculated sensitivity, specificity, and positive and negative predictive value, considering patient-reported data as the gold standard. To examine factors associated with agreement, a hierarchical generalized linear model was used. A subset analysis was also completed to compare start and stop dates of ARM. RESULTS Overall agreement for ARM was good with higher sensitivity and lower specificity for conventional synthetic disease-modifying antirheumatic drugs compared with biologic disease-modifying antirheumatic drugs. Increased Health Assessment Questionnaire pain index and 28 disease activity score-erythrocyte sedimentation rate (DAS28-ESR) were significantly associated with lower agreement. Reporting stop dates was higher (19.4%) for patient-reported data compared with rheumatologist-reported data (13.1%). CONCLUSION ARM reports had strong agreement particularly for patients who have low disease activity and pain. ARM discontinuation was reported more frequently by patients, which may indicate that patients may be discontinuing use of their rheumatoid arthritis medications before consulting their rheumatologist.
Collapse
|
16
|
Cahan EM, Frick SL. Orthopaedic phenotyping of NGLY1 deficiency using an international, family-led disease registry. Orphanet J Rare Dis 2019; 14:148. [PMID: 31217022 PMCID: PMC6584998 DOI: 10.1186/s13023-019-1131-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/12/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND NGLY1 deficiency is a rare autosomal recessive disorder caused by loss in enzymatic function of NGLY1, a peptide N-glycanase that has been shown to play a role in endoplasmic reticulum associated degradation (ERAD). ERAD dysfunction has been implicated in other well-described proteinopathies, such as Alzheimer's disease, Parkinson's disease, and Huntington's disease. The classical clinical tetrad includes developmental delay, hypolacrima, transiently elevated transaminases, and hyperkinetic movement disorders. The musculoskeletal system is also commonly affected, but the orthopaedic phenotype has been incompletely characterized. Best practices for orthopaedic clinical care have not been elucidated and considerable variability has resulted from this lack of evidence base. Our study surveyed patients enrolled in an international registry for NGLY1 deficiency in order to characterize the orthopaedic manifestations, sequelae, and management. RESULTS Our findings, encompassing the largest cohort for NGLY1 deficiency to date, detail levels of motor milestone achievement; physical exam findings; fracture rates/distribution; frequency of motor skill regression; non-pharmacologic and non-procedural interventions; pharmacologic therapies; and procedural interventions experienced by 29 participants. Regarding the orthopaedic phenotype, at time of survey response, we found that over 40% of patients experienced motor skill regression from their peak. Over 80% of patients had at least one orthopaedic diagnosis, and nearly two-thirds of the total had two or more. More than half of patients older than 6 years had sustained a fracture. Related to orthopaedic non-medical management, we found that 93 and 79% of patients had utilized physical therapy and non-operative orthoses, respectively. In turn, the vast majority took at least one medication (including for bone health and antispasmodic therapy). Finally, nearly half of patients had undergone an invasive procedure. Of those older than 6 years, two-thirds had one or more procedures. Stratification of these analyses by sex revealed distinctive differences in disease natural history and clinical management course. CONCLUSIONS These findings describing the orthopaedic natural history and standard of care in patients with NGLY1 deficiency can facilitate diagnosis, inform prognosis, and guide treatment recommendations in an evidence-based manner. Furthermore, the methodology is notable for its partnership with a disease-specific advocacy organization and may be generalizable to other rare disease populations. This study fills a void in the existing literature for this population and this methodology offers a precedent upon which future studies for rare diseases can build.
Collapse
Affiliation(s)
- Eli M Cahan
- New York University School of Medicine, New York, NY, 10010, USA.
- Department of Pediatric Orthopaedics, Stanford University, 300 Pasteur Drive, R107, Palo Alto, CA, 94305, USA.
| | - Steven L Frick
- Department of Pediatric Orthopaedics, Stanford University, 300 Pasteur Drive, R107, Palo Alto, CA, 94305, USA
| |
Collapse
|
17
|
Chuang LH, Gumbs P, van Hout B, Agnelli G, Kroep S, Monreal M, Bauersachs R, Willich SN, Gitt A, Mismetti P, Cohen A, Jimenez D. Health-related quality of life and mortality in patients with pulmonary embolism: a prospective cohort study in seven European countries. Qual Life Res 2019; 28:2111-24. [PMID: 30949836 DOI: 10.1007/s11136-019-02175-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2019] [Indexed: 12/14/2022]
Abstract
Purpose Little is known about the quality of life following pulmonary embolism (PE). The aim of the study was to assess the 12-month illness burden in terms of health-related quality of life (HrQoL) and mortality, in relation to differences in patient characteristics. Methods The PREFER in VTE registry, a prospective, observational study conducted in seven European countries, was used. Within 2 weeks following an acute symptomatic PE, patients were recruited and followed up for 12 months. Associations between patient characteristics and HrQoL (EQ-5D-5L) and mortality were examined using a regression approach. Results Among 1399 PE patients, the EQ-5D-5L index score at baseline was 0.712 (SD 0.265), which among survivors gradually improved to 0.835 (0.212) at 12 months. For those patients with and without active cancer, the average index score at baseline was 0.658 (0.275) and 0.717 (0.264), respectively. Age and previous stroke were significant factors for predicting index scores in those with/without active cancer. Bleeding events but not recurrences had a noticeable impact on the HrQoL of patients without active cancer. The 12-month mortality rate post-acute period was 8.1%, ranging from 1.4% in Germany, Switzerland, and Austria to 16.8% in Italy. Mortality differed between patients with active cancer and those without (42.7% vs. 4.7%). Conclusion PE is associated with a substantial decrease in HrQoL at baseline which normalizes following treatment. PE is associated with a high mortality rate especially in patients with cancer, with significant country variation. Bleeding events, in particular, impact the burden of PE.
Collapse
|
18
|
Bulathsinhala L, Eleangovan N, Heaney LG, Menzies-Gow A, Gibson PG, Peters M, Hew M, van Boven JFM, Lehtimäki L, van Ganse E, Belhassen M, Harvey ES, Perez de Llano L, Maitland-van der Zee AH, Papadopoulos NG, FitzGerald JM, Porsbjerg C, Canonica GW, Backer V, Rhee CK, Verhamme KMC, Buhl R, Cosio BG, Carter V, Price C, Le T, Stagno d'Alcontres M, Gopalan G, Tran TN, Price D. Development of the International Severe Asthma Registry (ISAR): A Modified Delphi Study. J Allergy Clin Immunol Pract 2018; 7:578-588.e2. [PMID: 30179741 DOI: 10.1016/j.jaip.2018.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/30/2018] [Accepted: 08/13/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND The lack of centralized data on severe asthma has resulted in a scarcity of information about the disease and its management. The development of a common data collection tool for the International Severe Asthma Registry (ISAR) will enable standardized data collection, subsequently enabling data interoperability. OBJECTIVES To create a standardized list of variables for the first international registry for severe asthma via expert consensus. METHODS A modified Delphi process was used to reach consensus on a minimum set of variables to capture in ISAR: the core variables. The Delphi panel brought together 27 international experts in the field of severe asthma research. The process consisted of 3 iterative rounds. In each round, all Delphi panel members were issued an electronic ISAR Delphi workbook to complete and return to the ISAR Delphi administrator. Workbooks and result summaries were anonymously distributed by the Delphi administrator to all panel members at subsequent rounds. Finalization of the core variable list was facilitated by 2 face-to-face meetings. RESULTS Of the initial 747 selected variables, the Delphi panel reached a consensus on 95. The chosen variables will allow severe asthma to be assessed against patient demographics and medical history, patient-reported outcomes, diagnostic information, and clinical characteristics. Physician-reported outcomes such as nonadherence and information about treatment and management strategies will also be recorded. CONCLUSIONS This is the first global attempt to generate an ISAR using a common set of core variables to ensure that data collected across all participating countries are standardized.
Collapse
Affiliation(s)
| | | | - Liam G Heaney
- UK Severe Asthma Network and National Registry, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Andrew Menzies-Gow
- UK Severe Asthma Network and National Registry, Royal Brompton & Harefield National Health Service (NHS) Foundation Trust, London, UK
| | - Peter G Gibson
- Australasian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Matthew Peters
- University of Sydney Medical School, Sydney, NSW, Australia
| | - Mark Hew
- Allergy, Asthma & Clinical Immunology Service, Alfred Health, Melbourne, Australia
| | - Job F M van Boven
- Department of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital, University of Tampere, Tampere, Finland
| | | | | | - Erin S Harvey
- Australasian Severe Asthma Network, Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | | | - Anke H Maitland-van der Zee
- Amsterdam University Medical Center, University of Amsterdam, Department of Respiratory Medicine, Amsterdam, The Netherlands
| | | | | | | | - G Walter Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Milan, Italy; SANI-Severe Asthma Network Italy, Italy
| | - Vibeke Backer
- Bispebjerg Hospital, Copenhagen University, Copenhagen, Denmark
| | | | | | | | - Borja G Cosio
- Son Espases University Hospital-IdISBa-Ciberes, Mallorca, Spain
| | | | | | - Thao Le
- Optimum Patient Care, Cambridge, UK
| | | | | | | | - David Price
- Optimum Patient Care, Cambridge, UK; Observational and Pragmatic Research Institute, Singapore; Academic Primary Care, University of Aberdeen, Aberdeen, UK.
| |
Collapse
|
19
|
Sheikhtaheri A, Nahvijou A, Sedighi Z, Hadji M, Golmahi M, Roshandel G, Beiki O, Ravankhah Z, Zendehdel K. Development of a tool for comprehensive evaluation of population-based cancer registries. Int J Med Inform 2018; 117:26-32. [PMID: 30032962 DOI: 10.1016/j.ijmedinf.2018.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/24/2018] [Accepted: 06/09/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Several methods have been suggested for evaluation of population-based cancer registries (PBCR) worldwide. However, most of these methods evaluate the data and outputs of the cancer registries. This study aimed to develop a comprehensive tool and protocol for evaluation of inputs, processes and outputs of a PBCR. METHODS The standards of the North American Association of Central Cancer Registries (NAACCR) were used to draft a comprehensive checklist. In addition, the national guidelines of PBCR were used to develop a questionnaire for evaluation of knowledge and practice of the PBCR personnel. Furthermore, a protocol for evaluation of the completeness and validity of the PBCR data was developed according to the International Agency for Research on Cancer (IARC) and the NAACCR guidelines. A 0-4 Likert based score and expert opinions (10 experts) were used to assess validity of the eight questionnaires/checklists. A modified Delphi method was applied to validate the checklists and questionnaires. Questions with a score higher than 3 remained in the final tools. RESULTS The final package consists of 546 questions including 108 (19.8%) for evaluation of guidelines, 54 (9.9%) for analysis and reports, 87 (15.9%) for governance and infrastructure, 155 (28.4%) for information technology, 21 (3.8%) for personnel knowledge and 121 (22.2%) for their practice. Additionally, data quality indicators were also considered for evaluation of PBCRs. CONCLUSION This comprehensive tool can be used to show the gaps and limitations of the PBCR programs and provide informative clues for their improvement.
Collapse
|
20
|
Muenzer J, Giugliani R, Scarpa M, Tylki-Szymańska A, Jego V, Beck M. Clinical outcomes in idursulfase-treated patients with mucopolysaccharidosis type II: 3-year data from the hunter outcome survey (HOS). Orphanet J Rare Dis 2017; 12:161. [PMID: 28974237 PMCID: PMC5627440 DOI: 10.1186/s13023-017-0712-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 04/24/2017] [Accepted: 09/24/2017] [Indexed: 12/20/2022] Open
Abstract
Background Mucopolysaccharidosis type II (MPS II; Hunter syndrome) is a rare,
X-linked disorder caused by deficient activity of the enzyme
iduronate-2-sulfatase (I2S). Treatment is available in the form of enzyme
replacement therapy (ERT) with recombinant I2S. Clinical outcomes following
≥3 years of ERT with idursulfase were investigated in a broad population of
patients with MPS II enrolled in the Hunter Outcome Survey (HOS). Methods As of January 2016, 639 patients (excluding female patients,
individuals who had received a bone marrow transplant and those enrolled in the
phase 1/2 [TKT018] or phase 2/3 [TKT024] clinical trial) followed prospectively
in the registry had received idursulfase for ≥6 months. These individuals all
had data available for ≥1 clinical parameter at baseline and ≥1 additional time
point following treatment initiation. Changes in clinical parameters were
assessed in the subcohorts of patients with a measurement at baseline and at
year 1, 2 or 3 of treatment. Safety data from patients who started treatment at
or after enrollment in HOS (n = 233) were
also assessed. Results Median (10th, 90th percentiles) age at first treatment was 6.2 (2.1,
18.2) years and median treatment duration was 56.3 (18.2, 97.6) months. Urinary
glycosaminoglycan (uGAG) levels decreased from baseline to year 3 in patients
with data available at this time point (median change from baseline: −201.0
[−591.4, −21.9] μg/mg creatinine [n = 121]).
Improvements in the following parameters were observed at year 3 in the
subcohorts: 6-min walking test (6MWT) distance, 10.6 (−33.6, 50.8)% (n = 26); left ventricular mass index (LVMI), −9.3
(−31.5, 19.7)% (n = 52); absolute forced
vital capacity (FVC), 29.7 (−13.4, 66.7)% (n = 23); absolute forced expiratory volume in 1 s
(FEV1), 22.8 (−15.2, 62.1) % (n = 22); palpable liver size, −54.5 (−85.7, 50.0)% (n = 53); palpable spleen size, −33.3 (−80.0, 33.3)%
(n = 17). No new or unexpected safety
concerns were identified in this analysis. Conclusions These findings suggest that idursulfase has a positive effect on
uGAG levels, 6MWT results, LVMI, FVC, FEV1 and
hepatosplenomegaly after 1, 2 and 3 years treatment. Electronic supplementary material The online version of this article (10.1186/s13023-017-0712-3) contains supplementary material, which is available to authorized
users.
Collapse
Affiliation(s)
- Joseph Muenzer
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Roberto Giugliani
- Medical Genetics Service/HCPA, Department of Genetics/UFRGS and INAGEMP, Porto Alegre, Brazil
| | - Maurizio Scarpa
- Rare Disease Centre, Helios Dr. Horst Schmidt Clinic, Wiesbaden, Germany.,Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Anna Tylki-Szymańska
- Department of Pediatric Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Michael Beck
- Department of Pediatrics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
21
|
Schneeweiss M, Merola JF, Karlson EW, Solomon DH. Rationale and Design of the Brigham Cohort for psoriasis and psoriatic arthritis registry (COPPAR). BMC Dermatol 2017; 17:11. [PMID: 28814312 PMCID: PMC5559864 DOI: 10.1186/s12895-017-0063-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 08/07/2017] [Indexed: 02/27/2023]
Abstract
Background Psoriasis (PsO) and psoriatic arthritis (PsA) are related conditions with poorly defined transition among them, risk factors for progression, complex treatment algorithms, and biomarkers for treatment response and long-term outcomes. We describe the development of a PsO/PsA registry at an academic medical center. Methods We developed a single-center PsO/PsA longitudinal disease registry including biorepository that captures relevant disease markers and treatment choices in a circumscribed population with a defined catchment area. We searched the electronic medical record for patients with visits in the last year for PsO or PsA. They formed the potentially eligible registry population. Baseline patient and provider questionnaires were developed using standardized measures, including demographics, comorbidities, medications, specific disease characteristics, functional status, quality of life, mental health, and resource use. An abbreviated set of items was collected every six month and at visits with treatment changes or disease flares. Biospecimens included blood (serum, plasma, DNA, RNA) and skin biopsy samples, with repeat collections of serum and plasma. Data from the EMR to augment the registry questionnaires are available on all patients. Discussion Searching the Brigham EMR system from 2013 through 2014, we found 1694 patients with PsO and 1028 with PsA. Their mean age was 55 years and 53% were female. Of these 17% had diabetes, 38% hyperlipidemia, and 45% hypertension. The median BMI was 29.6. PsA patients used more systemic prednisone, MTX, and TNF alpha inhibitors (47%, 60%, and 66%) compared to PsO patients (28%, 20% and 21%). We have collected plasma in 410 patients, DNA/RNA in 453 patients. In conclusion, we have developed a PsO/PsA registry to better define longitudinal disease characteristics, perform biomarker studies, and examine treatment trends.
Collapse
Affiliation(s)
- Maria Schneeweiss
- Division of Rheumatology, Department of Medicine of the Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.,Department of Dermatology of the Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Joseph F Merola
- Division of Rheumatology, Department of Medicine of the Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.,Department of Dermatology of the Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Elizabeth W Karlson
- Division of Rheumatology, Department of Medicine of the Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Daniel H Solomon
- Division of Rheumatology, Department of Medicine of the Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. .,Division of Pharmacoepidemiology, Department of Medicine of the Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| |
Collapse
|
22
|
Napier KR, Tones M, Simons C, Heussler H, Hunter AA, Cross M, Bellgard MI. A web-based, patient driven registry for Angelman syndrome: the global Angelman syndrome registry. Orphanet J Rare Dis 2017; 12:134. [PMID: 28764722 PMCID: PMC5540301 DOI: 10.1186/s13023-017-0686-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Received: 07/11/2017] [Accepted: 07/24/2017] [Indexed: 02/19/2023] Open
Abstract
Angelman syndrome (AS) is a rare neurodevelopmental disorder that is characterised by severe global developmental delays, ataxia, loss of speech, epilepsy, sleep disorders, and a happy disposition. There is currently no cure for AS, though several pharmaceutical companies are anticipating drug trials for new therapies to treat AS. The Foundation for Angelman Therapeutics (FAST) Australia therefore identified a need for a global AS patient registry to identify patients for recruitment for clinical trials.The Global AS Registry was deployed in September 2016 utilising the Rare Disease Registry Framework, an open-source tool that enables the efficient creation and management of patient registries. The Global AS Registry is web-based and allows parents and guardians worldwide to register, provide informed consent, and enter data on individuals with AS. 286 patients have registered in the first 8 months since deployment.We demonstrate the successful deployment of the first patient-driven global registry for AS. The data generated from the Global AS Registry will be crucial in identifying patients suitable for clinical trials and in informing research that will identify treatments for AS, and ultimately improve the lives of individuals and their families living with AS.
Collapse
Affiliation(s)
- Kathryn R. Napier
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Megan Tones
- Mater Research, Centre for Children’s Health Research, South Brisbane, QLD 4101 Australia
| | - Chloe Simons
- Foundation for Angelman Syndrome Therapeutics Australia, Salisbury, QLD 4107 Australia
| | - Helen Heussler
- Mater Research, University of Queensland, Children’s Health Queensland Hospital and Health Service, Brisbane, QLD 4101 Australia
| | - Adam A. Hunter
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Meagan Cross
- Foundation for Angelman Syndrome Therapeutics Australia, Salisbury, QLD 4107 Australia
| | - Matthew I. Bellgard
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| |
Collapse
|
23
|
Bellgard MI, Walker CE, Napier KR, Lamont L, Hunter AA, Render L, Radochonski M, Pang J, Pedrotti A, Sullivan DR, Kostner K, Bishop W, George PM, O'Brien RC, Clifton PM, Bockxmeer FMV, Nicholls SJ, Hamilton-Craig I, Dawkins HJ, Watts GF. Design of the Familial Hypercholesterolaemia Australasia Network Registry: Creating Opportunities for Greater International Collaboration. J Atheroscler Thromb 2017; 24:1075-1084. [PMID: 28344196 PMCID: PMC5656770 DOI: 10.5551/jat.37507] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 12/12/2022] Open
Abstract
Familial Hypercholesterolemia (FH) is the most common and serious monogenic disorder of lipoprotein metabolism that leads to premature coronary heart disease. There are over 65,000 people estimated to have FH in Australia, but many remain undiagnosed. Patients with FH are often undertreated, but with early detection, cascade family testing and adequate treatment, patient outcomes can improve. Patient registries are key tools for providing new information on FH and enhancing care worldwide. The development and design of the FH Australasia Network Registry is a crucial component in the comprehensive model of care for FH, which aims to provide a standardized, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes. Informed by stakeholder engagement, the FH Australasia Network Registry was collaboratively developed by government, patient and clinical networks and research groups. The open-source, webbased Rare Disease Registry Framework was the architecture chosen for this registry owing to its open-source standards, modular design, interoperability, scalability and security features; all these are key components required to meet the ever changing clinical demands across regions. This paper provides a high level blueprint for other countries and jurisdictions to help inform and map out the critical features of an FH registry to meet their particular health system needs.
Collapse
Affiliation(s)
| | - Caroline E Walker
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia
| | | | - Leanne Lamont
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia
| | - Adam A Hunter
- Centre for Comparative Genomics, Murdoch University, Murdoch
| | - Lee Render
- Centre for Comparative Genomics, Murdoch University, Murdoch
| | | | - Jing Pang
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia
| | - Annette Pedrotti
- Familial Hypercholesterolaemia Family Support Group of Western Australia
| | | | | | - Warrick Bishop
- Menzies Institute for Medical Research, University of Tasmania
| | | | | | - Peter M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia
| | - Frank M Van Bockxmeer
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital.,School of Surgery, University of Western Australia
| | - Stephen J Nicholls
- South Australian Health and Medical Research Institute, University of Adelaide
| | | | - Hugh Js Dawkins
- Centre for Comparative Genomics, Murdoch University, Murdoch.,Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia.,Centre for Population Health Research, Curtin University of Technology.,School of Pathology and Laboratory Medicine, University of Western Australia
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia.,Lipid Disorders Clinic, Cardiometabolic Service, Royal Perth Hospital
| |
Collapse
|
24
|
Ricci G, Ruggiero L, Vercelli L, Sera F, Nikolic A, Govi M, Mele F, Daolio J, Angelini C, Antonini G, Berardinelli A, Bucci E, Cao M, D'Amico MC, D'Angelo G, Di Muzio A, Filosto M, Maggi L, Moggio M, Mongini T, Morandi L, Pegoraro E, Rodolico C, Santoro L, Siciliano G, Tomelleri G, Villa L, Tupler R. A novel clinical tool to classify facioscapulohumeral muscular dystrophy phenotypes. J Neurol 2016; 263:1204-14. [PMID: 27126453 PMCID: PMC4893383 DOI: 10.1007/s00415-016-8123-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 01/09/2016] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 11/06/2022]
Abstract
Based on the 7-year experience of the Italian Clinical Network for FSHD, we revised the FSHD clinical form to describe, in a harmonized manner, the phenotypic spectrum observed in FSHD. The new Comprehensive Clinical Evaluation Form (CCEF) defines various clinical categories by the combination of different features. The inter-rater reproducibility of the CCEF was assessed between two examiners using kappa statistics by evaluating 56 subjects carrying the molecular marker used for FSHD diagnosis. The CCEF classifies: (1) subjects presenting facial and scapular girdle muscle weakness typical of FSHD (category A, subcategories A1–A3), (2) subjects with muscle weakness limited to scapular girdle or facial muscles (category B subcategories B1, B2), (3) asymptomatic/healthy subjects (category C, subcategories C1, C2), (4) subjects with myopathic phenotype presenting clinical features not consistent with FSHD canonical phenotype (D, subcategories D1, D2). The inter-rater reliability study showed an excellent concordance of the final four CCEF categories with a κ equal to 0.90; 95 % CI (0.71; 0.97). Absolute agreement was observed for categories C and D, an excellent agreement for categories A [κ = 0.88; 95 % CI (0.75; 1.00)], and a good agreement for categories B [κ = 0.79; 95 % CI (0.57; 1.00)]. The CCEF supports the harmonized phenotypic classification of patients and families. The categories outlined by the CCEF may assist diagnosis, genetic counseling and natural history studies. Furthermore, the CCEF categories could support selection of patients in randomized clinical trials. This precise categorization might also promote the search of genetic factor(s) contributing to the phenotypic spectrum of disease.
Collapse
Affiliation(s)
- Giulia Ricci
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Lucia Ruggiero
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Liliana Vercelli
- Department of Neuroscience, Center for Neuromuscular Diseases, University of Turin, Turin, Italy
| | - Francesco Sera
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK
| | - Ana Nikolic
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Govi
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabiano Mele
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jessica Daolio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Giovanni Antonini
- Department of Neuroscience, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome "Sapienza", Rome, Italy
| | - Angela Berardinelli
- Unit of Child Neurology and Psychiatry, IRCCS "C. Mondino" Foundation, Pavia, Italy
| | - Elisabetta Bucci
- Department of Neuroscience, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome "Sapienza", Rome, Italy
| | | | - Maria Chiara D'Amico
- Center for Neuromuscular Disease, CeSI, University "G. D'Annunzio", Chieti, Italy
| | - Grazia D'Angelo
- Department of Neurorehabilitation, IRCCS Institute Eugenio Medea, Bosisio Parini, Italy
| | - Antonio Di Muzio
- Center for Neuromuscular Disease, CeSI, University "G. D'Annunzio", Chieti, Italy
| | | | - Lorenzo Maggi
- IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy
| | - Maurizio Moggio
- Neuromuscular Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Tiziana Mongini
- Department of Neuroscience, Center for Neuromuscular Diseases, University of Turin, Turin, Italy
| | - Lucia Morandi
- IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy
| | - Elena Pegoraro
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Carmelo Rodolico
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Lucio Santoro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Giuliano Tomelleri
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Luisa Villa
- Neuromuscular Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, University of Milan, Milan, Italy
| | - Rossella Tupler
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Molecular Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, USA.
| |
Collapse
|
25
|
Mancuso M, Orsucci D, Angelini C, Bertini E, Carelli V, Comi GP, Federico A, Minetti C, Moggio M, Mongini T, Tonin P, Toscano A, Bruno C, Ienco EC, Filosto M, Lamperti C, Diodato D, Moroni I, Musumeci O, Pegoraro E, Spinazzi M, Ahmed N, Sciacco M, Vercelli L, Ardissone A, Zeviani M, Siciliano G. "Mitochondrial neuropathies": A survey from the large cohort of the Italian Network. Neuromuscul Disord 2016; 26:272-6. [PMID: 27020842 DOI: 10.1016/j.nmd.2016.02.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 02/10/2016] [Accepted: 02/15/2016] [Indexed: 11/21/2022]
Abstract
Involvement of the peripheral nervous system in mitochondrial disorders has been previously reported. However, the prevalence of peripheral neuropathy in mitochondrial disorders is still unclear. Based on the large database of the "Nation-wide Italian Collaborative Network of Mitochondrial Diseases", we reviewed the clinical data of 1200 patients, with special regard to peripheral neuropathy (mean age at onset 24.3 ± 20.1 years; age at last evaluation 39.8 ± 22.3 years; females 52.7%; childhood onset [before age 16 years] 43.1%). Peripheral neuropathy was present in 143/1156 patients (12.4%), being one of the ten most common signs and symptoms. POLG mutations cause a potentially painful, axonal/mixed, mainly sensory polyneuropathy; TYMP mutations lead to a demyelinating sensory-motor polyneuropathy; SURF1 mutations are associated with a demyelinating/mixed sensory-motor polyneuropathy. The only mtDNA mutation consistently associated with peripheral neuropathy (although less severely than in the above-considered nuclear genes) was the m.8993T > G (or the rarer T > C) changes, which lead to an axonal, mainly sensory polyneuropathy. In conclusion, peripheral neuropathy is one of the most common features of a mitochondrial disorder, and may negatively impact on the quality of life of these patients. Furthermore, the presence or absence of peripheral neuropathy, as well as its specific forms and the association with neuropathic pain (indicative of a POLG-associated disease) can guide the molecular analysis.
Collapse
|