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Mastronardi M, Curlo M, Cavalcanti E, Burattini O, Cuppone R, Tauro R, De Santis S, Serino G, Pesole PL, Stasi E, Caruso ML, Donghia R, Guerra V, Giorgio P, Chieppa M. Administration Timing Is the Best Clinical Outcome Predictor for Adalimumab Administration in Crohn's Disease. Front Med (Lausanne) 2019; 6:234. [PMID: 31737635 PMCID: PMC6838026 DOI: 10.3389/fmed.2019.00234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 05/27/2019] [Accepted: 10/03/2019] [Indexed: 01/01/2023] Open
Abstract
Biological intervention for Crohn's Disease (CDs) patients, mainly using anti-TNF antibodies, is often an efficient therapeutic solution. Nonetheless, data defining the administration timing to maximize the chances of clinical remission are lacking. The objective of this “real-life” retrospective study was to evaluate if early Adalimumab (ADA) administration (<12 months) was an efficient strategy to improve patients' clinical outcome. This single center study included 157 CD patients, of which 80 received the first ADA administration within the first 12 months from the diagnosis. After 1 year of therapy, clinical remission was observed in 50.32% of patients, mucosal healing in 37.58%. Clinical remission was observed in 66.25% of the early ADA administration patients vs. 33.77% of the late (>12 months) (p < 0.001); mucosal healing was observed in 53.75% of the early vs. 20.78% of the late (p < 0.001). Dose escalation was required for 30.00% of the early vs. 66.23% of the late (<0.01). In the early ADA administration group, 7.50% patients were considered non-responders at the end of the follow-up vs. 22.08% patients in the late administration group. These findings highlighted that early ADA administration (within 1 year of diagnosis) improves the clinical response and mucosal healing, and reduces the loss of response rate and need for dose escalation.
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Affiliation(s)
- Mauro Mastronardi
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Margherita Curlo
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Elisabetta Cavalcanti
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Osvaldo Burattini
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Renato Cuppone
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Romina Tauro
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Stefania De Santis
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy.,Department of Pharmacy, Faculty of Pharmacy and Medicine, University of Salerno, Fisciano, Italy
| | - Grazia Serino
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Pasqua Letizia Pesole
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Elisa Stasi
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Maria Lucia Caruso
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Rossella Donghia
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Vito Guerra
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Pietro Giorgio
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
| | - Marcello Chieppa
- Department of Research, National Institute of Gastroenterology "S. de Bellis", Bari, Italy
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Tauro R, Heaney A, Lennon D, Hull K. 35 * DELIRIUM AWARENESS - IMPROVING RECOGNITION AND MANAGEMENT THROUGH TRAINING AND EDUCATION. Age Ageing 2014. [DOI: 10.1093/ageing/afu124.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tauro R, Heaney A, Gibson R, Lennon D, Hull K. 36 * A MULTI-FACTORIAL ASSESSMENT AND INTERVENTIONAL PROGRAMME CAN DECREASE INPATIENT FALLS: AN UPDATE. Age Ageing 2014. [DOI: 10.1093/ageing/afu124.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Di Minno G, Martinez J, Cirillo F, Cerbone AM, Silver MJ, Colucci M, Margaglione M, Tauro R, Semeraro N, Quattrone A. A role for platelets and thrombin in the juvenile stroke of two siblings with defective thrombin-adsorbing capacity of fibrin(ogen). Arterioscler Thromb 1991; 11:785-96. [PMID: 1829631 DOI: 10.1161/01.atv.11.4.785] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Binding of iodine-125-labeled thrombin to fibrin clots from two siblings with juvenile stroke was 30% of normal, and abnormally high amounts of the radioligand (not adsorbed by fibrin) were found in the supernatant. In concordance with this finding, supernatants from the patients' fibrin clots caused abnormal enhancement of platelet aggregation, ATP secretion, and binding of 125I-fibrinogen to platelets exposed to subthreshold concentrations of ADP or epinephrine. Hirudin suppressed the enhancing effect of the patients' supernatants, and substitution of gamma-thrombin for alpha-thrombin led to normalization of platelet responses. Under some experimental conditions, degradation of the patients' fibrinogen by plasmin was impaired. However, the euglobulin lysis time, the rate of fibrin degradation by plasmin, and the lysis of the patients' plasma clots by human melanoma tissue-type plasminogen activator were normal. Patients' plasmas, as well as purified fibrinogen, showed a prolonged thrombin time (partially corrected by 10 mM CaCl2) and an impaired release of fibrinopeptide A in response to thrombin. However, the release in response to reptilase was normal, and the reptilase, ancrod, and thrombin coagulase times were within control (normal) values. In addition, the patients' fibrinogen showed normal polymerization of preformed fibrin monomers, normal sialic acid content, and normal binding to ADP or epinephrine-stimulated platelets. Our studies support the concept that thrombin and platelets play an important role in the occurrence of stroke in these patients and suggest a direction to be followed to identify the mechanism(s) contributing to thrombosis in subjects with abnormal fibrinopeptide release.
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Affiliation(s)
- G Di Minno
- Istituto di Medicina Interna e Malattie Dismetaboliche, Università degli Studi di Napoli, Italy
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