AI Article Synopsis
Article Abstract
Background: Reducing the dose of biological therapy (BT) when patients with immune-mediated arthritis achieve a sustained therapeutic goal may help to decrease costs for national health services and reduce the risk of serious infection. However, there is little information about whether such a decision can be applied universally. Therefore, the objective of this study was to develop appropriateness criteria for reducing the dose of BT in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and peripheral spondyloarthritis (pSpA).
Methods: The RAND/UCLA appropriateness method was coordinated by experts in the methodology. Five rheumatologists with clinical research experience in RA and/or SpA selected and precisely defined the variables considered relevant when deciding to reduce the dose of BT in the 3 diseases, in order to define patient profiles. Ten rheumatologists with experience in prescribing BT anonymously rated each profile on a scale of 1 (completely inappropriate) to 9 (completely appropriate) after revising a summary of the evidence obtained from 4 systematic literature reviews carried out specifically for this project.
Findings: A total of 2,304 different profiles were obtained for RA, 768 for axSpA, and 3,072 for pSpA. Only 327 (14.2%) patient profiles in RA, 80 (10.4%) in axSpA, and 154 (5%) in pSpA were considered appropriate for reducing the dose of BT. By contrast, 749 (32.5%) patient profiles in RA, 270 (35.3%) in axSpA, and 1,243 (40.5%) in pSpA were considered inappropriate. The remaining profiles were considered uncertain.
Interpretation: Appropriateness criteria for reducing the dose of BT were developed in 3 inflammatory conditions. These criteria can help clinicians treating these disorders to optimize the BT dose. However, further research is needed, since more than 50% of the profiles were considered uncertain and the real prevalence of each profile in daily clinical practice remains unknown.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727544 | PMC |
| http://dx.doi.org/10.1016/j.heliyon.2017.e00452 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Gadopiclenol Enables Reduced Gadolinium Dose While Maintaining Quality of Pulmonary Arterial Enhancement for Pulmonary MRA: An Opportunity for Improved Safety and Sustainability.
Invest Radiol
January 2025
From the Departments of Radiology (J.F.H., S.Y.C., J.-P.G., J.S., P.N., S.B.R., T.M.G.), Biomedical Engineering (S.B.R., T.M.G.), Medical Physics (S.Y.C., S.B.R., T.M.G.), Medicine (S.B.R.), and Emergency Medicine (S.B.R.), University of Wisconsin-Madison, WI; and Department of Diagnostic and Interventional Radiology (J.F.H., J.-P.G.), University Hospital Würzburg, Würzburg, Germany.
Rationale And Objectives: Pulmonary magnetic resonance angiography (MRA) is an imaging method with proven utility for the exclusion of pulmonary embolism and avoids the need for ionizing radiation and iodinated contrast agents. High-relaxivity gadolinium-based contrast agents (GBCAs), such as gadopiclenol, can be used to reduce the required gadolinium dose for pulmonary MRA. The aim of this study was to compare the contrast enhancement performance of gadopiclenol with an established gadobenate dimeglumine-enhanced pulmonary MRA protocol.
View Article and Find Full Text PDFEffect of different doses of dexmedetomidine on atrial fibrillation in adults after cardiac surgery.
J Cardiovasc Pharmacol
January 2025
Department of Anesthesiology, Jining No. 1 People's Hospital, Jining, Shandong, China.
In this study, we compared the effects of various doses of dexmedetomidine on the incidence of atrial fibrillation following cardiac surgery in adults. 224 adult patients who underwent elective cardiac surgery were randomly assigned to two groups. The DEX0.
View Article and Find Full Text PDFExploiting YES1-driven EGFR expression improves the efficacy of EGFR inhibitors.
Mol Cancer Res
January 2025
Cleveland Clinic, Cleveland, OH, United States.
Epidermal growth factor receptor (EGFR) is a highly expressed driver of many cancers, yet the utility of EGFR inhibitors is limited to cancers that harbor sensitizing mutations in the EGFR gene due to dose limiting toxicities. Rather than conventionally blocking the kinase activity of EGFR, we sought to reduce its transcription as an alternative approach to broaden the therapeutic window for EGFR inhibitors targeting wildtype or mutant EGFR. We found that YES1 is highly expressed in triple negative breast cancer (TNBC) and drives cell growth by elevating EGFR levels.
View Article and Find Full Text PDFDose-Response Relationship of Phloretin Therapy on Water and Glucose Transport during Experimental Peritoneal Dialysis.
Kidney360
January 2025
Lund University, Skåne University Hospital, Clinical Sciences Lund, Department of Nephrology, Lund, Sweden.
Background: Water retention, ultrafiltration insufficiency, and metabolic complications due to abnormally high glucose concentrations are still common problems in patients treated with peritoneal dialysis. Phloretin, a nonselective inhibitor of facilitative glucose transporter channels (GLUT), has shown to improve water transport and lower glucose absorption in experimental peritoneal dialysis. However, the dose-response relationship remains unknown, and we therefore performed a dose-response study to elucidate the pharmacodynamic properties of intra-peritoneal phloretin therapy.
View Article and Find Full Text PDFUnlabelled: One of the principles of prevention and non-drug treatment of liver diseases, including hepatitis of various etiologies, is the normalization of the diet, including the use of daily diet foods with physiologically active ingredients, in particular betulin, which helps to reduce metabolic and oxidative processes within liver cells. The aim of the work was to evaluate the in vivo effect of triterpene alcohol betulin Roth isolated from the bark of birch Betula pendula Roth. added to fat-containing products (for example, mayonnaise) on the biochemical parameters of blood and the morphological structure of the liver of rats with initiated acute toxic hepatitis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!