scholarly journals Refractory Acute Interstitial Nephritis in the Setting of Nivolumab Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Faieta ◽  
Tavis Dancik
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Interstitial Nephritis ◽  
Acute Interstitial Nephritis ◽  
Term Treatment ◽  
Steroid Dependent ◽  
Long Term Treatment ◽  
Grade 3

A 65-year-old male patient with metastatic CCRCC developed steroid-dependent, grade 3 AIN secondary to nivolumab weeks after its initiation that resulted in 3 hospitalizations with acute renal failure. The patient was started on MM and his AIN was successfully controlled after a 2-year period of follow-up. Refractory renal AIN resulting from PD-1 inhibitor use is rare, and its successful treatment with mofetil mycophenolate with a 2-year follow-up in a patient with metastatic CCRCC has not been reported. This case is important because not only was his renal irAEs controlled but also long-term treatment with MM did not result in progression of metastatic disease.

scholarly journals Slower Elimination of Tofacitinib in Acute Renal Failure Rat Models: Contribution of Hepatic Metabolism and Renal Excretion

Pharmaceutics ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 714
Author(s):  
Sung Hun Bae ◽  
Sun-Young Chang ◽  
So Hee Kim
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Hepatic Metabolism ◽  
Term Treatment ◽  
Concentration Time ◽  
Long Term Treatment ◽  
Total Body ◽  
Body Clearance

Tofacitinib is a Jak inhibitor developed as a treatment for rheumatoid arthritis. Tofacitinib is metabolized mainly through hepatic CYP3A1/2, followed by CYP2C11. Rheumatoid arthritis tends to increase renal toxicity due to drugs used for long-term treatment. In this study, pharmacokinetic changes of tofacitinib were evaluated in rats with gentamicin (G-ARF) and cisplatin-induced acute renal failure (C-ARF). The time-averaged total body clearance (CL) of tofacitinib in G-ARF and C-ARF rats after 1-min intravenous infusion of 10 mg/kg was significantly decreased by 37.7 and 62.3%, respectively, compared to in control rats. This seems to be because the time-averaged renal clearance (CLR) was significantly lower by 69.5 and 98.6%, respectively, due to decreased creatinine clearance (CLCR). In addition, the time-averaged nonrenal clearance (CLNR) was also significantly lower by 33.2 and 57.4%, respectively, due to reduction in the hepatic CYP3A1/2 and CYP2C11 subfamily in G-ARF and C-ARF rats. After oral administration of tofacitinib (20 mg/kg) to G-ARF and C-ARF rats, both CLR and CLNR were also significantly decreased. In conclusion, an increase in area under plasma concentration-time curves from time zero to time infinity (AUC) of tofacitinib in G-ARF and C-ARF rats was due to the significantly slower elimination of tofacitinib contributed by slower hepatic metabolism and urinary excretion of the drug.

Good Safety and Tolerance Profiles of Long Term Treatment of Advanced Multiple Myeloma (MM) with Bortezomib.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4811-4811
Author(s):  
Jean El-Cheikh ◽  
Anne-Marie Stoppa ◽  
Reda Bouabdallah ◽  
Diane Coso ◽  
Jean-Marc Schiano de Collela ◽  
...  
Keyword(s):  
Dose Reduction ◽  
Term Treatment ◽  
Term Therapy ◽  
Cycle Duration ◽  
Disease Response ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Grade 3

Abstract Bortezomib is a first-in-class proteasome inhibitor approved for the treatment of MM patients who have received at least one prior therapy. Classically, patients receive bortezomib 1.3 or 1.0 mg/m2 by IV bolus on days 1, 4, 8, and 11 of a 21-day cycle, associated or not to dexamethasone, for a total number of 8 cycles. Such administration schema is associated with a remarkable anti-tumor activity and response. However, a significant number of patients who are initially responders to bortezomib, will progress after drug discontinuation, raising the question of long term or maintenance treatment with bortezomib. The objective of this analysis was to evaluate the tolerance and safety profiles of long term treatment with bortezomib in a cohort of 16 patients with relapsed and/or refractory MM treated in a single institution. Eligible patients for this analysis are those who had relapsed MM, and who continued to receive bortezomib (1.3 or 1.0 mg/m2) as a long term therapy beyond the classical 8 cycles. All medical charts were uniformly reviewed in detail for assessment of toxicity, safety and response. The median age was 53 (range, 27–74) years. The majority of patients had already received at least one prior autologous or allogeneic stem cell transplantation (n=12; 75%). Also, 12 patients (75%) had received prior treatment with thalidomide at a median dose of 200 mg/day, for a median duration of 7 months. Before treatment with bortezomib, 7 patients (44%) already had some form of peripheral neuropathy (PN). With a median follow-up of 16 months from bortezomib initiation, patients from this series received a median of 10 (range, 9–16) cycles of bortezomib administered over a median period of 11 (range, 7–35) months. Overall, 6 patients had evidence of bortezomib-associated PN (38%; 4 grade 1, 1 grade 2 and 1 grade 3; sensory symptoms in all cases). Other bortezomib-related toxicities included thromobopenia (n=8; 50%; 1 grade 1, 5 grade 2, and 2 grade 3–4). General fatigue was also common and was encountered in 5 (31%) patients. Overall, bortezomib-associated toxicities led to dose reduction or increase of treatment cycle duration in 9 patients (56%), but none of the patients had to definitively discontinue treatment because of unacceptable toxicity. At last follow-up, 6 patients are still receiving bortezomib, 4 patients died from disease progression, no patient died from treatment-related causes, and the remaining 12 patients are still alive. Long term treatment with bortezomib was associated with an objective disease response rate in 87% (95%CI, 60–98%) of patients (n=14; 3 CR, 8 VGPR, 3 PR). The Kaplan-Meier estimate for overall survival is shown in the figure below. Though relatively small, results from this series suggest that long term treatment with bortezomib is feasible. Toxicity, tolerance and safety profiles of long term treatment are comparable to those observed with the standard schedule and manageable after dose reduction. Therefore, prospective studies aiming to optimize bortezomib administration schedule and duration (beyond the classical 8 cycles) are warranted, since such long term treatment can yield major objective disease response. Figure Figure

Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

2013 ◽  
Author(s):  
Christina Marel ◽  
Maree Teesson ◽  
Shane Darke ◽  
Katherine Mills ◽  
Joanne Ross ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Heroin Dependence ◽  
Long Term Treatment

scholarly journals Renal function following acute renal failure in childhood: A long term follow-up study

1989 ◽  
Vol 35 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Helen N. Georgaki-Angelaki ◽  
David B. Steed ◽  
Cyril Chantler ◽  
George B. Haycock
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Follow Up Study ◽  
Long Term Follow Up

Acute Renal Failure due to Allergic Interstitial Nephritis: Long Term Outcome

1991 ◽  
pp. 101-106
Author(s):  
Quirino Maggiore ◽  
G. Enia ◽  
G. Catalano ◽  
C. Martorano ◽  
F. Bartolomeo
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Interstitial Nephritis ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST

2020 ◽  
Author(s):  
Na Wu ◽  
Yuhong Chen ◽  
Yaping Yang ◽  
Xinghuai Sun
Keyword(s):  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Biomechanical Properties ◽  
Term Treatment ◽  
Prostaglandin Analogue ◽  
Corvis St ◽  
Long Term Treatment ◽  
Corneal Biomechanical Properties

Abstract Background: To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA). Methods: 111 newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between follow-up time and corneal biomechanics．Results: The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β=-0.0015, P=0.016), the first applanation velocity (AV1, β=-0.0004, P=0.00058) decreased and the first applanation time (AT1, β=0.0089, P<0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P=0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P=0.00002) in NTG than in HTG after adjusting for confounding factors.Conclusions: Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.

scholarly journals Long term dual antiplatelet therapy after myocardial infarction: retrospective analysis in an outpatient population

2021 ◽  
Author(s):  
Gennaro Ratti ◽  
Antonio Maglione ◽  
Emilia Biglietto ◽  
Cinzia Monda ◽  
Ciro Elettrico ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Term Treatment ◽  
Multivessel Disease ◽  
Coronary Syndrome ◽  
Anticoagulant Drugs ◽  
Long Term Treatment ◽  
Risk Condition ◽  
History Of

Long term treatment with ticagrelor 60 mg and low-dose aspirin are indicated after acute coronary syndrome (ACS). We retrospectively reviewed aggregate data of 187 patients (155 M and 38 F) (mean age 63.8±9 years) in follow up after ACS with at least one high risk condition (Multivessel disease, diabetes, GFR<60 mL/min, history of prior myocardial infarction, age >65 years) treated with ticagrelor 60 mg twice daily (after 90 mg twice daily for 12 months). The results were compared with findings (characteristics of the patients at baseline, outcomes, bleeding) of PEGASUS-TIMI 54 trial and Eu Label. The highrisk groups were represented as follows: multivessel disease 105 pts (82%), diabetes 63 pts (33%), GFR< 60 mL/min 27 pts (14%), history of prior MI 33 pts (17%), >65 year aged 85 pts (45%). Treatment was withdrawn in 7 patients: 3 cases showed atrial fibrillation and were placed on oral anticoagulant drugs, one developed intracranial bleeding, in three patients a temporary withdrawal was due to surgery (1 colon polyposis and 2 cases of bladder papilloma). Chest pain without myocardial infarction occurred in 16 patients (revascularization was required in 9 patients). Dyspnea was present in 15 patients, but was not a cause for discontinuation of therapy. Long term treatment with ticagrelor 60 mg twice daily plus aspirin 100 mg/day showed a favourable benefit/risk profile after ACS.  In this study all patients had been given ticagrelor 90 mg twice daily for 12 months and the 60 mg twice daily dosage was started immediately thereafter, unlike PEGASUS-TIMI 54 trial in which it was prescribed within a period ranging from 1 day to 1 year after discontinuation of the 90 mg dose. This makes our results more consistent with current clinical practice. However, a careful outpatient follow-up and constant counseling are mandatory to check out compliance to therapy and adverse side effects.

Dihydroergokryptine as long-term treatment of alzheimer type dementia: A multicenter two-year follow-up

1998 ◽  
Vol 26 ◽  
pp. 103-110 ◽  
Author(s):  
D. Cucinotta ◽  
D. De Leo ◽  
L. Frattola ◽  
M. Trabucchi ◽  
M.G. Albizatti ◽  
...  
Keyword(s):  
Term Treatment ◽  
Alzheimer Type ◽  
Alzheimer Type Dementia ◽  
Long Term Treatment
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