3 research outputs found
Real-Life Effectiveness and Safety of Baricitinib as Adjunctive to Standard-of-Care Treatment in Hospitalized Patients With Severe Coronavirus Disease 2019
Background. Therapeutic options for hospitalized patients with severe
coronavirus disease 2019 (sCOVID-19) are limited. Preliminary data have
shown promising results with baricitinib, but real-life experience is
lacking. We assessed the safety and effectiveness of add-on baricitinib
to standard-of-care (SOC) including dexamethasone in hospitalized
patients with sCOVID-19.
Methods. This study is a 2-center, observational, retrospective cohort
study of patients with sCOVID-19, comparing outcomes and serious events
between patients treated with SOC versus those treated with SOC and
baricitinib combination.
Results. We included 369 patients with sCOVID-19 (males 66.1%; mean age
65.2 years; median symptom duration 6 days). The SOC was administered in
47.7% and combination in 52.3%. Patients treated with the combination
reached the composite outcome (intensive care unit [ICU] admission or
death) less frequently compared with SOC (22.3% vs 36.9%, P = .002).
Mortality rate was lower with the combination in the total cohort
(14.7% vs 26.6%, P = .005), and ICU admission was lower in patients
with severe acute respiratory distress syndrome (29.7% vs 44.8%, P =
.03). By multivariable analysis, age (odds ratio [OR] = 1.82, 95%
confidence interval [CI] = 1.36-2.44, per 10-year increase), partial
pressure of oxygen/fraction of inspired oxygen ratio (OR = 0.60, 95% CI
= .52-0.68, per 10 units increase), and use of high-flow nasal cannula
(OR = 0.34; 95% CI, .16-0.74) were associated with the composite
outcome, whereas baricitinib use was marginally not associated with the
composite outcome (OR = 0.52; 95% CI, .26-1.03). However, baricitinib
use was found to be significant after inverse-probability weighted
regression (OR = 0.93; 95% CI, .87-0.99). No difference in serious
events was noted between treatment groups.
Conclusions. In real-life settings, addition of baricitinib to SOC in
patients hospitalized with sCOVID-19 is associated with decreased
mortality without concerning safety signals
ERCC1 19007 Polymorphism in Greek Patients with Advanced Urothelial Cancer Treated with Platinum-Based Chemotherapy: Effect of the Changing Treatment Paradigm: A Cohort Study by the Hellenic GU Cancer Group
We previously showed that ERCC1 19007 C>T polymorphism was associated with cancer-specific survival (CSS) after platinum-based chemotherapy in patients with advanced urothelial cancer (aUC). We aimed to confirm this association in a different cohort of patients. Genotyping of the 19007C>T polymorphism was carried out by polymerase chain reaction (PCR) amplification and restriction fragment length polymorphism (RFLP) in 98 aUC patients, treated with platinum-based chemotherapy. Median age of the patients was 68.8, 13.3% of them were female, 90.8% had ECOG PS of 0 or 1, and 48% received cisplatin-based chemotherapy. In addition to chemotherapy, 32.7% of the patients received immunotherapy, and 19.4% vinflunine. Eighty-one patients (82.7%) were carriers of the 19007T polymorphic allele: 46 (46.9%) were heterozygotes, and 35 (35.7%) were homozygotes. The ERCC1 polymorphism was not associated with CSS, progression-free (PFS), or overall (OS) survival in the total population. Nevertheless, there was a significant interaction between the prognostic significance of ERCC1 polymorphism and the use of modern immunotherapy: the T allele was associated with worse outcome in patients who received chemotherapy only, while this association was lost in patients who received both chemotherapy and immune checkpoint inhibitors. Our study suggests that novel therapies may influence the significance of ERCC1 polymorphism in patients with aUC. Its determination may be useful in the changing treatment landscape of the disease
ERCC1 19007 Polymorphism in Greek Patients with Advanced Urothelial Cancer Treated with Platinum-Based Chemotherapy: Effect of the Changing Treatment Paradigm: A Cohort Study by the Hellenic GU Cancer Group
We previously showed that ERCC1 19007 C>T polymorphism was associated
with cancer-specific survival (CSS) after platinum-based chemotherapy in
patients with advanced urothelial cancer (aUC). We aimed to confirm this
association in a different cohort of patients. Genotyping of the
19007C>T polymorphism was carried out by polymerase chain reaction (PCR)
amplification and restriction fragment length polymorphism (RFLP) in 98
aUC patients, treated with platinum-based chemotherapy. Median age of
the patients was 68.8, 13.3% of them were female, 90.8% had ECOG PS of
0 or 1, and 48% received cisplatin-based chemotherapy. In addition to
chemotherapy, 32.7% of the patients received immunotherapy, and 19.4%
vinflunine. Eighty-one patients (82.7%) were carriers of the 19007T
polymorphic allele: 46 (46.9%) were heterozygotes, and 35 (35.7%) were
homozygotes. The ERCC1 polymorphism was not associated with CSS,
progression-free (PFS), or overall (OS) survival in the total
population. Nevertheless, there was a significant interaction between
the prognostic significance of ERCC1 polymorphism and the use of modern
immunotherapy: the T allele was associated with worse outcome in
patients who received chemotherapy only, while this association was lost
in patients who received both chemotherapy and immune checkpoint
inhibitors. Our study suggests that novel therapies may influence the
significance of ERCC1 polymorphism in patients with aUC. Its
determination may be useful in the changing treatment landscape of the
disease