Особливості імуно-гормонального та мікробіологічного статусу у жінок з різними морфологічними формами поліпів ендометрія

Обследовано 58 женщин с полипами эндометрия. Выявлены особенности микробиологического пейзажа, гормонального и иммунного статуса в зависимости от морфологических форм полипов эндометрия. проведенный анализ позволил выделить группы риска по развитию полипов эндометрия. показано, что полип эндометрия следует рассматривать не как местный процесс, а как реакцию эндометрия в ответ на повреждение гормонального и иммунного гомеостаза, что необходимо учитывать при выборе лечения данной патологии58 women with endometrial polyps were investigated. Specific microflora and hormonal and immune status depending on the morphological forms of endometrial polyps were found. The analysis performed allowed to allocate risk groups according to development of endometrial polyp. It was shown that endometrial polyp shall be considered as endometrial reaction in response to hormonal and immune homeostasis disorder, rather than local process. This should be borne in mind when choosing treatment for this patholog

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

Spontaneous ADR reports as a trigger for pharmacogenetic research:a prospective observational study in the Netherlands

BACKGROUND: Information on genetic polymorphisms in drug-metabolizing enzymes is valuable when analysing the causal relationship between drug intake and an adverse drug reaction (ADR). Patients who have experienced an ADR should be informed about the possible existence of genetic polymorphisms that may contribute to the occurrence of ADRs, since this will allow adequate dosing of future medication.In collaboration with the regional hospital pharmacy Ziekenhuisapotheek Noord-Oost-Brabant (ZANOB), the Netherlands Pharmacovigilance Centre Lareb developed a method for informing physicians or pharmacists and their patients about a possible pharmacogenetic involvement in the pathogenesis of the reported ADR and for offering easy access to genotyping if requested by the treating physician. An anonymized copy of the test results could be used for the interpretation of possible signals at the pharmacovigilance centre. OBJECTIVES: The aim of this study was to gain insight into the feasibility of informing the reporting physician or pharmacist about possible involvement of a genetic polymorphism and subsequent genotyping of patients based on ADR reports received by the Netherlands Pharmacovigilance Centre. RESULTS: A total of 38 reports were selected in which genotyping was considered useful. In 15 of 38 cases (39.5%), the reporting health professionals actually initiated genotyping. The majority of the drugs implicated in causing ADRs were selective serotonin reuptake inhibitors, followed by other antidepressants and antipsychotic drugs. No logistical problems were encountered during this study. CONCLUSION: The level of participating health professionals in genotyping their patients was relatively high. Apparently, reporting health professionals share the vision that information on pharmacogenetic characteristics of their individual patients is important. The use of an existing infrastructure for DNA sampling that is familiar to the patients and health professionals may have contributed to the high response rate.Pharmacovigilance centres may suggest pharmacogenetic investigation and subsequent individualized pharmacogenetic counselling after a reported ADR. These centres can also be a valuable starting point for pharmacogenetic studies, since data from different sources can be combined in the assessment of the causal relationship between drug intake and an ADR. This study shows that genotyping initiated by pharmacovigilance centres is indeed feasible, when using the standard laboratory testing infrastructure