36 research outputs found
Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.
- Author
- Aamir A
- Abbas J
- Abbas N
- Abbott TEF
- Abdalla M
- Abdikadir H
- Abuhussein N
- Acquaah F
- Adamson R
- Adeleye O
- Adeogun A
- Adlan A
- Aftab R
- Afzal Z
- Agarwal M
- Aglan H
- Agnew CJF
- Agrawal R
- Ahern D
- Ahluwalia J
- Ahluwalia V
- Ahmad A
- Ahmad K
- Ahmed H
- Ahmed I
- Ahmed L
- Ahmed N
- Ahmed P
- Ainger E
- Ainsworth P
- Aishwarya G
- Ajibola-Taylor O
- Akhbari M
- Akhtar A
- Akhtar R
- Akpenyi O
- Al-Ausi M
- Al-Huneidi R
- Al-Khudairi R
- Al-Masri S
- Al-Mousawi A
- Al-Saadi N
- Alagappan A
- Alberts J
- Alfa-Wali M
- Ali A
- Ali B
- Ali I
- Ali M
- Ali Q
- Ali S
- Alturki N
- Alwandi A
- Amani L
- Amarnath T
- Amer M
- Amin H
- Amin MN
- Amoah R
- Amoah-Arko A
- Anandarajah C
- Ananthavarathan P
- Andah EJE
- Andrew K
- Andrews H
- Ang A
- Ang HL
- Ang JJ
- Ani C
- Anilkumar A
- Anto N
- Anwar S
- Apperley H
- Appleton S
- Aquilina T
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- Arif T
- Arneill M
- Arnell S
- Arnold TJ
- Arshad A
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- Arya J
- Asad M
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- Ashour R
- Ashraf MR
- Ashwood J
- Asif U
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- Atkins B
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- Aubrey-Jones D
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- Auluck I
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- Renukanthan A
- Renwick P
- Reynolds J
- Reza N
- Richards C
- Richards T
- Richardson E
- Rickard L
- Rickards C
- Ridgway P
- Riley BJ
- Rimmer L
- Rinkoff S
- Riyat H
- Roberts B
- Roberts G
- Roberts J
- Robertson D
- Robinson A
- Robinson H
- Robinson K
- Robinson SD
- Rockall T
- Rodman L
- Roe T
- Rogers A
- Rogers D
- Roper L
- Roscoe HW
- Ross F
- Rothnie K
- Rothwell L
- Rotundo A
- Roy C
- Runkel M
- Rushd A
- Russell J
- Rutherford A
- Rutherford D
- Rutler L
- Ryan G
- Saad M
- Saat MI
- Sadanand KS
- Sadhra SS
- Sadiq S
- Saeed F
- Saggar S
- Sagoo H
- Saha A
- Sait MS
- Sait S
- Saito R
- Sajid M
- Salciccioli J
- Saleem H
- Salekin D
- Sales A
- Salman M
- Samaraweera S
- Sammut T
- Samuel R
- Sanders E
- Sandhu A
- Sandhu J
- Sandhu N
- Sandland-Taylor L
- Sangal P
- Sansome S
- Sarathy PP
- Saravanabavan S
- Sardar M
- Sarens N
- Sasapu K
- Sathiyakeerthy A
- Sattar M
- Sattar Z
- Saunders I
- Saunders M
- Sawers N
- Sawkins H
- Schade A
- Schinle P
- Schramm M
- Scotcher S
- Scott K
- Scott M
- Searle C
- Seehra H
- Seehra J
- Seelarbokus A
- Seetharam P
- Sellahewa C
- Selvadurai S
- Sen P
- Seraj SS
- Serry M
- Seth I
- Sethi R
- Shafi A
- Shafiq N
- Shaid M
- Shaman S
- Shang E
- Sharif I
- Sharkey E
- Sharma A
- Sharma E
- Sharma S
- Shaw A
- Shaw C
- Sheik-Ali S
- Sheikh A
- Sheikh S
- Sheikh Z
- Shergill M
- Shergill S
- Sherlock J
- Shields P
- Shingles C
- Shirazi S
- Shurovi BN
- Siddiqui A
- Siddiqui I
- Silke E
- Sim DPY
- Sim R
- Simmonds L
- Simon A
- Simpson L
- Simpson R
- Sinclair E
- Singagireson S
- Singh K
- Singh KKR
- Sinha C
- Sivagnanasithiyar T
- Sivakumar C
- Sivakumar R
- Skulsky S
- Slade G
- Slade RD
- Sleight S
- Small S
- Smallwood J
- Smart B
- Smart G
- Smart YW
- Smith ACD
- Smith C
- Smith F
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- Smith J
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- Smith R
- Sonagara V
- Song A
- Soonawalla Z
- Soor P
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- Spoor H
- Springford LR
- Srikanthan M
- Sriram A
- Stageman N
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- Stanger S
- Stanier P
- STARSurg Collaborative Writing Committee, Data analysis, Steering committee, Advisory group, Regional leads, Collaborators and validators
- STARSurg Collaborative Writing Committee, Data analysis, Steering committee, Advisory group, Regional leads, Collaborators and validators, Nepogodiev, D
- Stechman M
- Stewart D
- Stewart E
- Stewart H
- Stewart R
- Stickler E
- Stoddart MT
- Stokes E
- Stott G
- Strang S
- Stringer H
- Stringfellow TD
- Stubbing-Moore A
- Sturrock S
- Subar D
- Subratty SM
- Sukirthan N
- Sukumar S
- Sulaiman SK
- Sultan S
- Sun L
- Sundaram K
- Suresh R
- Suresh S
- Sureshkumar A
- Suri A
- Svolkinas D
- Swan A
- Swan I
- Swaray A
- Swartbol T
- Symons L
- Szczap A
- Szuman A
- Tailor S
- Tam J
- Tam JP
- Tan CY
- Tan KL
- Tan L
- Tan LC
- Tan S
- Tan TSE
- Tang A
- Tang M
- Tanna A
- Taribagil P
- Tariq A
- Tate S
- Tayeh S
- Taylor K
- Taylor O
- Taylor R
- Taylor Z
- Telfer R
- Teng T
- Tenters F
- Teo R
- Thachettu A
- Thakrar D
- Thatcher A
- Theodoropoulou K
- Thomas A
- Thomas D
- Thomas M
- Thomas O
- Thomas S
- Thompson G
- Thompson J
- Thoms BL
- Thomson F
- Thorley N
- Thorn C
- Thornton T
- Thorpe O
- Tilliridou V
- Titu L
- Tod N
- Toellner H
- Toh C
- Toma T
- Tonks A
- Torrance HD
- Townsend D
- Traish M
- Trenear R
- Tresidder S
- Trevett J
- Triniman MC
- Trotter M
- Tsang JCH
- Tsang K
- Tseu B
- Tsui A
- Tullett A
- Tummon R
- Turlejski T
- Turner J
- Turner S
- Tyson N
- Ubhi HK
- Ujjal S
- Underhill R
- Vadgama N
- Vaidya A
- Vakharia A
- Van Den Berg N
- Van der Laan S
- Van Winsen K
- Vara S
- Varathan Y
- Varatharasasingam K
- Varcada M
- Vaughan R
- Vella-Baldacchino M
- Ventre C
- Venturini S
- Verma N
- Vernet G
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- Vine M
- Vipond M
- Virani N
- Vizor R
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- Wadood Q
- Waite K
- Wakeford W
- Walford B
- Walker EY
- Walker G
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- Walker NR
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- Wang H
- Wang L
- Wang X
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- Ward N
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- Warusavitarne J
- Waterman A
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- Watkinson G
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- Waugh D
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- Whewell H
- Whitcroft I
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- White F
- White P
- Whitham R
- Whyte M
- Widdison A
- Wiffen L
- Wigley C
- Wijeyaratne M
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- Williams H
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- Williams LM
- Williams P
- Williams S
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- Wilson J
- Wilson R
- Wilson V
- Wimalathasan A
- Woin E
- Wong C
- Wong E
- Wong J
- Wong MHY
- Wood CM
- Woodhams K
- Woolley A
- Wootton E
- Worley E
- Worsfold M
- Wright OW
- Wright R
- Wright S
- Wroe N
- Wynell-Mayow W
- Xu Y
- Yahaya AA
- Yalamarthi S
- Yang DD
- Yang N
- Yap J
- Yardimci E
- Yarham E
- Yasin IH
- Yasin T
- Yates J
- Ye W
- Yeo A
- Yeoh T
- Yeung J
- Yin ZD
- Yip J
- Yoganayagam N
- Yogeswara T
- York J
- Yousaf A
- Youssef H
- Yu T
- Yule A
- Zaat S
- Zanichelli D
- Zaver V
- Zeng R
- Zhang Y
- Zheleniakova T
- Zhu Y
- Zornoza A
- Zubikarai G
- Zulkifli A
- Zuzarte L
- Publication venue
- 'Wiley'
- Publication date
- 18/05/2018
- Field of study
Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
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- Abbass Hakam
- Adhikari Neill
- Affleck Julia
- Agno Sathianathan Ronan
- Ahmad Norfaizan
- Ahmed Iram
- Ainscough Kate
- Al Qasim Eman
- Al Swaidan Lolowa
- Al-Bassam Wisam
- Al-Beidh Farah
- Al-Beidh Farah
- Albert Martin
- Alegria Ana
- Alexander Brian
- Alexander Peter
- Allan Angela
- Allan Elizabeth
- Allen Louise
- Allibone Suzanne
- Amaro dos Santos Catorze Teodoro
- Anderson Tom
- Andric Zdravko
- Angus Derek
- Angus Derek C
- Anjum Aisha
- Ankert Juliane
- Annane Djillali
- Annane Djillali
- Anstey Matthew
- Antcliffe David
- Aparicio Christelle
- Appelt Peter
- Arabi Yaseen
- Arabi Yaseen
- Arbane Gill
- Archer Simon
- Aref Noah
- Arias Ana-Marie
- Arishi Hatim
- Arnold Donald
- Asghar Adeeba
- Ashelford Angela
- Attwood Ben
- Austin Karen
- Aysel Florescu Simin
- Azaiz Amine
- Babel JakĆĄa
- Babio-Galan Maite
- Badie Julio
- Bagshaw Sean
- Baillie Kenneth
- Baker Evelyn
- Bakthavatsalam Dhanalakshmi
- Bamford Peter
- Banach Dorota
- Bannard-Smith Jonathan
- Barbazza Leanne
- Barber Russell
- Barge Deborah
- Barnes Nicky
- BarĆĄiÄ Bruno
- Bashyal Archana
- Basile Kim
- Bass Frances
- Bates Michelle
- Bauchmuller Kris
- Bean Sarah
- Beane Abigail
- Beane Abigail
- Beasley Richard
- Begin Phillipe
- Bellemare David
- Benettaib Fatna
- Benzekri Dalila
- Berdaguer Fernando Daniel
- Bergin Colin
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- Berry Lindsay
- Berry Scott
- Berry Scott
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- Bihari Shailesh
- Bihari Shilesh
- Binnie Alexandra
- Bion Julian
- Biradar Vishwanath
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- Birchall Katie
- Birkinshaw Isobel
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- Bonten Marc
- Bonten Marc
- Borgatta Barbara
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- Boschert Catherine
- Bossard Isabelle
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- Bourgoin Charlotte
- Bourne Michelle
- Bourne Richard
- Bouwman Wietske
- Bowler Helen
- Boyd Craig
- Bracke Stephanie
- Bradbury Charlotte
- Bradbury Charlotte
- Bradley-Potts Joanne
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- Brimfield Lutece
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- Budd Joanna
- Buehner Ulrike
- Buhr Heidi
- Bullman Laetitia
- Burns Karen
- Burt Karen
- Buscher Hergen
- Butler Amelia
- Butler M
- Buxton Meredith
- Buxton Meredith
- Buzgau Adrian
- Byrne Deborah
- Byrne Kathleen
- BĂ©lteczki JĂĄnos
- Cabreros Leilani
- Calfee Carolyn
- Callender Owen
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- Cawley Kathryn
- Cazzola Federica
- Centofanti John
- Chablani Manish
- Chamara Warnapura Loku
- Chan Carmen
- Chan Charles
- Chan Peter
- Charlewood Richard
- Charron Cyril
- Chartier Delphine
- Chasse Michael
- Chassé Michaël
- Chen Yan
- Cheng Allen
- Cheng Allen C
- Cherian Shiney
- Cheung Winston
- Chhablani Manish
- Chudeau Nicolas
- Cirstea Emanuel
- Clarey Emma
- Claridge Helen
- Clark Michele
- Clark Sarah
- Claxton Andrew
- Clermont Giles
- Cloutier Ăve
- Coburn Susan
- Codreanu Daniel
- Coghlan Phoebe
- Cole Jade
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- Coles Jennifer
- Colin Gwenhael
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- Connor Jason
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- Cooper Jamie
- Cooper Melanie
- Cornell Sarah
- Cort Jon
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- Cowley Nicholas
- Cowton Amanda
- Coyne Mark
- Craner Michelle
- Craven Thomas
- Creagh-Brown Ben
- Crisp Nikki
- Croft Maria
- Cusack Rebecca
- Cutler Sean
- Cviljevic Sabina
- CĂĄrcel FernĂĄndez Sheila
- Daly James
- Daly Zoe
- Daneman Nick
- Dark Paul
- Darreau CĂ©dric
- Dasgin Joanne
- Davey Miriam
- Davidson Neil
- Davies Gwyneth
- Davies Louisa
- Davies Michelle
- Dawda Ashlish
- Day Christopher
- De Beaux Fiona
- De Bus Liesbet
- de Courcy-Golder Kim
- de Jager P
- de Jong Menno
- De Jong Menno
- de Jonge E
- de la Fuente Martos Carmen
- de Lima Pereira Tiago Nuno Alfaro
- de Man Angelique
- De Waele Jan
- Dearden Joy
- Dechert William
- Deelchand Vashish
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- Dell Amanda
- Demetriou Carrie
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- Depuydt Pieter
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- Digby Stephen
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- Duan Erick
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- DâAragon FrĂ©dĂ©rick
- DâSouza Ramsy
- Effelaar Evelien
- Elhassan Munzir
- Elin Hall Rebecca
- Ellis Christine
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- Elsefi Tarek
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- Evers Mirjam
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- Francoeur Charles
- Frey Anna
- Friedrich Hinrichs Carl
- Frohlich Stephen
- Fysh Ed
- Gallagher Linda Jude
- Ganguly Saibal
- Ganpat Radhika
- Garcia Rebecca
- Gardiner-Hill Caroline
- Garrard Hywel
- Garrard William
- Gates Simon
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- Gendall Emma
- Genetu Roman Mary
- Geng Wenli
- Geri Guillaume
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- Gibson Charly
- Girard Timothy
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- Godement Mathieu
- Golden David
- Goligher Ewan
- Gomm Linda
- Goodson Jennifer
- Goodwin Jayne
- Goossens Herman
- Goossens Herman
- Gopal Shameer
- Gopinath Amitha
- Gordon Anthony
- Gordon Anthony C
- Gordon Elizabeth
- Gosbell Iain
- Gould Richard
- Grecu Irina
- Green Cameron
- Green Cameron
- Gregory Jane
- Gresha Rebecca
- Grimmer Lisa
- Grimwade Kate
- Guilder E
- Guitton Christophe
- Hacking Danielle
- Hadebe Bernard
- Hagel Stefan
- Haidar Ghady
- Hall Andrew
- Hall Kathryn
- Hamilton David Oliver
- Hamilton-Davies Colin
- Hamlyn Vincent
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- Haniffa Rashan
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- Heinonen Jonna
- Heming Nicholas
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- Hickey Naomi
- Higgins Alisa M
- Higgins Lisa
- Hill Helen
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- Hills Tom
- Hird Clare
- Hodgson Carol
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- Jarczak Dominik
- Jeblaoui Asma
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- Jha Rajeev
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- Kirkby Amy
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- Kluge Stefan
- Knott Cameron
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- Kosa Alma Gabriela
- Kotarski Viktor
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- Krishnamurthy Vinodh
- Kruger Peter
- Kruger Peter
- Kuitunen Anne
- Kumar Anand
- Kumar Nikhil
- Kunz Kevin
- Kurenda Catherine
- KutleĆĄa Marko
- KuĆĄan Ira
- KyereDiabour Thyra
- Kyeremeh Lynsey
- Labbe Vincent
- Laffan Mike
- Laffey John
- Laha Shondipon
- Lai Vivian
- Lamb Thomas
- Lamonagne Francois
- Lamontagne Francois
- Lamontagne Francois
- Lamontagne François
- Landais Mickaël
- Lane Janis-Best
- Lankester Liana
- Laver Russell
- Lawler Patrick
- Lawler Patrick R
- Lawless Patrick
- Lazaro Juan Martin
- Leaver Susannah
- Leblond Julie
- Lee Kelvin
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- Lewis Roger
- Lewis Roger J
- Lewis Sarah
- LeĂłn LĂłpez Rafael
- Limb James
- Linstrum Kelsey
- Linstrum Kelsey
- Litton Ed
- Litton Edward
- Litton Edward
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- Lorenzi Elizabeth
- Lorenzi Elizabeth
- Lother Sylvain
- Lowe Benjamin
- Lowrey Julie
- Luis David
- Luk Tracy
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- Mackay Euan
- MacLennan Sheila
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- Xavier Kugan
- Xia Le Tai Charlotte
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- Yusuff Hakeem
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- Zaki Ahmed
- Zaman Mohsin
- Zammit Claire
- Zapalac Marija
- Zarychanski Ryan
- Zarychanski Ryan
- Zhao Xiao Bei
- Zinzoni Vanessa
- Zitter Letizia
- Äimoti Renata
- Publication venue
- JAMA: Journal of the American Medical Association
- Publication date
- 06/10/2020
- Field of study
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (nâ=â143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (nâ=â152), or no hydrocortisone (nâ=â108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (nâ=â137), shock-dependent (nâ=â146), and no (nâ=â101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial
- Author
- Abab Julie
- Abbas Ali
- Abbassi Sara
- Abd Alazeez Mohamed
- Abdulwahid Danya
- Abdulwahid Danya
- Abed Jessy
- Adab Fawzi
- Adams Marion
- Adamson Vanessa
- Addison Anglise
- Adeyoju Adebanji
- Adinkra Victoria
- Adnaan Jamila
- Afzal Naveed
- Agdiran Didem
- Aggarwal Ajay
- Ahamadali Sheefa
- Ahmad Belal
- Ahmed Ilyas
- Ahmed Imtiaz
- Ahmed Shahida
- Aiku Abimbola
- Ainsworth Sarah
- Ainsworth Sarah
- Aitken Katherine
- Ajzensztejn Daniel
- Akhtar Naeem
- Al-Chamali Hiba
- Al-hasso Abdulla
- Al-hasso Abdulla
- Al-Samarraie Amir
- Albrecht Virginia
- Alcock Christopher
- Alder Leanne
- Alderton Kate
- Aldous Mary
- Ali Jennyfa
- Ali Maryam
- Ali Zulfiqer
- Ali Zulfiqer
- Allan Elaine
- Allan Elaine
- Allen Julie
- Allen Kirsten
- Allen Rachael
- Allen Susan
- Allison Joanna
- Allison Michele
- Alonzi Roberto
- AlRashdan Abdulla
- Alzouebi Mymoona
- Amanie John Oliver
- Ammeter Barb
- Amoaten Thomas
- Amos Claire
- Anderson Beverley
- Anderson Chris
- Anderson Jim
- Anderson John
- Anderson John
- Anderson Juliette
- Anderson Juliette
- Anderson Leanne
- Anderson Naomi
- Anderson Susan
- Anderson Susan
- Andrade Gerard
- Andrews (nee Moore) Eleanor
- Andrews Kelly
- Andrews Stephen
- Ang Daniel
- Ann Taehee
- Annan Lynda
- Ansari Jawaher
- Ansari Jawaher
- Anscombe Eleanor
- Anyamene Nicola
- Appleby Bonny
- Appleby Rowan
- Archer Denise
- Archer Denise
- Archer Simon
- Archer Simon
- Arnott Seonaid
- Arsanious Nasr
- Ashcroft Jan
- Ashworth Sue
- Ashworth Sue
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- Atkinson Lorraine
- Attlee Julie
- Auladin Raidah
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- Austin Mandy
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- Keng-Koh Pek
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- MacRae Robert M
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- MacVicar Jennifer
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- Madeleine Jude
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- Manetta Caroline
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- Zarkar Anjali
- Zarkar Anjali
- Zarkar Anjali M.
- Zaza Khaled O
- Zelley Sarah
- Zeltser Fred
- Zhang Hanbo
- Zhang Tina Wanting
- Zietz Maria
- Zilkha Helene
- Zinck Connie
- Zinyemba Vivian
- Zurakovsky Hilary
- Zwarych Darlene
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/06/2024
- Field of study
Background
Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear.
Methods
RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047.
Findings
Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61â69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1â10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688â1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4â82·5) in the no ADT group and 80·4% (76·6â83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths.
Interpretation
Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population
Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial
- Author
- Abab Julie
- Abbas Ali
- Abbassi Sara
- Abd Alazeez Mohamed
- Abdulwahid Danya
- Abdulwahid Danya
- Abed Jessy
- Adab Fawzi
- Adams Marion
- Adamson Vanessa
- Addison Anglise
- Adeyoju Adebanji
- Adinkra Victoria
- Adnaan Jamila
- Afzal Naveed
- Agdiran Didem
- Aggarwal Ajay
- Ahamadali Sheefa
- Ahmad Belal
- Ahmed Ilyas
- Ahmed Imtiaz
- Ahmed Shahida
- Aiku Abimbola
- Ainsworth Sarah
- Ainsworth Sarah
- Aitken Katherine
- Ajzensztejn Daniel
- Akhtar Naeem
- Al-Chamali Hiba
- Al-hasso Abdulla
- Al-hasso Abdulla
- Al-Samarraie Amir
- Albrecht Virginia
- Alcock Christopher
- Alder Leanne
- Alderton Kate
- Aldous Mary
- Ali Jennyfa
- Ali Maryam
- Ali Zulfiqer
- Ali Zulfiqer
- Allan Elaine
- Allan Elaine
- Allen Julie
- Allen Kirsten
- Allen Rachael
- Allen Susan
- Allison Joanna
- Allison Michele
- Alonzi Roberto
- AlRashdan Abdulla
- Alzouebi Mymoona
- Amanie John Oliver
- Ammeter Barb
- Amoaten Thomas
- Amos Claire
- Anderson Beverley
- Anderson Chris
- Anderson Jim
- Anderson John
- Anderson John
- Anderson Juliette
- Anderson Leanne
- Anderson Naomi
- Anderson Susan
- Anderson Susan
- Andrade Gerard
- Andrews (nee Moore) Eleanor
- Andrews Kelly
- Andrews Stephen
- Ang Daniel
- Ann Taehee
- Annan Lynda
- Ansari Jawaher
- Ansari Jawaher
- Anscombe Eleanor
- Anyamene Nicola
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- Appleby Rowan
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- Archer Denise
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- Archer Simon
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- Ashworth Sue
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- Atkinson Lorraine
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- Catton Charles N
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- Chowdhury Amitava D
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- Conway Rachel
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- Cook Adrian D
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- Cook Audrey
- Cook Wendy
- Cooke Jill
- Cooke Juniebel
- Cooke Peter
- Coomber Kristy
- Coombs Sarah
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- Corcoran Sam
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- Coyle Catherine
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- Crellin Perric
- Crellin Perric
- Crook Juanita
- Cross Vanessa
- Cross William R
- Crossley Lin
- Crowe (nee Hughes) Dawn
- Crowley Claire
- Crundwell M
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- Cumming Kirsty
- Cunningham Amy
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- Curtis Sandra
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- Dawson-Athey Linda
- Dayes Ian S
- De Silva-Minor Shiroma
- Dean Lynsey
- Dearnaley David
- Deenihan Emma
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- Downs Nichola
- Doyle Kerrie
- Drachenberg Darrel E
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- Garrido-Perez Sandra
- Gauntlett Monica
- Gauthier Isabelle C
- Gearing Jennifer
- George Siny
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- Geraghty Kerry
- Ghoul Mokhtar
- Gibbins Andrew
- Gibbins Jackie
- Gibbins Kate
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- Glaholm John
- Glaholm John
- Gleave Martin E
- Glen Hilary
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- Goel Roshni
- Goh Chee
- Goh Chee L
- Golden Sophie
- Goldenberg S Larry
- Goldstein Cindy
- Goldsworthy Simon
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- Gomez JoseLuis
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- Gonzalez Celia
- Gooch Carol
- Goodhind Frances
- Goodsell Josie
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- Griffen Ailsa
- Griffin Hannah
- Griffiths Dorothy
- Griffiths Leyshon
- Griffiths Theresa
- Griffiths Theresa
- Gruschy Lisa
- Guarino Robyn
- Gudelis Susan O
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
- Gujral Sandeep
- Gumapac Nicole
- Gunn Melanie
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- Gurzanski Christina
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- Hammonds John Christopher
- Hanna Emma
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- Hardie Maryon
- Harding Claudia
- Harding Joshua
- Hardman John
- Hardstaff Lisa
- Hare Jennifer A
- Hargreaves Carolyn
- Hargreaves Jeanette
- Hargreaves Jeanette
- Harinarayanan Sathish
- Harinarayanan Sathish
- Harland Keith
- Harney Jackie
- Harnwell Juliette
- Harpell Rhonda
- Harris (n. Marchant) Emily
- Harris Catherine
- Harris Sarah
- Harris-Burland Angie
- Harrison Alison
- Harrow Sister Kath
- Hart Amber
- Hart Andrew
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- Hartman Carrie
- Hartt Nancy
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- Haskell Annelise
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- Hassan Nebah
- Hathout Lara
- Hatimy Umi
- Haydock Helen
- Haydock Helen
- Hayes Jill A
- Hayward Lesley
- Healey Gail
- Healey-Mariano Jennifer
- Healey-Mariano Jennifer
- Heasley Karen
- Heath Catherine
- Heath Catherine M
- Heckford Louise
- Hedges Andy
- Heeley Janine
- Hefferon Billy
- Hegarty Gemma
- Hejlesen Finn
- Helou Joelle
- Hendel Debra
- Henry Ann
- Henry Ann
- Henry Ann
- Henry Ann
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- Henson (nee Savidge) Verity
- Henson Helen
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- Hindle Margaret
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- Hocking Christopher
- Hodder June
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- Hornzee Gillian
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- Hoskins Chloe
- Hotine Jodie
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- Hughes Joanne
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- Hughes Owen
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- Hugill Angela
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- Humber Caroline
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- Hutchinson Camille
- Hyde Katherine
- Hyde Katherine
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- Hynds Sharon
- Ibrahim Azman
- Ingham Jo
- Ingle Charlotte
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- Innes Helen
- Iordanidi Elina
- Iqbal Fawaad
- Irwin P
- Isaew Andrea
- Iskender Amanda
- Islam Zaheer
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- Ivie Stephanie
- Jackman Dee
- Jackson Cathy
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- Jain Suneil
- Jakeman Christine
- James Naomi
- James Nicholas
- James Nicholas D
- Jamieson Ceri
- Jampana Raj
- Janke Susan
- Jannapureddy Revanth
- Jarvis Claire
- Jastrzebska Patrycja
- Javle P
- Jayachandran Resmi
- Jayachandran Resmi
- Jeffcutt Nicole
- Jeffrey David
- Jelski Joseph
- Jenkins Peter
- Jenkins Suzanne
- Jenner Abigail
- Jennings Marian
- Jepson Debbie
- Jevons Cody
- Jewers Karen
- Jewers Karen
- Jeyasanger Ganesan
- Joe Howard
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- Johnson Arlissa
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- Johnson Lyndsey
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- Jones (Birch) Janine
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- Jones-Skipper Kay
- Jonnada Sai
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- Jose Sanal
- Joseph Joji
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- Joshi Manisha
- Joshi Manisha
- Joslin Vicky
- Jovic Gordana
- Kaa Bach Birgit
- Kader Nicole
- Kalejaiye Odunayo
- Kaliski Alexandre
- Kalyvas Maria
- Kamran Asim
- Kanaga-Sundaram Subramanian
- Kancherla Kiran
- Kanji Femina
- Kanyi Karen
- Kapur Guarav
- Karim Omer
- Karp Stephen
- Karsera Louise
- Karunakaran Subashini
- Karvat Anand
- Kaushal Malan
- Kavanagh Roisin
- Kavanagh Roisin
- Kay Anne Marie
- Kazingizi Memory
- Keane Patrick
- Kearney S
- Kedge Liz
- Kehoe Laura
- Keith Sarah
- Keith Sarah
- Kelkar Anand
- Kellaway Joanne
- Kelly Alison
- Kelly Kay
- Kemp Gail
- Kempel Mette Moe
- Kendal Wayne S
- Keng-Koh Pek
- Keng-Koh Pek
- Keni Manjusha
- Kennedy Julie
- Kenny Shannon
- Kent Christopher
- Kent Emma
- Kenyon Lucille
- Kershaw Elizabeth
- Key Claire
- Keyes Mira
- Khaksar Sara
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- Khaouam Nader
- Khong Rachel
- Khoo Vincent
- Khoo Vincent
- Khoury Ghassan
- Kiff Janet
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- Kilmartin John
- Kilroy Stephen
- Kilroy Stephen
- Kiltie Anne
- Kiltie Anne
- Kim David
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- Kim-Sing Charmaine
- KimSing Charmaine
- King Amy
- King Jennifer
- King Jennifer
- King Lisa
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- KirbyBello Denise
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- Kirkbride Peter
- Kirkbride Peter
- Kirkby Amy
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- Kirkpatrick Suriya
- Kisanga Mary
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- Klapp Kathi
- Klotz Laurence
- Klovgaard Karina
- Knackstedt Jochen
- Knapp Jeanette
- Knight (n. Sherburn) Victoria
- Knott Helen
- Knox WF
- Kockelbergh Roger
- Kodavatiganti Ravi
- Koehler Ingrid
- Kokholm Kathrine Friser
- Koll Wayne
- Kong Vickie
- Kotze Michelle
- Koul Rashmi
- Koulouris Zoe
- Koupparis Anthony
- Kowalczyk-Williams Wioletta
- Kowalewska Paulina
- Kronstal Flo
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- Kuenzig Greg
- Kujawa Magda
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- Kullane Sagal
- Kumar Daniel
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- Kumar Shiyam
- Kumar Vikaash
- Kurian-Downer Sunita
- Kurup Rahul
- Kuzyk Valerie
- Kwan Winkle
- Kyffin Phillippa
- Kynaston Howard
- Kynaston Howard
- Lacey Cathy
- Lachance Nicole
- Lactao Ranee
- Ladouceur Cynthia
- Laing Robert
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- Lake Sister Judith
- Lalani Nafisha
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- Lambert Carole
- Lambert Katy
- Lamoureux Alexandra
- Lang Monika
- Langridge Nicole
- Laniado M
- Lao Bernadeth
- Larkins Rachel
- Larocque Stephanie
- Larouche Julie
- Larson Beverly
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- Lau Maurice
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- Littler John
- Littler Stephen
- Liu Stanley
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- Livsey Jacqueline
- Lloyd-Jones Hugh
- Loblaw Douglas Andrew
- Lock Michael I
- Locke Angela
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- Logue John
- Logue John
- Logue John
- Logue John
- Lokes Rachel
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- Lomas Alia
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- Lunau Anne Sofie
- Lydon Anna
- Lydon Anne Marie
- Lynch Rory
- Lyons Ciara
- Mabelin Louies
- Macavoy Tina
- Macdonald Alison
- MacDonald Angela
- MacDonald Graham
- Macefield Rhiannon
- MacGregor Barbara
- Macgregor Carol
- MacIsaac Kathy
- MacIsaac Patricia
- Mackay Rachel
- Macleod Nicholas
- MacMillan Antonia
- MacMullin Lisa
- MacRae Robert M
- Macrory Joanne
- MacVicar Jennifer
- MacVicar Karen
- Madeleine Jude
- Madhava Kudingila
- Madine John
- Magwaro Sophia
- Magwaro Sophia
- Magwaro Sophia
- Mahmood Rana
- Mahmood Rana
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- Mahmud Aamer
- Mahoney Catriona
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- Majumdar Arpita
- Makepeace Barbara
- Malde Rohit
- Malek Leila
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- Mallett Debbie
- Malone Shawn
- Malone Shawn C
- Manetta Caroline
- Manganaro Aileen
- Mangar Stephen
- Maniatis Christos
- Manley Rachel
- Mannan Aliyah
- Manning Courtney
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- Mansell Gemma
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- Mantle Mark
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- Mardell Stephen
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- Marley Hazel
- Marquis Tania
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- Marshall John
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- Marston Kerrie
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- Martindale John
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- Martindale John
- Martinez Maria
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- Mashegede Beverley
- Mason Jessica
- Mason Malcolm
- Masson Susan
- Masson Susan
- Masters Benjamin
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- McAleese Jonathan
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- McAllister Jo
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- McCabe Alastair
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- McCaul Damian
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- McClements Jane
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- McCormack Anne
- McCormick Marian
- McCracken Jillian
- McCrisken Lauren
- McCrudden Sylvia
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- McFarlane Jonathan
- McFarlane Victoria
- McGarry Karen
- McGinley Shannon
- McGlynn Brian
- McGrath John
- McGrath Katherine
- McIndoe Sue
- McInerney Paul
- McInerney Sue
- McInerney Veronica
- Mcintosh Gregor
- McKee Dianne
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- McKenzie Michael
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- McKinna Fiona
- McKinna Fiona
- McLain-Smith Susan
- McLaren Duncan
- McLarty Esther
- Mcleod Nick
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- McMenemin Rhona
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- McNish Jennifer
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- McPhail Neil
- McWilliam Donna
- McWilliam Marie
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- Meidhal Petersen Peter
- Melcher Lucinda
- Melcher Lucinda
- Menard Cynthia
- Menard Cynthia
- Mendoza Edeliza
- Merante Pat
- Mercer Lily
- Mercier Barbara
- Merrick Richard
- Metcalf Karen
- Meyer Ralph
- Michael Elena
- Michaelidou Andriana
- Michels Jorg
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- Mikropoulos Christos
- Mikropoulos Christos
- Millage Helen
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- Mills Jamie
- Mills Laurie
- Mills-Baldock Tina
- Milner Jessica
- Milosevic Michael
- Mirmooji Ramesh
- Mirza Arafat
- Mislang Albert
- Mistry Heena
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- Mitchell Darren
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- Mithal Natasha
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- Mohamed Fatima
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- Money-Kyrle Julian
- Montebello Joseph
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- Moore Eleanor
- Moore Eleanor
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- Morgan Rachel
- Morgan Scott
- Morris Stephen
- Morris Stephen L
- Morris William James
- Morrison Andrew
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- Morrison MaryBeth
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- Morton Gerard
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- Mthethwa Thobekile
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- Musunuru Hima Bindu
- Muthu Kumar Dakshinamoorthy
- Myatt Alison
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- Myrehaug Sten
- Nabid Abdenour
- Nabid Abdenour
- Nagar Yoodhvir
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- Nakashima Lynne
- Nallathambi Chandran
- Nam Robert K
- Narahari Krishna
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- Nathan Kannon
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- Ngumo Alice
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- Nicholson Alastair
- Nieforth Joan
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- O'Flynn Kieran
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- O'Neill John
- O'Sullivan Joe
- OBrien Anna
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- Ong Aldrich D
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- Venkatesan Varagur M
- Venkitaraman Ramachandran
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- Waring Lynsey
- Wassall Rebecca
- Watkinson Catrin
- Watson Melanie R
- Watson Michaella
- Watson-Jones Phillip
- Watts Angela
- Watts Erica
- Weaver Andrew
- Weaver Emma
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- Whitehouse James
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- Williams (NĂ©e Allen) Sister Tania
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- Wilson Russ
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- Winter Sister Helen
- Wise Marcus
- Wise Marcus
- Wise Marcus
- Wiss Elliott
- Wollaston Julie
- Woloshyn Rose
- Wong Jason W T
- Wood Allison
- Wood Catherine
- Wood Cathryn
- Wood Marian
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- Wood Sister Kim
- Wood Sister Kim
- Wood Sister Kim
- Woodhouse Iain
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- Woods Jane
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- Woodward Elizabeth
- Woolf David
- Woolf David
- Workman Bridget
- Worlding Jane
- Worlding Jane
- Worsley Lucy
- Worthington Hannah
- Wright Ann
- Wright Natalie
- Wright Seonaid
- Wrigley Martha
- Wronski Sue
- Wu Helen
- Wu Min
- Wyatt Clare
- Wylie James
- Wylie James
- Wylie James
- Wynn Hazel
- Wynn Hazel
- Yanchuk Janet
- Yarrow Sue
- Yassa Michael
- yates Victoria
- Yee Don
- Yeo Tanya
- Yoon Frederick
- Youd Sister Jill
- Young Anita
- Young Bobbie
- Young Douglas
- Young Sally
- Youngs Nora
- Yu Jason
- Yunace Lorrie
- Yusof Hilawati
- Zafar Waheed
- Zaidi Sadaf
- Zarkar Anjali
- Zarkar Anjali
- Zaza Khaled O
- Zelley Sarah
- Zeltser Fred
- Zhang Hanbo
- Zhang Tina Wanting
- Zietz Maria
- Zilkha Helene
- Zinck Connie
- Zinyemba Vivian
- Zurakovsky Hilary
- Zwarych Darlene
- Publication venue
- Elsevier
- Publication date
- 07/06/2024
- Field of study
Background
Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain.
Methods
RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and
ClinicalTrials.gov
,
NCT00541047
.
Findings
Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60â69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0â10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612â0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6â75·7) in the short-course ADT group and 78·1% (74·2â81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths.
Interpretation
Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy.
Funding
Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
- Author
- ?ivko Iris
- Abbass Hakam
- Abdeladim Lilia
- Abdelhady Hesham
- Abdelkharim Hussam
- Abdelrazik Marwa
- Abdi Zakee
- Abdukahil Sheryl Ann
- Abel Lynn
- Abraham Jacinta
- Abrahamson Gail
- Abusamra Yousuf
- Aceto Romina
- Adams Nick
- Adams Peter
- Adebambo Olumide
- Adhikari Neill
- Adhikari Sheetal
- Affleck Julia
- Agha Gloria
- Aghemo Alessio
- Agno Ronan
- Ahmad Norfaizan
- Ain Quratul
- Ainscough Kate
- Ainsworth James
- Aitken Lindianne
- Akamp Ceren
- Al Enezi Farhan
- Al-Bassam Wisam
- Al-Beidh Farah
- Albert Martin
- Albrett Jonathan
- Alderman Meera
- Aldo Bonizzoni Matteo
- Alegria Ana
- Alessandro CarĂ Gianmarco
- Alexander Brian
- Alexander Peter
- Alfonso Jordan
- Ali Maryam
- Ali Murtaza
- Allam Hayat
- Allen Barbara
- Allen Louise
- Allibone Suzanne
- Almeshhedani Hasham
- AlQahtani Samah
- Alswaidan Lolowa
- Altomy Mohammed
- Al Amri Ali
- Al Qasim Eman
- Amatya Sameena
- Ambrosino Richard
- Anderson Thomas
- Andreae Mark
- Aneman Anders
- Angus Derek C.
- Anjum Aisha
- Ankert Juliane
- Annane Djillali
- Anne-Laure Fedou
- Anstey Matthew
- Antcliffe David
- Anthony Alpha
- Antoine Marchalot
- Antoine Pierre
- Antoine Studer
- Anumakonda Vikram
- Aparicio Christelle
- Aquino Maia
- Arabi Yaseen M.
- Arachchige Malka
- Aravindan Latha
- Arbane Gill
- Archambault Patrick
- Archer Simon
- Aref Noah
- Arias Ana-Marie
- Arias Sonia
- Arishi Hatim
- Arnold Donald
- Arnold John
- Arnott Andrew
- Arora Anand
- Aryal Diptesh
- Asghar Adeeba
- Asif Namra
- Aspinwall Angelique
- Attokaran Antony
- Attwood Ben
- Au Carly
- Audry Mathilde
- Austin Karen
- Austin Pauline
- Auvet Adrien
- Avard Bronwyn
- Awan Sidra
- Ayee Robert
- Azaiz Amine
- Azzaui Harun
- Babu Suresh
- Bacon Gina
- Badalamenti Salvatore
- Badie Julio
- Bagavathy Kavitha
- Bagot Catherine
- Bagshaw Sean
- Baig Nadia
- Baikady Ravishankar
- Bailey Lucy
- Baillie Kenneth
- Bain William
- Baker Alice
- Baker Evelyn
- Baker Stuart
- Bakthavatsalam Dhanalakshmi
- Balaie Morteza
- Balls-Burgess Sam
- Bamford Amy
- Bamford Peter
- Banach Dorota
- Bannard-Smith Jonathan
- Barbash Ian
- Barber Russell
- Barbier François
- Barge Deborah
- Bariola Ryan
- Barker Gareth
- Barker Stephanie
- Barnes Nicky
- Baron Rebecca M.
- Barreau Amelie
- Barreau Amélie
- Bart Robert
- Bartholomew Jazz
- Bartley Shauna
- Barton David
- Barton Frances
- Bashyal Archana
- Basile Kim
- Bass Frances
- Bassford Christopher
- Bastos Joana Margarida Pereira Sousa
- Bates Michelle
- Bates Samantha
- Batista Teresa Margarida Oliveira
- Bauchmuller Kris
- Bayne Madeleine
- Bean Sarah
- Beane Abi
- Beane Abigail
- Beard Gregory
- Beasley Richard
- Beaudoin Rosalie
- Beavis Sarah
- Beddows Seonaid
- Bedford Caroline
- Beer Deborah
- Beer Sally
- Begin Phillipe
- Begum Salma
- Bell Gillian
- Bellemare David
- Belletti Allesandro
- Bendjemar Lynda
- Benettaib Fatna
- Bensen Nicole
- Bentley Andrew
- Benyon Sarah
- Benzekri Dalila
- Beqai Besa
- Berdaguer Fernando
- Beresford Stephanie
- Bergin Colin
- Berry Lindsay R.
- Berry Scott
- Berryman Emily
- Bertel Melanie
- Best-Lane Janis
- Besten Henny
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- Bonten Marc J. M.
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- de Courcy-Golder Kim
- de Groot Klaas
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- Depuydt Pieter
- Dequin Pierre-François
- Derde Lennie P. G.
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- Detry Michelle A.
- Deye Nicolas
- de la Fuente Carmen
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- Ebenezer R
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- Estcourt Lise J.
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- Goebeler M.E.
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- Haldeos Anne
- Hall Alistair S
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- Harrison David A.
- Harrison Susan
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- Hartley Melissa
- Harvala-Simmonds Heli
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- Hernandez Erik
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- Hey Samuel
- Hickey John
- Hierons Sarah
- Higgins Alisa M.
- Hill Claire
- Hill Dianne
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- Hodge Christopher
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- Hornsby James
- Horton Michelle
- Horvat Christopher M.
- Howcroft Clare
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- Howie Lucy
- Howle Ryan
- Hoxha Elvira
- Huang David T.
- Hughes Debbie
- Hugill Keith
- Huijbens Danique
- Hullegie Sebastiaan
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- Jha Avinash
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- Kremling Julius
- KreĂ Gabriele
- Krishnamoorthy S
- Krishnamurthy Vinodh
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- Le Basnier Elliot
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- Lewis Sarah
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- McAdams David
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- McAuley Daniel F.
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- Vamplew Luke
- van Amerongen Roosmarijn
- van Bentum-Puijk Wilma
- van Bree Sjoerd
- van de Veerdonk Frank L.
- van den Berg Lettie
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- Webb Steve A.
- Weber Lisa
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- Wetzold Richard
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- Wibrow Bradley
- Wigbers Jeanette
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- Wilby Elizabeth
- Wilcox Elizabeth
- Wilcox Louise
- Wild Helen
- Wild Laura
- Wilding Laura
- Wiles Matt
- Wiley Daisy
- Wilhelmsen Elva
- Wilkinson Dean
- Willams Felicity
- Williams Alexandra
- Williams Angharad
- Williams Anna
- Williams Erin
- Williams Gemma
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- Williamson Dawn
- Williamson James D
- Willis Joanna
- Willson Jayne
- Wilson Anna
- Wilson Craig
- Wilson Jean
- Wilson Maggie
- Winters James
- Winters Lauren
- Wise Matt
- Wisniewski Mary
- Wittekamp Bastiaan
- Wittenberg Wendy
- Wnuk Chris
- Woelke Amy
- Wong Jenny
- Wong Onyee
- Wood Erica
- Wood Hannah
- Wood Tracy
- Woods Jane
- Woods Lindsey
- Woodward Robert
- Woolett Melissa
- Worner Ruth
- Wren Jess
- Wren Lynn
- Wrey Brown Caroline
- Wright Chris
- Wright Kim
- Wunderley Renee
- Wyatt Rachel
- Wylie Katharine
- Xavier Kugan
- Yamagishi Yoshiaki
- Yamashita Chizuru
- Yang Yang
- Yarad Elizabeth
- Yates Bryan
- Yates David
- Yealy Donald
- Young Ian
- Young Meredith
- Young Paul
- Youngstein Taryn
- Yu Haili
- Yusuff Hakeem
- Zaharia Mihaela
- Zaidi Abbas
- Zaki Ahmed
- Zaman Mohsin
- Zarychanski Ryan
- Zdanavidiene Ausra
- Zhao Xiao
- Zinzoni Vanessa
- Zitter Letizia
- Zouita Louisa
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 11/04/2023
- Field of study
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 nonâcritically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (nâ=â257), ARB (nâ=â248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; nâ=â10), or no RAS inhibitor (control; nâ=â264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ supportâfree days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ supportâfree days among critically ill patients was 10 (â1 to 16) in the ACE inhibitor group (nâ=â231), 8 (â1 to 17) in the ARB group (nâ=â217), and 12 (0 to 17) in the control group (nâ=â231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ supportâfree days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
Federal Reserve Bank of Atlanta
- Publication venue
- Publication date
- 01/01/2001
- Field of study
exterior, Thrasherville state historical marker in front of bank, 200
Federal Reserve Bank of Atlanta
- Publication venue
- Publication date
- 01/01/2001
- Field of study
exterior, facade, 200
Reid House
- Publication venue
- Publication date
- 01/01/1989
- Field of study
exterior, The Peachtree and Reid House seen from High Museum of Art, 200
Olympic Aquatic Center
- Author
- Publication venue
- Publication date
- 01/01/1995
- Field of study
interior, pool and diving structure, before renovation, 200
Assessing spring direct mortality to avifauna from wind energy facilities in the Dakotas
- Author
- Anderson
- Arnett
- Baerwald
- Barclay
- Batt
- Bellrose
- Beston
- Bethke
- Bicknell
- Blank
- Bluemle
- Boyd
- Cryan
- Cryan
- Dinsmore
- Drever
- Drewitt
- Erickson
- Erickson
- Erickson
- Fargione
- Fletcher
- Greenwood
- Gue
- Hagen
- Higgins
- Higgins
- Hoekstra
- Jameson
- Johnson
- Kiesecker
- Knopf
- Korner-Nievergelt
- Kuchler
- Kunz
- Kuvlesky
- Loesch
- Longcore
- Loss
- Manville
- Niemuth
- Niemuth
- Niemuth
- Reynolds
- Rich
- Rollins
- Smallwood
- Smallwood
- Smallwood
- Smallwood
- Sorenson
- Stephens
- Stewart
- Stodola
- Vladislavleva
- Warudkar
- Wright
- Publication venue
- 'Wiley'
- Publication date
- Field of study