tbuckley/cabot-search huggingface dataset:
Atezolizumab plus bevacizumab for unresectable or metastatic hepatocellular carcinoma: A cost-effectiveness analysis.
Authors: Wenjun Wang, Jingjing Wang, Xin Zhang, Yikai Wang, Juanjuan Shi, Xiaoli Jia, Shuangsuo Dang
Journal: Journal of Clinical Oncology (2021)

295 Background: In May 2020, atezolizumab plus bevacizumab was approved by US Food and Drug Administration for patients with unresectable or metastatic hepatocellular carcinoma (HCC) who have not received prior systemic therapy due to improvement in overall and progression-free survival compared with standard sorafenib treatment. However, because of the high cost of atezolizumab plus bevacizumab, there is a need to assess its value by considering both efficacy and cost. The aim of this study is to evaluate the cost-effectiveness of atezolizumab plus bevacizumab vs sorafenib for patients with unresectable or metastatic HCC from the US payer perspective. Methods: A partitioned-survival model was developed to compare health care costs and clinical outcomes of atezolizumab plus bevacizumab vs sorafenib in first-line treatment of unresectable or metastatic HCC over 6-year horizon. Treatment effects were extracted from the IMbrave150 trial. Health care cost and health utility data were obtained from published studies and databases. Incremental cost-effectiveness ratio (ICER) was calculated as the ratio of the incremental cost to the incremental quality-adjusted life years (QALYs). One-way deterministic and probabilistic sensitivity analyses were used to examine model uncertainty. Additional subgroup analyses were performed. Results: Atezolizumab plus bevacizumab resulted in increase of 0.623 life-years, 0.484 QALYs and $158,781 per patient at the base case analysis. The ICER was $322,500 per QALY (95% confidence interval, $136,275 to $801,509 per QALY), with 0.5% and 4.1% chance of being cost-effective at a willingness-to-pay threshold of $100,000 and $150,000 per QALY, respectively. The ICER never went below $150,000 per QALY in the one-way sensitivity analyses and among patients of clinically relevant subgroups in the subgroup analyses. Conclusions: Atezolizumab plus bevacizumab is unlikely to be cost-effective compared with sorafenib in first-line treatment of patients with unresectable or metastatic HCC from the US payer perspective.
Response to: ‘Correspondence on ‘Anti-inflammatory therapy for COVID-19 infection: the case for colchicine’’ by Perricone<i>et al</i>
Authors: Binita Shah, Aaron Z Reyes, Kelly A Hu, Jacob Teperman, Theresa L Wampler Muskardin, Jean-Claude Tardif, Michael H Pillinger
Journal: Annals of the Rheumatic Diseases (2021)

We thank Drs Perricone et al for their thoughtful response1 to our manuscript, and agree that timing, dose and duration of colchicine will be important open questions should the agent be found to be helpful in COVID-19. Regarding the question of when in the COVID-19 course colchicine might be most efficacious, we postulated that earlier (ie, as an outpatient) might be better. In making this suggestion, we followed Perricone et al ’s recommendation to apply clinical rheumatologic experience. In gout, colchicine seems to be most effective early in acute disease, compelling both the the American College of Rheumatology and the European League Against Rheumatism to recommend treating gout flares with colchicine only in the earliest stages of the attack (ie, within 1–2 days of onset)2 3; these recommendations suggest that administration of colchicine in the earliest stages of COVID-19 might be more effective than later …
THU0096 Effect of anakinra (il-1ra) and soluble tumour necrosis factor receptor i (stnf-ri) on cellular immune function in rats
Authors: JE Atkinson, RV House, PS Cranmer, AE Colucil, H Davis, CK Edwards, DM Miller
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> This study investigated the potential for combined treatment with inhibitors of IL-1 and TNF-α to affect immunocompetence by assessing function of selected cell types involved in host resistance. <h3>Methods</h3> Basal NK cell activity, lymphoproliferation following stimulation with anti-CD3, pokeweedmitogen or concanavalin A, and antibody forming cell response (AFC) were determined in splenocytes from female rats (F-344; N = 12 per group) treated with placebo, IL-1ra alone (20 or 200 mg/kg, SC daily), sTNF-RI alone (5 or 50 mg/kg, SC twice weekly) or the dose combinations of the two cytokine inhibitors for 21 days. Satellite groups received positive control agents for the NK cell assay (0.5 mL anti-asialo GM 1 antibody) or the mitogenesis and AFC assay (25 mg/kg cyclophosphamide). <h3>Results</h3> Basal NK cell response was increased 21% (p &lt; 0.05) over placebo control only at the combination of 200 mg/kg IL-1ra + 5 mg/kg sTNF-RI. No effect was noted with IL-1ra or TNF-RI alone or at higher combination doses. Cells from IL-1ra (200 mg/kg) treated animals showed minimal decreases (30%, p &lt; 0.05) on lymphocyte proliferation only in response to anti CD3-mediated proliferation. Statistically significant differences (+10 to – 48%) in proliferative activity to all mitogens were observed with sTNF-RI alone or in combination with IL1-ra, but were not dose related. Diminution in the AFC response (29–36%) was noted for sTNF-RI alone (50 mg/kg) or in combination with both Il-1ra doses compared to the control group; however the differences were not statistically significant. IL1-ra alone, the low dose of sTNF-RI (5 mg/kg) alone or in combination with IL-1ra doses had no significant effect on AFC response. <h3>Conclusion</h3> Thus, IL-1ra alone has minimal effects on selected functions of the immune system. Effects on immune function noted at 50 mg/kg sTNF-RI were considered minimal and importantly were not exacerbated by the combination of IL-1ra.
Hospital Clowns Ease Children’s Symptoms, Review Shows
Authors: Mary Chris Jaklevic
Journal: JAMA (2021)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Substitution of Generic Drugs and Biosimilars
Authors: Sang Kyu Cho, Hankyung Jun
Journal: JAMA Internal Medicine (2021)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
AB0143 Gastroprotective effect of lansoprazole in osteoarthritis pa-tients long-time receiving diclophenac
Authors: SA Alexeenko, EL Nikonov, AG Amathnyak
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> To compare efficiency and safety of 4-week treatment by nimesulid, diclophenac and diclophenac in a combination with lansoprazole in osteoarthritis patients. <h3>Methods</h3> We observed 167 patients (130 women and 37 men, mean age 54 years). During 4 weeks in the first group 74 patients received diclophenac 100 mg per day, in the second group 31 patients – diclophenac in a combination with lansoprazole 30 mg per day and in the third group 62 patients received nimesulid 200 mg per day. Before and after 4-weeks treatment were estimated of a clinical symptomatology, upper GI endoscopy, 24 h Òî-metry (Digitrapper MkIII, Synectics, Sweden), histological research of biopsy of a mucosa from antral part of a stomach. For a estimate of clinical effi-ciency was used a questionnaire of a quality of life SF-36. <h3>Results</h3> The clinical efficiency of therapy by diclophenac or nimesulid in osteoarthritis patients was comparable. The frequency of development of erosions and ulcers of a stomach was higher at diclophenac group (41%), than at nimesulid group (24%). The combination of diclophenac and lansoprazole has allowed to lower frequency of development of erosions and ulcers of a stomach mucosa to 16%. Positive dynamics of morpho-functional of parameters of a stomach mucosa in lansoprazole group was found. <h3>Conclusion</h3> Our results prove gastroprotective effect of lansoprazole. The application lansoprazole for osteoarthritis patients long-time receiving diclophenac is accompanied by positive dynamics morphofunctional parameters of a mucosa of a stomach, lowering of frequency of development of erosions and ulcers of a stomach.
Keeping the peace: commensal Cutibacterium acnes trains CD4+ TH17 cells to trap and kill
Authors: Diane M. Thiboutot, Amanda M. Nelson
Journal: Journal of Clinical Investigation (2021)

Commensal or pathogenic bacterial communities of the skin interact with the host immune system to preserve homeostasis or sustain disease. In this issue of the JCI, Agak et al. substantially advance our conceptual understanding of TH17 cell biology. The researchers identified IL-26–independent mechanisms by which CD4+ TH17 clones directly kill bacteria. These CD4+ TH17 clones share antimicrobial properties with cytotoxic T cells and granulocytes as evidenced by secretion of granulysin, granzyme B, and histone-laden DNA extracellular traps. Interestingly, these clones emerged following monocyte education by Cutibacterium acnes strains associated with healthy skin, but not those associated with acne. Overall, the antimicrobial mechanisms employed by these TH17 subsets suggest a unique link between innate and adaptive immune responses.
Beyond the storm — subacute toxicities and late effects in children receiving CAR T cells
Authors: Haneen Shalabi, Juliane Gust, Agne Taraseviciute, Pamela L. Wolters, Allison B. Leahy, Carlos Sandi, Theodore W. Laetsch, Lori Wiener, Rebecca A. Gardner, Veronique Nussenblatt, Joshua A. Hill, Kevin J. Curran, Timothy S. Olson, Colleen Annesley, Hao-Wei Wang, Javed Khan, Marcelo C. Pasquini, Christine N. Duncan, Stephan A. Grupp, Michael A. Pulsipher, Nirali N. Shah
Journal: Nature Reviews Clinical Oncology (2021)
Mitochondrial oxidative metabolism contributes to a cancer stem cell phenotype in cholangiocarcinoma
Authors: Chiara Raggi, Maria Letizia Taddei, Elena Sacco, Nadia Navari, Margherita Correnti, Benedetta Piombanti, Mirella Pastore, Claudia Campani, Erica Pranzini, Jessica Iorio, Giulia Lori, Tiziano Lottini, Clelia Peano, Javier Cibella, Monika Lewinska, Jesper B. Andersen, Luca di Tommaso, Luca Viganò, Giovanni Di Maira, Stefania Madiai, Matteo Ramazzotti, Ivan Orlandi, Annarosa Arcangeli, Paola Chiarugi, Fabio Marra
Journal: Journal of Hepatology (2021)
Non-invasive respiratory support paths in hospitalized patients with COVID-19: proposal of an algorithm
Authors: J.C. Winck, R. Scala
Journal: Pulmonology (2021)

COVID-19 related Acute Respiratory Failure, may be successfully treated with Conventional Oxygen therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure or Bi-level Positive-Pressure ventilation. Despite the accumulated data in favor of the use of different Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, it is not fully understood when start, escalate and de-escalate the best respiratory supportive option for the different timing of the disease. Based on the current published experience with Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, we propose an algorithm in deciding when to start, when to stop and when to wean different NIRT. This strategy may help clinicians in better choosing NIRT during this second COVID-19 wave and beyond.
AB0483 INTERSTITIAL LUNG DISEASE IN PATIENTS WITH ANCA ASSOCIATED VASCULITIS – A PROSPECTIVE SINGLE CENTER STUDY
Authors: A. Hocevar, K. Perdan-Pirkmajer, M. Tomsic, Z. Rotar
Journal: Annals of the Rheumatic Diseases (2020)

Background: Recently, an association between anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and interstitial lung disease (ILD) has been uncovered. Objectives: To determine the rate of ILD in our prospective AAV patient cohort and to compare clinical characteristics of AAV patients with and without associated ILD. Methods: We retrospectively analysed medical records of prospectively diagnosed and followed AAV patients at our secondary/tertiary rheumatology centre between January 2010 and December 2019. The diagnosis of ILD was based on lung HRCT findings. Results: During the 10-year observation, we identified 94 incipient AAV patients (46 had granulomatosis with polyangiitis, and 48 microscopic polyangiitis). Thirteen (13.8%) patients had ILD (ILD-AAV group). 12/13 had usual interstitial pneumonia (UIP) pattern and 1/13 non-specific fibrosis on HRCT. ILD was diagnosed in tandem with AAV in 9/13 patients, and 9 months to 5 years prior to AAV in 4/17 patients. Characteristics of ILD-AAV, and non-ILD-AAV groups are presented in Table 1. ILD-AAV patients more commonly reported of weight loss, less frequently had ENT involvement, and were predominantly a-MPO ANCA positive (92.3%). Follow up data were available for 85 AAV patients (90.4%; 13 ILD-AAV and 72 non-ILD-AAV). During the median (IQR) follow up of 22.1 (4.8; 50.0) months, 5/13 (38.5%) ILD-AAV patients died, compared to 6 (8.3%) deaths registered in non-ILD-AAV group during 26.4 (11.6; 70.0) months of follow up. The crude mortality rate evaluated by Cox proportional hazards regression was significantly higher for AAV-ILD group (HR 5.6 (95%CI 1.7-18.7), p=0.005). Table 1. Clinical characteristics of ILD-AAV and non-ILD-AAV group Characteristic ILD - AAV (13 ) non-ILD- AAV (81 ) p Characteristic ILD - AAV (13 ) non-ILD - AAV (81 ) p Female 46.2 64.2 0.234 ENT 0 60.5 &lt;0.001 Age* 76 (67;77) 66 (55;77) 0.174 Heart 0 7.4 0.591 Smoking 61.5 39.5 0.226 GI tract 15.4 7.4 0.305 Fever 61.5 53.1 0.766 Kidney 53.8 63.0 0.552 Weight loss 84.6 51.9 0.035 PNS 38.5 29.6 0.531 Arthritis 15.4 14.8 1.0 CNS 0 2.5 1.0 Myalgia 15.4 27.2 0.504 ANCA 100 91.4 0.588 Skin 7.7 19.8 0.451 a-MPO 92.3 44.4 0.002 Eye 0 24.7 0.063 a-PR3 7.7 46.9 0.013 Legend: * median (IQR)); ENT ear-nose-throat; GI gastrointestinal tract; PNS peripheral nervous system; CNS central nervous system; Conclusion: In our incipient AAV cohort 13% of patients presented with ILD. The AAV patients with ILD had a higher mortality rate than the rest of the cohort. References: Acknowledgments: Disclosure of Interests: : ALOJZIJA HOCEVAR: None declared, Katja Perdan-Pirkmajer: None declared, Matija Tomsic: None declared, Ziga Rotar Consultant of: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi., Speakers bureau: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi.
Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease
Authors: Paul D. Terry, R. Eric Heidel, Rajiv Dhand
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

Rationale: Health outcomes of people with coronavirus disease (COVID-19) range from no symptoms to severe illness and death. Asthma, a common chronic lung disease, has been considered likely to increase the severity of COVID-19, although data addressing this hypothesis have been scarce until very recently.Objectives: To review the epidemiologic literature related to asthma's potential role in COVID-19 severity.Methods: Studies were identified through the PubMed (MEDLINE) and medRxiv (preprint) databases using the search terms "asthma," "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2), and "COVID-19," and by cross-referencing citations in identified studies that were available in print or online before December 22, 2020.Measurements and Main Results: Asthma prevalence data were obtained from studies of people with COVID-19 and regional health statistics. We identified 150 studies worldwide that allowed us to compare the prevalence of asthma in patients with COVID-19 by region, disease severity, and mortality. The results of our analyses do not provide clear evidence of increased risk of COVID-19 diagnosis, hospitalization, severity, or mortality due to asthma.Conclusions: These findings could provide some reassurance to people with asthma regarding its potential to increase their risk of severe morbidity from COVID-19.
Use of aromatase inhibitors and risk ofcardiovascular disease: A population-based study
Authors: L. McVicker, C. Cardwell, U. McMenamin
Journal: Clinical Cancer Research (2020)

Background: Adjuvant endocrine therapy, including aromatase inhibitors (AI) or tamoxifen, is recommended forwomen diagnosed with estrogen receptor- and/or progesterone receptor-positive breast cancer as it significantlyreduces the risk of recurrence and breast cancer-specific mortality  AIs are the preferred treatment forpostmenopausal women;however, concerns have been raised with respect to their cardiovascular safety  Somemeta-analyses of randomized controlled trials report an increase in cardiovascular disease (CVD) risk with use ofAIs compared to tamoxifen;however, “real-world” observational studies have yielded inconsistent findings  Objectives: We aimed to conduct a population-based study in Scotland to investigate whether breast cancerpatients treated with AIs are at an increased risk of cardiovascular disease compared to patients treated withtamoxifen  Methods: Women newly diagnosed with breast cancer, from 2009 to 2017, were identified from the Scottish CancerRegistry  AI and tamoxifen use were identified from the nationwide Scottish Prescribing Information System  Theprimary outcome was CVD, based on incidence or death from CVD obtained from hospital admission and deathrecords, respectively  Cox regression models calculated hazard ratios (HRs) and 95% intervals (CIs) comparing AIuse to tamoxifen use and risk of CVD, using an as treated exposure definition  Analyses were adjusted for a rangeof potential confounders and subgroup analysis investigated risk by CVD subtypes including myocardial infarction, heart failure, ischemic stroke, venous thromboembolism, and angina  Results: The cohort contained 28,712 breast cancer patients, followed for 110,999 person years, during which there were 776 cardiovascular events  Compared to tamoxifen use, AI use was associated with an increased risk of anyCVD event (adjusted HR 1 14, 95% CI: 1 02, 1 27), which was particularly marked for ischemic stroke (adjusted HR1 27, 95% CI: 0 99, 1 63)  There were no clear associations for other CVD subtypes  Conclusions: Our preliminary results suggest an increased risk of CVD, and specifically ischemic stroke, in AIusers compared to tamoxifen  Additional analyses will be conducted to further investigate these associations, including dose-response
FRI0056 Tnfalpha therapy initiation audit: rationing on an equitable basis – the norfolk and norwich (n/n) experience
Authors: MF Somerville, A Price-Forbes, A Brooksby, J Leeder, JK Gaffney, P Merry, DG Scott
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> BSR<sup>1</sup> and EULAR<sup>2</sup> consensus guidelines have been published regarding the evolving use of TNF@ therapy in rheumatoid arthritis (RA). It is anticipated that demand will exceed supply. Norfolk Health Authority has allocated £210,000 (for approximately 30 patients) for initiation of this treatment during 2000–01. An initial review highlighted discrepancies between the DAS28 (ie consensus guidelines), and our individual clinical assessment of patients. <h3>Objectives</h3> To evaluate prospectively a cohort of consecutive eligible patients, prioritise them according to a weighted scoring system, which we developed and observe changes in the profile of those fulfilling these revised criteria for treatment. <h3>Methods</h3> In a 3 month period, potential patients were recruited to an assessment clinic. Those fulfilling the criteria were further stratified using a 5- point cumulative scoring system based on 4 variables: 1) DAS28, 2) Age, 3) Disease duration and 4) Steroid dose. This weighted towards younger patients with shorter disease duration, requiring steroids and having a high DAS28, on the assumption that treating such patients would be more cost-effective. This resulted on a final list of 30 patients selected for treatment (N/N Priority). <h3>Results</h3> 135 out of 139 patients assessed, fulfilled the BSR eligibility criteria. Nearly two thirds of the 30 patients with the highest DAS28 (BSR priority) were subsequently replaced on our stratified list (N/N Priority). However, funding is still not available for 78% of our patients, who are otherwise eligible for treatment. <h3>Conclusion</h3> Rationing creates difficult choices. We have attempted to select patients according to need and cost effectiveness. These decisions should be debated openly as they have important implications for health policy and clinical management. <h3>References</h3> British Society for Rheumatology – Report of a Working Party, April 2000 Updated consensus statement on TNF blocking drugs for the treatment of RA. <i>Ann Rheum Dis</i>. 2000;<b>59</b>(Suppl I):i1–i2