Bleeding Related Episodes, Thrombotic Events and Platelet Counts Among Immune Thrombocytopenia Patients Receiving Second Line Therapy

This study utilizes a national electronic health record (EHR) database to understand clinical outcomes with use of second-line treatments including: thrombopoietin receptor agonists (specifically, eltrombopag and romiplostim), rituximab, and splenectomy.METHODS: Utilizing the Optum EHR database, we identified patients who initiated a second-line treatment from Jan. 1, 2009 to Sep. 30, 2016 for primary or unspecified ITP. Additionally, patients included in the analysis had the following characteristics: 18 years or older; previous treatment with corticosteroids or immune globulin products; and active in the database for at least 6 months prior to and 12 months post initiation of a second-line treatment. Evaluated outcomes included: (1) platelet counts; (2) bleeding related episodes (BREs); and (3) thrombotic events (TEs), including stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis, and pulmonary embolism. All outcomes were evaluated over the 12-month period following the initiation of second-line treatment. BREs and TEs were defined using ICD codes, collapsed to first three characters, indicating a form of bleeding or thrombotic events. Chi-square test and t-test were used to evaluate differences among the four treatment cohorts (eltrombopag, romiplostim, rituximab, and splenectomy).RESULTS: 2,047 patients met the inclusion criteria and used the second-line treatments as follows: eltrombopag, N=110 (5.4%); romiplostim, N=189 (9.2%); rituximab, N=1,...
Source: Blood - Category: Hematology Authors: Tags: 311. Disorders of Platelet Number or Function: Poster II Source Type: research

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Publication date: Available online 22 January 2020Source: Revista Española de Cardiología (English Edition)Author(s): Ernesto Valero, Jessika González-D’Gregorio, Nieves Carbonell, Mónica García-Simón, José Ferreres, Juan Sanchis
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Publication date: Available online 23 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Cindy L.J. Weinstein, Nicholas Ryan, Xiaoli Zhang, Tulin Shekar, Davis Gates, Stephen J. Lane, Ioana Agache, Robert A. Nathan, SPIRO InvestigatorsAbstractBackgroundDue to historical safety concerns with use of long-acting beta agonists in asthma, step-down from inhaled corticosteroid/long-acting beta agonist (ICS/LABA) combination therapy to ICS monotherapy is recommended once asthma control is achieved.ObjectiveTo evaluate the benefit/risk question about whether asthma patients who achieve diseas...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Authors: Dominique I, Ecochard R, Morel-Journel N, Terrier JE, Paparel P, Ruffion A, Champetier D Abstract INTRODUCTION: Preoperative information is a key to adherence to treatment for the patients, but may be misunderstood because of its density and complexity. The aim of this study was to assess comprehension and satisfaction of patients about preoperative information of benign prostatic hyperplasia (BPH) surgery. Factors influencing patient understanding were also studied. PATIENTS AND METHODS: It was a monocentric study on questionnaires including every patients planned for BPH surgery, whatever the surgica...
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
This study investigated whether RIPreC and RIPostC exerted neuroprotection against cerebral ischemic injury in type 2 diabetic mice. RIPreC (24 h before ischemia) and RIPostC (immediately after reperfusion) were performed in an ischemia/reperfusion induced stroke model with type 2 diabetes. Ischemic outcomes, flow cytometry, multiplex cytokine assay, and western blotting were analyzed after 45 min of ischemia followed by 48 h of reperfusion. Our data indicated that RIPreC and RIPostC attenuated cerebral injuries and neurological deficits. RIPreC significantly reduced CD4 T cell and CD8 T cell infiltration and increas...
Source: Neurochemistry International - Category: Neuroscience Source Type: research
We report here a case of isolated peripheral-type facial palsy due to acute bleeding of supratentorial cavernoma. To our knowledge, such case has not yet been reported.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
We report a young woman with a life-threatening basilar artery thrombosis during sexual intercourse, with a resulting locked-in syndrome. The positive high intensity transient signals (HITS) diagnosis showed a right-to-left shunt and is in line with paradoxic embolism. The molecular genetics revealed a homozygosity 4G/4G in the region PAI1, -675 (promoter polymorphism) as a risk factor for ischemic stroke. Sexual intercourse is a possible, albeit unusual stroke cause, especially in young people.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
We report 5 cases of tumors mimicking CMs. We compared clinical, initial radiologic features, and MRI evolution between 5 tumor mimics and 51 true hemorrhagic, sporadic, brain CM. Compared to true CM, mimic patients were older (47.0 vs. 38.3 years; p = 0.076) and more likely to have a history of primary neoplasm (60% vs 12%; p = 0.0267). Radiologically, the CM mimics demonstrated a higher likelihood of lesion enhancement on the initial diagnostic MRI (60% vs. 16.7%%; p = 0.0609). On follow-up MRI (
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Publication date: Available online 23 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Malak Elbatarny, Derrick Y. Tam, J. James Edelman, Rodolfo V. Rocha, Michael W.A. Chu, Mark D. Peterson, Ismail El-Hamamsy, Jehangir J. Appoo, Jan O. Friedrich, Munir Boodhwani, Bobby Yanagawa, Maral Ouzounian, Canadian Thoracic Aortic Collaborative (CTAC) InvestigatorsAbstractBackgroundAortic valve sparing operations theoretically have fewer stroke and bleeding complications but may increase late reoperation risk, versus composite valve grafts.MethodsWe meta-analyzed all studies comparing aortic valve sparing (reimplantation...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
We report herein a case of three patients with pseudotumoral neuro-Behçet’s disease aged between 30 and 45 years old, with a history of recurrent orogenital ulceration. All patients presented with neurological symptoms associated with at least one large space-occupying lesion on cerebral imaging. Behçet’s disease was diagnosed according to the International Study Group criteria. All cases received corticosteroids and immunosuppressant agents with a spectacular clinical and radiological improvement.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
Authors: Traynelis SF, Dlugos D, Henshall D, Mefford HC, Rogawski MA, Staley KJ, Dacks PA, Whittemore V, Poduri A, National Institutes of Neurological Disorders and Stroke (NINDS)/American Epilepsy Society (AES) Epilepsy Research Benchmark Stewards Abstract The goals of Epilepsy Benchmark Area III involve identifying areas that are ripe for progress in terms of controlling seizures and patient symptoms in light of the most recent advances in both basic and clinical research. These goals were developed with an emphasis on potential new therapeutic strategies that will reduce seizure burden and improve quality of lif...
Source: Epilepsy Currents - Category: Neurology Tags: Epilepsy Curr Source Type: research
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