Asunto(s)
Lesión Renal Aguda , Trasplante de Hígado , Daño por Reperfusión , Humanos , Trasplante de Hígado/efectos adversos , Daño por Reperfusión/etiología , Daño por Reperfusión/prevención & control , Riñón , Biomarcadores , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Lesión Renal Aguda/prevención & control , IsquemiaRESUMEN
OBJECTIVES: Tofacitinib is a Janus Kinase inhibitor used for treating moderate to severe ulcerative colitis (UC), mainly after the failure of biological therapy. There is a paucity of data on the outcome of tofacitinib in biological-naïve UC patients. The present study was aimed at analyzing the safety and efficacy of tofacitinib in biological-naïve Indian patients with UC. METHODS: The present study retrospectively evaluated consecutive patients with biological-naïve moderate-to-severe active UC from six tertiary care centers in India receiving tofacitinib from September 2020 to September 2022. Clinical remission or response assessment was based on partial Mayo score (PMS) calculated at baseline and weeks eight, 16 and 24. RESULTS: Total 47 cases (57.4% male, median age: 32 years) were included. After eight weeks of therapy, 33 (70.2%) achieved clinical remission and eight (17.0%) had a primary failure. The baseline serum albumin at treatment initiation was the only independent predictor of remission at eight weeks (Odds ratio: 11.560, 95% CI: 1.478 - 90.404), but not at 16 weeks. By 24 weeks, 59.6% (28/47) of the patients were in remission and 29.8% (14/47) had stopped tofacitinib either due to failure (27.6%) or adverse events (AEs) (2.1%). Among the 47 patients, 10 (21.2%) cases developed AEs during follow-up, including two tuberculosis (4.2%), one cytomegalovirus (CMV) colitis (2.1%) and one herpes zoster (2.1%). Four patients with infection required temporary drug discontinuations. One required permanent discontinuation (mania). CONCLUSION: Upfront tofacitinib is effective in biologic-naïve Indian patients with moderate-severe UC. Further randomized studies are required to validate the study findings.
Asunto(s)
Colitis Ulcerosa , Piperidinas , Pirimidinas , Humanos , Masculino , Adulto , Femenino , Colitis Ulcerosa/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/efectos adversos , Estudios Retrospectivos , Pirroles/efectos adversos , Resultado del TratamientoAsunto(s)
Hepatitis Alcohólica , Síndrome Hepatorrenal , Terlipresina , Vasoconstrictores , Humanos , Hepatitis Alcohólica/complicaciones , Hepatitis Alcohólica/tratamiento farmacológico , Síndrome Hepatorrenal/complicaciones , Síndrome Hepatorrenal/tratamiento farmacológico , Lipresina/efectos adversos , Terlipresina/uso terapéutico , Resultado del Tratamiento , Vasoconstrictores/uso terapéuticoAsunto(s)
Hepatitis Alcohólica , Trasplante de Hígado , Mucormicosis , Infecciones Oportunistas , Humanos , Trasplante de Hígado/efectos adversos , Hepatitis Alcohólica/complicaciones , Hepatitis Alcohólica/cirugía , Antifúngicos/uso terapéutico , Hemorragia Gastrointestinal/etiología , Tracto Gastrointestinal Inferior , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/etiología , Mucormicosis/tratamiento farmacológicoRESUMEN
Familial clustering of hepatitis B virus infection has been reported infrequently. We report a family of 27 members, where 13 members were HBsAg-positive. This included 7 of 10 members in one linear family across four generations. Nine subjects who were tested were HBeAg-negative. Of these nine, three subjects had elevated ALT; histology in one of them showed activity index <3. One subject received lamivudine therapy elsewhere; ALT levels returned to normal in two months.
