Assuntos
Inibidores da Angiogênese , Retinopatia Diabética , Injeções Intravítreas , Edema Macular , Ranibizumab , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão , Acuidade Visual , Humanos , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Ranibizumab/administração & dosagem , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/diagnóstico , Proteínas Recombinantes de Fusão/administração & dosagem , Proteínas Recombinantes de Fusão/uso terapêutico , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/uso terapêutico , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Resultado do TratamentoAssuntos
Inibidores da Angiogênese/administração & dosagem , Retinopatia Diabética/tratamento farmacológico , Edema Macular/tratamento farmacológico , Ranibizumab/administração & dosagem , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Acuidade Visual/fisiologia , Idoso , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/fisiopatologia , Feminino , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico por imagem , Edema Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidoresRESUMO
Novel treatment strategies such as targeted therapy with mitogen-activated protein-kinase-kinase/B-Raf proto-oncogene (MEK/BRAF) inhibitors have prolonged patient survival in metastatic melanoma and are used in oncology. The combination of binimetinib og encorafenib can induce extensive bilateral neuroretinal detachments. In this case report, we present a 72-year-old female patient with this condition. Dilated fundus examination and optical coherence tomography are essential in diagnosis and monitoring of patients treated with MEK/BRAF-inhibitors. No persistent visual deficits were documented in the patient, as this condition appears to be fully reversible.
Assuntos
Melanoma , Doenças Retinianas , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Benzimidazóis/uso terapêutico , Feminino , Humanos , Melanoma/tratamento farmacológico , Mutação , Inibidores de Proteínas Quinases/efeitos adversos , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas B-raf/genética , Doenças Retinianas/induzido quimicamenteRESUMO
BACKGROUND: Combination antiretroviral therapy (cART) has drastically increased the life expectancy of HIV-infected patients. However, HIV-infected patients exhibit increased inflammation and 33-58% exhibit a characteristic fat re-distribution termed HIV-associated lipodystrophy syndrome (HALS). Recombinant human growth hormone (rhGH) has been tested as treatment of HALS. Low-dose rhGH therapy improves thymopoiesis and fat distribution in HIV-infected patients and appears to be well tolerated. However, since high-dose rhGH is associated with adverse events related to inflammation, we wanted to investigate the impact of low-dose rhGH therapy on inflammation in HIV-infected patients. METHODS: Forty-six cART-treated HIV-infected men were included in the HIV-GH low-dose (HIGH/Low) study: a randomized, placebo-controlled, double-blinded trial. Subjects were randomized 3:2 to 0.7 mg/day rhGH, or placebo for 40 weeks. rhGH was self-administered between 1 pm and 3 pm. The primary outcome of this substudy was changes in inflammation measured by plasma C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR). RESULTS: Both CRP (-66%, p = 0.002) and suPAR (-9.7%, p = 0.06) decreased in the rhGH group compared to placebo; however, only CRP decreased significantly. The effect of rhGH on inflammation was not mediated through rhGH-induced changes in insulin-like growth factor 1, body composition, or immune parameters. CONCLUSION: Daily 0.7 mg rhGH treatment for 40 weeks, administered at nadir endogenous GH secretion, significantly reduced CRP. The effect does not appear to be mediated by other factors. Our findings suggest that low-dose rhGH treatment may minimize long-term risks associated with high-dose rhGH therapy.
