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5 results on '"Jessie Felton"'

1. Prior elicitation of the efficacy and tolerability of Methotrexate and Mycophenolate Mofetil in Juvenile Localised Scleroderma [version 1; peer review: 2 approved]

Author

Thomas Jaki, Yasin Desai, Thomas Burnett, Michael W Beresford, Heidi Jacobe, Despina Eleftheriou, Suzanne Li, Valentina Leone, Athimalaipet V Ramanan, Pavel Mozgunov, Marina E Anderson, Kathryn S Torok, Tadej Avcin, Jordi Anton, Ivan Foeldvari, Jessie Felton, Flora McErlane, Bisola Laguda, Francesco Zulian, Lindsay Shaw, and Clare E Pain

Subjects
juvenile localised scleroderma, methotrexate, mycophenolate mofetil, Bayesian approach, prior elicitation, eng, Medicine
Abstract

Background Evidence is lacking for safe and effective treatments for juvenile localised scleroderma (JLS). Methotrexate (MTX) is commonly used first line and mycophenolate mofetil (MMF) second line, despite a limited evidence base. A head to head trial of these two medications would provide data on relative efficacy and tolerability. However, a frequentist approach is difficult to deliver in JLS, because of the numbers needed to sufficiently power a trial. A Bayesian approach could be considered. Methods An international consensus meeting was convened including an elicitation exercise where opinion was sought on the relative efficacy and tolerability of MTX compared to MMF to produce prior distributions for a future Bayesian trial. Secondary aims were to achieve consensus agreement on critical aspects of a future trial. Results An international group of 12 clinical experts participated. Opinion suggested superior efficacy and tolerability of MMF compared to MTX; where most likely value of efficacy of MMF was 0.70 (95% confidence interval (CI) 0.34-0.90) and of MTX was 0.68 (95% CI 0.41-0.8). The most likely value of tolerability of MMF was 0.77 (95% CI 0.3-0.94) and of MTX was 0.62 (95% CI 0.32-0.84). The wider CI for MMF highlights that experts were less sure about relative efficacy and tolerability of MMF compared to MTX. Despite using a Bayesian approach, power calculations still produced a total sample size of 240 participants, reflecting the uncertainty amongst experts about the performance of MMF. Conclusions Key factors have been defined regarding the design of a future Bayesian approach clinical trial including elicitation of prior opinion of the efficacy and tolerability of MTX and MMF in JLS. Combining further efficacy data on MTX and MMF with prior opinion could potentially reduce the pre-trial uncertainty so that, when combined with smaller trial sample sizes a compelling evidence base is available.

Published
2021
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2. Cutaneous Squamous Cell Carcinoma in Epidermolysis Bullosa: a 28-year Retrospective Study

Author

Manpreet K. Lakhan, Elizabeth Orrin, Jessie Felton, John A. McGrath, Danielle Greenblatt, Anna E. Martinez, Susan J. Robertson, Gavin O'Sullivan, Jemima E. Mellerio, Alistair Robson, and Catina Bernardis

Subjects
Adult, squamous cell carcinoma, Multiple tumours, medicine.medical_specialty, Skin Neoplasms, Cutaneous squamous cell carcinoma, Adolescent, Mucocutaneous zone, Dermatology, Case review, Young Adult, Humans, Medicine, cancer, epidermolysis bullosa, Retrospective Studies, business.industry, Cancer, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Epidermolysis Bullosa Dystrophica, Increased risk, RL1-803, Carcinoma, Squamous Cell, Epidermolysis bullosa, prognosis, business
Abstract

Epidermolysis bullosa (EB), notably severe recessive dystrophic EB (RDEB-S), is associated with increased risk of aggressive mucocutaneous squamous cell carcinomas, the major cause of mortality in early adulthood. This observational, retrospective case review describes a series of EB patients with cutaneous squamous cell carcinomas over a 28-year period. Forty-four EB patients with squamous cell carcinomas were identified with a total of 221 primary tumours. They comprised: 31 (70%) with RDEB-S, 4 (9%) with other RDEB subtypes, 5 (11.4%) with dominant dystrophic EB, 3 (6.8%) with intermediate junctional EB and 1 (2.3%) with Kindler EB. Squamous cell carcinomas occurred earlier in RDEB-S (median age 29.5 years; age range 13-52 years) than other groups collectively (median age 47.1 years; age range 30-89 years) and most had multiple tumours (mean 5.8; range 1-44). Squamous cell carcinoma-associated mortality was high in RDEB-S (64.5%), with median survival after first squamous cell carcinoma of 2.4 years (range 0.5-12.6 years), significantly lower than previous reports, highlighting the need for early surveillance and better treatments.

Published
2021

3. An FCER2 polymorphism is associated with increased oral leukotriene receptor antagonists and allergic rhinitis prescribing

Author

Anke M. Hövels, Roger Tavendale, Colin N. A. Palmer, Stephen Bremner, Patrícia Soares, Christina J Jones, Jessie Felton, Katy Fidler, and Somnath Mukhopadhyay

Subjects
0301 basic medicine, Male, Adolescent, Genotype, Immunology, Antigen presentation, Immunoglobulin E, Polymorphism, Single Nucleotide, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Immune system, Polymorphism (computer science), medicine, Immunology and Allergy, Humans, Lectins, C-Type, Practice Patterns, Physicians', Receptor, Child, Asthma, biology, business.industry, Receptors, IgE, Atopic dermatitis, medicine.disease, Rhinitis, Allergic, 030104 developmental biology, 030228 respiratory system, Child, Preschool, biology.protein, Leukotriene Antagonists, Female, business
Abstract

The Fc Fragment of IgE Receptor II (FCER2) is expressed in several cells, such as macrophages, eosinophils, B cells and platelets. Studies have suggested that FCER2 is involved in the regulation of IgE responses, growth and differentiation of T and B cells, cellular adherence and antigen presentation. The activation of the receptor results in down-regulation of IgE-mediated immune responses. Two studies found that individuals with asthma on inhaled corticosteroids (ICS) with the CC genotype of the rs28364072 polymorphism had a two-fold increased odds of asthma exacerbations and uncontrolled asthma than individuals with at least one copy of the T allele (CT/TT).

Published
2021

4. A case of multiple cerebral cavernomas associated with en coup de sabre scleroderma

Author

Naila Dinani, Jessie Felton, and Noor Alwash

Subjects
Male, medicine.medical_specialty, Hemangioma, Cavernous, Central Nervous System, genetic structures, Dermatology, Scleroderma, Central Nervous System Neoplasms, 030207 dermatology & venereal diseases, 03 medical and health sciences, Scleroderma, Localized, 0302 clinical medicine, Neuroimaging, Seizures, Medicine, Humans, In patient, Linear Scleroderma, skin and connective tissue diseases, Localized Scleroderma, integumentary system, business.industry, Infant, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Scalp, Pediatrics, Perinatology and Child Health, Forehead, En coup de sabre, business
Abstract

Linear scleroderma is a form of localized scleroderma that presents as band-like sclerotic lesions. When it occurs on the scalp or forehead, it is called "en coup de sabre scleroderma" (ECDS). Extracutaneous associations, mostly neurologic, have been described with ECDS. We report a patient with ECDS associated with multiple cerebral cavernomas. This serves to highlight the importance of neuroimaging and multidisciplinary team involvement in patients with ECDS.

Published
2019

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