31 results on '"Zolfino T"'
Search Results
2. Predictors of serious adverse events and non-response in cirrhotic patients with primary biliary cholangitis treated with obeticholic acid
- Author
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De Vincentis, A, D'Amato, D, Cristoferi, L, Gerussi, A, Malinverno, F, Lleo, A, Colapietro, F, Marra, F, Galli, A, Fiorini, C, Coco, B, Brunetto, M, Niro, G, Cotugno, R, Saitta, C, Cozzolongo, R, Losito, F, Giannini, E, Labanca, S, Marzioni, M, Marconi, G, Morgando, A, Pellicano, R, Vanni, E, Cazzagon, N, Floreani, A, Chessa, L, Morelli, O, Muratori, L, Pellicelli, A, Pompili, M, Ponziani, F, Tortora, A, Rosina, F, Russello, M, Cannavo, M, Simone, L, Storato, S, Vigano, M, Abenavoli, L, D'Anto, M, De Gasperi, E, Distefano, M, Scifo, G, Zolfino, T, Calvaruso, V, Cuccorese, G, Palitti, V, Sacco, R, Bertino, G, Frazzetto, E, Alvaro, D, Mulinacci, G, Palermo, A, Scaravaglio, M, Terracciani, F, Galati, G, Ronca, V, Zuin, M, Claar, E, Izzi, A, Picardi, A, Invernizzi, P, Vespasiani-Gentilucci, U, Carbone, M, Feletti, V, Mussetto, A, Venere, R, Bernaccioni, G, Graciella Pigozzi, M, Fagiuoli, S, Terreni, N, Pozzoni, P, Baiocchi, L, Grassi, G, Vinci, M, Bellia, V, Boldizzoni, R, Casella, S, Omazzi, B, Poggi, G, De Vincentis A., D'Amato D., Cristoferi L., Gerussi A., Malinverno F., Lleo A., Colapietro F., Marra F., Galli A., Fiorini C., Coco B., Brunetto M., Niro G. A., Cotugno R., Saitta C., Cozzolongo R., Losito F., Giannini E. G., Labanca S., Marzioni M., Marconi G., Morgando A., Pellicano R., Vanni E., Cazzagon N., Floreani A., Chessa L., Morelli O., Muratori L., Pellicelli A., Pompili M., Ponziani F., Tortora A., Rosina F., Russello M., Cannavo M., Simone L., Storato S., Vigano M., Abenavoli L., D'Anto M., De Gasperi E., Distefano M., Scifo G., Zolfino T., Calvaruso V., Cuccorese G., Palitti V. P., Sacco R., Bertino G., Frazzetto E., Alvaro D., Mulinacci G., Palermo A., Scaravaglio M., Terracciani F., Galati G., Ronca V., Zuin M., Claar E., Izzi A., Picardi A., Invernizzi P., Vespasiani-Gentilucci U., Carbone M., Feletti V., Mussetto A., Venere R., Bernaccioni G., Graciella Pigozzi M., Fagiuoli S., Terreni N., Pozzoni P., Baiocchi L., Grassi G., Vinci M., Bellia V., Boldizzoni R., Casella S., Omazzi B., Poggi G., De Vincentis, A, D'Amato, D, Cristoferi, L, Gerussi, A, Malinverno, F, Lleo, A, Colapietro, F, Marra, F, Galli, A, Fiorini, C, Coco, B, Brunetto, M, Niro, G, Cotugno, R, Saitta, C, Cozzolongo, R, Losito, F, Giannini, E, Labanca, S, Marzioni, M, Marconi, G, Morgando, A, Pellicano, R, Vanni, E, Cazzagon, N, Floreani, A, Chessa, L, Morelli, O, Muratori, L, Pellicelli, A, Pompili, M, Ponziani, F, Tortora, A, Rosina, F, Russello, M, Cannavo, M, Simone, L, Storato, S, Vigano, M, Abenavoli, L, D'Anto, M, De Gasperi, E, Distefano, M, Scifo, G, Zolfino, T, Calvaruso, V, Cuccorese, G, Palitti, V, Sacco, R, Bertino, G, Frazzetto, E, Alvaro, D, Mulinacci, G, Palermo, A, Scaravaglio, M, Terracciani, F, Galati, G, Ronca, V, Zuin, M, Claar, E, Izzi, A, Picardi, A, Invernizzi, P, Vespasiani-Gentilucci, U, Carbone, M, Feletti, V, Mussetto, A, Venere, R, Bernaccioni, G, Graciella Pigozzi, M, Fagiuoli, S, Terreni, N, Pozzoni, P, Baiocchi, L, Grassi, G, Vinci, M, Bellia, V, Boldizzoni, R, Casella, S, Omazzi, B, Poggi, G, De Vincentis A., D'Amato D., Cristoferi L., Gerussi A., Malinverno F., Lleo A., Colapietro F., Marra F., Galli A., Fiorini C., Coco B., Brunetto M., Niro G. A., Cotugno R., Saitta C., Cozzolongo R., Losito F., Giannini E. G., Labanca S., Marzioni M., Marconi G., Morgando A., Pellicano R., Vanni E., Cazzagon N., Floreani A., Chessa L., Morelli O., Muratori L., Pellicelli A., Pompili M., Ponziani F., Tortora A., Rosina F., Russello M., Cannavo M., Simone L., Storato S., Vigano M., Abenavoli L., D'Anto M., De Gasperi E., Distefano M., Scifo G., Zolfino T., Calvaruso V., Cuccorese G., Palitti V. P., Sacco R., Bertino G., Frazzetto E., Alvaro D., Mulinacci G., Palermo A., Scaravaglio M., Terracciani F., Galati G., Ronca V., Zuin M., Claar E., Izzi A., Picardi A., Invernizzi P., Vespasiani-Gentilucci U., Carbone M., Feletti V., Mussetto A., Venere R., Bernaccioni G., Graciella Pigozzi M., Fagiuoli S., Terreni N., Pozzoni P., Baiocchi L., Grassi G., Vinci M., Bellia V., Boldizzoni R., Casella S., Omazzi B., and Poggi G.
- Abstract
Background & Aims: Obeticholic acid (OCA) has recently been restricted in patients with primary biliary cholangitis (PBC) with “advanced cirrhosis” because of its narrow therapeutic index. We aimed to better define the predicting factors of hepatic serious adverse events (SAEs) and non-response in cirrhotic patients undergoing OCA therapy. Methods: Safety and efficacy of treatment were evaluated in a cohort of consecutive PBC cirrhotic patients started with OCA. OCA response was evaluated according to the Poise criteria. Risk factors for hepatic SAEs and non-response were reported as risk ratios (RR) with 95% confidence intervals (CIs). Results: One hundred PBC cirrhotics were included, 97 Child-Pugh class A and 3 class B. Thirty-one had oesophageal varices and 5 had a history of ascites. Thirty-three per cent and 32% of patients achieved a biochemical response at 6 and 12 months respectively. Male sex (adjusted-RR 1.75, 95%CI 1.42–2.12), INR (1.37, 1.00–1.87), Child-Pugh score (1.79, 1.28–2.50), MELD (1.17, 1.04–1.30) and bilirubin (1.83, 1.11–3.01) were independently associated with non-response to OCA. Twenty-two patients discontinued OCA within 12 months: 10 for pruritus, 9 for hepatic SAEs (5 for jaundice and/or ascitic decompensation; 4 for upper digestive bleeding). INR (adjusted-RR 1.91, 95%CI 1.10–3.36), lower albumin levels (0.18, 0.06–0.51), Child-Pugh score (2.43, 1.50–4.04), history of ascites (3.5, 1.85–6.5) and bilirubin (1.30, 1.05–1.56), were associated with hepatic SAEs. A total bilirubin≥1.4 mg/dl at baseline was the most accurate biochemical predictor of hepatic SAEs under OCA. Conclusions: An accurate baseline assessment is crucial to select cirrhotic patients who can benefit from OCA. Although OCA is effective in one third of cirrhotics, bilirubin level ≥1.4 mg/dl should discourage from its use.
- Published
- 2022
3. Long-term results from the Italian real-world experience on obeticholic acid treatment in primary biliary cholangitis: The RECAPITULATE study
- Author
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Terracciani, F., primary, De Vincentis, A., additional, D'Amato, D., additional, Invernizzi, P., additional, Morgando, A., additional, Vanni, E., additional, Viganò, M., additional, Alvaro, D., additional, Venere, R., additional, Lleo, A., additional, Colapietro, F., additional, Degasperi, E., additional, Viganò, R., additional, Giannini, E.G., additional, Labanca, S., additional, Feletti, V., additional, Mussetto, A., additional, Cozzolongo, R., additional, Losito, F., additional, Pompili, M., additional, Ponziani, F.R., additional, Niro, G.A., additional, Cotugno, R., additional, Pozzoni, P., additional, Chessa, L., additional, Cuccorese, G., additional, Palitti, V. Pace, additional, Russello, M., additional, Cannavò, M., additional, Frazzetto, E., additional, Bertino, G., additional, Marzioni, M., additional, Terreni, N., additional, Zolfino, T., additional, Saitta, C., additional, Pellicelli, A., additional, Coco, B., additional, Brunetto, M., additional, Cazzagon, N., additional, Floreani, A., additional, Muratori, L., additional, Rosina, F., additional, Di Stefano, M., additional, Scifo, G., additional, Baiocchi, L., additional, Grassi, G., additional, Sacco, R., additional, Izzi, A., additional, Crocè, S. Lory, additional, Fiorini, C., additional, Marra, F., additional, Simone, L., additional, Morelli, O., additional, Abenavoli, L., additional, Pizzolante, F., additional, De Matthaeis, N., additional, Scaravaglio, M., additional, Gimignani, G., additional, Boano, V., additional, Manfredi, G.F., additional, Marignani, M., additional, Fanella, S., additional, Giacchetto, M., additional, Castellaneta, A., additional, Poggi, G., additional, Buzzanca, V., additional, Scivetti, P., additional, Tortora, A., additional, Casella, S., additional, Bellia, V., additional, Omazzi, B.F., additional, Alagna, G., additional, Ricci, C., additional, Poisa, P., additional, Rigamonti, C., additional, Calvaruso, V., additional, Carbone, M., additional, and Vespasiani-Gentilucci, U., additional
- Published
- 2023
- Full Text
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4. Prediction of response to obeticholic acid in primary biliary cholangitis: Development and validation of the OCA response score (ORS)
- Author
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De Vincentis, A., primary, Terracciani, F., additional, D'Amato, D., additional, Invernizzi, P., additional, Morgando, A., additional, Vanni, E., additional, Viganò, M., additional, Alvaro, D., additional, Venere, R., additional, Lleo, A., additional, Colapietro, F., additional, Degasperi, E., additional, Viganò, R., additional, Giannini, E.G., additional, Labanca, S., additional, Feletti, V., additional, Mussetto, A., additional, Cozzolongo, R., additional, Losito, F., additional, Pompili, M., additional, Ponziani, F.R., additional, Niro, G.A., additional, Cotugno, R., additional, Pozzoni, P., additional, Chessa, L., additional, Cuccorese, G., additional, Palitti, V. Pace, additional, Russello, M., additional, Cannavò, M., additional, Frazzetto, E., additional, Bertino, G., additional, Marzioni, M., additional, Terreni, N., additional, Zolfino, T., additional, Saitta, C., additional, Pellicelli, A., additional, Coco, B., additional, Brunetto, M., additional, Cazzagon, N., additional, Floreani, A., additional, Muratori, L., additional, Rosina, F., additional, Di Stefano, M., additional, Scifo, G., additional, Baiocchi, L., additional, Grassi, G., additional, Sacco, R., additional, Izzi, A., additional, Crocè, Saveria Lory, additional, Fiorini, Cecilia, additional, Marra, Fabio, additional, Simone, Loredana, additional, Morelli, Olivia, additional, Abenavoli, L., additional, Pizzolante, F., additional, De Matthaeis, N., additional, Scaravaglio, M., additional, Gimignani, G., additional, Boano, V., additional, Manfredi, G.F., additional, Marignani, M., additional, Fanella, S., additional, Giacchetto, M., additional, Castellaneta, A., additional, Poggi, G., additional, Buzzanca, V., additional, Scivetti, P., additional, Tortora, A., additional, Casella, S., additional, Bellia, V., additional, Omazzi, B.F., additional, Alagna, G., additional, Ricci, C., additional, Poisa, P., additional, Rigamonti, C., additional, Calvaruso, V., additional, Vespasiani-Gentilucci, U., additional, and Carbone, M., additional
- Published
- 2023
- Full Text
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5. Predictors of Serious Adverse Event and Non-response in Cirrhotic Patients With Primary Biliary Cholangitis under Obeticholic Acid
- Author
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De Vincentis, A., primary, D'Amato, D., additional, Cristoferi, L., additional, Gerussi, A., additional, Malinverno, F., additional, Lleo, A., additional, Colapietro, F., additional, Marra, F., additional, Galli, A., additional, Fiorini, C., additional, Coco, B., additional, Brunetto, M., additional, Niro, G.A., additional, Cotugno, R., additional, Saitta, C., additional, Cozzolongo, R., additional, Losito, F., additional, Giannini, E.G., additional, Labanca, S., additional, Marzioni, M., additional, Marconi, G., additional, Morgando, A., additional, Pellicano, R., additional, Vanni, E., additional, Cazzagon, N., additional, Floreani, A., additional, Chessa, L., additional, Morelli, O., additional, Muratori, L., additional, Pellicelli, A., additional, Pompili, M., additional, Ponziani, F., additional, Rosina, F., additional, Russello, M., additional, Cannavò, M., additional, Simone, L., additional, Storato, S., additional, Viganò, M., additional, Abenavoli, L., additional, D'Antò, M., additional, De Gasperi, E., additional, Distefano, M., additional, Scifo, G., additional, Zolfino, T., additional, Calvaruso, V., additional, Cuccorese, G., additional, Pace Palitti, V., additional, Sacco, R., additional, Bertino, G., additional, Frazzetto, E., additional, Alvaro, D., additional, Mulinacci, G., additional, Palermo, A., additional, Galati, G., additional, Ronca, V., additional, Zuin, M., additional, Claar, E., additional, Izzi, A., additional, Picardi, A., additional, Invernizzi, P., additional, Vespasiani-Gentilucci, U., additional, and Carbone, M., additional
- Published
- 2022
- Full Text
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6. Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis
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Ascione, A, De Luca, M, Melazzini, M, Montilla, S, Trotta, M, Petta, S, Puoti, M, Sangiovanni, V, Messina, V, Bruno, S, Izzi, A, Villa, E, Aghemo, A, Zignego, A, Orlandini, A, Fontanella, L, Gasbarrini, A, Marzioni, M, Giannini, E, Craxi, A, Abbati, G, Alberti, A, Andreone, P, Andreoni, M, Angeli, P, Angelico, M, Angarano, G, Angrisani, D, Antinori, A, Antonini, C, Avancini, I, Barone, M, Bruno, R, Benedetti, A, Bernabucci, V, Blanc, P, Boarini, C, Boffa, N, Boglione, L, Borghi, V, Borgia, G, Brancaccio, G, Brunetto, M, Cacciola, I, Calabrese, P, Calvaruso, V, Campagnolo, D, Canovari, B, Caporaso, N, Capra, F, Carolo, G, Cassola, G, Castelli, F, Cauda, R, Silberstein, F, Cecere, R, Chessa, L, Chiodera, A, Chirianni, A, Ciancio, A, Cima, S, Coco, B, Colombo, M, Coppola, N, Corti, G, Cosco, L, Corradori, S, Cozzolongo, R, Cristaudo, A, Danieli, E, Monforte, A, Monache, M, Del Poggio, P, de Luca, A, Dentone, C, Di Biagio, A, Di Leo, A, Di Perri, G, Di Stefano, M, D'Offizi, G, Donato, F, Durante, E, Erne, E, Fagiuoli, S, Falasca, K, Federico, A, Felder, M, Ferrari, C, Gaeta, G, Ganga, R, Gatti, P, Giacomet, V, Giacometti, A, Gianstefani, A, Giordani, M, Giorgini, A, Grieco, A, Guerra, M, Gulminetti, R, Ieluzzi, D, Imparato, M, Iodice, V, La Monica, S, Lazzarin, A, Lenzi, M, Levrero, M, Lichtner, M, Lionetti, R, Guercio, C, Madonna, S, Magnani, S, Maida, I, Marignani, M, Marrone, A, Marsetti, F, Martini, S, Masarone, M, Maserati, R, Mastroianni, C, Memoli, M, Menzaghi, B, Merli, M, Miele, L, Milella, M, Mondelli, M, Montalbano, M, Monti, M, Morelli, O, Morisco, F, Nardone, G, Novara, S, Onnelli, G, Onofrio, M, Paganin, S, Pani, L, Parisi, M, Parruti, G, Pasquazzi, C, Pasulo, L, Perno, C, Persico, M, Piai, G, Picciotto, A, Pigozzi, G, Piovesan, S, Piras, M, Pirisi, M, Piscaglia, A, Ponti, L, Potenza, D, Pravadelli, C, Quartini, M, Quirino, T, Raimondo, G, Rapaccini, G, Rendina, M, Rizzardini, G, Rizzetto, M, Rizzo, S, Romagnoli, D, Romano, A, Rossi, C, Rumi, M, Russello, M, Russo, F, Russo, M, Sansonno, D, Santantonio, T, Saracco, G, Schimizzi, A, Serviddio, G, Simeone, F, Solinas, A, Soria, A, Tabone, M, Taliani, G, Tarantino, G, Tarquini, P, Tavio, M, Termite, A, Teti, E, Toniutto, P, Torti, C, Tundi, P, Vecchiet, G, Verucchi, G, Gentilucci, U, Vinci, M, Vullo, V, Zolfino, T, Zuin, M, Ascione A., De Luca M., Melazzini M., Montilla S., Trotta M. P., Petta S., Puoti M., Sangiovanni V., Messina V., Bruno S., Izzi A., Villa E., Aghemo A., Zignego A. L., Orlandini A., Fontanella L., Gasbarrini A., Marzioni M., Giannini E. G., Craxi A., Abbati G., Alberti A., Andreone P., Andreoni M., Angeli P., Angelico M., Angarano G., Angrisani D., Antinori A., Antonini C., Avancini I., Barone M., Bruno R., Benedetti A., Bernabucci V., Blanc P., Boarini C., Boffa N., Boglione L., Borghi V., Borgia G., Brancaccio G., Brunetto M., Cacciola I., Calabrese P., Calvaruso V., Campagnolo D., Canovari B., Caporaso N., Capra F., Carolo G., Cassola G., Castelli F., Cauda R., Silberstein F. C., Cecere R., Chessa L., Chiodera A., Chirianni A., Ciancio A., Cima S., Coco B., Colombo M., Coppola N., Corti G., Cosco L., Corradori S., Cozzolongo R., Cristaudo A., Danieli E., Monforte A. D. A., Monache M., Del Poggio P., de Luca A., Dentone C., Di Biagio A., Di Leo A., Di Perri G., Di Stefano M., D'Offizi G., Donato F., Durante E., Erne E., Fagiuoli S., Falasca K., Federico A., Felder M., Ferrari C., Gaeta G. B., Ganga R., Gatti P., Giacomet V., Giacometti A., Gianstefani A., Giordani M., Giorgini A., Grieco A., Guerra M., Gulminetti R., Ieluzzi D., Imparato M., Iodice V., La Monica S., Lazzarin A., Lenzi M., Levrero M., Lichtner M., Lionetti R., Guercio C. L., Madonna S., Magnani S., Maida I., Marignani M., Marrone A., Marsetti F., Martini S., Masarone M., Maserati R., Mastroianni C. M., Memoli M., Menzaghi B., Merli M., Miele L., Milella M., Mondelli M., Montalbano M., Monti M., Morelli O., Morisco F., Nardone G., Novara S., Onnelli G., Onofrio M., Paganin S., Pani L., Parisi M. R., Parruti G., Pasquazzi C., Pasulo L., Perno C. F., Persico M., Piai G., Picciotto A., Pigozzi G. M., Piovesan S., Piras M. C., Pirisi M., Piscaglia A. M., Ponti L., Potenza D., Pravadelli C., Quartini M., Quirino T., Raimondo G., Rapaccini G. L., Rendina M., Rizzardini G., Rizzetto M., Rizzo S., Romagnoli D., Romano A., Rossi C., Rumi M. G., Russello M., Russo F. P., Russo M. L., Sansonno D. E., Santantonio T. A., Saracco G., Schimizzi A. M., Serviddio G., Simeone F., Solinas A., Soria A., Tabone M., Taliani G., Tarantino G., Tarquini P., Tavio M., Termite A., Teti E., Toniutto P., Torti C., Tundi P., Vecchiet G., Verucchi G., Gentilucci U. V., Vinci M., Vullo V., Zolfino T., Zuin M., Ascione, A, De Luca, M, Melazzini, M, Montilla, S, Trotta, M, Petta, S, Puoti, M, Sangiovanni, V, Messina, V, Bruno, S, Izzi, A, Villa, E, Aghemo, A, Zignego, A, Orlandini, A, Fontanella, L, Gasbarrini, A, Marzioni, M, Giannini, E, Craxi, A, Abbati, G, Alberti, A, Andreone, P, Andreoni, M, Angeli, P, Angelico, M, Angarano, G, Angrisani, D, Antinori, A, Antonini, C, Avancini, I, Barone, M, Bruno, R, Benedetti, A, Bernabucci, V, Blanc, P, Boarini, C, Boffa, N, Boglione, L, Borghi, V, Borgia, G, Brancaccio, G, Brunetto, M, Cacciola, I, Calabrese, P, Calvaruso, V, Campagnolo, D, Canovari, B, Caporaso, N, Capra, F, Carolo, G, Cassola, G, Castelli, F, Cauda, R, Silberstein, F, Cecere, R, Chessa, L, Chiodera, A, Chirianni, A, Ciancio, A, Cima, S, Coco, B, Colombo, M, Coppola, N, Corti, G, Cosco, L, Corradori, S, Cozzolongo, R, Cristaudo, A, Danieli, E, Monforte, A, Monache, M, Del Poggio, P, de Luca, A, Dentone, C, Di Biagio, A, Di Leo, A, Di Perri, G, Di Stefano, M, D'Offizi, G, Donato, F, Durante, E, Erne, E, Fagiuoli, S, Falasca, K, Federico, A, Felder, M, Ferrari, C, Gaeta, G, Ganga, R, Gatti, P, Giacomet, V, Giacometti, A, Gianstefani, A, Giordani, M, Giorgini, A, Grieco, A, Guerra, M, Gulminetti, R, Ieluzzi, D, Imparato, M, Iodice, V, La Monica, S, Lazzarin, A, Lenzi, M, Levrero, M, Lichtner, M, Lionetti, R, Guercio, C, Madonna, S, Magnani, S, Maida, I, Marignani, M, Marrone, A, Marsetti, F, Martini, S, Masarone, M, Maserati, R, Mastroianni, C, Memoli, M, Menzaghi, B, Merli, M, Miele, L, Milella, M, Mondelli, M, Montalbano, M, Monti, M, Morelli, O, Morisco, F, Nardone, G, Novara, S, Onnelli, G, Onofrio, M, Paganin, S, Pani, L, Parisi, M, Parruti, G, Pasquazzi, C, Pasulo, L, Perno, C, Persico, M, Piai, G, Picciotto, A, Pigozzi, G, Piovesan, S, Piras, M, Pirisi, M, Piscaglia, A, Ponti, L, Potenza, D, Pravadelli, C, Quartini, M, Quirino, T, Raimondo, G, Rapaccini, G, Rendina, M, Rizzardini, G, Rizzetto, M, Rizzo, S, Romagnoli, D, Romano, A, Rossi, C, Rumi, M, Russello, M, Russo, F, Russo, M, Sansonno, D, Santantonio, T, Saracco, G, Schimizzi, A, Serviddio, G, Simeone, F, Solinas, A, Soria, A, Tabone, M, Taliani, G, Tarantino, G, Tarquini, P, Tavio, M, Termite, A, Teti, E, Toniutto, P, Torti, C, Tundi, P, Vecchiet, G, Verucchi, G, Gentilucci, U, Vinci, M, Vullo, V, Zolfino, T, Zuin, M, Ascione A., De Luca M., Melazzini M., Montilla S., Trotta M. P., Petta S., Puoti M., Sangiovanni V., Messina V., Bruno S., Izzi A., Villa E., Aghemo A., Zignego A. L., Orlandini A., Fontanella L., Gasbarrini A., Marzioni M., Giannini E. G., Craxi A., Abbati G., Alberti A., Andreone P., Andreoni M., Angeli P., Angelico M., Angarano G., Angrisani D., Antinori A., Antonini C., Avancini I., Barone M., Bruno R., Benedetti A., Bernabucci V., Blanc P., Boarini C., Boffa N., Boglione L., Borghi V., Borgia G., Brancaccio G., Brunetto M., Cacciola I., Calabrese P., Calvaruso V., Campagnolo D., Canovari B., Caporaso N., Capra F., Carolo G., Cassola G., Castelli F., Cauda R., Silberstein F. C., Cecere R., Chessa L., Chiodera A., Chirianni A., Ciancio A., Cima S., Coco B., Colombo M., Coppola N., Corti G., Cosco L., Corradori S., Cozzolongo R., Cristaudo A., Danieli E., Monforte A. D. A., Monache M., Del Poggio P., de Luca A., Dentone C., Di Biagio A., Di Leo A., Di Perri G., Di Stefano M., D'Offizi G., Donato F., Durante E., Erne E., Fagiuoli S., Falasca K., Federico A., Felder M., Ferrari C., Gaeta G. B., Ganga R., Gatti P., Giacomet V., Giacometti A., Gianstefani A., Giordani M., Giorgini A., Grieco A., Guerra M., Gulminetti R., Ieluzzi D., Imparato M., Iodice V., La Monica S., Lazzarin A., Lenzi M., Levrero M., Lichtner M., Lionetti R., Guercio C. L., Madonna S., Magnani S., Maida I., Marignani M., Marrone A., Marsetti F., Martini S., Masarone M., Maserati R., Mastroianni C. M., Memoli M., Menzaghi B., Merli M., Miele L., Milella M., Mondelli M., Montalbano M., Monti M., Morelli O., Morisco F., Nardone G., Novara S., Onnelli G., Onofrio M., Paganin S., Pani L., Parisi M. R., Parruti G., Pasquazzi C., Pasulo L., Perno C. F., Persico M., Piai G., Picciotto A., Pigozzi G. M., Piovesan S., Piras M. C., Pirisi M., Piscaglia A. M., Ponti L., Potenza D., Pravadelli C., Quartini M., Quirino T., Raimondo G., Rapaccini G. L., Rendina M., Rizzardini G., Rizzetto M., Rizzo S., Romagnoli D., Romano A., Rossi C., Rumi M. G., Russello M., Russo F. P., Russo M. L., Sansonno D. E., Santantonio T. A., Saracco G., Schimizzi A. M., Serviddio G., Simeone F., Solinas A., Soria A., Tabone M., Taliani G., Tarantino G., Tarquini P., Tavio M., Termite A., Teti E., Toniutto P., Torti C., Tundi P., Vecchiet G., Verucchi G., Gentilucci U. V., Vinci M., Vullo V., Zolfino T., and Zuin M.
- Abstract
Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65 years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100 mg) and twice-daily dasabuvir (250 mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter defined as HCV RNA negative 12 weeks after the end of treatment (SVR12). Results: Patients who suffered any adverse event (AE) were 74/240 (30.8%); 13/240 (5.4%) discontinued the treatment. A multivariate analysis found albumin < 3.5 g/dL (OR 2.04: 95% CI 1.0–4.2, p < 0.05) and hypertension (OR 4.6: 95% CI 2.3–9.2, p < 0.001) as variables independently associated with AE occurrence. The SVR12 was 95% (228/240). Multivariate analysis identified baseline bilirubin < 2 mg/dL (OR 4.9: 95% CI 1.17–20.71, p = 0.029) as the only variable independently associated with SVR12. Conclusion: Our findings suggest that OBV/PTV/r + DSV + RBV is safe and effective in real-life use in patients with compensated cirrhosis, HCV-GT1 infection, and age over 65.
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- 2018
7. Characteristics of autoimmune hepatitis in patients who are not of European Caucasoid ethnic origin. (Liver Disease)
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Zolfino, T., Heneghan, M.A., Norris, S., Harrison, P.M., Portmann, B.C., and McFarlane, I.G.
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Health -- Research -- Analysis ,Health and race -- Research -- Analysis ,Prevalence studies (Epidemiology) -- Analysis -- Research ,Ethnic groups -- Research -- Analysis ,Disease susceptibility -- Research ,Chronic active hepatitis -- Demographic aspects -- Research ,Health ,Analysis ,Research ,Demographic aspects - Abstract
Background: Significant diversity in disease severity has been identified far autoimmune disorders among different ethnic groups but there is a lack of data on autoimmune hepatitis (AIM) in populations other [...]
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- 2002
8. [Therapeutic decisions and treatment with sorafenib in hepatocellular carcinoma: final analysis of GIDEON study in Italy]
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D'Angelo, S, Germano, D, Zolfino, T, Sansonno, D, Giannitrapani, L, Benedetti, A, Montesarchio, V, Attili, A, Buonadonna, A, Barni, S, Gasbarrini, A, Burlone, Me, Cillo, U, Marenco, S, Villa, Eleonora, Giovanis, P, Proserpio, I, Saitta, C, Magini, G, Cengarle, R, Fava, G, Cuttone, F, Calvani, N, Angelico, M, Di Costanzo, F, Noto, A, Poggi, G, Marignani, M, Cascinu, S, Amoroso, D, Palmieri, V, Massa, E, Crocè, Ls, Picardi, A, Tumulo, S, Erminero, C, Lencioni, R, Lorusso, V., D'Angelo, S., Germano, D., Zolfino, T., Sansonno, D., Giannitrapani, L., Benedetti, A., Montesarchio, V., Attili, A., Buonadonna, A., Barni, S., Gasbarrini, A., Burlone, M. E., Cillo, U., Marenco, S., Villa, E., Giovanis, P., Proserpio, I., Saitta, C., Magini, G., Cengarle, R., Fava, G., Cuttone, F., Calvani, N., Angelico, M., Di Costanzo, F., Noto, A., Poggi, G., Marignani, M., Cascinu, S., Amoroso, D., Palmieri, V., Massa, E., Croce, L. S., Picardi, A., Tumulo, S., Erminero, C., Lencioni, R., and Lorusso, V.
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GIDEON study ,Hepatocellular carcinoma ,Sorafenib ,Adult ,Aged, 80 and over ,Male ,Niacinamide ,Carcinoma, Hepatocellular ,Aged ,Antineoplastic Agents ,Female ,Humans ,Italy ,Liver Neoplasms ,Middle Aged ,Phenylurea Compounds ,Prospective Studies ,Settore MED/12 - GASTROENTEROLOGIA ,Carcinoma ,Hepatocellular ,80 and over - Abstract
Introduction. Sorafenib, an oral multikinase inhibitor, is the only targeted agent approved for the treatment of patients with hepatocellular carcinoma (HCC) after demonstration to increase overall survival compared to placebo in two randomized phase III study. GIDEON (Global Investigation of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) is the largest, global, non-interventional, prospective study of patients with uHCC (n>3200) treated with sorafenib in real-life clinical practice conditions. Here we report the final analysis of safety and efficacy in the Italian cohort of patients. Methods. Patients with unresectable HCC who are candidates for systemic therapy, and for whom a decision has been made to treat with sorafenib, are eligible for inclusion. Patients demographics disease characteristics and treatment history were recorded at baseline visit. Sorafenib dose, concomitant medications, performance status, liver function, adverse events and efficacy (survival and response rate) were collected throughout the study. Results. In the Italian cohort of the GIDEON study 278 patients were included in 36 centers. The global rate of adverse events was 81%. Drug-related events accounted for 67%, mostly of grade 1 and 2, and only 8% were classified as serious. The most common were diarrhea (24%), fatigue (23%), dermatological (14%), rash/exfoliation (10%), hypertension (9%), hemorrage/bleeding of gastrointestinal tract (6%). Overall survival was 14.4 months and time to progression 6.2 months. Objective responses were observed in 14 patients (5%) with 3 complete responses (1%). Stable diseases of at least 6 weeks were observed in 113 patients (41%) with a 30% of disease control rate. Discussion. The safety profile of sorafenib in terms of rate and type of adverse events is similar to that emerged in the global international GIDEON study as well as in the pivotal registration studies.
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- 2015
9. P.09.16 LONG-TERM SORAFENIB TREATMENT IN A LARGE COHORT OF HCC PATIENTS: A MULTICENTER STUDY
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Sacco, R., primary, Granito, A., additional, Zolfino, T., additional, Saitta, C., additional, Marzi, L., additional, Metrangolo, S., additional, Parisi, G., additional, Tumino, E., additional, Bresci, G., additional, and Cabibbo, G., additional
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- 2018
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10. Clinical outcomes with long-term sorafenib treatment: A multicenter, real-life study
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Sacco, R., primary, Parodi, S., additional, Zolfino, T., additional, Saitta, C., additional, Marzi, L., additional, Simonetti, N., additional, Attardo, S., additional, Rossa, M., additional, Bresci, G., additional, and Cabibbo, G., additional
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- 2017
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11. Sorafenib in clinical practice: Pooled analysis of two prospective observational studies in hepatocellular carcinoma (HCC)
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Di Costanzo, G.G., primary, D’Angelo, S., additional, Zolfino, T., additional, Lorusso, V., additional, Montesarchio, V., additional, de Stefano, G., additional, Sacco, R., additional, Attili, A.F., additional, Benedetti, A., additional, Sansonno, D., additional, Giannitrapani, L., additional, Buonadonna, A., additional, Giovanis, P., additional, Cabibbo, G., additional, De Vita, F., additional, Carucci, P., additional, Pirisi, M., additional, Moscovici, M., additional, Pisconti, S., additional, and Daniele, B., additional
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- 2016
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12. Final results of the gideon study according to patient etiology: The italian experience
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D'Angelo, S., primary, Germano, D., additional, Zolfino, T., additional, Sansonno, D., additional, Montalto, G., additional, Benedetti, A., additional, Montesarchio, V., additional, Attili, A.F., additional, Buonadonna, A., additional, Barni, S., additional, Gasbarrini, A., additional, Pirisi, M., additional, Cillo, U., additional, Marenco, S., additional, Villa, E., additional, Giovanis, P., additional, Pinotti, G., additional, Saitta, C., additional, Erminero, C., additional, de Giorgio, M., additional, and Lorusso, V., additional
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- 2015
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13. Hepatocellular Carcinoma In Elderly Patients: final results of The Italian Cohort Of GIDEON (Global Investigational of therapeutic DEcisions in HCC and of its treatment with sorafeNib) Study
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Zolfino, T., primary, Lorusso, V., additional, D'Angelo, S., additional, Sansonno, D., additional, Giannitrapani, L., additional, Benedetti, A., additional, Montesarchio, V., additional, Attili, A.F., additional, Buonadonna, A., additional, Barni, S., additional, Gasbarrini, A., additional, Pirisi, M., additional, Cillo, U., additional, Picciotto, A., additional, Villa, E., additional, Giovanis, P., additional, Pinotti, G., additional, Saitta, C., additional, Erminero, C., additional, de Giorgio, M., additional, and Daniele, B., additional
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- 2015
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14. Safety and efficacy of sorafenib in stella study, a Multicenter, Observational, Phase IV Study In Italian Centers
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Di Costanzo, G.G., primary, Sacco, R., additional, de Stefano, G., additional, Montesarchio, V., additional, Cabibbo, G., additional, Zolfino, T., additional, Carucci, P., additional, Pisconti, S., additional, De Vita, F., additional, Giovanis, P., additional, Attili, A.F., additional, Erminero, C., additional, Fontana, T., additional, and Daniele, B., additional
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- 2015
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15. P-111 Final results of the GIDEON (Global Investigational of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) study according to patient etiology: The Italian experience
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D'Angelo, S., primary, Germano, D., additional, Zolfino, T., additional, Sansonno, D., additional, Montalto, G., additional, Benedetti, A., additional, Montesarchio, V., additional, Attili, A., additional, Buonadonna, A., additional, Barni, S., additional, Gasbarrini, A., additional, Pirisi, M., additional, Cillo, U., additional, Marenco, S., additional, Villa, E., additional, Giovanis, P., additional, Pinotti, G., additional, Raimondo, G., additional, Erminero, C., additional, De Giorgio, M., additional, and Lorusso, V., additional
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- 2015
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16. P-110 Hepatocellular carcinoma in elderly patients: Final results of the Italian cohort of GIDEON study
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Zolfino, T., primary, Lorusso, V., additional, D'Angelo, S., additional, Sansonno, D., additional, Giannitrapani, L., additional, Benedetti, A., additional, Montesarchio, V., additional, Attili, A., additional, Buonadonna, A., additional, Barni, S., additional, Gasbarrini, A., additional, Pirisi, M., additional, Cillo, U., additional, Picciotto, A., additional, Villa, E., additional, Giovanis, P., additional, Pinotti, G., additional, Raimondo, G., additional, Erminero, C., additional, De Giorgio, M., additional, and Daniele, B., additional
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- 2015
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17. Transient elastography in patients with chronic autoimmune hepatitis: is a good tool in evaluation of hepatic fibrosis?
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Onali, S., primary, Cappellini, S., additional, Serra, G., additional, Zolfino, T., additional, Murgia, D., additional, Ponti, M.L., additional, Balestrieri, C., additional, Conti, M., additional, Sorbello, O., additional, Civolani, A., additional, Casale, M., additional, Casu, S., additional, Figorilli, F., additional, Pasetto, M.C., additional, Gaspardini, A., additional, Secci, L., additional, Salustro, C., additional, Ganga, R., additional, Piras, M.R., additional, Demelia, L., additional, and Chessa, L., additional
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- 2015
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18. Role of Killer cell immunoglobulin-like receptors and their HLA class I ligands in autoimmune hepatitis
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Littera, R., primary, Carcassi, C., additional, Secci, L., additional, Lai, S., additional, Cappai, L., additional, Porcella, R., additional, Alba, F., additional, Maddi, R., additional, Serra, M., additional, Cappellini, S., additional, Salustro, C., additional, Onali, S., additional, Balestrieri, C., additional, Serra, G., additional, Conti, M., additional, Zolfino, T., additional, Scioscia, R., additional, Barca, L., additional, and Chessa, L., additional
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- 2015
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19. 803 EFFICACY, SAFETY AND IMPACT ON QUALITY OF LIFE OF SORAFENIB IN ELDERLY PATIENTS WITH ADVANCED HEPATOCELLULAR CARCINOMA. PRELIMINARY RESULTS OF A PHASE II STUDY
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Mantovani, G., primary, Massa, E., additional, Spiga, C., additional, Chessa, L., additional, Madeddu, C., additional, Zolfino, T., additional, Lepori, S., additional, Serra, G., additional, Piras, M.R., additional, and Marini, S., additional
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- 2009
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20. Rate of non-response to ursodeoxycholic acid in a large real-world cohort of primary biliary cholangitis patients in Italy
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D. Bacca, Valeria Pace-Palitti, G. Scifo, Floriano Rosina, Rodolfo Sacco, Antonio Ascione, Giuseppe D'Adamo, Adriano M. Pellicelli, Luigi Elio Adinolfi, T. Zolfino, Giovanni Garrucciu, Grazia Anna Niro, Maurizio Russello, A. Barlattani, Alessandro Mussetto, Valentina Feletti, Raffaele Cozzolongo, Umberto Vespasiani-Gentilucci, Michela Barlattani, Luchino Chessa, Ernesto Claar, Antonio Izzi, Antonio De Vincentis, Gaetano Bertino, Vespasiani-Gentilucci, U, Rosina, F, Pace-Palitti, V, Sacco, R, Pellicelli, A, Chessa, L, De Vincentis, A, Barlattani, M, Barlattani, A, Feletti, V, Mussetto, A, Zolfino, T, Russello, M, Cozzolongo, R, Garrucciu, G, Niro, G, Bacca, D, Bertino, G, Claar, E, Ascione, A, D'Adamo, G, Adinolfi, Le, Scifo, G, and Izzi, A
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Adult ,Male ,Cholagogues and Choleretics ,medicine.medical_specialty ,real-world ,Severity of Illness Index ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,non-responder ,Primary biliary cholangitis ,ursodeoxycholic acid ,Internal medicine ,medicine ,Humans ,Treatment Failure ,Practice Patterns, Physicians' ,Response criteria ,Aged ,Aged, 80 and over ,Liver Cirrhosis, Biliary ,business.industry ,Middle Aged ,digestive system diseases ,Ursodeoxycholic acid ,Italy ,Primary biliary cholangiti ,030220 oncology & carcinogenesis ,Cohort ,Female ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Background and aim: Response to ursodeoxycholic acid (UDCA) is crucial for the prediction of primary biliary cholangitis (PBC) prognosis, and different response criteria were validated and proposed by reference centers for PBC. To date, rates of non-response to UDCA from real-world series are lacking.Methods: Hepatology/Gastroenterology centers belonging to 'Club Epatologi Ospedalieri' (CLEO) and 'Associazione Italiana Gastroenterologi Ospedalieri' (AIGO) were invited to participate in the study, and asked to extract all patients followed for PBC, without any selection or exclusion, and fill in the database provided.Results: Thirty-four centers were enrolled throughout Italy, for a total of 713 patients. None of these centers, except one, had a hepatology outpatient clinic devoted to the care of patients with autoimmune liver diseases. After excluding 79 cases of PBC/autoimmune hepatitis overlaps, 634 patients were analyzed: mean age, 64.4 ± 12.0 years; 91.2% females; F/M 10.3/1. For patients with at least 1 year of UDCA treatment (583), rates of non-response to UDCA were evaluated according to the Paris-I/-II, Toronto and GLOBE criteria, and compared with those in the original cohorts: 27% vs 39% in Paris-I cohort; 39.6% vs 52% in Paris-II; 20.1% vs 43.5% in Toronto; 15.7% vs 30% in GLOBE (age-specific cutoffs). Mean alkaline phosphatase levels on UDCA treatment, and the age-adjusted prevalence of F3/F4 fibrosis, appeared lower in this PBC population than in reference cohorts.Conclusions: A mean ∼15% better response to UDCA is observed in a real-world PBC population, probably due to migration of some of most severe/advanced cases to PBC referral centers.
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- 2019
21. Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis
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Giada Carolo, Veronica Bernabucci, Luchino Chessa, Maria Luisa Russo, Giorgio Maria Saracco, Marzia Montalbano, Barbara Menzaghi, Giovanni Di Perri, Adriano Lazzarin, Silvia La Monica, Raffaele Bruno, Gian Ludovico Rapaccini, Mario U. Mondelli, Anna Maria Schimizzi, Caterina Pasquazzi, Maurizia Rossana Brunetto, Antonio Craxì, Filomena Morisco, Carmela Lo Guercio, Vania Giacomet, Alessia Giorgini, Mario Masarone, Francesca Paolo Russo, T. Zolfino, Vincenzo Sangiovanni, Alessia Ciancio, Antonella d'Arminio Monforte, Savino Bruno, E.M. Erne, Antonio Gasbarrini, Francesco Castelli, Sergio Novara, G. Nardone, Andrea De Luca, Claudio Maria Mastroianni, Gioacchino Angarano, Chiara Dentone, Renato Maserati, Anna Maria Piscaglia, Tiziana Quirino, Giuseppe Tarantino, M. Lichtner, Antonio Chirianni, Giuseppina Brancaccio, S. Paganin, Alfredo Alberti, Silvia Corradori, Edoardo G. Giannini, Carlo Torti, Chiara Boarini, Raffaele Cozzolongo, Marco Di Stefano, Alessandro Soria, Paolo Tundi, Giovanni Cassola, Debora Angrisani, Antonio Grieco, Cecilia Pravadelli, Giuliano Rizzardini, Roberto Gulminetti, Vincenzo Messina, Maria Rendina, Massimo Pirisi, Irene Cacciola, Roberto Ganga, Raffaella Lionetti, Paolo Calabrese, Laura Ponti, Filomena Simeone, Maurizio Russello, Monica Monti, Nicola Boffa, Pierluigi Tarquini, Franco Capra, Ivo Avancini, Domenico Sansonno, Stefano Fagiuoli, Michele Barone, Giacomo Vecchiet, Salvatore Rizzo, Carlo Federico Perno, Teresa Santantonio, Pierluigi Toniutto, Massimo Zuin, Nicola Caporaso, Alessandra Orlandini, Grazielle Marie Pigozzi, Martina Felder, Antonio Cristaudo, Roberto Cecere, Massimo Marignani, Vincenza Calvaruso, G. Abbati, Domenico Potenza, Maria Chiara Piras, Mario Rizzetto, Serena Cima, Marco delle Monache, Alessio Aghemo, D. Ieluzzi, Guglielmo Borgia, Giampaolo Corti, Paolo Poggio, Manuela Merli, Elena Danieli, Andrea Giacometti, Massimo Andreoni, Antonino Picciotto, Mario Angelico, Benedetta Canovari, Sara Piovesan, Anna Linda Zignego, Antonio Benedetti, Emanuele Durante, Erica Villa, Marcello Persico, Antonio Patrizio Termite, Barbara Coco, Maria Vinci, Lucio Boglione, Cristina Rossi, Paolo Angeli, Massimo Memoli, Maria Teresa Giordani, Massimo De Luca, Luisa Pasulo, Vincenzo Vullo, Mario Melazzini, Attilio Solinas, Pietro Gatti, Michele Guerra, Silvia Martini, Antonio Ascione, Massimo Puoti, Roberto Cauda, Giovanna Onnelli, Silvia Magnani, Salvatore Madonna, Giovanni Raimondo, Marco Tabone, Gloria Taliani, Dante Romagnoli, Aldo Marrone, Umberto Vespasiani Gentilucci, Luca Miele, Marcello Tavio, Andrea Antinori, Giampiero D'Offizi, Mirella Onofrio, Valentina Iodice, Lucio Cosco, Guido Piai, Luca Pani, Francesca Ceccherini Silberstein, Simona Montilla, Marco Lenzi, Luca Fontanella, Alessandro Federico, Carlo Ferrari, Giustino Parruti, Antonio Di Biagio, Gabriella Verucchi, Fabio Marsetti, Michele Milella, Maria Grazia Rumi, Antonio Izzi, Marco Marzioni, Francesca Donato, Vanni Borghi, Mariano Quartini, Massimo Colombo, Michele Imparato, Giovanni Battista Gaeta, P.L. Blanc, Alfredo Di Leo, Nicola Coppola, Alessandro Chiodera, Ivana Maida, Davide Campagnolo, Cinzia Antonini, Antonietta Romano, A. Gianstefani, Katia Falasca, Massimo Levrero, Gaetano Serviddio, Maria Paola Trotta, Olivia Morelli, Salvatore Petta, Elisabetta Teti, Maria Rita Parisi, Pietro Andreone, Ascione, Antonio, De Luca, Massimo, Melazzini, Mario, Montilla, Simona, Trotta, Maria Paola, Petta, Salvatore, Puoti, Massimo, Sangiovanni, Vincenzo, Messina, Vincenzo, Bruno, Savino, Izzi, Antonio, Villa, Erica, Aghemo, Alessio, Zignego, Anna Linda, Orlandini, Alessandra, Fontanella, Luca, Gasbarrini, Antonio, Marzioni, Marco, Giannini, Edoardo G., Craxì, Antonio, Abbati, Giuseppe, Alberti, Alfredo, Andreone, Pietro, Andreoni, Massimo, Angeli, Paolo, Angelico, Mario, Angarano, Gioacchino, Angrisani, Debora, Antinori, Andrea, Antonini, Cinzia, Avancini, Ivo, Barone, Michele, Bruno, Raffaele, Benedetti, Antonio, Bernabucci, Veronica, Blanc, Pier, Boarini, Chiara, Boffa, Nicola, Boglione, Lucio, Borghi, Vanni, Borgia, Guglielmo, Brancaccio, Giuseppina, Brunetto, Maurizia, Cacciola, Irene, Calabrese, Paolo, Calvaruso, Vincenza, Campagnolo, Davide, Canovari, Benedetta, Caporaso, Nicola, Capra, Franco, Carolo, Giada, Cassola, Giovanni, Castelli, Francesco, Cauda, Roberto, Silberstein, Francesca Ceccherini, Cecere, Roberto, Chessa, Luchino, Chiodera, Alessandro, Chirianni, Antonio, Ciancio, Alessia, Cima, Serena, Coco, Barbara, Colombo, Massimo, Coppola, Nicola, Corti, Giampaolo, Cosco, Lucio, Corradori, Silvia, Cozzolongo, Raffaele, Cristaudo, Antonio, Danieli, Elena, Monforte, Antonella D’Arminio, Monache, Marco delle, Del Poggio, Paolo, de Luca, Andrea, Dentone, Chiara, Di Biagio, Antonio, Di Leo, Alfredo, Di Perri, Giovanni, Di Stefano, Marco, D’Offizi, Giampiero, Donato, Francesca, Durante, Emanuele, Erne, Elke, Fagiuoli, Stefano, Falasca, Katia, Federico, Alessandro, Felder, Martina, Ferrari, Carlo, Gaeta, Giovanni Battista, Ganga, Roberto, Gatti, Pietro, Giacomet, Vania, Giacometti, Andrea, Gianstefani, Alice, Giordani, Maria, Giorgini, Alessia, Grieco, Antonio, Guerra, Michele, Gulminetti, Roberto, Ieluzzi, Donatella, Imparato, Michele, Iodice, Valentina, La Monica, Silvia, Lazzarin, Adriano, Lenzi, Marco, Levrero, Massimo, Lichtner, Myriam, Lionetti, Raffaella, Guercio, Carmela Lo, Madonna, Salvatore, Magnani, Silvia, Maida, Ivana, Marignani, Massimo, Marrone, Aldo, Marsetti, Fabio, Martini, Silvia, Masarone, Mario, Maserati, Renato, Mastroianni, Claudio Maria, Memoli, Massimo, Menzaghi, Barbara, Merli, Manuela, Miele, Luca, Milella, Michele, Mondelli, Mario, Montalbano, Marzia, Monti, Monica, Morelli, Olivia, Morisco, Filomena, Nardone, Gaetano, Novara, Sergio, Onnelli, Giovanna, Onofrio, Mirella, Paganin, Simona, Pani, Luca, Parisi, Maria Rita, Parruti, Giustino, Pasquazzi, Caterina, Pasulo, Luisa, Perno, Carlo Federico, Persico, Marcello, Piai, Guido, Picciotto, Antonino, Pigozzi, Grazielle Marie, Piovesan, Sara, Piras, Maria Chiara, Pirisi, Massimo, Piscaglia, Anna Maria, Ponti, Laura, Potenza, Domenico, Pravadelli, Cecilia, Quartini, Mariano, Quirino, Tiziana, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Rendina, Maria, Rizzardini, Giuliano, Rizzetto, Mario, Rizzo, Salvatore, Romagnoli, Dante, Romano, Antonietta, Rossi, Cristina, Rumi, Maria Grazia, Russello, Maurizio, Russo, Francesca Paolo, Russo, Maria Luisa, Sansonno, Domenico Ettore, Santantonio, Teresa Antonia, Saracco, Giorgio, Schimizzi, Anna Maria, Serviddio, Gaetano, Simeone, Filomena, Solinas, Attilio, Soria, Alessandro, Tabone, Marco, Taliani, Gloria, Tarantino, Giuseppe, Tarquini, Pierluigi, Tavio, Marcello, Termite, Antonio, Teti, Elisabetta, Toniutto, Pierluigi, Torti, Carlo, Tundi, Paolo, Vecchiet, Giacomo, Verucchi, Gabriella, Gentilucci, Umberto Vespasiani, Vinci, Maria, Vullo, Vincenzo, Zolfino, Teresa, Zuin, Massimo, Ascione, A, De Luca, M, Melazzini, M, Montilla, S, Trotta, M, Petta, S, Puoti, M, Sangiovanni, V, Messina, V, Bruno, S, Izzi, A, Villa, E, Aghemo, A, Zignego, A, Orlandini, A, Fontanella, L, Gasbarrini, A, Marzioni, M, Giannini, E, Craxi, A, Abbati, G, Alberti, A, Andreone, P, Andreoni, M, Angeli, P, Angelico, M, Angarano, G, Angrisani, D, Antinori, A, Antonini, C, Avancini, I, Barone, M, Bruno, R, Benedetti, A, Bernabucci, V, Blanc, P, Boarini, C, Boffa, N, Boglione, L, Borghi, V, Borgia, G, Brancaccio, G, Brunetto, M, Cacciola, I, Calabrese, P, Calvaruso, V, Campagnolo, D, Canovari, B, Caporaso, N, Capra, F, Carolo, G, Cassola, G, Castelli, F, Cauda, R, Silberstein, F, Cecere, R, Chessa, L, Chiodera, A, Chirianni, A, Ciancio, A, Cima, S, Coco, B, Colombo, M, Coppola, N, Corti, G, Cosco, L, Corradori, S, Cozzolongo, R, Cristaudo, A, Danieli, E, Monforte, A, Monache, M, Del Poggio, P, de Luca, A, Dentone, C, Di Biagio, A, Di Leo, A, Di Perri, G, Di Stefano, M, D'Offizi, G, Donato, F, Durante, E, Erne, E, Fagiuoli, S, Falasca, K, Federico, A, Felder, M, Ferrari, C, Gaeta, G, Ganga, R, Gatti, P, Giacomet, V, Giacometti, A, Gianstefani, A, Giordani, M, Giorgini, A, Grieco, A, Guerra, M, Gulminetti, R, Ieluzzi, D, Imparato, M, Iodice, V, La Monica, S, Lazzarin, A, Lenzi, M, Levrero, M, Lichtner, M, Lionetti, R, Guercio, C, Madonna, S, Magnani, S, Maida, I, Marignani, M, Marrone, A, Marsetti, F, Martini, S, Masarone, M, Maserati, R, Mastroianni, C, Memoli, M, Menzaghi, B, Merli, M, Miele, L, Milella, M, Mondelli, M, Montalbano, M, Monti, M, Morelli, O, Morisco, F, Nardone, G, Novara, S, Onnelli, G, Onofrio, M, Paganin, S, Pani, L, Parisi, M, Parruti, G, Pasquazzi, C, Pasulo, L, Perno, C, Persico, M, Piai, G, Picciotto, A, Pigozzi, G, Piovesan, S, Piras, M, Pirisi, M, Piscaglia, A, Ponti, L, Potenza, D, Pravadelli, C, Quartini, M, Quirino, T, Raimondo, G, Rapaccini, G, Rendina, M, Rizzardini, G, Rizzetto, M, Rizzo, S, Romagnoli, D, Romano, A, Rossi, C, Rumi, M, Russello, M, Russo, F, Russo, M, Sansonno, D, Santantonio, T, Saracco, G, Schimizzi, A, Serviddio, G, Simeone, F, Solinas, A, Soria, A, Tabone, M, Taliani, G, Tarantino, G, Tarquini, P, Tavio, M, Termite, A, Teti, E, Toniutto, P, Torti, C, Tundi, P, Vecchiet, G, Verucchi, G, Gentilucci, U, Vinci, M, Vullo, V, Zolfino, T, and Zuin, M
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Cyclopropanes ,Liver Cirrhosis ,Male ,Cirrhosis ,Dasabuvir ,Elderly ,Ombitasvir ,Paritaprevir ,Aged ,80 and over ,Anilides ,Antiviral Agents ,Biomarkers ,Carbamates ,Female ,Hepacivirus ,Hepatitis C ,Chronic ,Humans ,Macrocyclic Compounds ,Ribavirin ,Ritonavir ,Sulfonamides ,Treatment Outcome ,Uracil ,Drug Therapy ,Combination ,Genotype ,Cirrhosis, Dasabuvir, Elderly, Ombitasvir, Paritaprevir, Microbiology (medical), Infectious Diseases ,Aged, 80 and over ,Hepatitis C, Chronic ,Drug Therapy, Combination ,Microbiology (medical) ,Infectious Diseases ,Gastroenterology ,chemistry.chemical_compound ,0302 clinical medicine ,2-Naphthylamine ,Medicine ,030212 general & internal medicine ,Valine ,General Medicine ,030211 gastroenterology & hepatology ,Macrocyclic Compound ,medicine.drug ,Human ,medicine.medical_specialty ,Proline ,Lactams, Macrocyclic ,Settore MED/12 - GASTROENTEROLOGIA ,Liver Cirrhosi ,Sulfonamide ,03 medical and health sciences ,Internal medicine ,Decompensation ,Hepatitis ,Antiviral Agent ,Cirrhosi ,Hepaciviru ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Anilide ,Biomarker ,medicine.disease ,chemistry ,Carbamate ,business - Abstract
Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100mg) and twice-daily dasabuvir (250mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter defined as HCV RNA negative 12weeks after the end of treatment (SVR12). Results: Patients who suffered any adverse event (AE) were 74/240 (30.8%); 13/240 (5.4%) discontinued the treatment. A multivariate analysis found albumin < 3.5g/dL (OR 2.04: 95% CI 1.0–4.2, p < 0.05) and hypertension (OR 4.6: 95% CI 2.3–9.2, p < 0.001) as variables independently associated with AE occurrence. The SVR12 was 95% (228/240). Multivariate analysis identified baseline bilirubin < 2mg/dL (OR 4.9: 95% CI 1.17–20.71, p = 0.029) as the only variable independently associated with SVR12. Conclusion: Our findings suggest that OBV/PTV/r + DSV + RBV is safe and effective in real-life use in patients with compensated cirrhosis, HCV-GT1 infection, and age over 65.
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- 2018
22. Ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin for patients with hepatitis C virus genotype 1 or 4 infection with cirrhosis (ABACUS): a prospective observational study
- Author
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Petta, Salvatore, Marzioni, Marco, Russo, Pierluigi, Aghemo, Alessio, Alberti, Alfredo, ASCIONE, ANTONIO, Antinori, Andrea, Bruno, Raffaele, Bruno, Savino, Chirianni, Antonio, Gaeta, Giovanni Battista, Giannini, Edoardo G, Merli, Manuela, Messina, Vincenzo, Montilla, Simona, Perno, Carlo Federico, Puoti, Massimo, Raimondo, Giovanni, Rendina, Maria, Silberstein, Francesca Ceccherini, Villa, Erica, Zignego, Anna Linda, Pani, Luca, Craxì, Antonio, Tabone, Marco, Andreoni, Massimo, Teti, Elisabetta, Angelico, Mario, Persico, Marcello, Masarone, Mario, Chiodera, Aledssandro, Solinas, Attilio, delle Monache, Marco, Cecere, Roberto, Maria Schimizzi, Anna, Piovesan, Sara, Campagnolo, Davide, Chiara Piras, Maria, Zolfino, Teresa, Paolo Russo, Francesca, Morelli, Olivia, Sangiovanni, Vincenzo, Onofrio, Mirella, Iodice, Valentina, Izzi, Antonio, Pirisi, Massimo, Danieli, Elena, Vinci, Maria, Rizzardini, Giuliano, Fagiuoli, Stefano, Pasulo, Luisa, D'Arminio Monforte, Antonella, Zuin, Massimo, Giorgini, Alessia, Simeone, Filomena, Piali, Guido, Lo Guercio, Carmela, Federico, Alessandro, Brancaccio, Giuseppina, Marrone, Aldo, Abbati, Giuseppe, Boarini, Chiara, Borghi, Vanni, Bernabucci, Veronica, Corti, Giampaolo, Monti, Monica, Rizzetto, Mario, Martini, Silvia, Andreone, Pietro, Gianstefani, Alice, Lenzi, Marco, Verucchi, Gabriella, Toniutto, Pierluigi, Borgia, Guglielmo, Caporaso, Nicola, Morisco, Filomena, Nardone, Gaetano, Angrisani, Debora, Giacometti, Andrea, Benedetti, Antonio, Tarantino, Giuseppe, Marsetti, Fabio, Tavio, Marcello, Novara, Sergio, Antonia Santantonio, Teresa, Serviddio, Gaetano, Brunetto, Maurizia, Coco, Barbara, Angarano, Gioacchino, Milella, Michele, BARONE, MICHELE, Di Leo, Alfredo, Ettore Sansonno, Domenico, Cacciola, Irene, Boffa, Nicola, Saracco, Giorgio, Di Biagio, Antonio, Picciotto, Antonino, de Luca, Andrea, Calvaruso, Vincenza, Corradori, Silvia, Ferrari, Carlo, Orlandini, Alessandra, Maida, Ivana, Torti, Carlo, Chessa, Luchino, Felder, Martina, Vespasiani Gentilucci, Umberto, Angeli, Paolo, Romano, Antonietta, Ludovico Rapaccini, Gian, Miele, Luca, Cima, Serena, Luisa Russo, Maria, Cozzolongo, Raffaele, Onnelli, Giovanna, D'Offizi, Giampiero, Lionetti, Raffaella, Montalbano, Marzia, Guerra, Michele, Di Perri, Giovanni, Boglione, Lucio, Capra, Franco, Carolo, Giada, Ieluzzi, Donatella, Antonini, Cinzia, Termite, Antonio, Madonia, Salvatore, Tarquini, Pierluigi, Parruti, Giustino, Vecchiet, Giacomo, Falasca, Katia, Menzaghi, Barbara, Quirino, Tiziana, Dentone, Chiara, Maria Piscaglia, Anna, Rossi, Cristina, Giordani, Maria, Fontanella, Luca, Cassola, Giovanni, Russello, Maurizio, Cristaudo, Antonio, Giacomet, Vania, Colombo, Massimo, Donato, Francesca, Durante, Emanuele, Cosco, Lucio, Marignani, Massimo, Quartini, Mariano, Memoli, Massimo, Ganga, Roberto, Ponti, Laura, Soria, Alessandro, Grazia Rumi, Maria, Gulminetti, Roberto, Maserati, Renato, Mondelli, Mario, Lazzarin, Adriano, Rita Parisi, Maria, Canovari, Benedetta, Avancini, Ivo, Pravadelli, Cecilia, Blanc, Pier, Pasquazzi, Caterina, Maria Mastroianni, Claudio, Lichtner, Myriam, Distefano, Marco, Magnani, Silvia, Paganin, Simona, Erne, Elke, Gatti, Pietro, Tundi, Paolo, Calabrese, Paolo, Gasbarrini, Antonio, Grieco, Antonio, Coppola, Nicola, Del Poggio, Paolo, Levrero, Massimo, Talliani, Gloria, Vullo, Vincenzo, Cauda, Roberto, La Monica, Silvia, Potenza, Domenico, Rizzo, Salvatore, Castelli, Francesco, Marie Pigozzi, Grazielle, Ciancio, Alessia, Romagnoli, Dante, Barchetti, Federica, Ivanovic, Jelena, Longo, Olimpia, Petraglia, Sandra, Paola Trotta, Maria, NARDONE, GERARDO ANTONIO PIO, Petta, Salvatore, Marzioni, Marco, Russo, Pierluigi, Aghemo, Alessio, Alberti, Alfredo, Ascione, Antonio, Antinori, Andrea, Bruno, Raffaele, Bruno, Savino, Chirianni, Antonio, Gaeta, Giovanni Battista, Giannini, Edoardo G, Merli, Manuela, Messina, Vincenzo, Montilla, Simona, Perno, Carlo Federico, Puoti, Massimo, Raimondo, Giovanni, Rendina, Maria, Silberstein, Francesca Ceccherini, Villa, Erica, Zignego, Anna Linda, Pani, Luca, Craxì, Antonio, Tabone, Marco, Andreoni, Massimo, Teti, Elisabetta, Angelico, Mario, Persico, Marcello, Masarone, Mario, Chiodera, Aledssandro, Solinas, Attilio, delle Monache, Marco, Cecere, Roberto, Maria Schimizzi, Anna, Piovesan, Sara, Campagnolo, Davide, Chiara Piras, Maria, Zolfino, Teresa, Paolo Russo, Francesca, Morelli, Olivia, Sangiovanni, Vincenzo, Onofrio, Mirella, Iodice, Valentina, Izzi, Antonio, Pirisi, Massimo, Danieli, Elena, Vinci, Maria, Rizzardini, Giuliano, Fagiuoli, Stefano, Pasulo, Luisa, D'Arminio Monforte, Antonella, Zuin, Massimo, Giorgini, Alessia, Simeone, Filomena, Piali, Guido, Lo Guercio, Carmela, Federico, Alessandro, Brancaccio, Giuseppina, Marrone, Aldo, Abbati, Giuseppe, Boarini, Chiara, Borghi, Vanni, Bernabucci, Veronica, Corti, Giampaolo, Monti, Monica, Rizzetto, Mario, Martini, Silvia, Andreone, Pietro, Gianstefani, Alice, Lenzi, Marco, Verucchi, Gabriella, Toniutto, Pierluigi, Borgia, Guglielmo, Caporaso, Nicola, Morisco, Filomena, Nardone, Gaetano, Angrisani, Debora, Giacometti, Andrea, Benedetti, Antonio, Tarantino, Giuseppe, Marsetti, Fabio, Tavio, Marcello, Novara, Sergio, Antonia Santantonio, Teresa, Serviddio, Gaetano, Brunetto, Maurizia, Coco, Barbara, Angarano, Gioacchino, Milella, Michele, Barone, Michele, Di Leo, Alfredo, Ettore Sansonno, Domenico, Cacciola, Irene, Boffa, Nicola, Saracco, Giorgio, Di Biagio, Antonio, Picciotto, Antonino, de Luca, Andrea, Calvaruso, Vincenza, Corradori, Silvia, Ferrari, Carlo, Orlandini, Alessandra, Maida, Ivana, Torti, Carlo, Chessa, Luchino, Felder, Martina, Vespasiani Gentilucci, Umberto, Angeli, Paolo, Romano, Antonietta, Ludovico Rapaccini, Gian, Miele, Luca, Cima, Serena, Luisa Russo, Maria, Cozzolongo, Raffaele, Onnelli, Giovanna, D'Offizi, Giampiero, Lionetti, Raffaella, Montalbano, Marzia, Guerra, Michele, Di Perri, Giovanni, Boglione, Lucio, Capra, Franco, Carolo, Giada, Ieluzzi, Donatella, Antonini, Cinzia, Termite, Antonio, Madonia, Salvatore, Tarquini, Pierluigi, Parruti, Giustino, Vecchiet, Giacomo, Falasca, Katia, Menzaghi, Barbara, Quirino, Tiziana, Dentone, Chiara, Maria Piscaglia, Anna, Rossi, Cristina, Giordani, Maria, Fontanella, Luca, Cassola, Giovanni, Russello, Maurizio, Cristaudo, Antonio, Giacomet, Vania, Colombo, Massimo, Donato, Francesca, Durante, Emanuele, Cosco, Lucio, Marignani, Massimo, Quartini, Mariano, Memoli, Massimo, Ganga, Roberto, Ponti, Laura, Soria, Alessandro, Grazia Rumi, Maria, Gulminetti, Roberto, Maserati, Renato, Mondelli, Mario, Lazzarin, Adriano, Rita Parisi, Maria, Canovari, Benedetta, Avancini, Ivo, Pravadelli, Cecilia, Blanc, Pier, Pasquazzi, Caterina, Maria Mastroianni, Claudio, Lichtner, Myriam, Distefano, Marco, Magnani, Silvia, Paganin, Simona, Erne, Elke, Gatti, Pietro, Tundi, Paolo, Calabrese, Paolo, Gasbarrini, Antonio, Grieco, Antonio, Coppola, Nicola, Del Poggio, Paolo, Levrero, Massimo, Talliani, Gloria, Vullo, Vincenzo, Cauda, Roberto, La Monica, Silvia, Potenza, Domenico, Rizzo, Salvatore, Castelli, Francesco, Marie Pigozzi, Grazielle, Ciancio, Alessia, Romagnoli, Dante, Barchetti, Federica, Ivanovic, Jelena, Longo, Olimpia, Petraglia, Sandra, Paola Trotta, Maria, Petta, S., Marzioni, M., Russo, P., Aghemo, A., Alberti, A., Ascione, A., Antinori, A., Bruno, R., Bruno, S., Chirianni, A., Gaeta, G., Giannini, E., Merli, M., Messina, V., Montilla, S., Perno, C., Puoti, M., Raimondo, G., Rendina, M., Silberstein, F., Villa, E., Zignego, A., Pani, L., Craxi, A., Tabone, M., Andreoni, M., Teti, E., Angelico, M., Persico, M., Masarone, M., Chiodera, A., Solinas, A., delle Monache, M., Cecere, R., Maria Schimizzi, A., Piovesan, S., Campagnolo, D., Chiara Piras, M., Zolfino, T., Paolo Russo, F., Morelli, O., Sangiovanni, V., Onofrio, M., Iodice, V., Izzi, A., Pirisi, M., Danieli, E., Vinci, M., Rizzardini, G., Fagiuoli, S., Pasulo, L., D'Arminio Monforte, A., Zuin, M., Giorgini, A., Simeone, F., Piali, G., Lo Guercio, C., Federico, A., Brancaccio, G., Marrone, A., Abbati, G., Boarini, C., Borghi, V., Bernabucci, V., Corti, G., Monti, M., Rizzetto, M., Martini, S., Andreone, P., Gianstefani, A., Lenzi, M., Verucchi, G., Toniutto, P., Borgia, G., Caporaso, N., Morisco, F., Nardone, G., Angrisani, D., Giacometti, A., Benedetti, A., Tarantino, G., Marsetti, F., Tavio, M., Novara, S., Antonia Santantonio, T., Serviddio, G., Brunetto, M., Coco, B., Angarano, G., Milella, M., Barone, M., Di Leo, A., Ettore Sansonno, D., Cacciola, I., Boffa, N., Saracco, G., Di Biagio, A., Picciotto, A., de Luca, A., Calvaruso, V., Corradori, S., Ferrari, C., Orlandini, A., Maida, I., Torti, C., Chessa, L., Felder, M., Vespasiani Gentilucci, U., Angeli, P., Romano, A., Ludovico Rapaccini, G., Miele, L., Cima, S., Luisa Russo, M., Cozzolongo, R., Onnelli, G., D'Offizi, G., Lionetti, R., Montalbano, M., Guerra, M., Di Perri, G., Boglione, L., Capra, F., Carolo, G., Ieluzzi, D., Antonini, C., Termite, A., Madonia, S., Tarquini, P., Parruti, G., Vecchiet, G., Falasca, K., Menzaghi, B., Quirino, T., Dentone, C., Maria Piscaglia, A., Rossi, C., Giordani, M., Fontanella, L., Cassola, G., Russello, M., Cristaudo, A., Giacomet, V., Colombo, M., Donato, F., Durante, E., Cosco, L., Marignani, M., Quartini, M., Memoli, M., Ganga, R., Ponti, L., Soria, A., Grazia Rumi, M., Gulminetti, R., Maserati, R., Mondelli, M., Lazzarin, A., Rita Parisi, M., Canovari, B., Avancini, I., Pravadelli, C., Blanc, P., Pasquazzi, C., Maria Mastroianni, C., Lichtner, M., Distefano, M., Magnani, S., Paganin, S., Erne, E., Gatti, P., Tundi, P., Calabrese, P., Gasbarrini, A., Grieco, A., Coppola, N., Del Poggio, P., Levrero, M., Talliani, G., Vullo, V., Cauda, R., La Monica, S., Potenza, D., Rizzo, S., Castelli, F., Marie Pigozzi, G., Ciancio, A., Romagnoli, D., Barchetti, F., Ivanovic, J., Longo, O., Petraglia, S., Paola Trotta, M., Savino, Bruno, Nardone, GERARDO ANTONIO PIO, Petta, S, Marzioni, M, Russo, P, Aghemo, A, Alberti, A, Ascione, A, Antinori, A, Bruno, R, Bruno, S, Chirianni, A, Gaeta, G, Giannini, E, Merli, M, Messina, V, Montilla, S, Perno, C, Puoti, M, Raimondo, G, Rendina, M, Silberstein, F, Villa, E, Zignego, A, Pani, L, Craxì, A, and Fagiuoli, S
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Cyclopropanes ,Compassionate Use Trials ,Liver Cirrhosis ,Male ,chemistry.chemical_compound ,0302 clinical medicine ,2-Naphthylamine ,HCV, direct-acting antiviral, mixed cryoglobulinemia, RBV ,Anilides ,030212 general & internal medicine ,Longitudinal Studies ,Prospective Studies ,Chronic ,Adult ,Aged ,Antiviral Agents ,Carbamates ,Drug Therapy, Combination ,Female ,Genotype ,Hepatitis C, Chronic ,Humans ,Macrocyclic Compounds ,Middle Aged ,Ribavirin ,Ritonavir ,Sulfonamides ,Treatment Outcome ,Uracil ,Settore MED/12 - Gastroenterologia ,Dasabuvir ,HCV DAA ,Gastroenterology ,virus diseases ,Valine ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,Hepatitis C ,Hepatology ,Combination ,030211 gastroenterology & hepatology ,medicine.drug ,medicine.medical_specialty ,Proline ,Lactams, Macrocyclic ,Hepatitis C virus genotype 1, Hepatitis C virus genotype 4, decompensated liver cirrhosis, antiviral therapy, dasabuvir, ombitasvir, paritaprevir ,03 medical and health sciences ,Drug Therapy ,Internal medicine ,medicine ,Decompensation ,Adverse effect ,business.industry ,Virology ,Ombitasvir ,Clinical trial ,chemistry ,Paritaprevir ,business - Abstract
Summary Background We ran a compassionate use nationwide programme (ABACUS) to provide access to ombitasvir, paritaprevir, and ritonavir, with dasabuvir, plus ribavirin for hepatitis C virus (HCV) genotype 1 infection and ombitasvir, paritaprevir, and ritonavir, plus ribavirin for HCV genotype 4 infection in patients with cirrhosis at high risk of decompensation while approval of these regimens was pending in Italy. Methods In this prospective observational study, we collected data from a compassionate use nationwide programme from March 17, 2014, to May 28, 2015. Patients with HCV genotype 1 infection and cirrhosis at high risk of decompensation were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once daily and dasabuvir (250 mg) twice daily for 12 weeks (patients with HCV genotype 1b infection) or 24 weeks (patients with HCV genotype 1a infection). Patients with HCV genotype 4 infection were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once per day for 24 weeks. All patients were given weight-based ribavirin. The primary efficacy endpoint was sustained virological response at week 12 after the end of treatment (SVR12), analysed by intention-to-treat. Univariate and multivariate logistic regression analyses were used to identify baseline characteristics associated with SVR12. Adverse events were recorded throughout the study. Findings 728 (96%) of 762 patients with cirrhosis who were given ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin therapy for 12 or 24 weeks achieved SVR12. Logistic regression analyses identified that bilirubin concentrations of less than 2 mg/dL were associated with SVR12 (odds ratio [OR] 4·76 [95% CI 1·83–12·3]; p=0·001). 166 (23%) of 734 patients included in safety analyses had an adverse event. 25 (3%) patients discontinued treatment because of adverse events. Asthenia was the most commonly reported adverse event, occurring in 36 (5%) patients. Interpretation Our findings suggest that the safety and effectiveness of ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin in patients with HCV genotype 1 or 4 infection and cirrhosis at high risk of decompensation in a real-life setting are similar to those reported in clinical trials. The concordance with clinical trials provides reassurance that the reported efficacy of this treatment in clinical trials will translate to its use in routine clinical practice. Funding Dipartimento Biomedico di Medicina Interna e Specialistica dell'Universita di Palermo.
- Published
- 2017
23. Scelte terapeutiche e trattamento con sorafenib nell'epatocarcinoma: Analisi finale dello studio GIDEON in Italia
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D'Angelo, Salvatore, Germano, Domenico, Zolfino, Teresa, Sansonno, Domenico, Giannitrapani, Lydia, Benedetti, Antonio, Montesarchio, Vincenzo, Attili, Adolfo, Buonadonna, Angela, Barni, Sandro, Gasbarrini, Antonio, Burlone, Michela E., Cillo, Umberto, Marenco, Simona, Villa, Erica, Giovanis, Petros, Proserpio, Ilaria, Saitta, Carlo, Magini, Giulia, Cengarle, Rita, Fava, Giammarco, Cuttone, Filiana, Calvani, Nicola, Angelico, Mario, Di Costanzo, Francesco, Noto, Alfonso, Poggi, Guido, Marignani, Massimo, Cascinu, Stefano, Amoroso, Domenico, Palmieri, Vincenzo, Massa, Elena, Croce', Saveria, Picardi, Antonio, Tumulo, Salvatore, Erminero, Claudia, Lencioni, Riccardo, Lorusso, Vito, D’Angelo, S, Germano, D, Zolfino, T, Sansonno, D, Giannitrapani, L, Benedetti, A, Montesarchio, V, Attili, A, Buonadonna, A, Barni, S, Gasbarrini, A, Burlone, ME, Cillo, U, Marenco, S, Villa, E, Giovanis, P, Proserpio, I, Saitta, C, Magini, G, Cengarle, R, Fava, G, Cuttone, F, Calvani, N, Angelico, M, Di Costanzo, F, Noto, A, Poggi, G, Marignani, M, Cascinu, S, Amoroso, D, Palmieri, V, Massa, E, Crocè, LS, Picardi, A, Tumulo, S, Erminero, C, Lencioni, R, Lorusso, V, D'Angelo, Salvatore, Germano, Domenico, Zolfino, Teresa, Sansonno, Domenico, Giannitrapani, Lydia, Benedetti, Antonio, Montesarchio, Vincenzo, Attili, Adolfo, Buonadonna, Angela, Barni, Sandro, Gasbarrini, Antonio, Burlone, Michela E., Cillo, Umberto, Marenco, Simona, Villa, Erica, Giovanis, Petro, Proserpio, Ilaria, Saitta, Carlo, Magini, Giulia, Cengarle, Rita, Fava, Giammarco, Cuttone, Filiana, Calvani, Nicola, Angelico, Mario, Di Costanzo, Francesco, Noto, Alfonso, Poggi, Guido, Marignani, Massimo, Cascinu, Stefano, Amoroso, Domenico, Palmieri, Vincenzo, Massa, Elena, Croce', Saveria, Picardi, Antonio, Tumulo, Salvatore, Erminero, Claudia, Lencioni, Riccardo, and Lorusso, Vito
- Subjects
Phenylurea Compound ,Adult ,Male ,Niacinamide ,Carcinoma, Hepatocellular ,Hepatocellular carcinoma ,Antineoplastic Agents ,Antineoplastic Agent ,80 and over ,Humans ,Prospective Studies ,Aged ,Aged, 80 and over ,GIDEON study ,Sorafenib ,Female ,Italy ,Liver Neoplasms ,Middle Aged ,Phenylurea Compounds ,Medicine (all) ,Carcinoma ,Hepatocellular ,Prospective Studie ,Hepatocellular carcinoma, sorafenib, GIDEON study ,Liver Neoplasm ,Human - Abstract
Summary. Introduction. Sorafenib, an oral multikinase inhibitor, is the only targeted agent approved for the treatment of patients with hepatocellular carcinoma (HCC) after demonstration to increase overall survival compared to placebo in two randomized phase III study. GIDEON (Global Investigation of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) is the largest, global, non-interventional, prospective study of patients with uHCC (n>3200) treated with sorafenib in real-life clinical practice conditions. Here we report the final analysis of safety and efficacy in the Italian cohort of patients. Methods. Patients with unresectable HCC who are candidates for systemic therapy, and for whom a decision has been made to treat with sorafenib, are eligible for inclusion. Patients demographics disease characteristics and treatment history were recorded at baseline visit. Sorafenib dose, concomitant medications, performance status, liver function, adverse events and efficacy (survival and response rate) were collected throughout the study. Results. In the Italian cohort of the GIDEON study 278 patients were included in 36 centers. The global rate of adverse events was 81%. Drug-related events accounted for 67%, mostly of grade 1 and 2, and only 8% were classified as serious. The most common were diarrhea (24%), fatigue (23%), dermatological (14%), rash/exfoliation (10%), hypertension (9%), hemorrage/bleeding of gastrointestinal tract (6%). Overall survival was 14.4 months and time to progression 6.2 months. Objective responses were observed in 14 patients (5%) with 3 complete responses (1%). Stable diseases of at least 6 weeks were observed in 113 patients (41%) with a 30% of disease control rate. Discussion. The safety profile of sorafenib in terms of rate and type of adverse events is similar to that emerged in the global international GIDEON study as well as in the pivotal registration studies.
- Published
- 2015
24. Development and Validation of a Scoring System to Predict Response to Obeticholic Acid in Primary Biliary Cholangitis.
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De Vincentis A, Ampuero J, Terracciani F, D'Amato D, Gerussi A, Cristoferi L, Cazzagon N, Bonaiuto E, Floreani A, Calvaruso V, Cadamuro L, Degasperi E, Morgando A, Vanni E, Lleo A, Colapietro F, Alvaro D, Castellaneta A, Labanca S, Viganò M, Distefano M, Pace Palitti V, Ricci C, De Matthaeis N, Marzioni M, Gómez-Dominguez E, Montero JL, Molina E, Garcia-Buey L, Casado M, Berenguer M, Conde I, Simon MA, Fuentes J, Costa-Moreira P, Macedo G, Jorquera F, Morillas RM, Presa J, Sousa JM, Gomes D, Santos L, Olveira A, Hernandez-Guerra M, Aburruza L, Santos A, Carvalho A, Uriz J, Gutierrez ML, Perez E, Chessa L, Pellicelli A, Marignani M, Muratori L, Niro GA, Brunetto M, Ponziani FR, Pompili M, Marra F, Galli A, Mussetto A, Alagna G, Simone L, Bertino G, Rosina F, Cozzolongo R, Russello M, Baiocchi L, Saitta C, Terreni N, Zolfino T, Rigamonti C, Vigano R, Cuccorese G, Pozzoni P, Pedone C, Grasso S, Picardi A, Invernizzi P, Sacco R, Izzi A, Fernandez-Rodriguez C, Vespasiani-Gentilucci U, and Carbone M
- Subjects
- Humans, Female, Male, Middle Aged, Prospective Studies, Aged, Liver Cirrhosis, Biliary drug therapy, Treatment Outcome, Adult, Cholagogues and Choleretics therapeutic use, Italy, Chenodeoxycholic Acid analogs & derivatives, Chenodeoxycholic Acid therapeutic use
- Abstract
Background & Aims: Obeticholic acid (OCA) is the only licensed second-line therapy for primary biliary cholangitis (PBC). With novel therapeutics in advanced development, clinical tools are needed to tailor the treatment algorithm. We aimed to derive and externally validate the OCA response score (ORS) for predicting the response probability of individuals with PBC to OCA., Methods: We used data from the Italian RECAPITULATE (N = 441) and the IBER-PBC (N = 244) OCA real-world prospective cohorts to derive/validate a score including widely available variables obtained either pre-treatment (ORS) or also after 6 months of treatment (ORS+). Multivariable Cox regressions with backward selection were applied to obtain parsimonious predictive models. The predicted outcomes were biochemical response according to POISE (alkaline phosphatase [ALP]/upper limit of normal [ULN]<1.67 with a reduction of at least 15%, and normal bilirubin), or ALP/ULN<1.67, or normal range criteria (NR: normal ALP, alanine aminotransferase [ALT], and bilirubin) up to 24 months., Results: Depending on the response criteria, ORS included age, pruritus, cirrhosis, ALP/ULN, ALT/ULN, GGT/ULN, and bilirubin. ORS+ also included ALP/ULN and bilirubin after 6 months of OCA therapy. Internally validated c-statistics for ORS were 0.75, 0.78, and 0.72 for POISE, ALP/ULN<1.67, and NR response, which raised to 0.83, 0.88, and 0.81 with ORS+, respectively. The respective performances in validation were 0.70, 0.72, and 0.71 for ORS and 0.80, 0.84, and 0.78 for ORS+. Results were consistent across groups with mild/severe disease., Conclusions: We developed and externally validated a scoring system capable to predict OCA response according to different criteria. This tool will enhance a stratified second-line therapy model to streamline standard care and trial delivery in PBC., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)
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- 2024
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25. Predictors of serious adverse events and non-response in cirrhotic patients with primary biliary cholangitis treated with obeticholic acid.
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De Vincentis A, D'Amato D, Cristoferi L, Gerussi A, Malinverno F, Lleo A, Colapietro F, Marra F, Galli A, Fiorini C, Coco B, Brunetto M, Niro GA, Cotugno R, Saitta C, Cozzolongo R, Losito F, Giannini EG, Labanca S, Marzioni M, Marconi G, Morgando A, Pellicano R, Vanni E, Cazzagon N, Floreani A, Chessa L, Morelli O, Muratori L, Pellicelli A, Pompili M, Ponziani F, Tortora A, Rosina F, Russello M, Cannavò M, Simone L, Storato S, Viganò M, Abenavoli L, D'Antò M, De Gasperi E, Distefano M, Scifo G, Zolfino T, Calvaruso V, Cuccorese G, Palitti VP, Sacco R, Bertino G, Frazzetto E, Alvaro D, Mulinacci G, Palermo A, Scaravaglio M, Terracciani F, Galati G, Ronca V, Zuin M, Claar E, Izzi A, Picardi A, Invernizzi P, Vespasiani-Gentilucci U, and Carbone M
- Subjects
- Albumins therapeutic use, Ascites drug therapy, Ascites etiology, Bilirubin, Chenodeoxycholic Acid analogs & derivatives, Humans, Liver Cirrhosis complications, Liver Cirrhosis drug therapy, Male, Liver Cirrhosis, Biliary complications, Liver Cirrhosis, Biliary drug therapy
- Abstract
Background & Aims: Obeticholic acid (OCA) has recently been restricted in patients with primary biliary cholangitis (PBC) with "advanced cirrhosis" because of its narrow therapeutic index. We aimed to better define the predicting factors of hepatic serious adverse events (SAEs) and non-response in cirrhotic patients undergoing OCA therapy., Methods: Safety and efficacy of treatment were evaluated in a cohort of consecutive PBC cirrhotic patients started with OCA. OCA response was evaluated according to the Poise criteria. Risk factors for hepatic SAEs and non-response were reported as risk ratios (RR) with 95% confidence intervals (CIs)., Results: One hundred PBC cirrhotics were included, 97 Child-Pugh class A and 3 class B. Thirty-one had oesophageal varices and 5 had a history of ascites. Thirty-three per cent and 32% of patients achieved a biochemical response at 6 and 12 months respectively. Male sex (adjusted-RR 1.75, 95%CI 1.42-2.12), INR (1.37, 1.00-1.87), Child-Pugh score (1.79, 1.28-2.50), MELD (1.17, 1.04-1.30) and bilirubin (1.83, 1.11-3.01) were independently associated with non-response to OCA. Twenty-two patients discontinued OCA within 12 months: 10 for pruritus, 9 for hepatic SAEs (5 for jaundice and/or ascitic decompensation; 4 for upper digestive bleeding). INR (adjusted-RR 1.91, 95%CI 1.10-3.36), lower albumin levels (0.18, 0.06-0.51), Child-Pugh score (2.43, 1.50-4.04), history of ascites (3.5, 1.85-6.5) and bilirubin (1.30, 1.05-1.56), were associated with hepatic SAEs. A total bilirubin≥1.4 mg/dl at baseline was the most accurate biochemical predictor of hepatic SAEs under OCA., Conclusions: An accurate baseline assessment is crucial to select cirrhotic patients who can benefit from OCA. Although OCA is effective in one third of cirrhotics, bilirubin level ≥1.4 mg/dl should discourage from its use., (© 2022 The Authors. Liver International published by John Wiley & Sons Ltd.)
- Published
- 2022
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26. The double-sided of human leukocyte antigen-G molecules in type 1 autoimmune hepatitis.
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Littera R, Perra A, Miglianti M, Piras IS, Mocci S, Lai S, Melis M, Zolfino T, Balestrieri C, Conti M, Serra G, Figorilli F, Firinu D, Onali S, Matta L, Porcu C, Pes F, Fanni D, Manieli C, Vacca M, Cusano R, Trucas M, Cipri S, Tranquilli S, Rassu S, Cannas F, Carta MG, Kowalik MA, Giuressi E, Faa G, Chessa L, and Giglio S
- Subjects
- Humans, Genetic Predisposition to Disease, HLA-DRB1 Chains genetics, Haplotypes, HLA-G Antigens genetics, Hepatitis, Autoimmune genetics
- Abstract
The immunomodulatory effects of HLA-G expression and its role in cancers, human liver infections and liver transplantation are well documented, but so far, there are only a few reports addressing autoimmune liver diseases, particularly autoimmune hepatitis (AIH)., Method and Materials: We analyzed the genetic and phenotypic characteristics of HLA-G in 205 type 1 AIH patients (AIH-1) and a population of 210 healthy controls from Sardinia (Italy)., Results: Analysis of the HLA-G locus showed no substantial differences in allele frequencies between patients and the healthy control population. The HLA-G UTR-1 haplotype was the most prevalent in both AIH-1 patients and controls (40.24% and 34.29%). Strong linkage was found between the HLA-G UTR-1 haplotype and HLA-DRB1*03:01 in AIH-1 patients but not controls ( D' = 0.92 vs D' = 0.50 respectively; P = 1.3x10
-8 ). Soluble HLA-G (sHLA-G) levels were significantly lower in AIH-1 patients compared to controls [13.9 (11.6 - 17.4) U/mL vs 21.3 (16.5 - 27.8) U/mL; P = 0.011]. Twenty-four patients with mild or moderate inflammatory involvement, as assessed from liver biopsy, showed much higher sHLA-G levels compared to the 28 patients with severe liver inflammation [33.5 (23.6 - 44.8) U/mL vs 8.8 (6.1 - 14.5) U/mL; P = 0.003]. Finally, immunohistochemistry analysis of 52 liver biopsies from AIH-1 patients did not show expression of HLA-G molecules in the liver parenchyma. However, a percentage of 69.2% (36/52) revealed widespread expression of HLA-G both in the cytoplasm and the membrane of plasma cells labeled with anti-HLA-G monoclonal antibodies., Conclusion: This study highlights the positive immunomodulatory effect of HLA-G molecules on the clinical course of AIH-1 and how this improvement closely correlates with plasma levels of sHLA-G. However, our results open the debate on the ambiguous role of HLA-G molecules expressed by plasma cells, which are pathognomonic features of AIH-1., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Littera, Perra, Miglianti, Piras, Mocci, Lai, Melis, Zolfino, Balestrieri, Conti, Serra, Figorilli, Firinu, Onali, Matta, Porcu, Pes, Fanni, Manieli, Vacca, Cusano, Trucas, Cipri, Tranquilli, Rassu, Cannas, Carta, Kowalik, Giuressi, Faa, Chessa and Giglio.)- Published
- 2022
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27. Rate of non-response to ursodeoxycholic acid in a large real-world cohort of primary biliary cholangitis patients in Italy.
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Vespasiani-Gentilucci U, Rosina F, Pace-Palitti V, Sacco R, Pellicelli A, Chessa L, De Vincentis A, Barlattani M, Barlattani A, Feletti V, Mussetto A, Zolfino T, Russello M, Cozzolongo R, Garrucciu G, Niro G, Bacca D, Bertino G, Claar E, Ascione A, D'Adamo G, Adinolfi LE, Scifo G, and Izzi A
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Italy, Liver Cirrhosis, Biliary diagnosis, Male, Middle Aged, Practice Patterns, Physicians', Severity of Illness Index, Treatment Failure, Cholagogues and Choleretics therapeutic use, Liver Cirrhosis, Biliary drug therapy, Ursodeoxycholic Acid therapeutic use
- Abstract
Background and aim: Response to ursodeoxycholic acid (UDCA) is crucial for the prediction of primary biliary cholangitis (PBC) prognosis, and different response criteria were validated and proposed by reference centers for PBC. To date, rates of non-response to UDCA from real-world series are lacking. Methods: Hepatology/Gastroenterology centers belonging to 'Club Epatologi Ospedalieri' (CLEO) and 'Associazione Italiana Gastroenterologi Ospedalieri' (AIGO) were invited to participate in the study, and asked to extract all patients followed for PBC, without any selection or exclusion, and fill in the database provided. Results: Thirty-four centers were enrolled throughout Italy, for a total of 713 patients. None of these centers, except one, had a hepatology outpatient clinic devoted to the care of patients with autoimmune liver diseases. After excluding 79 cases of PBC/autoimmune hepatitis overlaps, 634 patients were analyzed: mean age, 64.4 ± 12.0 years; 91.2% females; F/M 10.3/1. For patients with at least 1 year of UDCA treatment (583), rates of non-response to UDCA were evaluated according to the Paris-I/-II, Toronto and GLOBE criteria, and compared with those in the original cohorts: 27% vs 39% in Paris-I cohort; 39.6% vs 52% in Paris-II; 20.1% vs 43.5% in Toronto; 15.7% vs 30% in GLOBE (age-specific cutoffs). Mean alkaline phosphatase levels on UDCA treatment, and the age-adjusted prevalence of F3/F4 fibrosis, appeared lower in this PBC population than in reference cohorts. Conclusions: A mean ∼15% better response to UDCA is observed in a real-world PBC population, probably due to migration of some of most severe/advanced cases to PBC referral centers.
- Published
- 2019
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28. Clinical outcomes with long-term sorafenib treatment of patients with hepatocellular carcinoma: a multicenter real-life study.
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Sacco R, Granito A, Bargellini I, Zolfino T, Saitta C, Marzi L, Tapete G, Bresci G, Marinelli S, Tovoli F, Attardo S, Rossi M, Urbani L, Marchi S, Buccianti P, and Cabibbo G
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular mortality, Female, Humans, Italy epidemiology, Kaplan-Meier Estimate, Liver Neoplasms diagnosis, Liver Neoplasms mortality, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome, Young Adult, Antineoplastic Agents therapeutic use, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms drug therapy, Long-Term Care methods, Sorafenib therapeutic use
- Abstract
Aim: This multicenter field-practice study evaluates outcomes of long-term sorafenib in hepatocellular carcinoma (HCC) patients., Methods: Consecutive HCC patients on sorafenib were enrolled. We evaluated those receiving sorafenib for ≥12 months., Results: Out of 800 patients on sorafenib, 81 (10%) received long-term treatment. Median duration of treatment was 22.7 months (range: 12.3-92.6). Only 21 (26%) reported grade 3/4 adverse events. Complete response was reported in 11 patients (14%). Median overall survival was 34.8 months (95% CI: 29.9-44.3). Only baseline Child-Pugh class was associated with survival., Conclusion: Sorafenib could result in long-term control of HCC in a relevant proportion of patients. Given the availability of regorafenib in the second-line setting, an earlier introduction of systemic therapy may be considered according to clinical indications.
- Published
- 2018
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29. Exploring the Role of Killer Cell Immunoglobulin-Like Receptors and Their HLA Class I Ligands in Autoimmune Hepatitis.
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Littera R, Chessa L, Onali S, Figorilli F, Lai S, Secci L, La Nasa G, Caocci G, Arras M, Melis M, Cappellini S, Balestrieri C, Serra G, Conti M, Zolfino T, Casale M, Casu S, Pasetto MC, Barca L, Salustro C, Matta L, Scioscia R, Zamboni F, Faa G, Orrù S, and Carcassi C
- Subjects
- Adult, Age of Onset, Aged, Biomarkers blood, Case-Control Studies, Female, HLA-B Antigens genetics, HLA-B Antigens immunology, HLA-B18 Antigen genetics, HLA-B18 Antigen immunology, HLA-C Antigens genetics, HLA-C Antigens immunology, HLA-DR3 Antigen genetics, HLA-DR3 Antigen immunology, Haplotypes, Hepatitis, Autoimmune genetics, Hepatitis, Autoimmune pathology, Humans, Killer Cells, Natural pathology, Liver pathology, Male, Middle Aged, Outpatients, Receptors, KIR genetics, Receptors, KIR2DL3 genetics, Receptors, KIR2DL3 immunology, Receptors, KIR3DL1 genetics, Receptors, KIR3DL1 immunology, Gene Expression immunology, Hepatitis, Autoimmune diagnosis, Hepatitis, Autoimmune immunology, Killer Cells, Natural immunology, Liver immunology, Receptors, KIR immunology
- Abstract
Background: Natural killer cells are involved in the complex mechanisms underlying autoimmune diseases but few studies have investigated their role in autoimmune hepatitis. Killer immunoglobulin-like receptors are key regulators of natural killer cell-mediated immune responses., Methods and Findings: KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 114 patients diagnosed with type 1 autoimmune hepatitis and compared with a group of 221 healthy controls. HLA Class I and Class II antigen frequencies were compared to those of 551 healthy unrelated families representative of the Sardinian population. In our cohort, type 1 autoimmune hepatitis was strongly associated with the HLA-B18, Cw5, DR3 haplotype. The KIR2DS1 activating KIR gene and the high affinity HLA-C2 ligands were significantly higher in patients compared to controls. Patients also had a reduced frequency of HLA-Bw4 ligands for KIR3DL1 and HLA-C1 ligands for KIR2DL3. Age at onset was significantly associated with the KIR2DS1 activating gene but not with HLA-C1 or HLA-C2 ligand groups., Conclusions: The activating KIR gene KIR2DS1 resulted to have an important predictive potential for early onset of type 1 autoimmune hepatitis. Additionally, the low frequency of the KIR-ligand combinations KIR3DL1/HLA-Bw4 and KIR2DL3/HLA-C1 coupled to the high frequency of the HLA-C2 high affinity ligands for KIR2DS1 could contribute to unwanted NK cell autoreactivity in AIH-1.
- Published
- 2016
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30. An evaluation of long-term outcomes after liver transplantation for cryptogenic cirrhosis.
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Heneghan MA, Zolfino T, Muiesan P, Portmann BC, Rela M, Heaton ND, and O'grady JG
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- Adolescent, Adult, Aged, Evaluation Studies as Topic, Female, Follow-Up Studies, Graft Rejection mortality, Graft Rejection pathology, Graft Survival, Hepatitis C, Chronic mortality, Hepatitis C, Chronic surgery, Hepatitis, Alcoholic mortality, Hepatitis, Alcoholic surgery, Hepatitis, Chronic mortality, Humans, Liver Cirrhosis mortality, Male, Middle Aged, Survival Analysis, Treatment Outcome, Hepatitis, Chronic surgery, Liver Cirrhosis surgery, Liver Transplantation mortality
- Abstract
Patients with cryptogenic cirrhosis (CC) comprise a significant proportion of liver transplant recipients. Poor outcome after transplantation has been reported by some centers, with fibrosis occurring in a significant proportion of patients. Outcome of 46 patients with CC who underwent transplantation between 1989 and 1999 at King's College Hospital London were compared with time-matched recipients who underwent transplantation for hepatitis C virus (HCV) cirrhosis (n = 58) and patients with alcohol-related cirrhosis (AC, n = 53) during the same time period. Mean follow-up was 46 +/- 37 months for CC patients, 41 +/- 31 months for AC patients, and 49 +/- 31 months for HCV patients. No protocol liver biopsy specimens were obtained, and biopsies were performed only for investigation of biochemical abnormalities. Acute cellular rejection occurred in 30% of CC, 26% of AC, and 37% of HCV patients (P = NS). Overall patient and graft survival at 1 year was 85% and 80% for CC patients, 87% and 81% for AC patients, and 91% and 82% for patients with HCV (P = NS). Five-year patient and graft survival was 81% and 77% for CC patients, 60% and 48% for AC patients, and 79% and 57% for HCV patients (Log rank; P =.369). Twenty-two percent of CC patients had inflammation on last evaluable liver biopsy, compared with 25% of patients who underwent transplantation for AC and 68% of patients who underwent transplantation for HCV. No patient who underwent transplantation for CC had histologic evidence of cirrhosis on last evaluable biopsy, compared with 2% of patients who underwent transplantation for AC and 16% of patients who underwent transplantation for HCV (Chi-squared = 13.053, P =.0015). These results suggest that CC is a favorable indication for OLT and that although a proportion of patients develop inflammation in the liver allograft, this does not result in significant graft dysfunction or loss.
- Published
- 2003
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31. Cytomegalovirus infection after liver transplantation: viral load as a guide to treating clinical infection.
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Norris S, Kosar Y, Donaldson N, Smith HM, Zolfino T, O'Grady JG, Muiesan P, Rela M, and Heaton N
- Subjects
- Adult, Antibodies, Viral blood, Cytomegalovirus Infections drug therapy, Cytomegalovirus Infections prevention & control, Humans, Logistic Models, Sensitivity and Specificity, Cytomegalovirus Infections diagnosis, DNA, Viral blood, Liver Transplantation adverse effects, Viral Load
- Abstract
Background: Quantitative commercial assays for early and accurate detection of active cytomegalovirus (CMV) infection after liver transplantation are widely available. However, meaningful interpretation of viral load measurements is hampered by the lack of definitive cutoff points that correlate with clinically significant disease., Methods: One hundred fifty liver allograft recipients were prospectively monitored for the presence of CMV DNA for the first 12 weeks after orthotopic liver transplantation using the Murex hybrid capture system. The first CMV DNA value after liver transplantation, a weekly rise in CMV DNA (gradient value), and the CMV DNA value on clinical detection of active infection (critical value) were analyzed as risk factors for CMV infection., Results: Forty-four (29.3%) of 150 patients had detectable CMV DNA within 12 weeks of transplantation, and 20 (13.3%) experienced symptomatic CMV infection. Multiple regression analysis demonstrated that baseline CMV DNA level above 10 pg/mL, positive weekly increase in CMV DNA level, and critical CMV DNA level above 13 pg/mL were independent risk factors for clinically significant infection. Using Cox's multiple regression model, the hazard ratio was 13.9 for baseline CMV DNA above 10 (P =0.0001; 95% confidence interval, 3.5-54) and 13 for a weekly increase in the gradient (P =0.0003; 95% confidence interval, 3.5-50). Critical CMV DNA level above 13 correlated with active infection (100% sensitivity, 98% specificity, 90% positive predictive value, 100% negative predictive value)., Conclusion: Baseline and gradient CMV DNA viral load levels correlate with active CMV infection in liver allograft recipients. These data indicate that CMV viral load detection by hybridization methodology is useful in predicting active CMV infection and could be used in a preemptive strategy in liver allograft recipients.
- Published
- 2002
- Full Text
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