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- ItemSomente MetadadadosCurrent advances in targeted therapies for metastatic gastric cancer: improving patient care(Future medicine ltd, 2016) Aguiar, Pedro Nazareth, Jr. [UNIFESP]; Muniz, Thiago Pimentel [UNIFESP]; Miranda, Raelson Rodrigues [UNIFESP]; Tadokoro, Hakaru [UNIFESP]; Forones, Nora Manoukian [UNIFESP]; Monteiro, Ines-de-Paula; Castelo-Branco, Pedro; Janjigian, Yelena Y.; de Mello, Ramon AndradeIn this article, we review the literature on the current advances in targeted therapies for metastatic gastric cancer aimed at improving patient care. We conclude that the key to guiding targeted therapy is individual biomarkers, which are not completely elucidated. HER2 overexpression is the only predictive biomarker currently in use. Furthermore, it is necessary to understand that gastric tumors are heterogeneous
- ItemSomente MetadadadosEfficacy and safety of subcutaneous tocilizumab versus intravenous tocilizumab in combination with traditional DMARDs in patients with RA at week 97 (SUMMACTA)(Bmj Publishing Group, 2016) Burmester, Gerd R.; Rubbert-Roth, Andrea; Cantagrel, Alain; Hall, Stephen; Leszczynski, Piotr; Feldman, Daniel [UNIFESP]; Rangaraj, Madura J.; Roane, Georgia; Ludivico, Charles; Bao, Min; Rowell, Lucy; Davies, Claire; Mysler, Eduardo F.Objectives To evaluate the long-term efficacy and safety of subcutaneous (SC) tocilizumab (TCZ) versus intravenous (IV) TCZ, including switching formulations, in patients with rheumatoid arthritis (RA) and inadequate response to disease-modifying antirheumatic drugs (DMARDs). Methods Patients (n=1262) were randomised 1: 1 to receive TCZ-SC 162 mg weekly (qw)+placebo-IV every four weeks (q4w) or TCZ-IV 8 mg/kg q4w+placebo-SC qw in combination with DMARD(s). After a 24-week double-blind period, patients receiving TCZ-SC were re-randomised 11: 1 to TCZ-SC (n=521) or TCZ-IV (TCZ-SCIV, n=48), and patients receiving TCZ-IV were re-randomised 2: 1 to TCZ-IV (n=372) or TCZ-SC (TCZ-IV-SC
- ItemSomente MetadadadosEfficacy and safety of subcutaneous tocilizumab versus intravenous tocilizumab in combination with traditional DMARDs in patients with RA at week 97 (SUMMACTA)(Bmj Publishing Group, 2016) Burmester, Gerd R.; Rubbert-Roth, Andrea; Cantagrel, Alain; Hall, Stephen; Leszczynski, Piotr; Feldman, Daniel [UNIFESP]; Rangaraj, Madura J.; Roane, Georgia; Ludivico, Charles; Bao, Min; Rowell, Lucy; Davies, Claire; Mysler, Eduardo F.; Universidade Federal de São Paulo (UNIFESP)Objectives To evaluate the long-term efficacy and safety of subcutaneous (SC) tocilizumab (TCZ) versus intravenous (IV) TCZ, including switching formulations, in patients with rheumatoid arthritis (RA) and inadequate response to disease-modifying antirheumatic drugs (DMARDs). Methods Patients (n=1262) were randomised 1: 1 to receive TCZ-SC 162 mg weekly (qw)+placebo-IV every four weeks (q4w) or TCZ-IV 8 mg/kg q4w+placebo-SC qw in combination with DMARD(s). After a 24-week double-blind period, patients receiving TCZ-SC were re-randomised 11: 1 to TCZ-SC (n=521) or TCZ-IV (TCZ-SCIV, n=48), and patients receiving TCZ-IV were re-randomised 2: 1 to TCZ-IV (n=372) or TCZ-SC (TCZ-IV-SC n=186). Maintenance of clinical responses and safety through week 97 were assessed. Results The proportions of patients who achieved American College of Rheumatology (ACR) 20/50/70 responses, Disease Activity Score in 28 joints remission and improvement from baseline in Health Assessment Questionnaire Disability Index >= 0.3 were sustained through week 97 and comparable across arms. TCZ-SC had a comparable safety profile to TCZ-IV through week 97, except that injection site reactions (ISRs) were more common with TCZ-SC. Safety profiles in patients who switched were similar to those in patients who received continuous TCZ-SC or TCZ-IV treatment. The proportion of patients who developed anti-TCZ antibodies remained low across treatment arms. No association between anti-TCZ antibody development and clinical response or adverse events was observed. Conclusions The long-term efficacy and safety of TCZ-SC was maintained and comparable to that of TCZ-IV, except for ISRs. Profiles in patients who switched formulations were comparable to those in patients who received TCZ-IV or TCZ-SC. TCZ-SC provides additional treatment options for patients with RA.
- ItemAcesso aberto (Open Access)Enzyme replacement therapy with galsulfase for mucopolysaccharidosis type vi(Amer Inst Physics, 2016) Brunelli, Marcela Junqueira [UNIFESP]; Atalla, Alvaro N. [UNIFESP]; da Silva, Edina M. K. [UNIFESP]Background Mucopolysaccharidosis type VI or Maroteaux-Lamy syndrome is a rare genetic disorder caused by the deficiency of arylsulphatase B. The resultant accumulation of dermatan sulphate causes lysosomal damage. The clinical symptoms are related to skeletal dysplasia (i.e. short stature and degenerative joint disease). Other manifestations include cardiac disease, impaired pulmonary function, ophthalmological complications, hepatosplenomegaly, sinusitis, otitis, hearing loss and sleep apnea. Intellectual impairment is generally absent. Clinical manifestation is typically by two or three years of age
- ItemSomente MetadadadosOpioids for restless legs syndrome(Inst Brasileiro Pesquisa & Ensino Fisiologia Exercicio-Ibpefex, 2016) de Oliveira, Cesar Osorio [UNIFESP]; Carvalho, Luciane Bizari Coin [UNIFESP]; Carlos, Karla; Conti, Cristiane Fiquene; de Oliveira, Marcio Moysés; Prado, Lucila Bizari Fernandes.; Prado, Gilmar Fernandes [UNIFESP]Background Restless legs syndrome (RLS) is a distressing and common neurological disorder that may have a huge impact in the quality of life of those with frequent and intense symptoms. Patients complain of unpleasant sensations in the legs, at or before bedtime, and feel an urge to move the legs, which improves with movement, such as walking. Symptoms start with the patient at rest (e.g. sitting or lying down), and follow a circadian pattern, increasing during the evening or at night. Many pharmacological intervention are available for RLS, including drugs used to treat Parkinson's disease (L-Dopa and dopaminergic agonists), epilepsy (anticonvulsants), anxiety (benzodiazepines), and pain (opioids). Dopaminergic drugs are those most frequently used for treatment of RLS, but some patients do not respond effectively and require other medication. Opioids, a class of medications used to treat severe pain, seem to be effective in treating RLS symptoms, and are recommended for patients with severe symptoms, because RLS and pain appear to share the same mechanismin the central nervous system. All available drugs are associated to some degree with side effects, which can impede treatment. Opioids are associated with adverse events such as constipation, tolerance, and dependence. This justifies the conduct of a systematic review to ascertain whether opioids are safe and effective for treatment of RLS. Objectives To asses the effects of opioids compared to placebo treatment for restless legs syndrome in adults. Search methods We searched the Cochrane Central Register of Controlled trials, CENTRAL 2016, issue 4 and MEDLINE, EMBASE, and LILACS up to April 2016, using a search strategy adapted by Cochraneto identify randomised clinical trials. We checked the references of each study and established personal communication with other authors to identify any additional studies. We considered publications in all languages. Selection criteria Randomised controlled clinical trials of opioid treatment in adults with idiopathic RLS. Data collection and analysis Two review authors independently screened articles, independently extracted data into a standard form, and assessed for risk of bias. If necessary, they discussed discrepancies with a third researcher to resolve any doubts. Main results We included one randomised clinical trial (N = 304 randomised
- ItemAcesso aberto (Open Access)Pharmacological treatment for buerger's disease(Wiley, 2016) Cacione, Daniel G. [UNIFESP]; Macedo, Cristiane R. [UNIFESP]; Baptista-Silva, Jose C. C. [UNIFESP]Background Buerger's disease (thromboangiitis obliterans) is a non-atherosclerotic, segmental inflammatory pathology that most commonly affects the small and medium sized arteries, veins, and nerves in the upper and lower extremities. The etiology is unknown, but involves hereditary susceptibility, tobacco exposure, immune and coagulation responses. In many cases, there is no possibility of revascularization to improve the condition. Pharmacological treatment is an option for patients with severe complications, such as ischaemic ulcers or rest pain. Objectives To assess the effectiveness of any pharmacological agent (intravenous or oral) compared with placebo or any other pharmacological agent in patients with Buerger's disease. Search methods The Cochrane Vascular Trials Search Co-ordinator searched their Specialised Register (last searched in April 2015) and the Cochrane Register of Studies (Issue 3, 2015). The review authors searched trial registers and the European grey literature
- ItemAcesso aberto (Open Access)Pharmacological treatment for buerger's disease(Wiley, 2016) Cacione, Daniel G. [UNIFESP]; Baptista-Silva, Jose C. C. [UNIFESP]; Macedo, Cristiane R. [UNIFESP]Background Buerger's disease (thromboangiitis obliterans) is a non-atherosclerotic, segmental inflammatory pathology that most commonly affects the small and medium sized arteries, veins, and nerves in the upper and lower extremities. The etiology is unknown, but involves hereditary susceptibility, tobacco exposure, immune and coagulation responses. Inmany cases, there is no possibility of revascularization to improve the condition. Pharmacological treatment is an option for patients with severe complications, such as ischaemic ulcers or rest pain. Objectives To assess the effectiveness of any pharmacological agent (intravenous or oral) compared with placebo or any other pharmacological agent in patients with Buerger's disease. Search methods The Cochrane Vascular Trials Search Co-ordinator searched their Specialised Register (last searched in April 2015) and the Cochrane Register of Studies (Issue 3, 2015). The review authors searched trial registers and the European grey literature