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1. Assessment of the impact of adherence and other predictors during HAART on various CD4 cell responses in resource-limited settings

Author

Abrogoua DP, Kablan BJ, Kamenan BAT, Aulagner G, N'Guessan K, and Zohoré C

Subjects
Medicine (General), R5-920
Abstract

Danho Pascal Abrogoua1,2, Brou Jerome Kablan1, Boua Alexis Thierry Kamenan1,3, Gilles Aulagner4, Konan N'Guessan1, Christian Zohoré11Laboratoire de Pharmacie Clinique, Pharmacologie et Therapeutique – UFR Sciences Pharmaceutiques et Biologiques, 2Laboratoire de Pharmacologie Clinique, CHU de Cocody, 3Service de Pharmacie, CHU de Cocody, Abidjan, Cote d'Ivoire, 4Service Pharmaceutique Hopital Louis Pradel, Lyon, FranceObjective: The aim of this study was to quantify, by modeling, the impact of significant predictors on CD4 cell response during antiretroviral therapy in a resource-limited setting.Methods: Modeling was used to determine which antiretroviral therapy response predictors (baseline CD4 cell count, clinical state, age, and adherence) significantly influence immunological response in terms of CD4 cell gain compared to a reference value at different periods of monitoring.Results: At 6 months, CD4 cell response was significantly influenced by baseline CD4 count alone. The probability of no increase in CD4 cells was 2.6 higher in patients with a baseline CD4 cell count of ≥200/mm3. At 12 months, CD4 cell response was significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was three times higher in patients with a baseline CD4 cell count of ≥200/mm3 and 0.15 times lower with adherent patients. At 18 months, CD4 cell response was also significantly influenced by both baseline CD4 cell count and adherence. The probability of no increase in CD4 cells was 5.1 times higher in patients with a baseline CD4 cell count of ≥200/mm3 and 0.28 times lower with adherent patients. At 24 months, optimal CD4 cell response was significantly influenced by adherence alone. Adherence increased the probability (by 5.8) of an optimal increase in CD4 cells. Age and baseline clinical state had no significant influence on immunological response.Conclusion: The relationship between adherence and CD4 cell response was the most significant compared to that of baseline CD4 cell count. Counseling before initiation of treatment and educational therapy during follow-up must always help to strengthen adherence and optimize the efficiency of antiretroviral therapy in a resource-limited setting.Keywords: antiretroviral therapy, CD4 cells response, adherence, predictors, modeling, Abidjan

Published
2012

34. Management of patients with metastatic colorectal cancer in lebanese hospitals and associated direct cost: A multicentre cohort study [Prise en charge des patients atteints d’un cancer colorectal métastatique dans les hôpitaux libanais et coût direct associé: étude de cohorte multicentrique]

Author

Henaine, A.M., Chahine, G., Massoud, M., Salameh, P., Awada, S., Lahoud, N., Elias, E., Salem, M., Ballout, S., Hartmann, D., Aulagner, G., Armoiry, X., Centre d'Energétique et de Thermique de Lyon (CETHIL), Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Matériaux, ingénierie et science [Villeurbanne] (MATEIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)

Subjects
disease control, cancer patient, very elderly, overall survival, folinic acid, comparative effectiveness, bevacizumab, chemotherapy, Article, multiple cycle treatment, Lebanese, fluorouracil, [SPI.MAT]Engineering Sciences [physics]/Materials, primary tumor, male, cost benefit analysis, cetuximab, metastasis, controlled study, human, gene, health care economics and organizations, irinotecan, progression free survival, capecitabine plus oxaliplatin, metastatic colorectal cancer, capecitabine, adult, clinical effectiveness, oxaliplatin, clinical trial, cohort analysis, major clinical study, aged, tumor growth, multicenter study, female, cytotoxic agent, disease exacerbation, KRAS gene, Kirsten murine sarcoma virus, prospective study
Abstract

cited By 0; International audience; Background: For metastatic colorectal cancer a series of novel therapies has emerged during the last decade but their use in routine clinical practice and their costs are not well documented. Aims: This study evaluated the clinical effectiveness of metastatic colorectal cancer patients in Lebanese oncologic units and estimated the costs. Methods: A prospective cohort study was conducted on metastatic colorectal cancer patients during 2008–2013. The type of medical management, overall survival and total costs from diagnosis to death were described. Cost analysis was performed using tariffs from 2013 in US dollars. Results: One hundred and seventy-nine metastatic patients were selected among which 84.9% had colorectal cancer involvement. The average follow-up from diagnosis until death or the latest news was 34.8 months. Around 49.7% were still alive at last follow-up date. Three lines of treatment accounted for 4.5%, 39.6% and 55.9% with an average duration of 14.5, 11.4 and 14.6 months respectively. A 73.2% of patients benefited from targeted therapy. The median overall survival was 20.8 months. The mean total costs of drugs was 22 256 in patients with standard therapy alone whereas the cost increased to 80 396 after the addition of targeted therapy. The mean global total cost was estimated at 64 805 per patient (min 3703; max 304 086). Conclusions: Targeted therapy associated to standard therapy is highly prevalent in Lebanon in metastatic disease and the associated medical cost substantial. This study is the first to show the clinical effectiveness and costs of targeted therapy in patients with metastatic colorectal cancer. © World Health Organization (WHO) 2019.

Published
2019

46. Abstracts of papers Rational use of drugs: 18th European Symposium on Clinical Pharmacy

Author

Dukes, M. N. G., Elenbaas, Robert M., Tognoni, G., Smith, Dorothy L., Lunde, Inga, Leufkens, H. G. M., Hekster, Y. A., Bakker, A., Ostino, G., Petri, H., Sturmans, F., Banta, H. D., Rutten, F. F. H., Martens, L. L., Noyce, P. R., Merkus, F. W. H. M., de Jong-v.d.Berg, Lolkje, Haaijer-Ruskamp, Flora, Dukes, Graham, Vidgren, B. -M., Vidgren, S., Martini, N., Sala, M. L., Scroccaro, G., Olivencia, P., McLcod, D. C., Coln, W. G., Hartzcma, A. G., Thaver, C. F., Rodriguez-Sasiain, J. M., Sangroniz, B., Mauleon, M. D., Wood, M. A., Martinez, M. J., Leinebø, O., Saugen, J. N., Marini, P., Olivato, R., Alberola, C., Cruz-Martos, E., Cruz, T., Marfagon, N., de Tejada, A. Herreros, Denig, P., Haaijer-Ruskamp, F. M., Wesseling, H., Versluis, A., Gascón, M. P., Horne, Robert, Hough, Jane, Klazinga, N. S., van Everdingen, J. J. -E., van den Broek, P. J., Roberts, D. K., Veitch, G. B. A., Tan K. K. C., Holland D. A., Allwood M. C., Nicholls, A., Astobieta, A., Calvo, R., Rodriquez-Sasiain, J. M., Barriquand, D., Pochon, C., Aulagner, G., Vial, A., Dumarest, C., Maire, P. H., Jelliffe, R. W., Brouwers, J. R. B. J., Cramer, K., Gulyas, J., vd Kam, H. J., Sijtsma, J., Donadio, C., Tramonti, G., Garcea, G., Costagli, M., Lucchetti, A., Giordani, R., Paizis, G., Pierotti, R., Falcone, G., Bianchi, C., Gallastegui C., Farré R., Jiménez I., Mangues M. A., Guasch E., Ginovart G., Sagrera X., Raspall F., Queralto J. M., Kovarik, J. M., Rademaker, C. M. A., Verhoef, J., Silvestri, L., Caputo, M., Andrew, M., Toverud, E. -L., Jimenez I., Castro I., Alvarez E., Altimiras J., van de Leur, J. J. J. P. M., Muller, N. F., Van Turnhout, J. M., Mendizabal, L., Sasiain, J. M. Rodriguez, Morana, G., Ofstad, K. Moss, Timenes, A. -M., Vroom, J. K. F., de Jong-van den Berg, L. T. W., van den Berg, P. B., de Gier, J. J., Ferres J., Recoder O., Sanchez Rio T., Garcia M. P., Julia A., Balet A., Farre R., Manques M. A., Berod, T., Dufay, E., Naveau, C., Combe, M., Sauvageon, A., Hansen, Erik Wind, Christensen, Jens Dencker, Lie-A-Huen, L., Kinqma, J. H., Meijer, D. K. P., Le Meur, F., Isoard, P., Salek, M. S., Finlay, A. Y., Khan, G. K., Luscombe, D. K., Stuurman, A., Boidin, M. P., Wallenius, K., Ojala, R., Kariluoto, A., Ikonen, M., Paes, A. H. P., Blom, A. Th. G., Bakker, A., Wallenius, S., Enlund, H., Vainio, K., Codina, C., Roca, M., Sardà, P., Corominas, N., Massó, J., Ribas, J., Kentra, K., Myllyntausta, M., Saarenpää, M., Airaksinen, M. S. A., Mendarte, L., Rimola, A., Meisters, R., Hekster, Y., Janssen, W., Cox, A., Kempen, R., Aerdts, S. J. A., van Dalen, R., Clasener, H. A. L., Festen, J., Schjphorst, PP, Benraad, HB, van Asten, P., de Wit, R., Muller, N. F., Limbeek, R. J. G., Nagel, H. G. M., Mgyboom, R. H. B., Stricker, B. H. C., van den Berg, B. A. M., Nelen, T. H. A., Tijssen, T. A. G., Wassink, P., Wassink-L'Ortije, M. J. E., Gascón, P., Selva, C., Bassons, T., Pardo, C., Mas, M. P., Saqalés, M., Sánchez, F., Mercade, V., Pujol, R., Agustí, C., Cano, M., Gurrera, T., Gorchs, M., Fabregas, X., Murgui, L. L., Verdaguer, A., Witjes, W. P. J., Vollaard, E. J., Crul, B. J. P., Limpens, C., Ahonen, K., Klaukka, T., Vohlonen, I., Martikainen, J., Goldenberg, Daniel, Brodsky, Andres, Aparici, Ines, Argeri, Cecilia, Goldenberg D., Saidman C., Sevinski L., Allevato N., Mujico B., Ubogui J., Dorfman P., Rodriguez Lupo L., Varela M., Higa J., Fourrier, Annie, Larrouturou, Philippe, Samarran, Claire, Huchet, Jacqueline, Barber, N. D., Party, N., Wilson, P., Eide, Grethe, Horvei, Kari, Kruse-Jensen, Angelika, Wold, Ingrid, Møark, Turid, Barrett, C. W., Tugwell, A. C., Søndergaard, B., Rasmussen, M., Davidsen, F., Hey, H., Kierkeby, L., Riis, L., Korhonen, M., Vidgren, P., Ojanen, T., Vidqren, M., Ferrés J., Sanchez T., Gallastequi C., Julià A., Herings, R. M. C., Stricker, B. H. Ch., Janssen, A. J. H. H., Dinter, Heike, Janssen, A. J. H. M., Barbaut, X., Proust, S., Amlagner, G., Eskens, F. A. L. M., Clasener, H. A. L., Vollaard, E. J., Arnoldussen, E., Sieradzki, E., Wanat-Słupska, E., Zlółkowska, M., Pankowska, I., Mazur, R., Ksiazkiewicz, B., Jankowski, A., Marzec, A., Marzec, C., Marzec, M. O., Marzec, J. P., Marzec, A., Mungall, D. R., Portnoy, Lynne, Lucas, F., Kadir, F., Pijpers, A., Vulto, A., Zuidema, J., Tan, K. K. C., Sutton, P., Samu, Antal, Murphy, John E., Chapman, Ronnie, Wieringa, Nicolien, de Gier, J. J., Rolloos, J., Voesten, M. T. P. J., de Meijer, P. J. J., de Koning, G. H. P., Salek, S., Reerink, E., Mungall, D. R., Farrow, L., Raskob G., Rosenbloom D., Hull R., Ferres J., Torras A., Farre R., Recorder O., Garcia M. P., Torras C., Cubellsl J., Font, M., Madridejos, R., Catalán, A., Huguet, M., Franquesa, N., Gratacós, J., Martinez, M., Saltó, A., van der Kleijn, E., ter Wee, R. J. M., Holmberg, N., and Brenninkmeijer, R. F.

Published
1989
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50. Management of glioblastoma: comparison of clinical practices and cost-effectiveness in two cohorts of patients (2008 versus 2004) diagnosed in a French university hospital

Author

Diebold, G., primary, Ducray, F., additional, Henaine, A.-M., additional, Frappaz, D., additional, Guyotat, J., additional, Cartalat-Carel, S., additional, Breant, V., additional, Fouquet, A., additional, Aulagner, G., additional, Honnorat, J., additional, and Armoiry, X., additional

Published
2014
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