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排序方式: 共有118条查询结果,搜索用时 15 毫秒
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Neil K. Jairath Alan Dal Pra Randy Vince Robert T. Dess William C. Jackson Jeffrey J. Tosoian Sean M. McBride Shuang G. Zhao Alejandro Berlin Brandon A. Mahal Amar U. Kishan Robert B. Den Stephen J. Freedland Simpa S. Salami Samuel D. Kaffenberger Alan Pollack Phuoc Tran Rohit Mehra Daniel E. Spratt 《European urology》2021,79(3):374-383
ContextMolecular biomarkers aim to address the established limitations of clinicopathologic factors to accurately risk stratify patients with prostate cancer (PCa). Questions remain as to whether sufficient evidence supports adoption of these biomarkers for clinical use.ObjectiveTo perform a systematic review of the available evidence supporting the clinical utility of the Decipher genomic classifier (GC).Evidence acquisitionThe review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching PubMed and conference abstracts from January 2010 to June 2020. Evidence was then graded using the criteria of Simon et al (Simon RM, Paik S, Hayes DF. Use of archived specimens in evaluation of prognostic and predictive biomarkers. J Natl Cancer Inst 2009;101:1446–52) and American Urology Association (AUA) criteria.Evidence synthesisIn total, 42 studies and 30 407 patients were included. GC performance data were available for localized, postprostatectomy, nonmetastatic castration-resistant, and metastatic hormone-sensitive PCa as part of retrospective studies (n = 12 141), prospective registries (n = 17 053), and prospective and post hoc randomized trial analyses (n = 1213). In 32 studies (n = 12 600), the GC was independently prognostic for all study endpoints (adverse pathology, biochemical failure, metastasis, and cancer-specific and overall survival) on multivariable analysis and improved the discrimination over standard of care in 24 studies (n = 8543). GC use changed the management in active surveillance (number needed to test [NNT] = 9) and postprostatectomy (NNT = 1.5–4) settings in five studies (n = 4331). Evidence strength was levels 1 and 2 by the Simon criteria for all disease states other than high-risk PCa, and grades A and B by AUA criteria depending on disease state.ConclusionsConsistent data are now present from diverse levels of evidence, which when viewed together, have demonstrated clinical utility of the GC in PCa. The utility of the GC is strongest for intermediate-risk PCa and postprostatectomy decision-making.Patient summaryIn this paper, we review the evidence of the Decipher genomic classification tool for men with prostate cancer. We found consistent evidence that the test helps identify which cancers are more or less aggressive, which in turn aids in personalized treatment decision-making. 相似文献
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Marjolijn Duijvestein Robert Battat Niels Vande Casteele Geert R. D’Haens William J. Sandborn Reena Khanna Vipul Jairath Brian G. Feagan 《Current Treatment Options in Gastroenterology》2018,16(1):129-146
Purpose of review
This article reviews current treatment options and strategies and provides an update on the status of drug development programs of new therapeutic agents for inflammatory bowel diseases (IBD).Recent findings
In the past two decades, tumor necrosis factor antagonist therapy has given clinicians better treatment options. However, not all patients respond to induction therapy with these agents, and of those initially responding, up to 40% ultimately lose response due to suboptimal drug exposure (e.g., caused by immunogenicity), side effects, or other poorly characterized mechanisms. Recently, additional therapies, such as vedolizumab, an integrin blocker that prevents T cell trafficking to the gut, and ustekinumab, an antibody blocking the common p40 subunit of interleukin (IL)-12 and 23, were introduced to the market. In addition, other agents including novel anti-trafficking therapies (e.g., anti-β7 and sphingosine-1-phosphate receptor modulators), antibodies against p19 (unique to IL-23), and small molecules including Janus kinase inhibitors are under investigation in phase II and III trials.Furthermore, the management of IBD has evolved from targeting control of symptoms to suppression of mucosal inflammation. This shift in thinking has been accompanied by the early use of highly effective therapy in poor prognosis patients, accelerated treatment escalation and utilization of a treat to target paradigm approach, and adoption of therapeutic drug monitoring.Summary
The treatment landscape for IBD is rapidly evolving with the recent approval of novel biologics as well as several other agents in late phase of clinical development. Moreover, we have started to use agents more intelligently with a focus on risk stratification and early use of highly effective therapy in high-risk patients, treat to target using patient-reported outcomes (PROs), biomarkers, endoscopy, and therapeutic drug monitoring.4.
Hanzel Jurij Almradi Ahmed Istl Alexandra C. Yang Mei Lucy Fleshner Katherine A. Parker Claire E. Guizzetti Leonardo Ma Christopher Singh Siddharth Jairath Vipul 《Digestive diseases and sciences》2022,67(2):646-660
Digestive Diseases and Sciences - Postoperative complication rates in patients with inflammatory bowel disease (IBD) receiving preoperative biologics have been analyzed without considering the... 相似文献
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BACKGROUND:
Discrepancies exist in reported mortality rates of nonvariceal upper gastrointestinal bleeding (NVUGIB).OBJECTIVE:
To perform a systematic review assessing possible reasons for these disparate findings and to more reliably compare them.METHODS:
The MEDLINE, EMBASE and ISI Web of Knowledge databases were searched for studies reporting mortality rates in NVUGIB involving adults and published in English. To ensure robust and contemporary estimates, studies spanning 1996 to January 2011 that included more than 1000 patients were selected.RESULTS:
Eighteen of 3077 studies were selected. Ten studies used administrative databases and the remaining eight used registries. The mortality rates reported in these studies ranged from 1.1% in Japan to 11% in Denmark. There were variations in reported mortality rates among countries and also within countries. Reasons for these disparities included a spectrum of quality in reporting as well as heterogeneous definitions of case ascertainment, differing patient populations with regard to severity of presentation and associated comorbidities, varying durations of follow-up and different health care system-related practices.CONCLUSIONS:
Wide differences in reported NVUGIB mortality rates are attributable to differences in adopted methodologies and populations studied. More uniform standards in reporting are needed; only then can true observed variations enable a better understanding of causes of death and pave the way to improved patient outcomes. 相似文献6.
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Cathy Lu Brandon Baraty Helen Lee Robertson Alexis Filyk Hua Shen Tak Fung Kerri Novak Christopher Ma Remo Panaccione Jean-Paul Achkar Sara El Ouali David Bruining Vipul Jairath Brian Feagan Florian Rieder the Stenosis Therapy Research Consortium 《Alimentary pharmacology & therapeutics》2020,51(12):1233-1246
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Letter: predicting azathioprine‐associated pancreatitis in IBD—phenotype or genotype? Authors' reply 下载免费PDF全文
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