logo

English
                 

Medical Monoclonal antibody

2020.10.16 07:28

이병붕*63 Views:525

I would like to share some new(?) information on monoclonal antibody as following;

 

Study Results Suggest Ustekinumab May Trigger Acute CV Events Early in Treatment

Diana Swift

September 18, 2020

 

Initiating treatment with the interleukin-12/23p40–targeting monoclonal antibody ustekinumab may trigger early severe cardiovascular events (SCEs) in susceptible patients, according to a large French case-time-control analysis.

Investigators led by Florence Poizeau, MD, of the department of dermatology at Rennes (France) University Hospital, found high-risk patients had more than four times the risk of an acute SCE in the 6 months after starting treatment. Although ustekinumab (Stelara) effectively treats moderate to severe psoriasispsoriatic arthritis (PsA), and Crohn's disease (indications approved by the Food and Drug Administration), the early months after ustekinumab initiation may be associated with atherosclerotic plaque destabilization via the inhibition of helper T cell subtype 17, the group reported in JAMA Dermatology.

The observational study drew on France's 66 million–registrant health insurance database to identify all patients exposed to ustekinumab between April 1, 2010, and Dec. 31, 2016. Classified by high or low cardiovascular risk level, ustekinumab recipients served as their own controls, being compared during two time windows: the risk period covered the 6 months after initiating treatment and leading up to the SCE, defined as acute coronary syndrome (ACS) or stroke, while a reference period spanned the 6-12 months leading up to the risk period.

In the statistical analysis of 9,290 ustekinumab-exposed patients (mean age 43 years, 52% male), conducted from September 2017 to July 2018, 7,588 (82%) received ustekinumab for psoriasis or PsA, and 724 (8%) for Crohn's disease. (The remaining indications were for psoriasis or PsA and Crohn's disease, or were undetermined.)

Of these patients, 98 experienced SCEs (52 with ACS admitted to the ICU and 46 with strokes). In patients deemed at high cardiovascular risk – those with two risk factors or a personal history of atherosclerotic disease – there was a statistically significant association between starting ustekinumab and SCE occurrence, for an odds ratio of 4.17 (95% confidence interval, 1.19-14.59). In contrast, no such association emerged in ustekinumab users at low cardiovascular risk, for an OR of 0.30 (95% CI, 0.03-3.13). The OR for all was 2.41 (95% CI, 0.83-7.01).

Of the 98 patients included in the final case-time-control analysis, 62 were men (63%), the median age was 57 years, and 76 (78%) were at high cardiovascular risk. A total of 89 patients (91%) had psoriasis, four (4%) had Crohn's disease, and two (2%) had both.

The investigators also did an analysis including these 98 patients plus 13 patients with ACS who were not hospitalized in an ICU, and 68 with unstable angina, for a total of 179. In this group, the ORs for SCE were 1.75 (95% CI, 0.86-3.56) overall, compared with 3.20 (95% CI, 1.29-7.92) among those at high cardiovascular risk and 0.21 (95% CI, 0.02-1.69) among those at low cardiovascular risk.

The Rennes investigators' decision to focus on early SCEs stemmed in part from a meta-analysis of randomized clinical trials that reported a possible excess of early SCEs in adults exposed to anti–IL-12/23p40 antibodies, which at that time included the now-discontinued experimental antibody briakinumab. Briakinumab trials were aborted and the drug was never brought to market, leaving ustekinumab as the only antibody of this type.

 

All the best,

BB Lee

No. Subject Date Author Last Update Views
Notice How to write your comments onto a webpage [2] 2016.07.06 운영자 2016.11.20 17771
Notice How to Upload Pictures in webpages 2016.07.06 운영자 2018.10.19 31855
Notice How to use Rich Text Editor [3] 2016.06.28 운영자 2018.10.19 5498
Notice How to Write a Webpage 2016.06.28 운영자 2020.12.23 43428
663 Cognitive Motor Dissociation (CMD) [1] 2023.10.13 운영자 2023.10.13 93
662 Metformin as a Logevity Drug? [2] 2023.05.06 운영자 2023.05.06 81
661 Medical Tourism to Mexico [2] 2022.12.16 온기철*71 2022.12.17 73
660 Fraud in Alzheimer’s disease research [3] 2022.08.30 온기철*71 2022.09.01 107
659 Postmortem Sperm Retrieval Is Turning Dead Men Into Fathers [1] 2022.07.20 운영자 2022.07.20 294
658 COVID19 Another wave in Summer [2] 2022.06.14 온기철*71 2022.06.18 93
657 흰머리, 탈모를 치료할 수있을까? Recent scientific study. [1] 2022.06.04 운영자 2022.06.05 82
656 COVID19 Pandemic is not over yet! [2] 2022.06.01 온기철*71 2022.06.04 70
655 Abortion by Pills [3] 2022.05.07 운영자 2022.05.08 369
654 Ivermectin does nothing to cure Covid [1] 2022.03.31 운영자 2022.03.31 58
653 Brain damage after Covid infection [2] 2022.03.08 운영자 2022.03.08 70
652 Alcohol consumption is bad, no matter how small it is. [1] 2022.03.04 운영자 2022.03.04 75
651 They might have known the source of Covid-19 was Wuhan Lab [1] 2022.01.29 운영자 2022.01.31 56
650 Can You Trust U.S. Medical Care? [2] 2022.01.29 온기철*71 2022.01.30 273
649 If you think that glass of wine is good for you, it's time to reconsider [1] 2022.01.23 운영자 2022.01.23 69
648 서울대 병원 라오스에 국립대학병원 건설 2022.01.02 온기철*71 2022.01.06 1872
647 Alcohol and Cancer Risk; National Cancer Institute [5] 2021.11.09 온기철*71 2021.11.10 160
646 한국 대학병원은 세계에서? [5] 2021.10.01 온기철*71 2021.10.31 119
645 [Medical]Tylenol Use During Pregnancy, Warned [1] 2021.09.24 이한중*65 2021.09.24 21285
644 Israel is talking about the 4th Covid vaccination Now !! [4] 2021.09.13 운영자 2021.09.13 66