FELIPE MOURA MAIA PINHEIRO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 4 de 4
  • article 1 Citação(ões) na Scopus
  • article 6 Citação(ões) na Scopus
    Association between sitagliptin plus vitamin D3 (VIDPP-4i) use and clinical remission in patients with new-onset type 1 diabetes: a retrospective case-control study
    (2023) PINHEIRO, Marcelo Maia; PINHEIRO, Felipe Moura Maia; ARRUDA, Marcelo Mueller de; BEATO, Geane Moron; VERDE, Graciele Alves Correa Lima; BIANCHINI, Georgiana; CASALENUOVO, Pedro Rosario Moraes; ARGOLO, Aline Aparecida Agostini; SOUZA, Lucilene Telles de; PESSOA, Flavia Gomes; HIROSE, Thiago Santos; SENRA, Eduardo Filgueiras; RICORDI, Camillo; FABBRI, Andrea; INFANTE, Marco; DINIZ, Susana Nogueira
    Objective: The occurrence of partial remission (honeymoon phase) in type 1 diabetes (T1D) has been associated with a reduced risk of chronic microvascular complications of diabetes. We have published case reports showing that a combination therapy with the DPP-4 inhibitor sitagliptin plus vitamin D3 (VIDPP-4i) can prolong the honeymoon phase in patients with new-onset T1D. In the present case-control study, we investigated the frequency of occurrence of clinical remission (CR) in patients with new-onset T1D after VIDPP-4i treatment. Subjects and methods: In this case-control study, we collected data spanning 10 years from medical records of 46 patients (23 females) recently diagnosed with T1D. Overall, 27 participants with CR (insulin dose-adjusted glycated hemoglobin [IDAA1c] = 9) at 12 or 24 months composed the case group, and 19 participants without CR served as the control group. Chi-square with Yates correction was used to analyze the association between VIDPP-4i use and CR, and odds ratio (OR) was used to determine the chance of CR due to VIDPP-4i treatment exposure. Results: In all, 37 patients (80.4%) experienced CR at some time over 24 months. The mean CR duration was 13.15 +/- 9.91 months. Treatment with VIDPP-4i was significantly associated with CR. At 24 months, the OR of CR after VIDPP-4i exposure was 9.0 (95% confidence interval [CI] 2.21-30.18, p = 0.0036). Additionally, 9 (33.6%) and 4 (14.8%) patients in the VIDPP-4i group experienced insulin-free CR at 12 and 24 months, respectively. Conclusion: Therapy with VIDPP-4i was associated with a higher frequency and duration of the honeymoon phase. Randomized controlled trials are needed to confirm these findings.
  • article 0 Citação(ões) na Scopus
    Type 1 diabetes prevention and treatment: Time to think outside the box
    (2023) PINHEIRO, Marcelo Maia; PINHEIRO, Felipe Moura Maia
  • article 3 Citação(ões) na Scopus
    How to manage intolerance to dopamine agonist in patients with prolactinoma
    (2023) STUMPF, Matheo Augusto Morandi; PINHEIRO, Felipe Moura Maia; SILVA, Gilberto Ochman; CESCATO, Valter Angelo Sperling; MUSOLINO, Nina Rosa Castro; CUNHA-NETO, Malebranche Berardo Carneiro; GLEZER, Andrea
    PurposeDopamine agonists (DA) are the gold-standard for prolactinoma and hyperprolactinemia treatment. Intolerance to DA leading to drug drop out occurs in 3 to 12% of cases. We provide here a review of published data about DA intolerance and present a case report concerning the use of intravaginal cabergoline.MethodsWe review the literature on the definition, the pathogenesis, frequency and management of DA intolerance. In addition, the review provides strategies to enhance tolerability and avoid precocious clinical treatment withdrawal.ResultsCabergoline is often cited as the most tolerable DA and its side effects tend to ameliorate within days to weeks. Restarting the same drug at a lower dose or switching to another DA can be used in cases of intolerance. The vaginal route can be tried specifically if there are gastrointestinal side effects in the oral administration. Symptomatic treatment could be attempted, although mainly based on a strategy used in other diseases.ConclusionsDue to limited data, no guidelines have been developed for the management of intolerance in DA treatment. The most frequent management is to perform transsphenoidal surgery. Nevertheless, this manuscript provides data derived from published literature and expert opinion, suggesting new approaches to this clinical issue.