NICOLE ANDRESSA GOMES FONTOURA
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
conferenceObject Yellow Fever Vaccination in Brazil: Short-Term Safety in Pediatric Autoimmune Rheumatic Diseases(2018) AIKAWA, Nadia E.; BALBI, Verena A.; TONACIO, Adriana C.; SALLUM, Adriana M. E.; CAMPOS, Lucia M. A.; KOZU, Katia T.; VENDRAMINI, Margarete B.; FONTOURA, Nicole; SARTORI, Ana M. C.; ANTONANGELO, Leila; SILVA, Clovis A.; BONFA, Eloisa- Anti-adalimumab antibodies kinetics: an early guide for juvenile idiopathic arthritis (JIA) switching(2020) BRUNELLI, Juliana Barbosa; SILVA, Clovis Almeida; PASOTO, Sandra Gofinet; SAA, Carla Goncalves Schahin; KOZU, Katia Tomie; GOLDENSTEIN-SCHAINBERG, Claudia; LEON, Elaine Pires; VENDRAMINI, Margarete B. G.; FONTOURA, Nicole; BONFA, Eloisa; AIKAWA, Nadia EmiObjective To assess the longitudinal production of anti-adalimumab antibody (AAA) and baseline risk factors for this antibody development in juvenile idiopathic arthritis (JIA) patients initiating adalimumab (ADA). Method Thirty consecutive JIA patients under ADA therapy were prospectively followed. JIA clinical/laboratorial/treatment data and sera for ADA and AAA assays (ELISA and bridging ELISA) were obtained at baseline (BL), 2 months (2M), 3 months (3M), 6 months (6M), 12 months (12M), and 24 months (24M). Patients with therapy failure requiring ADA withdrawn had their sera evaluated at their last medical visit prior to biologic switch (blinded to ADA and AAA levels). Results AAA was absent at BL, first detected at 2M after ADA initiation in 2/30 (7%) patients with a significant increase at 3M (10/29 (34%), p = 0.013) and no major change in 6M (11/30 (37%)) and 12M (9/26 (35%)). Of note, at 3M, AAA levels correlated negatively with ADA levels (r = - 0.781, p = 0.0001). Analysis of BL predictors revealed a significantly higher risk of developing AAA in patients with female gender (OR 21; 95% CI 1.08-406.57; p = 0.044), ESR > 30 mm/1st hour (OR 5.44; 95% CI 1.04-28.53; p = 0.045), and leflunomide use (OR 9.33; 95% CI 1.51-57.66; p = 0.016). In contrast, concomitant use of methotrexate was protective for AAA appearance (OR 0.08; 95% CI 0.01-0.53; p = 0.009). After 12M of ADA, 60% of AAA-positive patients required drug switch for drug failure compared with 15% in AAA-negative group (p = 0.03). Conclusions This study provides novel evidence of AAA production kinetics demonstrating a timely significant increase starting at 3M and stable throughout 24M. We also identified female gender, increased ESR, and leflunomide use as relevant risk factors for AAA production at BL, whereas methotrexate was protective. Early systematic monitoring of AAA at 3M may, therefore, guide drug switching in these patients.
conferenceObject Prospective Evaluation of American Academy of Ophthalmology Low Dose Hydroxychloroquine Recommendation in Stable Lupus Nephritis with High-Risk Retinopathy: Lipid Profile and Flare Rates(2019) PEDROSA, Tatiana; PASOTO, Sandra G.; YUKI, Emily; AIKAWA, Nadia; BORBA, Eduardo; FERREIRA FILHO, Julio; CARRICONDO, Pedro; ZANETTI, Caio; CONDE, Paola; FONTOURA, Nicole; ROMANO, Paschoalina; CARVALHO, Valdemir; SILVA, Clovis; BONFA, Eloisa- UHPLC-MS/MS Method for Determination of Hydroxychloroquine and Its Main Metabolites in Oral Fluid and Whole Blood for Therapeutic Drug Monitoring(2021) DUARTE, Nilo J. C.; KUPA, Leonard V. K.; FERREIRA-FILHO, Julio C. R.; FONTOURA, Nicole; CHALOM, Marc Y.; ROMANO, Paschoalina; EBNER, Persio A. R.; SILVA, Clovis A. A.; CARVALHO, Valdemir M.; BONFA, EloisaBackground: Hydroxychloroquine (HCQ) blood levels are used to monitor efficacy, safety, and patient adherence during treatment. Oral fluid has emerged as an alternative noninvasive, easily accessible, and low-complexity matrix for drug monitoring. However, there is no analytical method to measure HCQ in oral fluid. Therefore, we developed and validated an ultra-high-performance liquid chromatography-tandem mass (UHPLC-MS/MS) method for the measurement of HCQ and its main metabolites in oral fluid and compared to whole blood. Methods: Ten microliters of matrices were used for sample preparation by protein precipitation with acetonitrile followed by online solid phase extraction. The validation process included assessment of lower limit of quantification, linearity, precision, recovery, matrix effect, interferences assessment, carryover, and sample dilution validation. Results: The lower limit of quantification was 50 ng/mL for HCQ and metabolites in both oral fluid and whole blood. The calibration curve was linear from 50 to 2000 ng/mL (r(2) = 0.999). The coefficient of variation for precision assay was 1.2% to 9.7% for intraday and 1.1% to 14.2% for interday for both HCQ and metabolites in oral fluid and whole blood samples at 150, 750, and 1250 ng/mL. The recovery was 85.3% to 118.5% for 150, 750, and 1250 ng/mL of HCQ and metabolites in both oral fluid and whole blood. Dilution factor up to 5-fold was validated for concentrations higher than the upper limit of quantification. Conclusions: The validated method is specific, precise, and accurate to determine the analytical range for therapeutic monitoring of HCQ and its main metabolites in oral fluid and blood.
- Understanding the dynamics of hydroxychloroquine blood levels in lupus nephritis(2020) PEDROSA, Tatiana N.; PASOTO, Sandra G.; AIKAWA, Nadia E.; YUKI, Emily F. N.; BORBA, Eduardo F.; FERREIRA FILHO, Julio C. R.; CARRICONDO, Pedro C.; ZANETTI, Caio B.; CONDE, Paola G.; DUARTE, Nilo J. C.; FONTOURA, Nicole; ROMANO, Paschoalina; CARVALHO, Valdemir M.; SILVA, Clovis A.; BONFA, EloisaObjectives It is unknown if hydroxychloroquine blood level dynamics impact flare rates in lupus nephritis patients. We prospectively evaluated hydroxychloroquine levels to determine which blood-based patterns are more associated with disease activity. Methods In total, 82 lupus nephritis patients under a prescribed hydroxychloroquine dose of 4-5.5 mg/kg actual body weight (maximum 400 mg/day) for >= 3 months were evaluated at baseline and 7 months. Hydroxychloroquine blood levels were determined by liquid chromatography-tandem mass spectrometry. Flare was defined as increase >= 3 in the Systemic Lupus Erythematosus Disease Activity Index 2000 score and/or a change or increase in therapy. Results Overall, 9/82(11%) patients had flares during follow-up and had lower baseline hydroxychloroquine blood levels than those without flares (220.4 (53.5-1471.1) vs. 1006.3 (53.5-2137.8) ng/ml, p = 0.013). The hydroxychloroquine blood level cut-off that best predicted flares was 613.5 ng/ml (odds ratio = 8.67, 95% confidence interval: 1.66-45.18, p = 0.006). For 77 (94%) patients, the 7-month hydroxychloroquine level dynamics was evaluated and revealed: 59/77 (77%) had a persistent pattern of adequate (41/77(53%)) or fluctuating (18/77 (23%)) levels, with a low and comparable risk of flares (2/41 (5%) vs. 1/18 (5%), p = 1.000). The remaining group had persistent low levels (18/77 (23%)) and their flare frequency was significantly higher than the adequate group (5/18 (28%) vs. 2/41 (5%), p = 0.023). The frequencies of adequate/inadequate hydroxychloroquine blood levels in patients were comparable at baseline and 7 months (McNemar's test, p = 0.480). Conclusion We provide novel evidence that hydroxychloroquine blood-level patterns (persistently low, adequate, or intermittent) have distinct impacts on flare rates in lupus nephritis patients. These findings reinforce the need of routine hydroxychloroquine measurements to maintain the appropriate blood levels.
conferenceObject Anti-Adalimumab Antibodies Kinetics: An Early Guide for Juvenile Idiopathic Arthritis (JIA) Switching(2018) BRUNELLI, Juliana; SILVA, Clovis A.; PASOTO, Sandra G.; SAAD, Carla G. S.; KOZU, Katia T.; LEON, Elaine P.; VENDRAMINI, Margarete B.; FONTOURA, Nicole; BONFA, Eloisa; AIKAWA, Nadia E.