MATHEUS FREITAS CARDOSO DE AZEVEDO
Índice h a partir de 2011
5
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Long-term effectiveness and safety of ustekinumab in bio-naive and bio-experienced anti-tumor necrosis factor patients with Crohn's disease: a real-world multicenter Brazilian study(2022) PARRA, Rogerio Serafim; CHEBLI, Julio Maria Fonseca; QUEIROZ, Natalia Sousa Freitas; DAMIAO, Aderson Omar Mourao Cintra; AZEVEDO, Matheus Freitas Cardoso de; CHEBLI, Liliana Andrade; BERTGES, Erika Ruback; ALVES JUNIOR, Antonio Jose Tiburcio; AMBROGINI JUNIOR, Orlando; SILVA, Bianca Loyo Pona Schiavetti da; LUBINI, Marcio; BAFUTTO, Mauro; FLORES, Cristina; VILELA, Eduardo Garcia; BORATTO, Sandra Felice; GASPARETTI JUNIOR, Newton Luiz Tricarico; STEINWURZ, Flavio; CARVALHO, Nayara Salgado; FERES, Omar; ROCHA, Jose Joaquim Ribeiro daBackground The effectiveness of ustekinumab (UST) in the treatment of Crohn's disease (CD) has been demonstrated in the pivotal Phase 3 UNITI 1 and 2 and IM-UNITI studies in both anti-TNF-naive and anti-TNF-exposed patients. Given the selective nature of pivotal trial designs, real-world effectiveness and safety studies are warranted. We report our experience with UST treatment in a large, real-world multicenter cohort of Brazilian patients with CD. Methods We performed a retrospective multicenter study including patients with CD, predominantly biologically refractory CD, who received UST. The primary endpoint was the proportion of patients in clinical remission at weeks 8, 24 and 56. Possible predictors of clinical and biological response/remission and safety outcomes were also assessed. Results Overall, 245 CD (mean age 39.9 [15-87]) patients were enrolled. Most patients (86.5%) had been previously exposed to biologics. According to nonresponder imputation analysis, the proportions of patients in clinical remission at weeks 8, 24 and 56 were 41.0% (n = 98/239), 64.0% (n = 153/239) and 39.3% (n = 94/239), respectively. A biological response was achieved in 55.4% of patients at week 8, and 59.3% were in steroid-free remission at the end of follow-up. No significant differences in either clinical or biological remission were noted between bio-naive and bio-experienced patients. Forty-eight patients (19.6%) presented 60 adverse events during the follow-up, of which 8 (13.3%) were considered serious adverse events (3.2% of 245 patients). Overall, a proximal disease location, younger age, perianal involvement, and smoking were associated with lower rates of clinical remission over time. Conclusions UST therapy was effective and safe in the long term in this large real-life cohort of Brazilian patients with refractory CD, regardless of previous exposure to other biological agents.
- An Unusual Presentation of Tuberculosis in a Crohn's Disease Patient Treated With Anti-TNF(2022) BARROS, L. L.; CARLOS, A. de Sousa; AZEVEDO, M. F. C. D.In view of the increase in the therapeutic arsenal available for the treatment of inflammatory bowel disease in recent years, concerns about safety and side effects of immunosuppressive therapies have been increasingly common in clinical practice. The combination of thiopurines and anti-tumor necrosis factor agents exposes patients to greater risks of serious and opportunistic infection such as tuberculosis (TB). Here we report a case of a 38-year-old female with an 8-year history of a fistulizing ileocolonic and perianal Crohn's disease that developed TB on the tongue and disseminated during treatment with adalimumab and azathioprine. TB remains a global public health problem characterized by high morbidity and mortality worldwide. The reported case draws attention to an extremely unusual presentation of TB involving the tongue. TB should be included in the differential diagnosis of oral lesions in patients with inflammatory bowel disease, especially in endemic areas.