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1.
Turk J Gastroenterol ; 33(5): 414-420, 2022 05.
Article in English | MEDLINE | ID: mdl-35678799

ABSTRACT

BACKGROUND: Hepatitis C is one of the leading causes of death in patients with inherited bleeding disorders. Currently, direct-acting antiviral drugs used for the treatment of hepatitis C have become an effective and a reliable option for people with inherited bleeding disorders. The aim of this study is to report the efficacy and safety of ombitasvir + paritaprevir/ritonavir and dasabuvir combination in the treatment of hepatitis C in patients with inherited bleeding disorders. METHODS: In this retrospective study, we evaluated the efficacy and safety of the combination of ombitasvir + paritaprevir/ritonavir and dasabuvir in 10 adult patients with hemophilia A, 4 patients with hemophilia B, and 1 patient with von Willebrand disease who were infected with hepatitis C genotype 1. RESULTS: Five patients had genotype 1a and 10 patients had genotype 1b chronic hepatitis C. One patient had Child A cirrhosis, 14 patients had chronic hepatitis C without cirrhosis. Hepatitis C virus ribonucleic acid was negative in all patients at week 4 and at the end of the treatment. Sustained virologic response was obtained in all patients. Serious side effects were detected in 3 patients, which were intra- muscular bleeding, erosive gastritis-related gastrointestinal bleeding, and pneumonia. CONCLUSION: Ombitasvir + paritaprevir combined with ritonavir and dasabuvir ± ribavirin is an effective treatment for patients infected with genotype 1 hepatitis C who have coagulation disorders. Tolerance and side effects are similar to other treatment options.


Subject(s)
Hepatitis C, Chronic , Hepatitis C , Macrocyclic Compounds , 2-Naphthylamine , Adult , Anilides/therapeutic use , Antiviral Agents/therapeutic use , Carbamates/therapeutic use , Child , Cyclopropanes , Drug Therapy, Combination , Genotype , Hepacivirus/genetics , Hepatitis C/drug therapy , Humans , Lactams, Macrocyclic , Liver Cirrhosis , Macrocyclic Compounds/therapeutic use , Proline/analogs & derivatives , Retrospective Studies , Ribavirin/therapeutic use , Ritonavir/therapeutic use , Sulfonamides , Uracil/analogs & derivatives , Valine/therapeutic use
2.
Pancreas ; 50(9): 1274-1280, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34860811

ABSTRACT

OBJECTIVE: The aim of the study was to identify the frequency of azathioprine-induced acute pancreatitis (AZA-AP) and related factors. METHODS: Seven hundred eighty-seven inflammatory bowel disease (IBD) patients on AZA therapy were retrospectively analyzed. Azathioprine-induced AP was diagnosed with positive imaging and/or an at least 3-fold increased amylase level, in presence of typical abdominal pain. The AZA-AP group was compared with patients on AZA therapy with no history of pancreatitis and 4 numerical adjacent cases with the same diagnosis were selected (group B). RESULTS: Fifty-four patients developed gastrointestinal symptoms (6.9%); however, only half of them (26 of 54) had pancreatitis, except 1, all within the first 2 months under AZA. When the AZA-AP group was compared with group B, only budesonide usage and active smoking were significantly more common in group A (46.2% vs 25%, P = 0.034, and 77% vs 51%, P = 0.017, respectively). Active smoking was the only independent risk factor for AZA-AP development (odds ratio, 3.208 [95% confidence interval, 1.192-8.632]). CONCLUSIONS: All IBD patients developed AZA-AP nearly all within the first 2 months. Azathioprine intolerance may be a hidden diagnosis in at least half of the patients with AZA-AP symptoms. All smoker IBD patients should be monitored closely for AZA-AP development.


Subject(s)
Abdominal Pain/diagnosis , Azathioprine/therapeutic use , Inflammatory Bowel Diseases/drug therapy , Pancreatitis/diagnosis , Tertiary Care Centers/statistics & numerical data , Abdominal Pain/chemically induced , Acute Disease , Adult , Antimetabolites, Antineoplastic/adverse effects , Antimetabolites, Antineoplastic/therapeutic use , Azathioprine/adverse effects , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Pancreatitis/chemically induced , Regression Analysis , Retrospective Studies , Risk Factors , Time Factors , Young Adult
3.
Turk J Gastroenterol ; 30(7): 599-604, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31290746

ABSTRACT

BACKGROUND/AIMS: The aim of the present study was to compare the demographic features and long-term outcomes of patients with inflammatory bowel disease (IBD) with or without ankylosing spondylitis (AS). MATERIALS AND METHODS: Among 1640 IBD (Crohn's disease and ulcerative colitis), 76 patients with IBD+AS were identified. The study group consisted of 76 patients with IBD with synchronous AS. The control group consisted of patients with only IBD, and those were selected according to their registry sequence number being the previous and next case to the diseased case with IBD+AS. The primary endpoint was to compare the rate of intestinal resections between both groups (IBD vs. IBD+AS). RESULTS: Among 76 patients with IBD+AS, 52 (68%) first presented with IBD, 11 (15%) with AS, and the remaining 13 (17%) had both diagnoses at the same time. The mean follow-up time was significantly longer in patients with IBD+AS (43.4 vs. 27.8 months; p=0.01). Twenty-two percent of patients with IBD and 14% of those with IBD+AS had an intestinal resection (p=NS). Biologic and systemic corticosteroid treatments were significantly more common among patients with IBD+AS (32% vs. 7% for biologics, p<0.0001 and 44% vs. 28% for corticosteroids, p=0.042). Age-sex-adjusted regression analysis for both groups disclosed IBD duration as the only independent predictor for resection (R2=0.178; p=0.016). CONCLUSION: The present study shows that up to 5% of patients with IBD may have AS. Patients with IBD+AS do not have a worse disease outcome than solo patients with IBD.


Subject(s)
Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/therapy , Spondylitis, Ankylosing/complications , Spondylitis, Ankylosing/therapy , Adult , Case-Control Studies , Demography , Female , Humans , Male , Turkey
5.
Pituitary ; 18(4): 554-60, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25301076

ABSTRACT

PURPOSE: We aimed to evaluate the disease activity of medically controlled patients with acromegaly after withdrawal of somatostatin receptor ligands (SRL). METHODS: Sixteen patients who were on a stable dose of SRL for more than 2 years and had at least 1 year of remission were included in the study. Five patients were on 10 mg, four were on 20 mg and three were on 30 mg of octreotide; whereas for lanreotide, one was on 60 mg, two were on 90 mg, and one was on 120 mg. All patients had received SRL with 28-day intervals. Basal GH, IGF1, glucose-suppressed GH levels were measured with 3-month intervals for a total of 12 months after withdrawal. Sella MRI evaluation was obtained at 6-month intervals. If the nadir GH level after glucose suppression was >1 ng/ml or IGF1 was above the normal limits during the follow-up period, SRL was restarted. RESULTS: Three months after stopping SRL, 10 (63%) had biochemical disease recurrence. After 12 months of follow-up, in total 13 (81%) of the patients recurred. The final basal GH levels before withdrawal, basal GH at month-3, and glucose suppressed GH levels were significantly lower in patients with sustained remission (p = 0.003, p < 0.001, and p = 0.001). Basal GH and glucose suppressed GH levels at month-3 were correlated with the basal GH levels at month-0 (r = 0.6, p = 0.008 and r = 0.5, p = 0.03). CONCLUSION: The final GH levels prior to discontinuation of SRL should be taken into consideration in patients with acromegaly in long-term remission. Moreover, the first visit 3 months after withdrawal is critically important for determining the future status of remission.


Subject(s)
Acromegaly/drug therapy , Adenoma/drug therapy , Antineoplastic Agents, Hormonal/therapeutic use , Growth Hormone-Secreting Pituitary Adenoma/drug therapy , Neoplasm Recurrence, Local/metabolism , Octreotide/therapeutic use , Peptides, Cyclic/therapeutic use , Somatostatin/analogs & derivatives , Withholding Treatment , Acromegaly/metabolism , Acromegaly/pathology , Adenoma/metabolism , Adenoma/pathology , Adult , Aged , Female , Glucose Tolerance Test , Growth Hormone-Secreting Pituitary Adenoma/metabolism , Growth Hormone-Secreting Pituitary Adenoma/pathology , Human Growth Hormone/metabolism , Humans , Insulin-Like Growth Factor I/metabolism , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Remission Induction , Somatostatin/therapeutic use , Time Factors
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