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Real-life omalizumab exposure and discontinuation in a large nationwide population-based study of paediatric and adult asthma patients. 一项针对儿科和成人哮喘患者的全国性大型人群研究中的奥马珠单抗实际暴露和停药情况。
Pub Date : 2022-11-10 Print Date: 2022-11-01 DOI: 10.1183/13993003.03130-2021
Marc Humbert, Arnaud Bourdin, Camille Taillé, Driss Kamar, Céline Thonnelier, Audrey Lajoinie, Alexandre Rigault, Antoine Deschildre, Mathieu Molimard

Background: This real-life study aimed to assess omalizumab treatment patterns in adult and paediatric asthma patients, and to describe asthma control and healthcare resource use (HCRU) at omalizumab initiation and discontinuation.

Methods: The French healthcare database system (Système National des Données de Santé (SNDS)) was used to identify asthma patients aged ≥6 years who initiated omalizumab for at least 16 weeks from 2009 to 2019. We examined omalizumab treatment patterns using dispensation records.

Results: We identified 16 750 adults and 2453 children initiating omalizumab. Median treatment persistence before discontinuation (TSTOP) was 51.2 (95% CI 49.3-53.4) months in adults and 53.7 (95% CI 50.6-56.4) months in children. At 2 years of omalizumab exposure, rate of hospitalisation for asthma decreased by 75% and use of oral corticosteroids (OCS) by 30%, in adults and children. Among adults who discontinued omalizumab while asthma was controlled, 70%, 39% and 24% remained controlled and did not resume omalizumab at 1, 2 and 3 years after discontinuation, respectively. These proportions were higher in children (76%, 44% and 33%, respectively). Over 2 years of follow-up after discontinuation, HCRU remained stable in adults and children, notably rate of hospitalisations for asthma (none before TSTOP, 1.3% and 0.6% at 2 years) and use of OCS (in adults and children, respectively: 20.0% and 20.2% before TSTOP, 33.3% and 24.6% at 2 years).

Conclusion: This is the first large-scale study describing omalizumab real-life exposure patterns in adult and paediatric asthma patients in France with >10 years of follow-up. We showed the long-term maintenance of low HCRU in adults and children who discontinued omalizumab while asthma was controlled, notably for OCS use and hospitalisations for asthma.

研究背景这项真实研究旨在评估成人和儿童哮喘患者的奥马珠单抗治疗模式,并描述奥马珠单抗启动和停药时的哮喘控制情况和医疗资源使用情况(HCRU):利用法国医疗保健数据库系统(SNDS)来识别2009年至2019年期间年龄≥6岁、开始使用奥马珠单抗至少16周的哮喘患者。我们利用配药记录研究了奥马珠单抗的治疗模式:我们确定了16 750名成人和2453名儿童开始使用奥马珠单抗。成人停药前的中位治疗持续时间(TSTOP)为 51.2 个月(95% CI 49.3-53.4),儿童为 53.7 个月(95% CI 50.6-56.4)。在接触奥马珠单抗2年后,成人和儿童因哮喘住院的比例下降了75%,口服皮质类固醇(OCS)的使用率下降了30%。在哮喘得到控制而停用奥马珠单抗的成人中,分别有70%、39%和24%的人在停药1年、2年和3年后哮喘仍然得到控制,并且没有重新使用奥马珠单抗。儿童的这一比例更高(分别为 76%、44% 和 33%)。在停药后的 2 年随访中,成人和儿童的 HCRU 保持稳定,尤其是哮喘住院率(TSTOP 前为零,2 年后分别为 1.3% 和 0.6%)和 OCS 使用率(成人和儿童分别为:TSTOP 前为 20.0% 和 20.2%,2 年后分别为 33.3% 和 24.6%):这是首次对法国成人和儿童哮喘患者的奥马珠单抗实际暴露模式进行的大规模研究,随访时间超过 10 年。我们的研究表明,在哮喘得到控制的情况下停用奥马珠单抗的成人和儿童中,HCRU长期维持在较低水平,特别是在使用OCS和因哮喘住院方面。
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引用次数: 0
Response to Letter to the Editor. 回应致编辑的信。
IF 1.6 Pub Date : 2022-09-01 Epub Date: 2022-05-06 DOI: 10.1177/00099228221094544
Kelli Baldwin, Sara Karjoo, Melissa Crenshaw
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引用次数: 0
What Is Monkeypox? 什么是猴痘?
IF 29 Pub Date : 2022-07-12 DOI: 10.1001/jama.2022.10259
Kristin Walter, Preeti N Malani
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引用次数: 32
Management of Primary Angle-Closure Glaucoma. 原发性闭角型青光眼的管理。
IF 4.4 Pub Date : 2016-01-01 DOI: 10.1097/APO.0000000000000180
Jimmy Lai, Bonnie N K Choy, Jennifer W H Shum

Primary angle-closure glaucoma (PACG) is a progressive optic nerve degeneration and is defined as a glaucomatous optic neuropathy with associated characteristic enlargement of optic disc cupping and visual field loss that is secondary to ocular hypertension caused by closure of the drainage angle. Angle closure is caused by appositional approximation or adhesion between the iris and the trabecular meshwork. The main treatment strategy for PACG lies in the reduction of intraocular pressure, reopening of the closed angle, and possible prevention of further angle closure. There is no universally agreed best surgical treatment for PACG. Trabeculectomy, goniosynechialysis (GSL), glaucoma implant, and cyclodestructive procedures are effective surgical options. Each of them plays an important role in the management of PACG with its own pros and cons. Accumulating evidence is available to show the effectiveness of visually significant and visually nonsignificant cataract extraction in the treatment of PACG. Trabeculectomy and GSL are often combined with cataract extraction, which may offer additional pressure control benefits to patients with PACG. This review article will discuss laser peripheral iridotomy, argon laser peripheral iridoplasty, and surgeries such as GSL, phacoemulsification, and phaco plus glaucoma surgeries that lower intraocular pressure and also alter the anterior segment and/or drainage angle anatomy. Currently, glaucoma implants and cyclodestruction are mainly reserved for PACG patients who have failed previous filtering operations. Their role as initial surgical treatment for PACG will not be discussed.

原发性闭角型青光眼(PACG)是一种进行性视神经变性,定义为青光眼性视神经病变,伴有特征性的视盘杯状扩大和视野缺损,继发于排水角关闭引起的眼压升高。房角关闭是由虹膜和小梁网膜之间的贴近或粘连引起的。PACG 的主要治疗策略是降低眼压、重新打开闭合的角,并尽可能防止进一步的角关闭。目前还没有公认的治疗 PACG 的最佳手术方法。小梁切除术、巩膜切开术(GSL)、青光眼植入术和环形破坏性手术都是有效的手术方案。它们在 PACG 的治疗中都发挥着重要作用,各有利弊。目前已有越来越多的证据表明,视力明显和视力不明显的白内障摘除术在治疗 PACG 方面效果显著。小梁切除术和 GSL 通常与白内障摘除术相结合,这可能会为 PACG 患者带来额外的压力控制益处。这篇综述文章将讨论激光周边虹膜切开术、氩激光周边虹膜成形术以及 GSL、超声乳化术和超声乳化加青光眼手术等手术,这些手术在降低眼压的同时还能改变前段和/或排水角的解剖结构。目前,青光眼植入手术和环形切削术主要用于先前滤过手术失败的 PACG 患者。我们将不讨论它们作为 PACG 初始手术治疗的作用。
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引用次数: 0
Interface Reactions Between Sealing Glass and Metal Interconnect Under Static and Dynamic Heat Treatment Conditions 静态和动态热处理条件下密封玻璃与金属互连的界面反应
Pub Date : 2015-12-01 DOI: 10.1115/1.4032337
Lianwei Peng, Qingshan Zhu, Z. Xie, Ping Wang
Chemical compatibility of sealing glass with metal interconnects is a critical issue for planar solid oxide fuel cell (SOFC). In this paper, interface reactions between a sealing glass and a ferritic metal interconnect (SS410) are tested under three different heat treatment conditions: sealing (static), aging (static), and thermal cycling (dynamic). The results show that the BaCrO4 crystals with two different morphology (round-shaped and needle-shaped) form both at the three-phase boundary (where air, glass, and SS410 meet) and on the surface of the sealing glass under the three conditions. Round-shaped BaCrO4 crystals form with low O-2 concentration and short reaction time. Needle-shaped BaCrO4 crystals form with high O-2 concentration and long reaction time. For the thermal cycling condition, the BaCrO4 formed at early stages causes the delamination of the sealing interface. Then, O-2 diffuses into the interior interface along the delamination path, which results in the formation of BaCrO4 at the interior interface. The delaminationenhanced BaCrO4 formation during thermal cycling will lead to crack along the sealing interface, causing the striking increase of leak rates.
密封玻璃与金属连接件的化学相容性是平面固体氧化物燃料电池(SOFC)的关键问题。本文测试了密封玻璃与铁素体金属互连(SS410)在三种不同热处理条件下的界面反应:密封(静态)、老化(静态)和热循环(动态)。结果表明,在三种条件下,在三相边界(空气、玻璃和SS410相遇处)和密封玻璃表面均形成了两种不同形态的BaCrO4晶体(圆形和针状)。在较低的o2浓度和较短的反应时间内形成圆形的BaCrO4晶体。反应时间长,O-2浓度高,形成针状BaCrO4晶体。在热循环条件下,早期形成的BaCrO4会导致密封界面分层。然后,O-2沿脱层路径扩散到内部界面,导致内部界面形成BaCrO4。热循环过程中分层增强的BaCrO4形成将导致沿密封界面产生裂缝,导致泄漏率显著增加。
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引用次数: 8
Mechanistic Three-Dimensional Analytical Solutions for a Direct Liquid Fuel Cell Stack 直接液体燃料电池堆的力学三维解析解
Pub Date : 2015-12-01 DOI: 10.1115/1.4031958
C. Ling, Ming Han, Yunzhong Chen, E. Birgersson
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引用次数: 2
Depositing Catalyst Layers in Polymer Electrolyte Membrane Fuel Cells: A Review 聚合物电解质膜燃料电池催化剂层沉积研究进展
Pub Date : 2015-12-01 DOI: 10.1115/1.4031961
A. Strong, Courtney Thornberry, S. Beattie, Rongrong Chen, S. Coles
Fuel cell technology continues to advance and offers to be a potentially promising solution to many energy needs. Of particular interest are manufacturing techniques to improve performance and decrease overall cost. For catalyst deposition on the membrane electrode assembly (MEA), there are a number of techniques that have been used in the past decades. This paper aims to review many of these main techniques that have been published to show the wide variety of catalyst deposition methods.
燃料电池技术不断发展,为许多能源需求提供了一个潜在的有前途的解决方案。特别感兴趣的是提高性能和降低总体成本的制造技术。对于膜电极组件(MEA)上的催化剂沉积,在过去的几十年中已经使用了许多技术。本文的目的是回顾许多这些主要的技术,已经发表,以显示各种各样的催化剂沉积方法。
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引用次数: 34
Hybrid Direct Carbon Fuel Cell Performance With Anode Current Collector Material 阳极集流材料的混合直接碳燃料电池性能
Pub Date : 2015-12-01 DOI: 10.1115/1.4032260
L. Deleebeeck, K. Hansen
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引用次数: 3
Modeling and Temperature Analysis of the Nexa 1.2 kW Fuel Cell System Nexa 1.2 kW燃料电池系统建模及温度分析
Pub Date : 2015-12-01 DOI: 10.1115/1.4032061
Reem Salim, H. Noura, Mahmoud Nabag, A. Fardoun
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引用次数: 7
Development and Validation of a Uniaxial Nonlinear Viscoelastic Viscoplastic Stress Model for a Fuel Cell Membrane 燃料电池膜单轴非线性粘弹性粘塑性应力模型的建立与验证
Pub Date : 2015-12-01 DOI: 10.1115/1.4032491
J. A. May, M. Ellis, D. Dillard, S. Case, R. Moore, Yonqiang Li, Y. Lai, Craig A. Gittleman
Proton exchange membranes (PEMs) in operating fuel cells are subjected to varying thermal and hygral loads while under mechanical constraint imposed within the compressed stack. Swelling during hygrothermal cycles can result in residual in-plane tensile stresses in the membrane and lead to mechanical degradation or failure through thinning or pinhole development. Numerical models can predict the stresses resulting from applied loads based on material characteristics, thus aiding in the development of more durable membrane materials. In this work, a nonlinear viscoelastic stress model based on the Schapery constitutive formulation is used with a viscoplastic term to describe the response of a novel membrane material comprised of a blend of perfluorocyclobutane (PFCB) ionomer and poly(vinylidene fluoride) (PVDF). Uniaxial creep and recovery experiments characterize the time-dependent linear viscoelastic compliance and the fitting parameters for the nonlinear viscoelastic viscoplastic model. The stress model is implemented in a commercial finite element code, abaqus®, to predict the response of a membrane subjected to mechanical loads. The stress model is validated by comparing model predictions to the experimental responses of membranes subjected to multiple-step creep, stress relaxation, and force ramp loads in uniaxial tension.
运行中的燃料电池中的质子交换膜(PEMs)承受着不同的热载荷和湿载荷,同时还受到压缩堆内施加的机械约束。在湿热循环过程中的膨胀会导致膜中残留的平面内拉伸应力,并通过变薄或针孔发展导致机械退化或失效。数值模型可以根据材料特性预测由施加载荷产生的应力,从而有助于开发更耐用的膜材料。在这项工作中,基于Schapery本构公式的非线性粘弹性应力模型与粘塑性术语一起用于描述由全氟环丁烷(PFCB)离聚体和聚偏氟乙烯(PVDF)组成的新型膜材料的响应。单轴蠕变和恢复试验表征了随时间变化的线性粘弹性柔度和非线性粘弹性粘塑性模型的拟合参数。应力模型在商业有限元代码abaqus®中实现,以预测膜在机械载荷下的响应。通过将模型预测与膜在单轴拉伸下经受多步蠕变、应力松弛和力斜坡载荷的实验响应进行比较,验证了应力模型的有效性。
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引用次数: 3
期刊
Journal of Fuel Cell Science and Technology
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