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Loss of humoral response 3 months after SARS-CoV-2 vaccination in the CKD spectrum: the multicentric SENCOVAC study

Quiroga, Borja ; Soler, María José ; Ortiz, Alberto ; [et al.]

Oxford University Press (OUP) ; 2022

In: Nephrology Dialysis Transplantation Vol. 37, No. 5 ( 2022-04-25), p. 994-999

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In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 37, No. 5 ( 2022-04-25), p. 994-999

Type of Medium: Online Resource

ISSN: 0931-0509 , 1460-2385

URL: Article

DOI: 10.1093/ndt/gfac007

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2022

detail.hit.zdb_id: 1465709-0

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Humoral response after the fourth dose of the SARS-CoV-2 vaccine in the CKD spectrum: a prespecified analysis of the SENCOVAC study

Quiroga, Borja ; Soler, María José ; Ortiz, Alberto ; [et al.]

Oxford University Press (OUP) ; 2023

In: Nephrology Dialysis Transplantation Vol. 38, No. 4 ( 2023-03-31), p. 969-981

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In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. 4 ( 2023-03-31), p. 969-981

Abstract: There is scarce evidence on the fourth dose of severe acute respiratory syndrome coronavirus 2 vaccines in chronic kidney disease (CKD) patients. We evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), haemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. Methods This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analysed factors associated with persistent negative humoral response and higher anti-Spike antibody titres as well as the efficacy of vaccination on coronavirus disease 2019 (COVID-19) severity. Results Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titres in HD (P = .001) and ND-CKD (P = .014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titres at 12 months were independently associated with repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titres and not being a KT recipient. Breakthrough COVID-19 was registered in 137 (6%) patients, 5% of whom required admission. Admitted patients had prior titres & lt;620 UI/ml and median values were lower (P = .020) than in non-admitted patients. Conclusions A fourth vaccine dose increased anti-Spike antibody titres or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titres or KT recipients) derived the least benefit in terms of antibody titres. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titres.

Type of Medium: Online Resource

ISSN: 0931-0509 , 1460-2385

URL: Article

DOI: 10.1093/ndt/gfac307

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2023

detail.hit.zdb_id: 1465709-0

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3

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Postoperative anaemia increases unplanned readmission: an international prospective cohort study of patients undergoing major abdominal surgery

Macpherson, Kenneth J ; Motos, Ane Abad ; Mosca, Vinicio ; [et al.]

Oxford University Press (OUP) ; 2024

In: British Journal of Surgery Vol. 111, No. 7 ( 2024-07-02)

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In: British Journal of Surgery, Oxford University Press (OUP), Vol. 111, No. 7 ( 2024-07-02)

Type of Medium: Online Resource

ISSN: 0007-1323 , 1365-2168

URL: Article

DOI: 10.1093/bjs/znae158

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2024

detail.hit.zdb_id: 2006309-X

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A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial

Zampieri, Fernando G. ; da Costa, Bruno R. ; Vaara, Suvi T. ; [et al.]

Springer Science and Business Media LLC ; 2022

In: Critical Care Vol. 26, No. 1 ( 2022-08-25)

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In: Critical Care, Springer Science and Business Media LLC, Vol. 26, No. 1 ( 2022-08-25)

Abstract: Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%] , − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66. Conclusions In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation.

Type of Medium: Online Resource

ISSN: 1364-8535

URL: Article

DOI: 10.1186/s13054-022-04120-y

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 2051256-9

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The Effect of an Accelerated Renal Replacement Therapy Initiation Is Not Modified by Baseline Risk

Angriman, Federico ; Ferreyro, Bruno L. ; Angeloni, Natalia ; [et al.]

American Thoracic Society ; 2022

In: Annals of the American Thoracic Society Vol. 19, No. 9 ( 2022-09), p. 1613-1618

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In: Annals of the American Thoracic Society, American Thoracic Society, Vol. 19, No. 9 ( 2022-09), p. 1613-1618

Type of Medium: Online Resource

ISSN: 2329-6933 , 2325-6621

URL: Article

DOI: 10.1513/AnnalsATS.202201-046RL

Language: English

Publisher: American Thoracic Society

Publication Date: 2022

detail.hit.zdb_id: 2702474-X

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Access to and quality of elective care: a prospective cohort study using hernia surgery as a tracer condition in 83 countries

Dönmez, A Eylül ; Goswami, Aakansha Giri ; Raheja, Aashna ; [et al.]

Elsevier BV ; 2024

In: The Lancet Global Health Vol. 12, No. 7 ( 2024-07), p. e1094-e1103

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In: The Lancet Global Health, Elsevier BV, Vol. 12, No. 7 ( 2024-07), p. e1094-e1103

Type of Medium: Online Resource

ISSN: 2214-109X

URL: Article

DOI: 10.1016/S2214-109X(24)00142-6

Language: English

Publisher: Elsevier BV

Publication Date: 2024

detail.hit.zdb_id: 2723488-5

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Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Quiroga, Borja ; Soler, María José ; Ortiz, Alberto ; [et al.]

Oxford University Press (OUP) ; 2022

In: Clinical Kidney Journal Vol. 15, No. 10 ( 2022-09-22), p. 1856-1864

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In: Clinical Kidney Journal, Oxford University Press (OUP), Vol. 15, No. 10 ( 2022-09-22), p. 1856-1864

Abstract: Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results A total of 711 patients [67% male, median age (range) 67 (20–89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P = .001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P = .693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P = .001), lower time from booster (P = .043) and past breakthrough SARS-CoV-2 infection (P & lt; .001). Conclusions In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infection.

Type of Medium: Online Resource

ISSN: 2048-8505 , 2048-8513

URL: Article

DOI: 10.1093/ckj/sfac169

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2022

detail.hit.zdb_id: 2656786-6

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Cost-Utility Comparison of Bevacizumab and Aflibercept in the Treatment of Central or Hemiretinal Vein Occlusion in the SCORE2 Trial

Kymes, Steven M. ; Oden, Neal L. ; VanVeldhuisen, Paul C. ; [et al.]

American Medical Association (AMA) ; 2023

In: JAMA Ophthalmology Vol. 141, No. 6 ( 2023-06-01), p. 554-

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In: JAMA Ophthalmology, American Medical Association (AMA), Vol. 141, No. 6 ( 2023-06-01), p. 554-

Abstract: Retinal vein occlusion is the second most common retinal vascular disease. Bevacizumab was demonstrated in the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2) to be noninferior to aflibercept with respect to visual acuity in study participants with macular edema due to central retinal vein occlusion (CRVO) or hemiretinal vein occlusion (HRVO) following 6 months of therapy. In this study, the cost-utility of bevacizumab vs aflibercept for treatment of CRVO is evaluated. Objective To investigate the relative cost-effectiveness of bevacizumab vs aflibercept for treatment of macular edema associated with CRVO or HRVO. Design, Setting, and Participants This economic evaluation study used a microsimulation cohort of patients with clinical and demographic characteristics similar to those of SCORE2 participants and a Markov process. Parameters were estimated and validated using a split-sample approach of the SCORE2 population. The simulated cohort included 5000 patients who were evaluated 100 times, each with a different set of characteristics randomly selected based on the SCORE2 trial. SCORE2 data were collected from September 2014 October 2019, and data were analyzed from October 2019 to July 2021. Interventions Bevacizumab (followed by aflibercept among patients with a protocol-defined poor or marginal response to bevacizumab at month 6) vs aflibercept (followed by a dexamethasone implant among patients with a protocol-defined poor or marginal response to aflibercept at month 6). Main Outcomes and Measures Incremental cost-utility ratio. Results The simulation demonstrated that patients treated with aflibercept will have an expected cost $18 127 greater than those treated with bevacizumab in the year following initiation. When coupled with the lack of clinical superiority over bevacizumab (ie, patients treated with bevacizumab had a gain over aflibercept in visual acuity letter score of 4 in the treated eye and 2 in the fellow eye), these results demonstrate that first-line treatment with bevacizumab dominated aflibercept in the simulated cohort of SCORE2 participants. At current price levels, aflibercept would be considered the preferred cost-effective option only if treatment restored the patient to nearly perfect health. Conclusions and Relevance While there will be some patients with CRVO-associated or HRVO-associated macular edema who will benefit from first-line treatment with aflibercept rather than bevacizumab, given the minimal differences in visual acuity outcomes and large cost differences for bevacizumab vs aflibercept, first-line treatment with bevacizumab is cost-effective for this condition.

Type of Medium: Online Resource

ISSN: 2168-6165

URL: Article

DOI: 10.1001/jamaophthalmol.2023.1463

Language: English

Publisher: American Medical Association (AMA)

Publication Date: 2023

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Intraocular Pressure–Related Events After Anti–Vascular Endothelial Growth Factor Therapy for Macular Edema Due to Central Retinal Vein Occlusion or Hemiretinal Vein Occlusion : SCORE2 Report 16 on a Secondary Analysis of a Randomized Clinical Trial

Aref, Ahmad A. ; Scott, Ingrid U. ; VanVeldhuisen, Paul C. ; [et al.]

American Medical Association (AMA) ; 2021

In: JAMA Ophthalmology Vol. 139, No. 12 ( 2021-12-01), p. 1285-

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In: JAMA Ophthalmology, American Medical Association (AMA), Vol. 139, No. 12 ( 2021-12-01), p. 1285-

Type of Medium: Online Resource

ISSN: 2168-6165

URL: Article

DOI: 10.1001/jamaophthalmol.2021.4395

Language: English

Publisher: American Medical Association (AMA)

Publication Date: 2021

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Baseline Characteristics and Outcomes After Anti–Vascular Endothelial Growth Factor Therapy for Macular Edema in Participants With Hemiretinal Vein Occlusion Compared With Participants With Central Retinal Vein Occlusion : Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2) Report 18

Scott, Ingrid U. ; Oden, Neal L. ; VanVeldhuisen, Paul C. ; [et al.]

American Medical Association (AMA) ; 2022

In: JAMA Ophthalmology Vol. 140, No. 5 ( 2022-05-01), p. 458-

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In: JAMA Ophthalmology, American Medical Association (AMA), Vol. 140, No. 5 ( 2022-05-01), p. 458-

Type of Medium: Online Resource

ISSN: 2168-6165

URL: Article

DOI: 10.1001/jamaophthalmol.2022.0352

Language: English

Publisher: American Medical Association (AMA)

Publication Date: 2022

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