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The Most Highly Cited Publications on Basketball Originate From English‐Speaking Countries, Are Published After 2000, Are Focused on Medicine‐Related Topics, and Are Level III Evidence
Griffin, Zachary D., McQuivey, Kade S. , Arthur, Jaymeson R. , Chhabra, Anikar , Chhabra, Anikar , Griffin, Zachary D., Pollock, Jordan Riley , Moore, M. Lane

Arthroscopy, Sports Medicine, and Rehabilitation | February 14, 2022 | Volume: 4 | Issue: 3 | Pages: No page available

10.1016/j.asmr.2021.12.020 | PMID 35747657 Get It

Purpose To identify the 50 most highly cited research publications in the sport of basketball. Methods Using the Clarivate Analytics Web of Knowledge database and the search term “basketball”, we identified 2,704 articles. These articles were filtered by the total number of citations and the top 50 most cited articles with a central focus on basketball were selected for this analysis. For each article, we further identified and analyzed author name, publication year, country of origin, journal name, article type, main research topic area, competitive level, gender of study population, and the level of evidence. Results Medicine‐related topics, particularly those involving knee injuries, are more common than nonmedical topics (coaching, sports psychology etc.) among the highest cited articles. Articles originated from 13 different countries, with 48% originating in the United States. Only four authors had more than one article included in the top 50 most cited articles. Conclusion A majority of the top 50 research articles were from English‐speaking countries, published after 2000, primarily focused on medicine‐related topics, and were Level III evidence. Publications examining knee injuries were the most highly cited and appear to be of high interest to current investigators. The prestige of an author’s name appeared to be less influential to the number of citations. Clinical Relevance The top 50 most cited articles list will provide researchers, medical students, residents, and fellows with a foundational list of the most important and influential academic contributions to the basketball literature.
Inflation-Adjusted Medicare Reimbursement Has Decreased for Orthopaedic Sports Medicine Procedures: Analysis From 2000 to 2020
Richman, Evan H. , Estipona, Benzi I., Brinkman, Joseph C. , Hinckley, Nathaniel B. , Haglin, Jack M. , Pollock, Jordan Riley , Moore, M. Lane , Chhabra, Anikar

Orthopaedic Journal of Sports Medicine | February 11, 2022 | Volume: 10 | Issue: 2 | Pages: No page available

10.1177/23259671211073722 | PMID 35174250 Get It

Background: Decreases in Medicare reimbursement have been noted among many medical specialties. An in-depth analysis of the subspecialty of orthopaedic sports medicine is needed to determine changes in Medicare reimbursement in this field. Purpose/Hypothesis: The purpose was to elucidate the trends in inflation-adjusted Medicare reimbursement for orthopaedic sports medicine procedures between 2000 and 2020. It was hypothesized that Medicare reimbursement decreased substantially during the study period. Study Design: Economic decision and analysis; Level of evidence, 4. Methods: The Physician Fee Schedule Look-up Tool was used to extract Medicare reimbursement information between 2000 and 2020 for 67 procedures related to orthopaedic sports medicine. These values were adjusted for inflation using the Consumer Price Index. The compound annual growth rate (CAGR) was calculated to measure the annual rate of change, and descriptive analyses were performed using the Student t test. Results: Between 2000 and 2020, inflation-adjusted Medicare reimbursement for the 67 included procedures decreased by an average of 33% (CAGR = –2.2%; R 2 = 0.78). Reimbursement decreased for procedures related to the shoulder and elbow by 34% (CAGR = –2.3%; R 2 = 0.80), for hip-related procedures by 23% (CAGR = –1.4%; R 2 = 0.77), for knee-related procedures by 31% (CAGR = –2.0%; R 2 = 0.81), and for procedures relating to the foot and ankle by 38% (CAGR = –2.5%; R 2 = 0.79). Conclusion: Study findings indicated that inflation-adjusted Medicare reimbursement decreased substantially between 2000 and 2020 for orthopaedic sports medicine procedures, ranging from a 23% decrease for hip-related procedures to a 38% decrease for foot and ankle–related procedures. The results of this study could be used to provide further context for health care policy decisions and help ensure sustainable financial environments for orthopaedic sports medicine surgeon.
Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods
Liou, Harris , Lane, Colton, Huang, Crystal , Mookadam, Martina , Joseph, Malin, DuVal, Jennifer Hecker, Hecker DuVal, Jennifer

Telemedicine and e-Health | February 8, 2022 | Volume: 28 | Issue: 9 | Pages: 1359-1366

10.1089/tmj.2021.0454 | PMID 35133887 Get It

Introduction: Eye movement desensitization and reprocessing (EMDR) is an evidence-based psychotherapy method designed to treat distress associated with traumatic memories. The COVID-19 pandemic has challenged providers to shift EMDR to telehealth platforms. Objectives: This research had to aims. (1) To compare EMDR in conjunction with cognitive behavioral therapy (CBT) with CBT alone for treatment of a patient population with prevalent anxiety and (2) to compare the efficacy of virtual EMDR with that of in-person EMDR in the primary care setting. Methods: Retrospective chart review of all adult patients seen by a single therapist at a primary care center was conducted from January 2018 to December 2020. Charts were reviewed for demographics, psychiatric diagnoses, number of visits, number and type of EMDR treatments, and patient health questionnaire (PHQ)-9 and general anxiety disorder (GAD-7) scores pre- and post-treatment. Results: Patients who underwent EMDR with CBT demonstrated greater decreases in PHQ-9 and GAD-7 scores than patients who had only CBT (2.4, 2.5 vs. 0.9, 1.1). However, after adjusting for total number of sessions, post-traumatic stress disorder, grief, and pain, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent EMDR with CBT and CBT-exclusive patients were not statistically significant. Similarly, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent virtual EMDR and those who had in-person EMDR were not statistically significant. Conclusions: To our knowledge, this is the first study describing the use of virtual EMDR in a primary care setting. Although our data did not provide evidence for the superiority of EMDR with CBT over CBT alone, we demonstrate that both in-person and virtual EMDR led to significantly improved GAD-7 scores.
Correction: An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels
León, José de , Schoretsanitis, Georgios , Smith, Robert L. , Molden, Espen , Solismaa, Anssi , Seppälä, Niko , Kopeček, Miloslav , Švancer, Patrik , Olmos, I. Cánovas , Ricciardi, Carina , Iglesias-Alonso, Ana , Ruan, Can‐Jun , Wang, Chuanyue , Wang, Gang , Tang, Yi‐lang , Kim, Yong Sik , Kim, Se Hyun , Jung–Cook, Helgi , Nielsen, Jimmi , Verdoux, Hélène , Quilès, Clélia , Cohen, Dan , Schulte, Peter F.J. , Chopra, Nitin , McCollum, Betsy , Shelton, Charles , Cotes, Robert O. , Kaithi, Arun R., Farooq, Saeed , Ng, Chee H. , Bilbily, John , Lana, Fernando , Rădulescu, Flavian Ștefan , Seifritz, Erich , Every‐Palmer, Susanna , Bebawi, Emmanuel , Kelly, Deanna L. , Lazáry, Judit , Torres, Rafael , Yécora, Agustín, Berardis, Domenico De , Adebayo, Richard A. , Fountoulakis, Konstantinos Ν. , Ayub, Muhammad , Silva, Alzira , Bonelli, Raphael M., Crespo‐Facorro, Benedicto , Temmingh, Henk , Decloedt, Eric , Pedro, Maria Rosel , Gründer, Gerhard , Čelofiga, Andreja , Ristić, Dragana Ignjatović , Elkis, Hélio , Siskind, Dan , Masmoudi, R. , Saffian, Shamin Mohd , Buckley, P.F. , Freudenreich, Oliver , Müller, Daniel J. , de Leon, Jose , Olmos, Ismael , Iglesias-Garcia, Celso , Iglesias-Alonso, Ana , Spina, Edoardo , Ruan, Can-Jun , Wang, Chuan-Yue , Tang, Yi-Lang , Lin, Shih-Ku , Lane, Hsien-Yuan , Kim, Yong Sik , Kim, Se Hyun , Rajkumar, Anto P , González-Esquivel, Dinora F , Jung-Cook, Helgi , Baptista, Trino , Rohde, Christopher , Nielsen, Jimmi , Verdoux, Hélène , Quiles, Clelia , Sanz, Emilio J , De Las Cuevas, Carlos , Cohen, Dan , Schulte, Peter F J , Ertuğrul, Aygün , Anıl Yağcıoğlu, A Elif , Chopra, Nitin , McCollum, Betsy , Shelton, Charles , Cotes, Robert O , Kane, John M , Farooq, Saeed , Ng, Chee H , Bilbily, John , Hiemke, Christoph , López-Jaramillo, Carlos , McGrane, Ian , Lana, Fernando , Eap, Chin B , Every-Palmer, Susanna , Bousman, Chad A , Bebawi, Emmanuel , Bhattacharya, Rahul , Kelly, Deanna L , Otsuka, Yuji , Lazary, Judit , Motuca, Mariano , Chan, Sherry K W , Zolezzi, Monica , Ouanes, Sami , De Berardis, Domenico , Grover, Sandeep , Procyshyn, Ric M , Adebayo, Richard A , Kirilochev, Oleg O , Soloviev, Andrey , Fountoulakis, Konstantinos N , Wilkowska, Alina , Cubała, Wiesław J , Ayub, Muhammad , Silva, Alzira , Villagrán-Moreno, José M , Crespo-Facorro, Benedicto , Temmingh, Henk , Decloedt, Eric , Pedro, Maria R , Takeuchi, Hiroyoshi , Tsukahara, Masaru , Gründer, Gerhard , Sagud, Marina , Celofiga, Andreja , Ignjatovic Ristic, Dragana , Ortiz, Bruno B , Elkis, Helio , Pacheco Palha, António J , LLerena, Adrián , Fernandez-Egea, Emilio , Siskind, Dan , Weizman, Abraham , Masmoudi, Rim , Mohd Saffian, Shamin , Leung, Jonathan G , Buckley, Peter F , Marder, Stephen R , Citrome, Leslie , Freudenreich, Oliver , Correll, Christoph Ulrich , Müller, Daniel J , Kopecek, Miloslav , Schoretsanitis, Georgios , García, Celso Iglesias , Rajkumar, Anto P. , González‐Esquivel, Dinora F. , Rohde, Christopher , Sanz, Emílio J. , Cuevas, Carlos De las , Yağcıoğlu, A. Elif Anıl , Kane, John M. , Hiemke, Christoph , López‐Jaramillo, Carlos , McGrane, Ian R. , Arrojo, Manuel , Bousman, Chad , Bhattacharya, Rahul , Motuca, Mariano , Chan, Sherry Kit Wa , Кирилочев, О.О. , Soloviev, A. G. , Wilkowska, Alina , Cubała, Wiesław Jerzy , Tsukahara, Masaru , Ortiz, Bruno Bertolucci , LLerena, Adrián , Leung, Jonathan G. , Citrome, Leslie

Pharmacopsychiatry | January 20, 2022 | Volume: 55 | Issue: 02 | Pages: e1-e1

10.1055/a-1737-1527 | PMID 35052001 Get It

Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals
Campbell, Kristin L. , Cormie, Prue , Weller, Sarah, Alibhai, Shabbir M.H. , Bolam, Kate A., Campbell, Anna , Cheville, Andrea , Dalzell, Mary-Ann, Hart, Nicolas H. , Higano, Celestia S. , Lane, Kirstin , Mansfield, Sami, Newton, Robert U. , Quist, Morten , Rauw, Jennifer, Rosenberger, Friederike , Mina, Daniel Santa , Winters-Stone, Kerri M., Wiskemann, Joachim , Goulart, Jennifer , Cheville, Andrea L , McNeely, Margaret L , Newton, Robert U , Quist, Morten , Rosenberger, Friederike , Santa Mina, Daniel , Schmitz, Kathryn H , Wiskemann, Joachim , Goulart, Jennifer , Campbell, Anna M , Campbell, Kristin L , Cormie, Prue , Weller, Sarah , Alibhai, Shabbir M. H. , Bolam, Kate A. , Dalzell, Mary-Ann, Hart, Nicolas H. , Higano, Celestia S. , Lane, Kirstin , Mansfield, Sami, Rauw, Jennifer, Winters-Stone, Kerri M.

JCO Oncology Practice | January 6, 2022 | Volume: 18 | Issue: 5 | Pages: e697-e709

10.1200/op.21.00454 | PMID 34990293 Get It

PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. CONCLUSION: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases.
Persistent foramen of Huschke: Presentation, evaluation, and management
Macielak, Robert J. , Nassiri, Ashley M. , Fillmore, W. Jonathan , Lane, John I. , Driscoll, Colin L. W., Carlson, Matthew L.

Laryngoscope Investigative Otolaryngology | January 5, 2022 | Volume: 7 | Issue: 1 | Pages: 237-241

10.1002/lio2.725 | PMID 35155803 Get It

AbstractObjectiveDescribe the presentation and management strategy for patients with symptomatic foramen of Huschke (FH).PatientsAdults with persistent FH confirmed on imaging.InterventionsDiagnosis and management of symptomatic persistent FH.Main outcome measureResolution of otologic symptoms.ResultsA total of four patients with symptomatic, radiographically‐confirmed persistent FH were included. The majority of patients endorsed otalgia (n = 4) and otorrhea (n = 3), and only one patient was noted to have a conductive hearing loss. All patients were noted to have dynamic movement of an external auditory canal mass with mandible manipulation on examination, and all patients had an identifiable fistula on imaging. Patients underwent surgical intervention, including both preauricular (n = 2) and transcanal (n = 2) approaches, and all endorsed symptomatic resolution after convalescence.ConclusionsPersistent FH remains an uncommon and potentially underrecognized cause of otologic symptoms. Diagnosis requires a high index of suspicion, and one must rely on both key examination findings and imaging to confirm this diagnosis. In appropriately selected patients, surgical intervention can provide durable symptomatic resolution.Level of evidenceIV
Between 2000 and 2020, Reimbursement for Orthopaedic Foot and Ankle Surgery Decreased by 30%
Haglin, Jack M. , LeBlanc, Matthew P., Rosenow, Christian S. , Makovicka, Justin L. , Deckey, David G. , Bingham, Joshua S. , Pollock, Jordan Riley , Moore, M. Lane , Hassebrock, Jeffrey D. , Patel, Karan A.

Arthroscopy, Sports Medicine, and Rehabilitation | December 24, 2021 | Volume: 4 | Issue: 2 | Pages: No page available

10.1016/j.asmr.2021.11.016 | PMID 35494293 Get It

Purpose To examine and analyze Medicare reimbursement rates from 2000 to 2020 for orthopaedic foot and ankle procedures. Methods The 20 most used orthopaedic foot and ankle surgical procedures were gathered from the Centers for Medicare & Medicaid Services website using the Medicare Provider Utilization and Payment Data Public Use File 2017. The reimbursement data for each code were gathered from The Physician Fee Schedule Look‐Up Tool from Centers for Medicare & Medicaid Services. The reimbursement values were adjusted for inflation to 2020 U.S. dollars using the consumer price index. Results The average inflation‐adjusted reimbursement for included procedures decreased by 30% from 2000 to 2020. The greatest mean decreases were observed for “correction of hallux valgus” (–47%) and “partial excision of foot bone” (–41%). The procedures with the smallest mean decreases were observed in “treatment of “Amputation of toe” (–19%) and “closed treatment of metatarsal fracture” (–7%). Conclusions From 2000 to 2020, Inflation‐adjusted Medicare reimbursement for foot and ankle surgery decreased by 30%. Level of Evidence IV; economic analysis.
An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels
León, José de , Schoretsanitis, Georgios , Smith, Robert L. , Molden, Espen , Solismaa, Anssi , Seppälä, Niko , Kopeček, Miloslav , Švancer, Patrik , Olmos, I. Cánovas , Ricciardi, Carina , García, Celso Iglesias , Iglesias-Alonso, Ana , Ruan, Can‐Jun , Wang, Chuanyue , Wang, Gang , Tang, Yi‐lang , Kim, Yong Sik , Kim, Se Hyun , Rajkumar, Anto P. , González‐Esquivel, Dinora F. , Jung–Cook, Helgi , Verdoux, Hélène , Quilès, Clélia , Sanz, Emílio J. , Cuevas, Carlos De las , Cohen, Dan , Schulte, Peter F.J. , Yağcıoğlu, A. Elif Anıl , Chopra, Nitin , McCollum, Betsy , Shelton, Charles , Cotes, Robert O. , Kaithi, Arun R., Kane, John M. , Farooq, Saeed , Ng, Chee H. , Bilbily, John , Hiemke, Christoph , López‐Jaramillo, Carlos , McGrane, Ian R. , Lana, Fernando , Arrojo, Manuel , Rădulescu, Flavian Ștefan , Seifritz, Erich , Every‐Palmer, Susanna , Bebawi, Emmanuel , Bhattacharya, Rahul , Kelly, Deanna L. , Otsuka, Yuji , Lazáry, Judit , Torres, Rafael , Yécora, Agustín, Motuca, Mariano , Chan, Sherry Kit Wa , Berardis, Domenico De , Adebayo, Richard A. , Кирилочев, О.О. , Soloviev, A. G. , Fountoulakis, Konstantinos Ν. , Wilkowska, Alina , Cubała, Wiesław Jerzy , Ayub, Muhammad , Silva, Alzira , Bonelli, Raphael M., Crespo‐Facorro, Benedicto , Temmingh, Henk , Decloedt, Eric , Pedro, Maria Rosel , Tsukahara, Masaru , Gründer, Gerhard , Čelofiga, Andreja , Ristić, Dragana Ignjatović , Ortiz, Bruno Bertolucci , Elkis, Hélio , Siskind, Dan , Masmoudi, R. , Saffian, Shamin Mohd , Leung, Jonathan G. , Buckley, P.F. , Freudenreich, Oliver , Müller, Daniel J. , de Leon, Jose , Olmos, Ismael , Iglesias-Garcia, Celso , Spina, Edoardo , Ruan, Can-Jun , Wang, Chuan-Yue , Tang, Yi-Lang , Lin, Shih-Ku , Lane, Hsien-Yuan , Kim, Yong Sik , Kim, Se Hyun , Rajkumar, Anto P , González-Esquivel, Dinora F , Jung-Cook, Helgi , Baptista, Trino , Rohde, Christopher , Nielsen, Jimmi , Verdoux, Hélène , Quiles, Clelia , Sanz, Emilio J , De Las Cuevas, Carlos , Cohen, Dan , Schulte, Peter F J , Ertuğrul, Aygün , Anıl Yağcıoğlu, A Elif , Chopra, Nitin , McCollum, Betsy , Shelton, Charles , Cotes, Robert O , Kane, John M , Farooq, Saeed , Ng, Chee H , Bilbily, John , Hiemke, Christoph , López-Jaramillo, Carlos , McGrane, Ian , Lana, Fernando , Eap, Chin B , Every-Palmer, Susanna , Bousman, Chad A , Bebawi, Emmanuel , Bhattacharya, Rahul , Kelly, Deanna L , Otsuka, Yuji , Lazary, Judit , Motuca, Mariano , Chan, Sherry K W , Zolezzi, Monica , Ouanes, Sami , De Berardis, Domenico , Grover, Sandeep , Procyshyn, Ric M , Adebayo, Richard A , Kirilochev, Oleg O , Soloviev, Andrey , Fountoulakis, Konstantinos N , Wilkowska, Alina , Cubała, Wiesław J , Ayub, Muhammad , Silva, Alzira , Villagrán-Moreno, José M , Crespo-Facorro, Benedicto , Temmingh, Henk , Decloedt, Eric , Pedro, Maria R , Takeuchi, Hiroyoshi , Tsukahara, Masaru , Gründer, Gerhard , Sagud, Marina , Celofiga, Andreja , Ignjatovic Ristic, Dragana , Ortiz, Bruno B , Elkis, Helio , Pacheco Palha, António J , LLerena, Adrián , Fernandez-Egea, Emilio , Siskind, Dan , Weizman, Abraham , Masmoudi, Rim , Mohd Saffian, Shamin , Leung, Jonathan G , Buckley, Peter F , Marder, Stephen R , Citrome, Leslie , Freudenreich, Oliver , Correll, Christoph Ulrich , Müller, Daniel J , Kopecek, Miloslav , Arrojo-Romero, Manuel , Schoretsanitis, Georgios , Rohde, Christopher , Nielsen, Jimmi , Bousman, Chad , LLerena, Adrián , Citrome, Leslie

Pharmacopsychiatry | December 15, 2021 | Volume: 55 | Issue: 02 | Pages: 73-86

10.1055/a-1625-6388 | PMID 34911124 Get It

Abstract This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas’ original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300–600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75–150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175–300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100–200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250–400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150–300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300–600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.
Integrated Safety Analysis of Tagraxofusp, a CD123-Directed Targeted Therapy, in Patients with Hematologic Malignancies
Pemmaraju, Naveen , Sweet, Kendra , Ali, Haris , Stein, Anthony S. , Yacoub, Abdulraheem , Rizzieri, David A. , Vasu, Sumithira , Lee, Sang‐Min , Schiller, Gary J. , Foran, James M. , Rosenblat, Todd , Walter, Roland B. , Sieminski, Debra, Anant, Madhu, Patnaik, Mrinal M. , Mughal, Tariq I. , Konopleva, Marina , Walter, Roland B , Kantarjian, Hagop M. , Wang, Eunice S. , Lane, Andrew A. , Gupta, Vikas , Taparia, Minakshi

Blood | November 24, 2021 | Volume: 138 | Issue: Supplement 1 | Pages: 2318-2318

10.1182/blood-2021-145344 Get It

Abstract Introduction: The interleukin-3 receptor alpha chain (CD123) is a cell-surface target aberrantly expressed on various myeloid neoplasms including blastic plasmacytoid dendritic cell neoplasm (BPDCN), acute myeloid leukemia (AML), chronic myelomonocytic leukemia (CMML), and myelofibrosis (MF). Tagraxofusp (TAG, SL-401), a first-in-class CD123-targeted therapy, is the only treatment approved by the FDA and EMA for patients (pts) with BPDCN. It has also been investigated in phase 1/2 clinical trials for AML (including pts with minimal residual disease [MRD]), CMML, and MF. We report the aggregated safety data of TAG monotherapy from trials in BPDCN, AML, CMML, and MF. Methods: An integrated safety analysis was performed for pts who received TAG monotherapy in three phase 1/2, multicenter clinical studies: Study 0114 (NCT02113982; BPDCN/AML), Study 0214 (NCT02270463; AML with/without MRD), and Study 0314 (NCT02268253; CMML/MF; Table 1). Pts received the recommended phase 2 dose of 12 mcg/kg/day (d) IV on d1-3 (MF and CMML) or d1-5 (BPDCN and AML) and were analyzed for incidence and timing of treatment-related adverse events (TRAEs), AEs of interest, and discontinuations. Safety data for TAG monotherapy, reported as individual case study reports (ICSRs) postapproval (US) and from an early access program (EAP; EU) are also presented. Results: In total, 201 pts receiving TAG (12 mcg/kg/d) in a clinical trial setting were included: BPDCN, n=86; AML, n=36; AML with/without MRD, n=10; CMML, n=33; MF, n=36. As of Jul 2021, 11 (6%) pts discontinued TAG due to any-grade (Gr) TRAE. Most common TRAEs (any-Gr) are shown in Table 2 and included hypoalbuminemia (41%), increased alanine aminotransferase (ALT; 40%), increased aspartate aminotransferase (AST; 39%), and thrombocytopenia (26%). The most common Gr ≥3 TRAEs were thrombocytopenia (n=41; 20%), increased AST (n=40; 20%), and increased ALT (n=35; 17%). Tumor lysis syndrome occurred in 5% of pts and 1.5% had infusion-related reactions. Any-Gr and Gr ≥3 hematologic TRAEs are presented in Table 3. Most common was thrombocytopenia. All TRAEs were transient in nature; prolonged bone marrow suppression was not observed. Overall, 23% (47/201) of pts experienced ≥1 treatment-related serious AE. Onset of most TRAEs, irrespective of Gr, commonly occurred in cycle 1 and resolved by cycle 2. Although the number of pts in cycles ≥2 was lower than in cycle 1, the incidence rates of common TRAEs also substantially decreased in subsequent cycles. Capillary leak syndrome (CLS) occurred in 17% of the overall 201 pts. The majority of all CLS events were nonsevere, Gr ≤2 (n=22; 63%); also reported were Gr 3, n=10 (29%); Gr 4, n=3 (9%), and 2 pts experienced a Gr 5 event. Onset of CLS was usually within the first week of cycle 1 (median time to onset [range], d: 5.5 [1-51]) and resolved quickly (median time to resolution [range], d: 5.0 [2-69]); no pts experienced the first onset after cycle 2. Of the 15 pts who resumed treatment after an initial CLS event, only 1 pt experienced a recurrence. The most common AEs reported as ICSRs postapproval and from an EAP (December 2018 to June 2021) were CLS, blood albumin decreased, thrombocytopenia, pyrexia, and hepatic enzyme increased. No new safety signals that would alter the safety profile were observed. Conclusions: This integrated analysis represents the largest collection of safety data (N=201) following treatment with TAG monotherapy. TAG has an established and manageable safety profile, with the vast majority of AEs reported as transient and decreasing in frequency/severity with increasing cycles. CLS was reported in 17% of pts; onset was usually within cycle 1, resolved quickly (median time to resolution: 5.0 d) by early intervention measures including holding treatment, and no pts experienced first onset after cycle 2. Risk-minimization guidelines for CLS were developed and implemented during clinical trials and incorporated into prescribing information. No myelosuppression or cumulative toxicity was observed over multiple treatment cycles. The safety profile observed postapproval and in the EAP was consistent with the clinical trial data reported, reflecting successful adoption of risk-management strategies in real-world practice. These data confirm the favorable benefit-risk profile of TAG monotherapy has been maintained in the 3 years following US approval. Figure 1 Figure 1. Disclosures Pemmaraju: ASCO Leukemia Advisory Panel: Membership on an entity's Board of Directors or advisory committees; Sager Strong Foundation: Other; Blueprint Medicines: Consultancy; Incyte: Consultancy; Bristol-Myers Squibb Co.: Consultancy; Pacylex Pharmaceuticals: Consultancy; Cellectis S.A. ADR: Other, Research Funding; Aptitude Health: Consultancy; Celgene Corporation: Consultancy; CareDx, Inc.: Consultancy; Springer Science + Business Media: Other; Daiichi Sankyo, Inc.: Other, Research Funding; Samus: Other, Research Funding; Clearview Healthcare Partners: Consultancy; Dan's House of Hope: Membership on an entity's Board of Directors or advisory committees; MustangBio: Consultancy, Other; Abbvie Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other, Research Funding; HemOnc Times/Oncology Times: Membership on an entity's Board of Directors or advisory committees; ASH Communications Committee: Membership on an entity's Board of Directors or advisory committees; LFB Biotechnologies: Consultancy; Novartis Pharmaceuticals: Consultancy, Other: Research Support, Research Funding; Protagonist Therapeutics, Inc.: Consultancy; Affymetrix: Consultancy, Research Funding; DAVA Oncology: Consultancy; Plexxicon: Other, Research Funding; Roche Diagnostics: Consultancy; Stemline Therapeutics, Inc.: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other, Research Funding; ImmunoGen, Inc: Consultancy. Kantarjian: NOVA Research: Honoraria; Aptitude Health: Honoraria; Immunogen: Research Funding; BMS: Research Funding; Precision Biosciences: Honoraria; Novartis: Honoraria, Research Funding; Ascentage: Research Funding; Pfizer: Honoraria, Research Funding; Astra Zeneca: Honoraria; Astellas Health: Honoraria; Jazz: Research Funding; Ipsen Pharmaceuticals: Honoraria; Amgen: Honoraria, Research Funding; Daiichi-Sankyo: Research Funding; KAHR Medical Ltd: Honoraria; AbbVie: Honoraria, Research Funding; Taiho Pharmaceutical Canada: Honoraria. Sweet: Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; AROG: Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees; Bristol Meyers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees. Wang: Kite Pharmaceuticals: Consultancy, Honoraria, Other: Advisory Board; Jazz Pharmaceuticals: Consultancy, Honoraria, Other: Advisory Board; DAVA Oncology: Consultancy, Speakers Bureau; BMS/Celgene: Membership on an entity's Board of Directors or advisory committees; Stemline Therapeutics: Consultancy, Honoraria, Other: Advisory board, Speakers Bureau; Genentech: Membership on an entity's Board of Directors or advisory committees; GlaxoSmithKline: Consultancy, Honoraria, Other: Advisory Board; Takeda: Consultancy, Honoraria, Other: Advisory board; Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Honoraria, Other: Advisory Board, Speakers Bureau; Kura Oncology: Consultancy, Honoraria, Other: Advisory board, steering committee, Speakers Bureau; Novartis: Consultancy, Honoraria, Other: Advisory Board; Mana Therapeutics: Consultancy, Honoraria; Rafael Pharmaceuticals: Other: Data safety monitoring committee; Gilead: Consultancy, Honoraria, Other: Advisory board; Daiichi Sankyo: Consultancy, Honoraria, Other: Advisory board; PTC Therapeutics: Consultancy, Honoraria, Other: Advisory board; Genentech: Consultancy; MacroGenics: Consultancy. Lane: N-of-One: Consultancy, Honoraria; Stemline Therapeutics: Research Funding; Qiagen: Consultancy, Honoraria; AbbVie: Research Funding. Ali: Incyte: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS: Speakers Bureau; CTI BioPharma: Membership on an entity's Board of Directors or advisory committees. Stein: Amgen: Consultancy, Speakers Bureau; Celgene: Speakers Bureau; Stemline: Speakers Bureau. Yacoub: Agios: Membership on an entity's Board of Directors or advisory committees; Acceleron Pharma: Membership on an entity's Board of Directors or advisory committees; CTI Biopharma: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Incyte: Speakers Bureau. Rizzieri: Celltron/Teva: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: presentation to FDA for biosimilar review ; AROG: Other; Amgen: Other: personal fee; Bayer: Consultancy, Honoraria; Kite: Other: personal fee; Mustang: Consultancy, Honoraria; Stemline Therapeutics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Incyte: Other: personal fee; Gilead: Other: personal fee; Jazz: Other: personal fee; Pharmacyclics: Other. Vasu: Seattle Genetics: Other: travel support; Boehringer Ingelheim: Other: Travel support; Kiadis, Inc.: Research Funding; Omeros, Inc.: Membership on an entity's Board of Directors or advisory committees. Gupta: AbbVie: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Roche: Consultancy; Constellation Pharma: Consultancy, Honoraria; Pfizer: Consultancy; BMS-Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Sierra Oncology: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Honoraria, Research Funding. Lee: BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees; Pin Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees; Innate: Consultancy, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees. Schiller: Sangamo: Research Funding; Actinium Pharmaceuticals, Inc: Research Funding; FujiFilm: Research Funding; Pfizer: Current equity holder in publicly-traded company, Research Funding; Abbvie: Research Funding; Karyopharm: Research Funding; Onconova: Research Funding; Celator: Research Funding; Actuate: Research Funding; Incyte: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Trovagene: Research Funding; Deciphera: Research Funding; Gamida Cell Ltd.: Research Funding; Forma: Research Funding; Ono-UK: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Arog: Research Funding; Takeda: Research Funding; Geron: Research Funding; Jazz: Consultancy, Honoraria, Research Funding, Speakers Bureau; PrECOG: Research Funding; Kite/Gilead: Honoraria, Research Funding, Speakers Bureau; Mateon: Research Funding; Constellation Pharmaceuticals: Research Funding; Daiichi-Sankyo: Research Funding; Tolero: Research Funding; Stemline Therapeutics, Inc.: Honoraria, Research Funding, Speakers Bureau; Samus: Research Funding; Astellas: Honoraria, Research Funding, Speakers Bureau; Regimmune: Research Funding; BMS/Celgene: Consultancy, Current equity holder in publicly-traded company, Research Funding, Speakers Bureau; Agios: Consultancy, Research Funding, Speakers Bureau; Amgen: Consultancy, Current equity holder in publicly-traded company, Honoraria, Research Funding, Speakers Bureau; Bio: Research Funding; Elevate: Research Funding; Delta-Fly: Research Funding; Genentech-Roche: Research Funding; Ariad: Research Funding; Sanofi: Honoraria, Research Funding, Speakers Bureau; Pharma: Consultancy; Johnson & Johnson: Current equity holder in publicly-traded company; Biomed Valley Discoveries: Research Funding; Eli Lilly: Research Funding; ASH foundation: Other: Chair-unpaid; Sellas: Research Funding; Ono: Consultancy; Incyte: Consultancy; AstraZeneca: Consultancy; Kaiser Permanente: Consultancy; Cyclacel: Research Funding; MedImmune: Research Funding; Ambit: Research Funding; Leukemia & Lymphoma Society: Research Funding; Bluebird Bio: Research Funding; Boehringer-Ingleheim: Research Funding; Cellerant: Research Funding; CTI Biopharma: Research Funding; Janssen: Research Funding; Kura Oncology: Research Funding; Pharmacyclics: Honoraria, Speakers Bureau; Millennium: Research Funding; National Marrow Donor Program: Research Funding; NIH: Research Funding; Onyx: Research Funding; Pharmamar: Research Funding; UC Davis: Research Funding; UCSD: Research Funding; Evidera: Consultancy; NCI: Consultancy; Novartis: Speakers Bureau. Foran: trillium: Research Funding; actinium: Research Funding; aptose: Research Funding; novartis: Honoraria; OncLive: Honoraria; servier: Honoraria; gamida: Honoraria; takeda: Research Funding; boehringer ingelheim: Research Funding; abbvie: Research Funding; certara: Honoraria; bms: Honoraria; pfizer: Honoraria; sanofi aventis: Honoraria; revolution medicine: Honoraria; taiho: Honoraria; syros: Honoraria; kura: Research Funding; h3bioscience: Research Funding; aprea: Research Funding; sellas: Research Funding; stemline: Research Funding. Walter: Macrogenics: Consultancy, Research Funding; Jazz: Research Funding; Pfizer: Consultancy, Research Funding; Selvita: Research Funding; Amphivena: Consultancy, Other: ownership interests; Agios: Consultancy; Astellas: Consultancy; BMS: Consultancy; Genentech: Consultancy; Janssen: Consultancy; Kite: Consultancy; Immunogen: Research Funding; Celgene: Consultancy, Research Funding; Aptevo: Consultancy, Research Funding; Amgen: Research Funding. Sieminski: Stemline Therapeutics: Current Employment, Current holder of stock options in a privately-held company. Patnaik: Kura Oncology: Research Funding; Stemline Therapeutics: Membership on an entity's Board of Directors or advisory committees; Stemline Therapeutics: Membership on an entity's Board of Directors or advisory committees. Mughal: Oxford University Press, Informa: Other: financial benefit and/or patents ; Stemline: Current Employment, Current holder of stock options in a privately-held company. Konopleva: Calithera: Other: grant support, Research Funding; Reata Pharmaceuticals: Current holder of stock options in a privately-held company, Patents & Royalties: intellectual property rights; Genentech: Consultancy, Honoraria, Other: grant support, Research Funding; Agios: Other: grant support, Research Funding; Ascentage: Other: grant support, Research Funding; AstraZeneca: Other: grant support, Research Funding; Rafael Pharmaceuticals: Other: grant support, Research Funding; Forty Seven: Other: grant support, Research Funding; Ablynx: Other: grant support, Research Funding; Eli Lilly: Patents & Royalties: intellectual property rights, Research Funding; Novartis: Other: research funding pending, Patents & Royalties: intellectual property rights; Stemline Therapeutics: Research Funding; KisoJi: Research Funding; F. Hoffmann-La Roche: Consultancy, Honoraria, Other: grant support; Cellectis: Other: grant support; Sanofi: Other: grant support, Research Funding; AbbVie: Consultancy, Honoraria, Other: Grant Support, Research Funding.