BACKGROUND CONTEXT: Spondylodiscitis management presents significant clinical challenges, particularly in critically ill patients, where the risks and benefits of surgical intervention must be carefully balanced. The optimal timing of surgery in this context remains a subject of debate. PURPOSE: This study aims to evaluate the effectiveness of early surgery versus delayed surgery or conservative management in critically ill patients with de novo pyogenic spondylodiscitis. STUDY DESIGN/SETTING: This is an international, multicenter retrospective cohort study involving 24 centers, primarily in Europe. PATIENT SAMPLE: The study included 192 critically ill patients (65.63% male) with a median age of 69 years, all severely affected by pyogenic spondylodiscitis characterized by an initial CRP level >200 mg/l or the presence of two out of four Systemic Inflammatory Response Syndrome criteria upon admission. OUTCOME MEASURES: The primary outcome was 30-day mortality. Secondary outcomes included length of ICU stay, length of hospital stay, and relapse rates of spondylodiscitis. METHODS: Patients were divided into three groups: early surgery (within three days of admission), delayed surgery (after three days of admission), and conservative therapy. Propensity score matching and multivariate regression analyses were performed to adjust for baseline differences and assess the impact of treatment modalities on mortality and other clinical outcomes. RESULTS: Delayed surgery was associated with significantly lower 30-day mortality (4.05%) compared to early surgery (27.85%) and conservative therapy (27.78%) (p<.001). Delayed surgery also resulted in shorter hospital stays (42.76 days) compared to conservative therapy (55.53 days) and early surgery (26.33 days) (p<.001), and shorter ICU stays (4.52 days) compared to conservative therapy (16.48 days) and early surgery (7.92 days) (p<.001). The optimal window for surgery, minimizing mortality, was identified as ten to fourteen days postadmission (p=.02). Risk factors for increased mortality included age (p<.05), multiple organ failure (p<.05), and vertebral body destruction (p<.05), whereas delayed surgery (p<.05) and the presence of an epidural abscess were associated with reduced mortality (p<.05). CONCLUSIONS: Delayed surgery, optimally between 10 to 14 days postadmission, was associated with lower mortality in critically ill spondylodiscitis patients. These findings highlight the potential benefits of considering surgical timing to improve patient outcomes.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• délka pobytu MeSH
• discitida * terapie   mortalita   chirurgie   mikrobiologie   MeSH
• konzervativní terapie MeSH
• kritický stav MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: Inflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of cardiovascular events. METHODS: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients who had myocardial infarction to receive either colchicine or placebo and either spironolactone or placebo. The results of the colchicine trial are reported here. The primary efficacy outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization, evaluated in a time-to-event analysis. C-reactive protein was measured at 3 months in a subgroup of patients, and safety was also assessed. RESULTS: A total of 7062 patients at 104 centers in 14 countries underwent randomization; at the time of analysis, the vital status was unknown for 45 patients (0.6%), and this information was most likely missing at random. A primary-outcome event occurred in 322 of 3528 patients (9.1%) in the colchicine group and 327 of 3534 patients (9.3%) in the placebo group over a median follow-up period of 3 years (hazard ratio, 0.99; 95% confidence interval [CI], 0.85 to 1.16; P = 0.93). The incidence of individual components of the primary outcome appeared to be similar in the two groups. The least-squares mean difference in C-reactive protein levels between the colchicine group and the placebo group at 3 months, adjusted according to the baseline values, was -1.28 mg per liter (95% CI, -1.81 to -0.75). Diarrhea occurred in a higher percentage of patients with colchicine than with placebo (10.2% vs. 6.6%; P<0.001), but the incidence of serious infections did not differ between groups. CONCLUSIONS: Among patients who had myocardial infarction, treatment with colchicine, when started soon after myocardial infarction and continued for a median of 3 years, did not reduce the incidence of the composite primary outcome (death from cardiovascular causes, recurrent myocardial infarction, stroke, or unplanned ischemia-driven coronary revascularization). (Funded by the Canadian Institutes of Health Research and others; CLEAR ClinicalTrials.gov number, NCT03048825.).

• MeSH
• C-reaktivní protein * analýza   MeSH
• cévní mozková příhoda prevence a kontrola   MeSH
• dvojitá slepá metoda MeSH
• infarkt myokardu * prevence a kontrola   mortalita   MeSH
• Kaplanův-Meierův odhad MeSH
• kolchicin * terapeutické užití   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• recidiva MeSH
• sekundární prevence MeSH
• senioři MeSH
• spironolakton terapeutické užití   škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

Dlouhotrvající subklinický zánět je prokazatelně jedním z faktorů, které ovlivňují progresi aterosklerózy a vedou k destabilizaci aterosklerotických plátů s rizikem komplikací pod obrazem akutního koronárního syndromu. Kromě farmakologického ovlivnění tradičních rizikových faktorů aterosklerózy, jako je dyslipidemie, přináší kontrola prozánětlivého stavu podobné benefity ústící v pokles rizika kardiovaskulárních příhod, což lze monitorovat např. koncentrací vysoce senzitivního C-reaktivního proteinu. Možnosti cíleného ovlivnění subklinického zánětu medikamenty jsou prozatím velmi limitované, lze ovšem využít dostupná léčiva z plejády hypolipidemik, která vedle samotného hypolipidemického účinku umožňují kontrolu prozánětlivého stavu, což ústí v další redukci kardiovaskulárního rizika.

Long-term subclinical inflammation is one of the factors that influence the progression of atherosclerosis and lead to the destabilization of atherosclerotic plaques with increased risk of complications such as acute coronary syndrome. Control of the pro-inflammatory state brings similar benefits as pharmacological management of traditional risk factors of atherosclerosis resulting in lower risk of cardiovascular events. Decreased inflammatory state can be monitored, for example, by the concentration of highly sensitive C-reactive protein. The possibilities of targeted influence of subclinical inflammation are currently limited, but it is possible to use available substances with hypolipidemic effect, which are able to decrease the pro-inflammatory state resulting in a further reduction of cardiovascular risk.

• MeSH
• ateroskleróza * farmakoterapie   MeSH
• C-reaktivní protein účinky léků   MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• statiny farmakologie   terapeutické užití   MeSH
• zánět farmakoterapie   MeSH

Alveolární echinokokóza (AE) je vzácné, ale závažné parazitární onemocnění jater, které často napodobuje maligní ložiska. V této kazuistice prezentujeme případ 76letého pacienta, u něhož byla AE diagnostikována náhodně při vyšetření pro renální insuficienci. Ultrazvukové vyšetření odhalilo mnohočetná hyperechogenní ložiska v játrech. Následné CT a MR jater zobrazily mnohočetná ložiska nepravidelných okrajů bez typické vaskularizace, největší o velikosti 71 × 38 mm. Laboratorní výsledky ukázaly zvýšené jaterní enzymy, CRP a renální insuficienci. Core cut biopsie jater potvrdila přítomnost pseudocystických struktur. Vzorky byly následně zaslány do Národní referenční laboratoře pro tkáňové helmintózy, která diagnózu AE potvrdila. Sérologické vyšetření bylo provedeno až po bioptickém vyšetření a potvrdilo přítomnost protilátek proti Echinococcus multilocularis. Pacient byl odeslán do infekční ambulance, kde byla zahájena léčba albendazolem v dávce 800 mg denně. Po rehydrataci a úpravě léčby došlo ke stabilizaci renálních funkcí a při kontrolních zobrazovacích vyšetřeních byl nález stacionární. Tento případ zdůrazňuje nutnost zařazení AE do diferenciální diagnostiky ložiskových procesů jater, zejména u pacientů bez onkologické anamnézy.

Alveolar echinococcosis (AE) is a rare but serious parasitic liver disease that often mimics malignant lesions. We present the case of a 76-year-old patient in whom AE was incidentally diagnosed during examination for renal insufficiency. Abdominal ultrasound revealed multiple hyperechogenic liver lesions. Subsequent MRI showed multiple irregularly bordered lesions without typical vascularization, the largest measuring 71 × 38 mm. Laboratory tests revealed elevated liver enzymes, CRP, and renal insufficiency. A core-cut liver biopsy confirmed the presence of pseudocystic structures. Samples were sent to the National Reference Laboratory for Tissue Helminthiases, which confirmed the diagnosis of AE. Serological testing was performed after the biopsy confirming the presence of antibodies against Echinococcus multilocularis. The patient was referred to an infectious disease clinic, where treatment with albendazole at a dose of 800 mg daily was initiated. After rehydration and adjustment of therapy, renal function stabilized, and follow-up imaging showed stable findings. This case highlights the need to include AE in the differential diagnosis of hepatic lesions, particularly in patients without an oncological history.

• MeSH
• albendazol farmakologie   terapeutické užití   MeSH
• biopsie MeSH
• diagnostické zobrazování metody   MeSH
• echinokokóza jater * diagnóza   farmakoterapie   MeSH
• játra diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVE: In patients with axial spondyloarthritis (axSpA) initiating secukinumab (SEC), we aimed to identify baseline (treatment start) predictors of achieving low disease activity (LDA) after 6 months, as measured by the Axial Spondyloarthritis Disease Activity Score using C-reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), as well as treatment continuation after 12 months. METHODS: From 11 European registries, patients with axSpA who initiated SEC treatment in routine care, with available data on 6-month ASDAS-CRP and BASDAI assessments were included. Logistic regression analyses on multiply imputed baseline data were performed; potential baseline predictors included demographic, diagnosis, lifestyle, clinical, and patient-reported variables. RESULTS: In a pooled cohort of 1174 patients with axSpA, 5 of 19 potential assessed variables were mutually predictive for achieving LDA by ASDAS-CRP and BASDAI: higher physician global assessment score, noncurrent smoking, lack of prior exposure to biologic/targeted synthetic disease-modifying antirheumatic drugs, and lower Health Assessment Questionnaire scores and BASDAI scores. Moreover, radiographic axSpA and CRP ≤ 10 mg/L were associated with achieving ASDAS-CRP LDA, and HLA-B27 positivity and history of psoriasis with achieving BASDAI LDA, whereas earlier time of secukinumab initiation (2015-2017) was associated with treatment continuation. CONCLUSION: In this European real-world study of patients with axSpA initiating SEC, predictors of achieving LDA by ASDAS-CRP and BASDAI at 6 months and remaining on treatment at 12 months included both clinical, patient-reported, and lifestyle factors, underscoring the complex mechanisms of real-world drug effectiveness.

• MeSH
• antirevmatika * terapeutické užití   MeSH
• axiální spondyloartritida * farmakoterapie   MeSH
• C-reaktivní protein metabolismus   MeSH
• dospělí MeSH
• humanizované monoklonální protilátky * terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• registrace MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Syndrom komplexní regionální bolesti (KRBS) je onemocnění s multifaktoriální patofyziologií, v níž se uplatňuje senzitizace centrálního a periferního nervového systému, zánět, genetické faktory, vegetativní nervový systém, autoimunitní reakce a psychika. Složitá a nejednoznačná patofyziologie KRBS komplikuje klinickou diagnostiku. Ta je založena na mezinárodně schválených Budapešťských kritériích, jež berou v úvahu přítomnost symptomů a vylučují alternativní příčiny. Terapeutický management vyžaduje multidisciplinární přístup se zaměřením na individuální léčebné plány včetně řešení psychologických faktorů. Tento článek poskytuje přehled aktualizací v diagnostice a léčbě KRBS. Nejnovější doporučení pro léčbu KRBS zdůrazňují důležitost včasné diagnózy a intervence.

Complex Regional Pain Syndrome (CRPS) is a disease with a multifactorial pathophysiology involving central and peripheral nervous system sensitization, inflammation, genetic factors, autonomic nervous system, autoimmune response, and psychological disposition. The complex and ambiguous pathophysiology of CRPS complicates clinical diagnosis. This is based on the internationally approved Budapest criteria, which take into account the presence of symptoms and exclude alternative causes. Therapeutic management requires a multidisciplinary approach with a focus on individual treatment plans including addressing psychological factors. This review provides an overview of updates in the diagnosis and treatment of CRPS. The most recent guidelines for the treatment of CRPS emphasize the importance of early diagnosis and intervention.

• Klíčová slova
• Budapešťská kritéria,
• MeSH
• diferenciální diagnóza MeSH
• komplexní regionální syndromy bolesti * diagnóza   farmakoterapie   patologie   MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND AND AIMS: Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U. METHODS: In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled. Demographic, clinical, and laboratory data, as well as adverse events (AEs), were recorded at Week 8 post-induction. RESULTS: One hundred children were included (90 UC and 10 IBD-U, median age 15.6 [interquartile range 13.3-17.1] years). Ninety-eight were previously treated with biologic therapies, and 76 were treated with ≥2 biologics. At the end of the 8-week induction period, clinical response, clinical remission, and corticosteroid-free clinical remission (CFR) were observed in 84%, 62%, and 56% of the children, respectively. Normal C-reactive protein and fecal calprotectin (FC) <150 mcg/g were achieved in 75% and 50%, respectively. Combined CFR and FC remission was observed in 18/46 (39%) children with available data at 8 weeks. Adverse events were recorded in 37 children, including 1 serious AE of an appendiceal neuroendocrine tumor. The most frequent AEs were hyperlipidemia (n = 13), acne (n = 12), and infections (n = 10, 5 of whom with herpes viruses). CONCLUSIONS: Upadacitinib is an effective induction therapy for refractory pediatric UC and IBD-U. Efficacy should be weighed against the potential risks of AEs.

• MeSH
• C-reaktivní protein analýza   MeSH
• dítě MeSH
• heterocyklické sloučeniny tricyklické * terapeutické užití   škodlivé účinky   MeSH
• indukce remise metody   MeSH
• indukční chemoterapie metody   MeSH
• leukocytární L1-antigenní komplex analýza   MeSH
• lidé MeSH
• mladiství MeSH
• retrospektivní studie MeSH
• ulcerózní kolitida * farmakoterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Východiská: Schnitzlerovej syndróm je získané autoinflamačné ochorenie so základom v poruche prirodzenej imunity. Podozrivým je proteín MyD88 – toll-like receptor zapojený do zápalovej kaskády vyúsťujúcej aj do zvýšenej sekrécie interleukínu-1 (IL-1), kľúčového cytokínu v patogenéze a klinickej manifestácii viacerých autoinflamačných stavov. Syndróm je pomenovaný po francúzskej kožnej lekárke Liliane Schnitzler, ktorá v roku 1972 opísala kazuistickú sériu pacientov s prejavmi urtikárie v spojení s monoklonálnou gamapatiou. V klinickom obraze dominujú prejavy chronickej urtikárie, pričom histologicky ide najčastejšie o neutrofilovú dermatózu. Nevyhnutným kritériom na zadefinovanie Schnitzlerovej syndrómu je monoklonálna gamapatia, pričom až v 90 % prípadov ide o monoklonálnu IgM gamapatiu. Zvyšná skupina pacientov má prítomnú gamapatiu v triede IgG. Z vedľajších kritérií potrebných na potvrdenie syndrómu podľa Strassburgskej klasifikácie je to zvýšená nešpecifická zápalová aktivita (elevácia sérového CRP, leukocytóza), morfologické zmeny na kostiach (verifikované hyperostotické či osteosklerotické zmeny skeletu na CT, scintigraficky, alebo PET/CT s použitím rádioaktívneho natrium fluoridu NaF18), bolesti kostí či artralgia. Pacienti sú vo zvýšenom riziku rozvoja lymfoproliferačného ochorenia ako Waldenströmovej makroglobulinémie alebo low-grade lymfómu (15–20 %). Rizikom je tiež rozvoj AA amyloidózy pri dlhodobej nekontrolovanej hyperinflamácii. Akútnou, život ohrozujúcou komplikáciou môže byť syndróm aktivovaných makrofágov. Vzhľadom na imunologickú podstatu ochorenia a eleváciu zápalových cytokínov je základom anticytokínová liečba. Najlepšie výsledky sú pozorované pri anakinre (antagonista receptora pre IL-1), inou možnosťou je eventuálne kanakinumab (monoklonálna protilátka proti IL-1b). Pozitívny efekt bol opisovaný aj pri inhibítoroch Brutonovej tyrozínkinázy. Kortikoidy a konvenčné imunosupresíva nie sú dostatočne efektívne. Prípad: V predkladanom texte prezentujeme formou kazuistickej série dve pacientky so Schnitzlerovej syndrómom s raritnejšími klinickými príznakmi a s diferencovanou odpoveďou na anticytokínovú liečbu. Cieľom autorov bolo informovať a zlepšiť povedomie o tomto vzácnom ochorení a jeho možnostiach liečby. Záver: Ochorenie je chronické, liečba je len symptomatická, ale vedie k ústupu klinických príznakov a dosiahnutiu kontroly nad zápalom. Riziko vzniku hematologickej malignity anticytokínová liečba pravdepodobne neovplyvňuje.

Background: Schnitzler‘s syndrome is an acquired autoinflammatory disease with a disorder in innate immune response. The suspect is the protein MyD88 – a toll-like receptor involved in the inflammatory cascade resulting in increased secretion of interleukin-1 (IL-1), a key cytokine in the pathogenesis and clinical manifestation of several autoinflammations. The syndrome is named after the French dermatologist Liliane Schnitzler, who described a case series of patients with manifestations of urticaria and monoclonal gammapathy in 1972. The clinical picture is characterized by chronic urticaria, histologically it is most often neutrophilic dermatosis. A necessary criterion for defining Schnitzler‘s syndrome is monoclonal gammapathy. In up to 90% of cases, it is monoclonal IgM gammapathy, the remaining group of patients has IgG gammapathy. Among the secondary criteria necessary to define the syndrome according to the Strasbourg classification, non-specific inflammatory activity is present in patients (elevation of CRP, leukocytosis), morphological changes on the bones (hyperostotic or osteosclerotic changes of the skeleton verified by CT, scintigraphy or PET/CT using radioactive sodium fluoride NaF18), bone pain or arthralgia. Patients are at an increased risk of developing a lymphoproliferative disease, especially Waldenström‘s macroglobulinemia or low grade lymphoma (15–20%). There is also a risk of the development of AA amyloidosis due to long-term uncontrolled hyperinflammation. Macrophage activating syndrome can be an acute life-threatening complication, as we describe in our patient. Considering the immunological nature of the disease and the elevation of inflammatory cytokines, the basis of treatment is anticytokine therapy. The best results are seen with anakinra (IL-1 receptor antagonist), possibly canakinumab (a monoclonal antibody against IL-1b). A positive effect was also described with Bruton‘s tyrosine kinase inhibitors. Corticoids and conventional immunosuppressants are not effective enough. Case: In this text, we present a case series of two patients with Schnitzler‘s syndrome with rare clinical symptoms. The authors‘ goal was to improve awareness of this rare hematoinflammatory disease and its treatment options. Conclusion: The disease is chronic, the treatment is only symptomatic, but can lead to the reduction of clinical symptoms. Anticytokine treatment probably does not affect the risk of hematological malignancy.

• MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• imunoglobulin G imunologie   MeSH
• interleukin-1 imunologie   MeSH
• lidé MeSH
• paraproteinemie genetika   imunologie   MeSH
• senioři MeSH
• syndrom aktivovaných makrofágů diagnóza   etiologie   MeSH
• syndrom Schnitzlerové * diagnóza   farmakoterapie   genetika   imunologie   MeSH
• urtikarie diagnóza   etiologie   imunologie   MeSH
• zánět diagnóza   etiologie   imunologie   klasifikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVES: To investigate sex differences in patient-reported outcome measures (PROMs) among axSpA patients initiating their first TNFi and identify factors contributing to these disparities over the follow-up. METHODS: Data were included from 15 EuroSpA registries and consisted of axSpA patients initiating their first TNFi, with ≥2 measurements for each analysed PROM (BASDAI and BASFI, scale 0-100) taken at any time point. Linear mixed models were employed to analyse sex differences in PROMs over 24 months and to evaluate how baseline characteristics were related to the observed sex differences. RESULTS: We analysed 13 102 (38% women) in the BASDAI analyses and 10 623 (38% women) in the BASFI analyses. At follow-up, mean sex differences in BASDAI increased from 4.3 units at baseline (95% CI, 3.5-5.1) to 8.0 (7.2-8.8) at 6 months, and in BASFI from 2.2 (1.4-3.1) to 4.6 (3.6-5.5), with consistently worse scores in women. Baseline characteristics could not substantially account for the observed sex differences over time; however, the magnitude of the sex differences was reduced by HLA-B27 positivity, longer disease duration, and increased CRP levels, but increased by TNFi initiation in later years and peripheral arthritis. CONCLUSION: In axSpA patients initiating their first TNFi, baseline sex differences in BASDAI and BASFI increased two-fold after 6 months of treatment and persisted thereafter, with worse scores in women. Several baseline characteristics moderated the sex differences, though none could fully account for them. These findings improve our understanding of sex differences and underscore their importance in axSpA.

• MeSH
• antirevmatika * terapeutické užití   MeSH
• axiální spondyloartritida * farmakoterapie   MeSH
• dospělí MeSH
• hodnocení výsledků péče pacientem * MeSH
• inhibitory TNF * terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• registrace MeSH
• sexuální faktory MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Androgen deprivation therapy has long been the first-line treatment for hormone-sensitive prostate cancer (HSPC). After progression to castration-resistant prostate cancer (CRPC), androgen receptor pathway inhibitors (ARPIs) are commonly used. Recently, combined therapy with androgen deprivation and an ARPI has been recommended for metastatic HSPC patients. Novel markers are urgently needed for monitoring this disease and for making therapeutic decisions. Plasma samples were collected from 140 patients with either metastatic HSPC (n = 72) or CRPC (n = 68) before the start of ARPI therapy. Digital PCR was used to assess AR gene amplification, while the expression levels of miR-375 were measured by quantitative PCR. Sixteen other clinical markers were also evaluated, including prostate-specific antigen (PSA), chromogranin A (CGA), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), C-reactive protein (CRP), lymphocyte-to-monocyte ratio, and platelet count. A multivariate analysis, adjusted for age and metastatic dissemination, identified miR-375 expression and lymphocyte-to-monocyte ratio to be the independent negative predictors of ARPI therapy failure in CRPC patients. Regarding the HSPC patients, this article reports the primary finding of the independent negative predictive value of platelet count, CRP, and CGA for the failure of combined androgen deprivation therapy and ARPI.

• MeSH
• androgenní receptory genetika   MeSH
• C-reaktivní protein * metabolismus   MeSH
• chromogranin A * krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• mikro RNA * genetika   krev   MeSH
• nádorové biomarkery krev   MeSH
• nádory prostaty rezistentní na kastraci * krev   genetika   patologie   farmakoterapie   diagnóza   MeSH
• neúspěšná terapie MeSH
• prognóza MeSH
• prostatický specifický antigen * krev   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• trombocyty * metabolismus   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH