Publications by authors named "Elizabeth Lesser"

Objective: The study objective was to compare long-term treatment persistence between patients initiating guselkumab vs 3 commonly prescribed biologics in the United States.

Methods: Adult plaque psoriasis patients enrolled in the CorEvitas Psoriasis Registry initiating guselkumab, adalimumab, secukinumab, or ixekizumab (July 2017 - January 2022) were divided into biologic-naïve and biologic-experienced cohorts. The primary outcome measure was average 2-year treatment persistence, estimated as restricted mean survival time (RMST), comparing guselkumab with adalimumab, secukinumab, and ixekizumab.

View Article and Find Full Text PDF

To investigate the effect of mycophenolate mofetil (MMF) and rituximab (RTX) on pulmonary function test (PFT) results in a mixed cohort of patients with connective tissue disease-associated interstitial lung disease (CTD-ILD), longitudinally followed up for 1 year in a single academic center. Patients with CTD-ILD were identified in electronic medical records from 1 January 2009 to 30 April 2019. Prescribed MMF and RTX doses, dosage changes, and therapy plans were analyzed individually with improvement in PFT outcomes determined using multivariable linear regression models during 12-month follow-up.

View Article and Find Full Text PDF
Article Synopsis
  • - Nimodipine is the only FDA-approved drug for neuroprotection in patients with aneurysmal subarachnoid hemorrhage (aSAH) and has shown clinical benefits in randomized trials, though these were conducted before advancements in precision medicine.
  • - The standard dosage of nimodipine (60 mg every 4 hours) often leads to systemic arterial hypotension in up to 78% of patients, which can compromise its effectiveness and cerebral blood flow, especially during vasospasm.
  • - A study involving 150 aSAH patients explored the effects of nimodipine dose adjustments on clinical outcomes, highlighting the importance of pharmacogenomics for personalized dosing strategies in future treatments.
View Article and Find Full Text PDF

Importance: Factors associated with clinical heterogeneity in Alzheimer disease (AD) lay along a continuum hypothesized to associate with tangle distribution and are relevant for understanding glial activation considerations in therapeutic advancement.

Objectives: To examine clinicopathologic and neuroimaging characteristics of disease heterogeneity in AD along a quantitative continuum using the corticolimbic index (CLix) to account for individuality of spatially distributed tangles found at autopsy.

Design, Setting, And Participants: This cross-sectional study was a retrospective medical record review performed on the Florida Autopsied Multiethnic (FLAME) cohort accessioned from 1991 to 2020.

View Article and Find Full Text PDF

Objective: The aims of this study were to assess whether a relationship between anti-SSA-52 and interstitial lung disease (ILD) can be further defined, and to enhance screening, detection, and potentially guide treatment.

Methods: A historical cohort study of 201 patients was conducted at a single tertiary care center between January 1, 2016 and December 31, 2020. All included patients were anti-SSA-52 antibody positive.

View Article and Find Full Text PDF

Background: This study aims to determine the population-based incidence and characterize the features of nonarteritic anterior ischemic optic neuropathy (NAION) using the Rochester Epidemiology Project (REP).

Methods: All patients diagnosed with an optic neuropathy from January 1, 1990, to December 31, 2016, were retrospectively reviewed to identify incident cases of NAION using the REP database, which is a record-linkage system of medical records for all patient-physician encounters among Olmsted County, Minnesota residents. The overall incidence of NAION was estimated using the age-specific and sex-specific population figures for Olmsted County census data for 1990 through 2016.

View Article and Find Full Text PDF

Introduction: Complete and near-complete skin clearance have become achievable treatment goals for patients with psoriasis receiving systemic biologic therapies. However, there is limited real-world evidence regarding the impact of the degree of skin clearance on biologic treatment patterns among these patients.

Methods: This longitudinal cohort study assessed the relationship between degree of skin clearance following initiation of a systemic biologic therapy and treatment failure among patients from the CorEvitas Psoriasis Registry (April 2015-August 2021).

View Article and Find Full Text PDF
Article Synopsis
  • This analysis evaluates the safety of upadacitinib, a medication for psoriatic arthritis, over three years for patients with inadequate prior treatment responses.
  • The study pooled safety data from two phase 3 trials, comparing upadacitinib (15 mg and 30 mg) against placebo and adalimumab, focusing on treatment-emergent adverse events (TEAEs) and laboratory results.
  • Results showed that common TEAEs with upadacitinib included upper respiratory infections and elevated creatine phosphokinase, with similar rates of serious events (malignancies, cardiovascular issues) between treatments, although herpes zoster and certain infections were more frequent with upadacitinib.
View Article and Find Full Text PDF

Objective: To assess the efficacy and safety of upadacitinib (UPA), an oral Janus kinase inhibitor, as monotherapy or in combination with non-biologic DMARDs (nbDMARDs) in patients with PsA.

Methods: Pooled data were analysed from patients with prior inadequate response or intolerance to one or more nbDMARD (SELECT-PsA 1) or one or more biologic DMARD (SELECT-PsA 2) who received placebo, UPA 15 mg once daily (QD) or UPA 30 mg QD as monotherapy or in combination with two or fewer nbDMARDs for 24 weeks. Efficacy outcomes included achievement of ACR responses, Psoriasis Area and Severity Index responses, minimal disease activity and change from baseline and clinically meaningful improvement in the HAQ Disability Index.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare echocardiographic assessments using a subcostal-only window (EASy) against focused transthoracic echocardiography (FTTE) using three different windows, to determine if EASy could serve as an effective entry technique for novice sonographers.
  • Researchers analyzed echocardiographic data from 102 patients, focusing on key indicators like left and right ventricular size and contractility, and found substantial agreement between EASy and FTTE findings for various cardiac assessments.
  • The results indicated that using the subcostal window (EASy) provided nearly perfect agreement for identifying pericardial effusion and significant agreement for left ventricular and right ventricular assessments, suggesting it can be a reliable technique
View Article and Find Full Text PDF

Successful therapeutics and vaccines for coronavirus disease 2019 (COVID-19) have harnessed the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence that SARS-CoV-2 exists as locally evolving variants suggests that immunological differences may impact the effectiveness of antibody-based treatments such as convalescent plasma and vaccines. Considering that near-sourced convalescent plasma likely reflects the antigenic composition of local viral strains, we hypothesize that convalescent plasma has a higher efficacy, as defined by death within 30 days of transfusion, when the convalescent plasma donor and treated patient were in close geographic proximity.

View Article and Find Full Text PDF

Introduction: Hypertension (HTN) is a risk factor for cardiovascular disease; therefore, it is imperative to risk stratify potential kidney donors during evaluation. Clinic blood pressure (CBP) measurement is inaccurate in assessing presence or absence of HTN. There is paucity of data about utility of 24-h ambulatory blood pressure monitoring (ABPM) during kidney donor evaluation.

View Article and Find Full Text PDF

In this study, the authors aimed to assess both nighttime and daytime blood pressure (BP) variability using 24-hour ambulatory BP monitoring (ABPM) in persons with and without psychiatric conditions and with or without selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) treatment. In this retrospective study, patients who underwent psychiatric evaluation and ABPM within 6 months of each other between January 1, 2012 and December 31, 2017 were identified using billing data. Participants were divided into three groups-participants with no psychiatric diagnosis and no psychiatric medicine (-Diagnosis/-Medication), those with psychiatric diagnosis and on SSRIs/SNRIs (+Diagnosis/+Medication), and psychiatric diagnosis but no psychiatric medications (+Diagnosis/-Medication).

View Article and Find Full Text PDF

Deep learning has pushed the scope of digital pathology beyond simple digitization and telemedicine. The incorporation of these algorithms in routine workflow is on the horizon and maybe a disruptive technology, reducing processing time, and increasing detection of anomalies. While the newest computational methods enjoy much of the press, incorporating deep learning into standard laboratory workflow requires many more steps than simply training and testing a model.

View Article and Find Full Text PDF

Selective vulnerability of different brain regions is seen in many neurodegenerative disorders. The hippocampus and cortex are selectively vulnerable in Alzheimer's disease (AD), however the degree of involvement of the different brain regions differs among patients. We classified corticolimbic patterns of neurofibrillary tangles in postmortem tissue to capture extreme and representative phenotypes.

View Article and Find Full Text PDF

Background: Convalescent plasma has been widely used to treat coronavirus disease 2019 (Covid-19) under the presumption that such plasma contains potentially therapeutic antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can be passively transferred to the plasma recipient. Whether convalescent plasma with high antibody levels rather than low antibody levels is associated with a lower risk of death is unknown.

Methods: In a retrospective study based on a U.

View Article and Find Full Text PDF

Background: Migraine is a common and often refractory feature for individuals with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) without consensus guidelines for treatment. Migraine treatment poses a theoretical risk within this unique population with precarious cerebrovascular autoregulation, given the vasomodulatory influence of many antimigraine medications. In this systematic review and meta-analysis, we evaluate the frequency and efficacy of treatments for migraine in individuals with CADASIL.

View Article and Find Full Text PDF

Objective: To provide an update on key safety metrics after transfusion of convalescent plasma in hospitalized coronavirus 2019 (COVID-19) patients, having previously demonstrated safety in 5000 hospitalized patients.

Patients And Methods: From April 3 to June 2, 2020, the US Food and Drug Administration Expanded Access Program for COVID-19 convalescent plasma transfused a convenience sample of 20,000 hospitalized patients with COVID-19 convalescent plasma.

Results: The incidence of all serious adverse events was low; these included transfusion reactions (n=78; <1%), thromboembolic or thrombotic events (n=113; <1%), and cardiac events (n=677, ~3%).

View Article and Find Full Text PDF

Importance: Passive antibody transfer is a longstanding treatment strategy for infectious diseases that involve the respiratory system. In this context, human convalescent plasma has been used to treat coronavirus disease 2019 (COVID-19), but the efficacy remains uncertain.

Objective: To explore potential signals of efficacy of COVID-19 convalescent plasma.

View Article and Find Full Text PDF

Introduction: Percutaneous left atrial appendage closure is an established alternative to anticoagulation therapy for stroke prophylaxis among patients with nonvalvular atrial fibrillation. There are currently no guidelines on the choice of antithrombotic therapy following placement of the Watchman® device, the optimal time to discontinue anticoagulation or the duration of follow-up imaging after device deployment. Our main objective was to evaluate clinical outcomes among these patients.

View Article and Find Full Text PDF

Introduction The accurate diagnosis of acute septic arthritis is essential to initiating appropriate treatment and minimizing potential cartilage damage. A synovial fluid cell count of 50,000 cells/mm has been used as a diagnostic cutoff for acute septic arthritis, although data supporting this is lacking. The purpose of this study was to assess the efficacy of synovial cell counts to predict septic arthritis in patients with symptomatic native joints.

View Article and Find Full Text PDF

BACKGROUNDConvalescent plasma is the only antibody-based therapy currently available for patients with coronavirus disease 2019 (COVID-19). It has robust historical precedence and sound biological plausibility. Although promising, convalescent plasma has not yet been shown to be safe as a treatment for COVID-19.

View Article and Find Full Text PDF

Background: Convalescent plasma is the only antibody based therapy currently available for COVID-19 patients. It has robust historical precedence and sound biological plausibility. Although promising, convalescent plasma has not yet been shown to be safe as a treatment for COVID-19.

View Article and Find Full Text PDF

Unlabelled: Previous studies have recommended synovial fluid cell count thresholds of 50,000 cells/mm to diagnose septic arthritis; however, data to support this are limited. It is also unknown if this value is valid in immunosuppressed patients.

Methods: We retrospectively reviewed 33 immunosuppressed patients treated at our institution from 2008 to 2018.

View Article and Find Full Text PDF

Background: Nonarteritic anterior ischemic optic neuropathy (NAION) is a common cause of acute optic neuropathy in adults and is associated with vascular risk factors. Owing to the overlapping risk factor profiles between NAION and cerebral stroke, previous studies have produced conflicting results with regard to NAION as an independent risk factor for stroke.

Methods: A retrospective chart review was conducted using the Rochester Epidemiology Project database to identify all cases of NAION occurring among Olmsted County, Minnesota residents from January 1, 1990, through December 31, 2016.

View Article and Find Full Text PDF