Osteoclast Precursors OCPs are dramatically increased in PsA, compared to controls, particularly in patients with bone damage on X-ray. The number of these circulating precursor cells dropped rapidly following treatment with TNFi.
OCPs may serve as response biomarkers, but cost, time and high variability limit these assays. These markers may predict TNFi treatment response.
Cross sectional: 36 patients will take part in the cross-sectional part of the study. This population should be in good disease state such that their disease is controlled and treatment will not need to be changed. If longitudinal subjects fit the cross-sectional criteria and wish to participate, they will be re-consented for the cross-sectional part of the study.
While 66 subjects will be studied in both the longitudinal and cross-sectional studies combined, up to 80 PsA subjects may be consented to allow for screen failures and to replace longitudinal subjects who withdraw or are lost to follow-up. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision.
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Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Due to the demographic distribution of the disease the investigators expect all or nearly all subjects to be caucasian, however no subjects will be excluded based on race or ethnic origin. Criteria Inclusion Criteria:. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.
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Table 2 from Combining longitudinal studies of PSA. - Semantic Scholar
Identification of such a biomarker would permit rapid transition to a new agent, a major treatment advance. TNFi are the most effective therapies in PsA, however, methotrexate is frequently initiated early in the disease course based on its significantly lower cost. Three groups of subjects will be recruited. Longitudinal: 30 subjects starting out on standard of care treatment with a TNFi or non-biologic DMARD will take part in the longitudinal section of the study.
Subjects may be asked to have a blood draw at one additional visit before starting therapy for additional research assays if they are DC-STAMP positive. If the longitudinal subjects that return for an additional blood draw before starting medication have unusable sample data, they will be replaced by additional longitudinal subjects out of the 30 enrolled longitudinal participants to get sufficient data results of two subjects.
The subjects with unusable data will continue in the longitudinal follow up study visits as intended. Assay Development: Up to 40 PsA or healthy subjects may be enrolled for blood draw for assay development and to test development of techniques for ultrasound comparison and scoring system validation. Seven years after we summarised available knowledge on this in our book, we now have results from two recent clinical trials to help us make even stronger informed decisions: the Prostate Testing for Cancer and Treatment ProtecT — 10 years of follow-up - and Prostate Cancer Intervention versus Observation Trial PIVOT — 20 years of follow-up.
Read more: Latest research shows surgery for early stage prostate cancer doesn't save lives.
Two Australian oncologists, Ian Haines and George Miklos, have given us an important, excoriating summary of these two studies. They conclude the data:. They are unambiguous in their implications … The bottom line?
live.yssofindia.org/sitemap11.xml Men with early stage abnormalities of the prostate who do not undergo surgery or radiation treatment, but whose condition is monitored for any progression of the cancer, live just as long as men who opted for complete removal of the prostate and who now live with its immediate consequences, including incontinence, intimacy issues, bowel problems and intervention regret. This figure shows the median age of death in men from various cancers and all causes of death combined for , the latest available year.
This shows that prostate cancer is very clearly a disease that mostly kills very late in life. The average age of death for prostate cancer in Australia is 82 years, while the median age for all male cancers combined other than prostate cancer is 75 — considerably younger. Just 2. Significantly, the average age of death from all causes combined for an Australian man in was 78 years.
So men who die from any cause after that time — prostate cancer included — are already living longer than average. Clearly then, the great majority of men who develop prostate cancer will not die from it but from something else. Yet the drive to promote prostate testing continues unabated, which is causing massive anxiety, intervention and significant decrements to the quality of life of men who are treated unnecessarily.
Haines and Miklos point the finger at financial reasons for this over-treatment. It will be even more difficult to dislodge early PSA testing, particularly in countries such as the United States, where it has now become deeply entrenched in a belief-based or business enterprise. A constant supply of patients is obligatory, and an increasing supply is preferable. Many male doctors do not have PSA tests themselves.
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As more information emerges that challenges the wisdom of the promotion of prostate testing, we need to ask whether this bubble is near to bursting. Screen music and the question of originality - Miguel Mera — London, Islington. UEA Inaugural lecture: Alternative performance measures: do managers disclose them to inform us, or to mislead us? Edition: Available editions United Kingdom. Simon Chapman , University of Sydney.
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