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  • Küçük Resim Yok
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    Modulatory therapy experience in patients with cystic fibrosis in Turkey: A multi-center study
    (European Respiratory Society Journals Ltd., 2023) Ergenekon, Pınar; Erdem Eralp, Ela; Kılınç Sakallı, Ayşe Ayzıt; Yanaz, Mürüvvet; Kılıç Başkan, Azer; Gulieva, Aynur; Pekcan, Sevgi; Gökdemir, Yasemin
    Background: Modulatory therapies are not reimbursed in Turkey and approach to the treatment is currently available for three months only by court decision. In between the court decisions, most of the patients could not receive the treatment. The aim of the current study is to report the results in patients. Methods: In this ongoing study, patients who have used modulator therapy for at least 3 months from 12 centers, were included in the study. Demographical data of the patients, sweat test values at baseline and during treatment, FEV1% and lung clearence index (LCI) values, body mass indexes (BMI), side effects of the treatment, age-appropriate quality of life questionnaires (CFQR), PHQ-9 (depression) and GAD-7 (anxiety) questionnaires were recorded. Results: The median age of 111 patients was 18 years. 86 patients were receiving ivacaftor/ tezacaftor/elexacaftor, whereas 13 patients on ivacaftor, six on lumacaftor/ivacaftor, and six subjects on tezacaftor/ivacaftor. The FEV1% of 86 patients who completed the three month treatment, increased by 15.4%. The BMI value of the 91 patients who completed the three month treatment, increased by 4.8%. The increase in FEV1% value of 68 patients receiving elexacaftor/tezacaftor/ivacaftor was 26.7% (p<0.001). The increase in FEV1% of 29 patients who completed the 6 month treatment, was 18.5%. Statistical significant improvement was observed in the depression and anxiety levels and quality of life parameters of the patients at 6th month (p<0.05). Conclusion: Significant improvements of our patients demonstrate the major benefits of CFTR modulator treatments and the necessity of continuous access to this treatment for all eligible patients.
  • Küçük Resim
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    Screening for latent tuberculosis in children with immune-mediated inflammatory diseases treated with anti-tumor necrosis factor therapy: Comparison of tuberculin skin and T-SPOT tuberculosis tests
    (Turkish League Against Rheumatism, 2020) Girit, Saniye; Ayzıt Atabek, Ayşe; Şenol, Ebru; Koçkar Kızılırmak, Tuba; Pekcan, Sevgi; Göktaş, Şafak; Öktem, Sedat; Kasapçopur, Özgür; Çokuğraş, Haluk
    Objectives: This study aims to analyze the coherence between T-SPOT tuberculosis test (T-SPOT.TB) and tuberculin skin test (TST) with different cut-off values in screening latent tuberculosis infection (LTBI) both prior to and at the sixth month of anti-tumor necrosis factor (anti-TNF) treatment.Patients and methods: This prospective multicentric study included 57 children (34 girls, 23 boys, mean age 12.4 +/- 3.9 years; range, 6 to 18 years) diagnosed with immune-mediated inflammatory diseases (IMIDs) evaluated with TST and T-SPOT.TB for screening LTBI both prior to and at the sixth month of treatment with anti-TNF agents. Coherence between two tests was analyzed for TST cut-off values suggested by the local guidelines and also for different possible cut-off values of TST.Results: Tuberculin skin test was positive (>= 5 mm) in 28.1% (n=16) of patients in the screening prior to treatment and in 33.3% (n=19) at the sixth month of treatment. T-SPOT.TB test was positive in 8.8% (n=5) of patients both prior to and at the sixth month of treatment. Coherence between two tests was poor or fair when compared with all possible TST cut-off values both prior to and at the sixth month of anti-TNF therapy.Conclusion: Our results show poor coherence between T-SPOT.TB and TST for all possible cut- off values of TST. Thus, using both tests would be beneficial in screening LTBI until further studies bring new evidence on the subject.