Deprescribing 5-Aminosalicytes in patients with inflammatory bowel disease on concomitant advanced therapy: A qualitative analysis

This study assessed patients' satisfaction and barriers to their current UC or IBD treatment, their perceived quality of life, and pill burden associated with their current treatment. Patients are open to deprescribing their 5-ASA but would have several questions for their prescribing physician including assurance of continued symptom management or ease of returning to the 5-ASA if needed.
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Switching MS Fumarates

It is unexpected that patients with stable lymphocytes on one fumarate would experience significant changes when switching to another fumarate; however, this was being observed in clinical practice. We wanted to identify the frequency and severity of lymphopenia after switching from dimethyl fumarate to either diroximel fumarate (DRF) or monomethyl fumarate (MMF). Our study determined that patients switching to DRF were more likely to have decreased lymphocyte counts post switch compared to MMF.
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DAA Treatment Failure And Retreatment Strategies Following NAT+ HCV Solid Organ Transplantation In HCV-Negative Recipients: A Case Series

Given the high efficacy rates of DAA treatment in patients following NAT+ HCT SOT in HCV-recipients, little data is available to guide retreatment selection. This study aims to fill this gap by polling data from multiple treatment sites, assessing the retreatment strategies and SVC rates of said strategies.
Review Publication

Implementation of EHR Flowsheet to track patients taking specialty medications with complex dosing regimens

The purpose of this quality improvement project was to implement a transparent, streamlined process of managing patients with IBD receiving specialty medications that have complex dosing regimens with IV to SubQ routes of administration. This was achieved by implementing an EHR flowsheet for patient management and care coordination between infusion and specialty pharmacy staff.

High Dose Deutetrabenazine Outcomes- Dual Site analysis

This dual site retrospective study evaluated deutetrabenazine for the treatment of HD chorea at doses above current FDA approval. Deutetrabenazine >48 mg daily appears safe and well tolerated in patients with uncontrolled HD chorea, though no significant change in total maximal chorea score was found. Psychiatric changes were less commonly reported at doses >48 mg/day, but extrapyramidal symptoms were more common. The median PDC was 0.99 and only 2 patients discontinued due to AEs.
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Hepatitis C Cascade of Care in a Multidisciplinary Substance Use Bridge Clinic Model in Tennessee

Many barriers prevent individuals with substance use disorders from receiving hepatitis C virus (HCV) treatment. This study describes 96 patients with active HCV treated in an opioid use disorder bridge clinic model. Of 33 patients who initiated treatment, 25 patients completed treatment, and 13 patients achieved sustained virologic response.
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Access and Outcomes of Risankizumab Dose Escalation

In a cohort study of 61 patients prescribed risankizumab (RZB) for Crohn's Disease more frequently than the FDA approved dose, almost half had improvement. There was a trend suggesting patients who failed multiple advanced therapies were less likely to improve. A third (33%) of patients had additional medication changes. With available data, improvements were seen in CRP (54%), ESR (46%), and HBI (56%) measures. This study provides the largest cohort of escalated dosing in RZB.

Getting To Specialty Treatment In Dermatologic Inflammatory Conditions: Treatment Requirements And Patient Journey

This single-center, retrospective review evaluated medication outcomes and time to access therapy in patients using step therapy or formulary alternatives after being prescribed specialty medications for psoriasis or atopic dermatitis. Most patients denied specialty medications due to insurance requirements eventually needed them or were lost to follow-up (n=37; 60%). Only 5 patients (8%) benefited from and remained on step therapy.
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Ustekinumab Infusion to Subcutaneous Transition: Coordinating Care and Identifying Potential Gaps

This study described the care coordination process and patient outcomes from decision to treat with ustekinumab through initiating subcutaneous (SQ) injection. Prescriptions filled with Vanderbilt Specialty Pharmacy (VSP) had 2.5 times higher odds of being shipped in the appropriate window compared to non-VSP with 56% dose-escalated during the first year. This study shows ustekinumab initiation and escalation in the first year can be a lengthy process requiring a high level of care coordination.
Review Publication