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Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy

Objectives: To analyze the efficacy and tolerability of diflunisal for the treatment of acquired amyloid neuropathy in domino liver transplant recipients. Methods: We performed a retrospective longitudinal study of prospectively collected data for all domino liver transplant recipients with acquired...

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Autores principales: Nedkova-Hristova, Velina, Baliellas, Carmen, González-Costello, José, Lladó, Laura, González-Vilatarsana, Emma, Vélez-Santamaría, Valentina, Casasnovas, Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9044119/
https://www.ncbi.nlm.nih.gov/pubmed/35497887
http://dx.doi.org/10.3389/ti.2022.10454
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author Nedkova-Hristova, Velina
Baliellas, Carmen
González-Costello, José
Lladó, Laura
González-Vilatarsana, Emma
Vélez-Santamaría, Valentina
Casasnovas, Carlos
author_facet Nedkova-Hristova, Velina
Baliellas, Carmen
González-Costello, José
Lladó, Laura
González-Vilatarsana, Emma
Vélez-Santamaría, Valentina
Casasnovas, Carlos
author_sort Nedkova-Hristova, Velina
collection PubMed
description Objectives: To analyze the efficacy and tolerability of diflunisal for the treatment of acquired amyloid neuropathy in domino liver transplant recipients. Methods: We performed a retrospective longitudinal study of prospectively collected data for all domino liver transplant recipients with acquired amyloid neuropathy who received diflunisal at our hospital. Neurological deterioration was defined as an score increase of ≥2 points from baseline on the Neurological Impairment Scale/Neurological Impairment Scale-Lower Limbs. Results: Twelve patients who had received compassionate use treatment with diflunisal were identified, of whom seven had follow-up data for ≥12 months. Five patients (71.4%) presented with neurological deterioration on the Neurological Impairment Scale after 12 months (p = 0.0382). The main adverse effects were cardiovascular and renal, leading to diflunisal being stopped in five patients and the dose being reduced in two patients. Conclusion: Our study suggests that most domino liver transplant recipients with acquired amyloid neuropathy will develop neurological deterioration by 12 months of treatment with diflunisal. This therapy was also associated with a high incidence of adverse effects and low treatment retention. The low efficacy and low tolerability of diflunisal treatment encourage the search for new therapeutic options.
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spelling pubmed-90441192022-04-28 Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy Nedkova-Hristova, Velina Baliellas, Carmen González-Costello, José Lladó, Laura González-Vilatarsana, Emma Vélez-Santamaría, Valentina Casasnovas, Carlos Transpl Int Health Archive Objectives: To analyze the efficacy and tolerability of diflunisal for the treatment of acquired amyloid neuropathy in domino liver transplant recipients. Methods: We performed a retrospective longitudinal study of prospectively collected data for all domino liver transplant recipients with acquired amyloid neuropathy who received diflunisal at our hospital. Neurological deterioration was defined as an score increase of ≥2 points from baseline on the Neurological Impairment Scale/Neurological Impairment Scale-Lower Limbs. Results: Twelve patients who had received compassionate use treatment with diflunisal were identified, of whom seven had follow-up data for ≥12 months. Five patients (71.4%) presented with neurological deterioration on the Neurological Impairment Scale after 12 months (p = 0.0382). The main adverse effects were cardiovascular and renal, leading to diflunisal being stopped in five patients and the dose being reduced in two patients. Conclusion: Our study suggests that most domino liver transplant recipients with acquired amyloid neuropathy will develop neurological deterioration by 12 months of treatment with diflunisal. This therapy was also associated with a high incidence of adverse effects and low treatment retention. The low efficacy and low tolerability of diflunisal treatment encourage the search for new therapeutic options. Frontiers Media S.A. 2022-04-13 /pmc/articles/PMC9044119/ /pubmed/35497887 http://dx.doi.org/10.3389/ti.2022.10454 Text en Copyright © 2022 Nedkova-Hristova, Baliellas, González-Costello, Lladó, González-Vilatarsana, Vélez-Santamaría and Casasnovas. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Nedkova-Hristova, Velina
Baliellas, Carmen
González-Costello, José
Lladó, Laura
González-Vilatarsana, Emma
Vélez-Santamaría, Valentina
Casasnovas, Carlos
Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title_full Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title_fullStr Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title_full_unstemmed Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title_short Treatment With Diflunisal in Domino Liver Transplant Recipients With Acquired Amyloid Neuropathy
title_sort treatment with diflunisal in domino liver transplant recipients with acquired amyloid neuropathy
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9044119/
https://www.ncbi.nlm.nih.gov/pubmed/35497887
http://dx.doi.org/10.3389/ti.2022.10454
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