| 1. |
- Coelho, Teresa, et al.
(författare)
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Characteristics of Patients with Hereditary Transthyretin Amyloidosis-Polyneuropathy (ATTRv-PN) in NEURO-TTRansform, an Open-label Phase 3 Study of Eplontersen
- 2023
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Ingår i: Neurology and Therapy. - : Springer Nature. - 2193-8253 .- 2193-6536. ; 12, s. 267-287
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hereditary transthyretin (ATTRv) amyloidosis is a rare, severe, progressive, debilitating, and ultimately fatal disease caused by systemic deposition of transthyretin (TTR) amyloid fibrils. ATTRv amyloidosis occurs in both males and females. Eplontersen (ION-682884), a ligand-conjugated antisense oligonucleotide designed to degrade hepatic TTR mRNA, is being evaluated for the treatment of ATTRv amyloidosis with polyneuropathy (ATTRv-PN) in the phase 3, international, multicenter, open-label NEURO-TTRansform study (NCT04136184). To describe the study population of this pivotal trial, here we report the baseline characteristics of patients enrolled in the NEURO-TTRansform study.Methods: Patients eligible for NEURO-TTRansform were 18–82 years old with a diagnosis of ATTRv-PN and Coutinho stage 1 (ambulatory without assistance) or stage 2 (ambulatory with assistance) disease; documented TTR gene variant; signs and symptoms consistent with neuropathy associated with ATTRv; no prior liver transplant; and New York Heart Association (NYHA) functional class I or II.Results: The NEURO-TTRansform study enrolled 168 patients across 15 countries/territories (North America, 15.5%; Europe, 38.1%; South America/Australia/Asia, 46.4%). At baseline, the study cohort had a mean age of 52.8 years, 69.0% of patients were male, and 78.0% of patients were White. The V30M variant was most prevalent (60.1% of patients), and prevalence varied by region. Overall, 56.5% and 17.3% of patients had received previous treatment with tafamidis or diflunisal, respectively. A majority of patients (79.2%) had Coutinho stage 1 disease (unimpaired ambulation) and early (before age 50) disease onset (53.0%). Time from diagnosis to enrollment was 46.6 (57.4) months (mean [standard deviation]). Most patients had a baseline polyneuropathy disability (PND) score of I (40.5%) or II (41.1%), and the mean modified Neuropathy Impairment Score + 7 (mNIS + 7) was 79.0.Conclusion: The recruited population in the ongoing NEURO-TTRansform study has global representation characteristic of contemporary clinical practice.
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| 2. |
- Coelho, Teresa, et al.
(författare)
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Eplontersen for Hereditary Transthyretin Amyloidosis with Polyneuropathy
- 2023
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Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 330:15, s. 1448-1458
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Transthyretin gene silencing is an emerging treatment strategy for hereditary transthyretin (ATTRv) amyloidosis.Objective: To evaluate eplontersen, an investigational ligand-conjugated antisense oligonucleotide, in ATTRv polyneuropathy.Design, Setting, and Participants: NEURO-TTRansform was an open-label, single-group, phase 3 trial conducted at 40 sites across 15 countries (December 2019-April 2023) in 168 adults with Coutinho stage 1 or 2 ATTRv polyneuropathy, Neuropathy Impairment Score 10-130, and a documented TTR variant. Patients treated with placebo from NEURO-TTR (NCT01737398; March 2013-November 2017), an inotersen trial with similar eligibility criteria and end points, served as a historical placebo ("placebo") group.Interventions: Subcutaneous eplontersen (45 mg every 4 weeks; n = 144); a small reference group received subcutaneous inotersen (300 mg weekly; n = 24); subcutaneous placebo weekly (in NEURO-TTR; n = 60).Main Outcomes and Measures: Primary efficacy end points at week 65/66 were changes from baseline in serum transthyretin concentration, modified Neuropathy Impairment Score +7 (mNIS+7) composite score (scoring range, -22.3 to 346.3; higher scores indicate poorer function), and Norfolk Quality of Life Questionnaire-Diabetic Neuropathy (Norfolk QoL-DN) total score (scoring range, -4 to 136; higher scores indicate poorer quality of life). Analyses of efficacy end points were based on a mixed-effects model with repeated measures adjusted by propensity score weights.Results: Among 144 eplontersen-treated patients (mean age, 53.0 years; 69% male), 136 (94.4%) completed week-66 follow-up; among 60 placebo patients (mean age, 59.5 years; 68% male), 52 (86.7%) completed week-66 follow-up. At week 65, adjusted mean percentage reduction in serum transthyretin was -81.7% with eplontersen and -11.2% with placebo (difference, -70.4% [95% CI, -75.2% to -65.7%]; P <.001). Adjusted mean change from baseline to week 66 was lower (better) with eplontersen vs placebo for mNIS+7 composite score (0.3 vs 25.1; difference, -24.8 [95% CI, -31.0 to -18.6; P <.001) and for Norfolk QoL-DN (-5.5 vs 14.2; difference, -19.7 [95% CI, -25.6 to -13.8]; P <.001). Adverse events by week 66 that led to study drug discontinuation occurred in 6 patients (4%) in the eplontersen group vs 2 (3%) in the placebo group. Through week 66, there were 2 deaths in the eplontersen group consistent with known disease-related sequelae (cardiac arrhythmia; intracerebral hemorrhage); there were no deaths in the placebo group.Conclusions and Relevance: In patients with ATTRv polyneuropathy, the eplontersen treatment group demonstrated changes consistent with significantly lowered serum transthyretin concentration, less neuropathy impairment, and better quality of life compared with a historical placebo.Trial Registration: ClinicalTrials.gov Identifier: NCT04136184; EU Clinical Trials Register: EudraCT 2019-001698-10.
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| 3. |
- Heidbuechel, Ingo, et al.
(författare)
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The master transit time distribution of variable flow systems
- 2012
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Ingår i: Water resources research. - 0043-1397 .- 1944-7973. ; 48, s. W06520-
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Tidskriftsartikel (refereegranskat)abstract
- The transit time of water is an important indicator of catchment functioning and affects many biological and geochemical processes. Water entering a catchment at one point in time is composed of water molecules that will spend different amounts of time in the catchment before exiting. The next water input pulse can exhibit a totally different distribution of transit times. The distribution of water transit times is thus best characterized by a time-variable probability density function. It is often assumed, however, that the variability of the transit time distribution is negligible and that catchments can be characterized with a unique transit time distribution. In many cases this assumption is not valid because of variations in precipitation, evapotranspiration, and catchment water storage and associated (de) activation of dominant flow paths. This paper presents a general method to estimate the time-variable transit time distribution of catchment waters. Application of the method using several years of rainfall-runoff and stable water isotope data yields an ensemble of transit time distributions with different moments. The combined probability density function represents the master transit time distribution and characterizes the intra-annual and interannual variability of catchment storage and flow paths. Comparing the derived master transit time distributions of two research catchments (one humid and one semiarid) reveals differences in dominant hydrologic processes and dynamic water storage behavior, with the semiarid catchment generally reacting slower to precipitation events and containing a lower fraction of preevent water in the immediate hydrologic response.
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| 4. |
- Johnson, Candice, et al.
(författare)
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Skin sensitization in silico protocol
- 2020
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Ingår i: Regulatory toxicology and pharmacology. - : Elsevier BV. - 0273-2300 .- 1096-0295. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- The assessment of skin sensitization has evolved over the past few years to include in vitro assessments of key events along the adverse outcome pathway and opportunistically capitalize on the strengths of in silico methods to support a weight of evidence assessment without conducing a test in animals. While in silico methods vary greatly in their purpose and format; there is a need to standardize the underlying principles on which such models are developed and to make transparent the implications for the uncertainty in the overall assessment. In this contribution, the relationship between skin sensitization relevant effects, mechanisms, and endpoints are built into a hazard assessment framework. Based on the relevance of the mechanisms and effects as well as the strengths and limitations of the experimental systems used to identify them, rules and principles are defined for deriving skin sensitization in silico assessments. Further, the assignments of reliability and confidence scores that reflect the overall strength of the assessment are discussed. This skin sensitization protocol supports the implementation and acceptance of in silico approaches for the prediction of skin sensitization.
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| 5. |
- Staudinger, Maria, et al.
(författare)
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Catchment water storage variation with elevation
- 2017
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Ingår i: Hydrological Processes. - : Wiley. - 0885-6087 .- 1099-1085. ; 31:11, s. 2000-2015
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Tidskriftsartikel (refereegranskat)abstract
- One of the most important functions of catchments is the storage of water. Catchment storage buffers meteorological extremes and interannual streamflow variability, controls the partitioning between evaporation and runoff, and influences transit times of water. Hydrogeological data to estimate storage are usually scarce and seldom available for a larger set of catchments. This study focused on storage in prealpine and alpine catchments, using a set of 21 Swiss catchments comprising different elevation ranges. Catchment storage comparisons depend on storage definitions. This study defines different types of storage including definitions of dynamic and mobile catchment storage. We then estimated dynamic storage using four methods, water balance analysis, streamflow recession analysis, calibration of a bucket-type hydrological model Hydrologiska Byrans Vattenbalansavdelning model (HBV), and calibration of a transfer function hydrograph separation model using stable isotope observations. The HBV model allowed quantifying the contributions of snow, soil and groundwater storages compared to the dynamic catchment storage. With the transfer function hydrograph separation model both dynamic and mobile storage was estimated. Dynamic storage of one catchment estimated by the four methods differed up to one order of magnitude. Nevertheless, the storage estimates ranked similarly among the 21 catchments. The largest dynamic and mobile storage estimates were found in high-elevation catchments. Besides snow, groundwater contributed considerably to this larger storage. Generally, we found that with increasing elevation the relative contribution to the dynamic catchment storage increased for snow, decreased for soil, but remained similar for groundwater storage.
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| 6. |
- Wang, Xiaofeng, et al.
(författare)
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Evidence for type ia supernova diversity from ultraviolet observations with the hubble space telescope
- 2012
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 749:2, s. 126-
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Tidskriftsartikel (refereegranskat)abstract
- We present ultraviolet (UV) spectroscopy and photometry of four Type Ia supernovae (SNe 2004dt, 2004ef, 2005M, and 2005cf) obtained with the UV prism of the Advanced Camera for Surveys on the Hubble Space Telescope. This data set provides unique spectral time series down to 2000 angstrom. Significant diversity is seen in the near-maximum-light spectra (similar to 2000-3500 angstrom) for this small sample. The corresponding photometric data, together with archival data from Swift Ultraviolet/Optical Telescope observations, provide further evidence of increased dispersion in the UV emission with respect to the optical. The peak luminositiesmeasured in the uvw1/F250W filter are found to correlate with the B-band light-curve shape parameter Delta m(15)(B), but with much larger scatter relative to the correlation in the broadband B band (e.g., similar to 0.4 mag versus similar to 0.2 mag for those with 0.8 mag < Delta m(15)(B) < 1.7 mag). SN 2004dt is found as an outlier of this correlation (at > 3 sigma), being brighter than normal SNe Ia such as SN 2005cf by similar to 0.9 mag and similar to 2.0 mag in the uvw1/F250W and uvm2/F220W filters, respectively. We show that different progenitor metallicity or line-expansion velocities alone cannot explain such a large discrepancy. Viewing-angle effects, such as due to an asymmetric explosion, may have a significant influence on the flux emitted in the UV region. Detailed modeling is needed to disentangle and quantify the above effects.
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| 7. |
- Weiler, Markus, et al.
(författare)
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Do we need a Community Hydrological Model?
- 2015
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Ingår i: Water resources research. - 0043-1397 .- 1944-7973. ; 51:9, s. 7777-7784
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Tidskriftsartikel (refereegranskat)abstract
- We believe that there are too many models in hydrology and we should ask ourselves the question, if we are currently wasting time and effort in developing another model again instead of focusing on the development of a Community Hydrological Model. In other fields, this kind of models has been quite successful, but due to several reasons, no single community model has been developed in the field of hydrology yet. The concept, strength, and weakness of a community model were discussed at the Chapman Conference on Catchment Spatial Behaviour and Complex Organisation held in Luxembourg in September 2014. This discussion as well as our own opinions about the potential of a community models or at least the necessary discussion to establish one are debated in this commentary.
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