Cesari M

References (7)

Title : Socioeconomic disparities in clinical trials on Alzheimer's disease: a systematic review - Canevelli_2018_Eur.J.Neurol_25_626
Author(s) : Canevelli M , Bruno G , Vico C , Zaccaria V , Lacorte E , Iavicoli I , Vanacore N , Cesari M
Ref : Eur Journal of Neurology , 25 :626 , 2018
Abstract : BACKGROUND AND PURPOSE: There is now a wide consensus at recognizing social and economic circumstances as main determinants of an individual's health status. Nevertheless, characteristics relating to socioeconomic status (SES) are poorly described in research reports. The aim of the present review was to verify whether the SES of participants is adequately reported in interventional studies targeting Alzheimer's disease (AD), and to explore the impact of SES proxy measures on the efficacy of the considered medications. METHODS: A systematic review of available randomized controlled trials (RCTs) on the currently marketed drugs for AD (i.e. cholinesterase inhibitors and memantine) was conducted by performing a structured search on PubMed and the Cochrane databases. The following indicators of SES were considered in the retained studies: (i) educational level, (ii) lifetime job category, (iii) income and (iv) wealth. The study quality was assessed using the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RESULTS: A total of 48 articles were finally selected. Overall, only eight RCTs reported data concerning the four considered SES indicators. Indeed, only information pertaining to the educational level of participants was provided. Only one RCT (n = 60) performed ad hoc, secondary analyses accounting for the SES of participating subjects. CONCLUSIONS: The research and clinical relevance of SES has mistakenly been overlooked by the vast majority of RCTs on AD. A greater effort should be made to collect and report data on those SES indicators that may significantly affect the clinical manifestations and trajectories of patients with cognitive disturbances.
ESTHER : Canevelli_2018_Eur.J.Neurol_25_626
PubMedSearch : Canevelli_2018_Eur.J.Neurol_25_626
PubMedID: 29383812

Title : Sex and gender differences in the treatment of Alzheimer's disease: A systematic review of randomized controlled trials - Canevelli_2016_Pharmacol.Res_115_218
Author(s) : Canevelli M , Quarata F , Remiddi F , Lucchini F , Lacorte E , Vanacore N , Bruno G , Cesari M
Ref : Pharmacol Res , 115 :218 , 2016
Abstract : In recent years, epidemiological, clinical, and biological evidence has drawn the attention on the influence of sex and gender on Alzheimer's disease (AD). Nevertheless, not enough attention has been paid to their impact on treatment outcomes. The present study is aimed at systematically retrieve, review and discuss data coming from available randomized placebo-controlled trials (RCTs) on currently marketed treatments for AD (i.e., cholinesterase inhibitors [ChEIs] and memantine) in order to describe possible sex and gender differences in their efficacy, safety and tolerability. A systematic review of literature was performed. None of the retrieved studies reported data on the efficacy, safety and tolerability of considered medications separately in male and female patients with AD. We thus analyzed 48 excluded studies of potential interest, that is, almost all of the currently available trials on the four considered drugs. Nearly all the considered RCTs recruited a larger number of female participants to mirror the sexually unbalanced prevalence of AD. Only two studies took into account the potential influence of sex and gender on treatment efficacy, reporting no significant differences between men and women. None of the studies investigated potential sex and gender differences in the safety and tolerability of the four considered treatments. The existence of sex and gender differences in the efficacy and tolerability of ChEIs and memantine in AD has, to date, drawn limited to no attention. However, a considerable amount of data, with an adequate representativeness in terms of sex/gender distribution, seem to be already available for dedicated analyses on this topic. A greater effort should be made to collect and report data on those factors interacting with sex and gender that may significantly influence clinical manifestations, outcomes, and trajectories over time of AD patients.
ESTHER : Canevelli_2016_Pharmacol.Res_115_218
PubMedSearch : Canevelli_2016_Pharmacol.Res_115_218
PubMedID: 27913252

Title : Lipoprotein-associated phospholipase A2 single-nucleotide polymorphisms and cardiovascular events in patients with coronary artery disease - Maiolino_2015_J.Cardiovasc.Med.(Hagerstown)_16_29
Author(s) : Maiolino G , Lenzini L , Pedon L , Cesari M , Seccia TM , Frigo AC , Rossitto G , Caroccia B , Rossi GP
Ref : J Cardiovasc Med (Hagerstown) , 16 :29 , 2015
Abstract : AIMS: We tested the hypothesis that variations in the PLA2G7 gene encoding the lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme deemed to have proatherogenic activity, affect the Lp-PLA2 levels and predicts cardiovascular events. METHODS: Using a prospective cohort study design, we investigated incident cardiovascular events as a function of the PLA2G7 gene for rs1805017, rs1805018, and rs1051931 single-nucleotide polymorphisms (SNPs) in 643 randomly selected white patients from the GENICA Study, who at baseline underwent coronary angiography, measurement of Lp-PLA2 mass and activity. Cardiovascular event-free survival was compared across the genotypes by Cox regression, propensity score matching, and haplotype analysis. RESULTS: The rs1805018 SNP did not follow the Hardy-Weinberg equilibrium and was not further explored. The rs1805017 GG genotype had a lower Lp-PLA2 mass and a higher Lp-PLA2 activity, thus suggesting that this SNP is functional. Long-term follow-up (median 7.8 years) was obtained in 75% of the cohort and allowed recording of incident cardiovascular events in 25.8% of the patients. On Cox regression analysis, the common rs1805017 GG genotype predicted acute myocardial infarction (AMI) [hazard ratio 1.75, 95% confidence interval (CI) 1.03-2.99, P=0.041]; this finding was confirmed on propensity score matching (82.6% AMI-free survival in GG vs. 94.4% in GA+AA, P=0.003). The rs1805017 and rs1051931 G/G haplotype was also associated with AMI (52.7 vs. 42.2%, P=0.026) and cardiovascular event incidence (49.5 vs. 41.7%, P=0.025). CONCLUSION: In high-risk coronary artery disease patients of European ancestry, the PLA2G7 rs1805017 GG genotype is associated with increased Lp-PLA2 plasma activity and AMI.
ESTHER : Maiolino_2015_J.Cardiovasc.Med.(Hagerstown)_16_29
PubMedSearch : Maiolino_2015_J.Cardiovasc.Med.(Hagerstown)_16_29
PubMedID: 24732951
Gene_locus related to this paper: human-PLA2G7

Title : Effects of Gingko biloba supplementation in Alzheimer's disease patients receiving cholinesterase inhibitors: data from the ICTUS study - Canevelli_2014_Phytomedicine_21_888
Author(s) : Canevelli M , Adali N , Kelaiditi E , Cantet C , Ousset PJ , Cesari M
Ref : Phytomedicine , 21 :888 , 2014
Abstract : Ginkgo biloba (Gb) is currently the most investigated and adopted herbal remedy for cognitive disorders and Alzheimer's disease (AD). Nevertheless, its efficacy in the prevention and treatment of dementia still remains controversial. Specifically, the added effects of Gb in subjects already receiving "conventional" anti-dementia treatments have been to date very scarcely investigated. We evaluated whether the use of Gb is associated with additional cognitive and functional benefit in AD patients already in treatment with cholinesterase inhibitors (ChEIs). Data are from mild to moderate AD patients under ChEI treatment recruited in the Impact of Cholinergic Treatment USe (ICTUS) study. Mixed model analyses were performed to measure six-monthly modifications in the Mini Mental State Examination (MMSE), the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) subscale score, and the Activities of Daily Living (ADL) scale over a follow-up of 1 year according to the additional Gb supplementation. A total of 828 subjects were considered for the present analyses. Significantly different modifications at the MMSE score over the 12-month follow-up were reported between patients on combined therapy compared to those only taking ChEIs. On the contrary, the modification of the ADAS-Cog score between the two groups did not show statistically significant differences, although similar trends were noticed. No significant modifications of the two adopted outcome measures were observed at the mid-term 6-month evaluation. The modifications over time of the ADL score did not show statistically significant differences between the two groups of interest. Our findings suggest that Gb may provide some added cognitive benefits in AD patients already under ChEIs treatment. The clinical meaningfulness of such effects remains to be confirmed and clarified.
ESTHER : Canevelli_2014_Phytomedicine_21_888
PubMedSearch : Canevelli_2014_Phytomedicine_21_888
PubMedID: 24548724

Title : Predictors of decline in walking ability in community-dwelling Alzheimer's disease patients: Results from the 4-years prospective REAL.FR study - Rolland_2013_Alzheimers.Res.Ther_5_52
Author(s) : Rolland Y , Cantet C , Barreto PD , Cesari M , van Kan GA , Vellas B
Ref : Alzheimers Res Ther , 5 :52 , 2013
Abstract : INTRODUCTION: The aim of this study was to explore the predictors of decline in walking ability in patients with Alzheimer's disease (AD).
METHODS: The prospective REseau surla maladie ALzheimer FRancais (REAL.FR) study enrolled six hundred eighty four community-dwelling AD subjects (71.20% women; mean age 77.84 Standard Deviation, SD, 6.82 years, Mini-Mental State Examination 20.02, SD 4.23). Decline in walking ability was defined as the first loss of 0.5 points or more in the walking ability item of the Activities of Daily Living scale (ADL), where higher score means greater independence, during the four-years of follow-up. Demographic characteristics, co-morbidities, and level of education were reported at baseline. Disability, caregiver burden, cognitive and nutritional status, body mass index, balance, behavioral and psychological symptoms of dementia, medication, hospitalization, institutionalization and death were reported every six months during the four years. Cox survival analyses were performed to assess the independent factors associated with decline in walking ability.
RESULTS: The mean incident decline in walking ability was 12.76% per year (95% Confidence Interval (CI) 10.86 to 14.66). After adjustment for confounders, the risk of decline in walking ability was independently associated with older age (Relative Risk, RR = 1.05 (95% CI 1.02 to 1.08)), time from diagnosis of dementia (RR = 1.16 (1.01 to 1.33)), painful osteoarthritis (RR = 1.84 (1.19 to 2.85)), hospitalization for fracture of the lower limb (RR = 6.35 (3.02 to 13.37)), higher baseline ADL score (RR = 0.49 (0.43 to 0.56)), and the use of acetylcholinesterase inhibitors (RR = 0.52 (0.28 to 0.96)).
CONCLUSIONS: The risk of decline in walking ability is predicted by older age, increased dementia severity, poor functional score, and orthopedic factors and seems to be prevented by the use of acetylcholinesterase inhibitors medication.
ESTHER : Rolland_2013_Alzheimers.Res.Ther_5_52
PubMedSearch : Rolland_2013_Alzheimers.Res.Ther_5_52
PubMedID: 24517197

Title : Lipoprotein-associated phospholipase A2 activity predicts cardiovascular events in high risk coronary artery disease patients - Maiolino_2012_PLoS.One_7_e48171
Author(s) : Maiolino G , Pedon L , Cesari M , Frigo AC , Wolfert RL , Barisa M , Pagliani L , Rossitto G , Seccia TM , Zanchetta M , Rossi GP
Ref : PLoS ONE , 7 :e48171 , 2012
Abstract : OBJECTIVE: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is deemed to play a role in atherosclerosis and plaque destabilization as demonstrated in animal models and in prospective clinical studies. However, most of the literature is either focused on high-risk, apparently healthy patients, or is based on cross sectional studies. Therefore, we tested the hypothesis that serum Lp-PLA2 mass and activity are useful for predicting cardiovascular (CV) events over the coronary atherosclerotic burden and conventional risk factors in high-risk coronary artery disease patients. METHODS AND RESULTS: In a prospective cohort study of 712 Caucasian patients, who underwent coronary angiography and measurement of both Lp-PLA2 mass and activity at baseline, we determined incident CV events at follow-up after splitting the patients into a high and a low Lp-PLA2 mass and activity groups based on ROC analysis and Youden index. Kaplan-Meier and propensity score matching analysis were used to compare CV event-free survival between groups. Follow-up data were obtained in 75% of the cohort after a median of 7.2 years (range 1-12.7 years) during which 129 (25.5%) CV events were observed. The high Lp-PLA2 activity patients showed worse CV event-free survival (66.7% vs. 79.5%, p=0.023) and acute coronary syndrome-free survival (75.4% vs. 85.6%, p=0.04) than those in low Lp-PLA2 group. CONCLUSIONS: A high Lp-PLA2 activity implies a worse CV prognosis at long term follow up in high-risk Caucasian patients referred for coronary angiography.
ESTHER : Maiolino_2012_PLoS.One_7_e48171
PubMedSearch : Maiolino_2012_PLoS.One_7_e48171
PubMedID: 23118945
Gene_locus related to this paper: human-PLA2G7

Title : Collaborative meta-analysis of individual participant data from observational studies of Lp-PLA2 and cardiovascular diseases - Ballantyne_2007_Eur.J.Cardiovasc.Prev.Rehabil_14_3
Author(s) : Ballantyne C , Cushman M , Psaty B , Furberg C , Khaw KT , Sandhu M , Oldgren J , Rossi GP , Maiolino G , Cesari M , Lenzini L , James SK , Rimm E , Collins R , Anderson J , Koenig W , Brenner H , Rothenbacher D , Berglund G , Persson M , Berger P , Brilakis E , McConnell JP , Sacco R , Elkind M , Talmud P , Cannon CP , Packard C , Barrett-Connor E , Hofman A , Kardys I , Witteman JC , Criqui M , Corsetti JP , Rainwater DL , Moss AJ , Robins S , Bloomfield H , Collins D , Wassertheil-Smoller S , Ridker P , Danesh J , Gu D , Nelson JJ , Thompson S , Zalewski A , Zariffa N , Di Angelantonio E , Kaptoge S , Thompson A , Walker M , Watson S , Wood A
Ref : Eur J Cardiovasc Prev Rehabil , 14 :3 , 2007
Abstract : BACKGROUND: A large number of observational epidemiological studies have reported generally positive associations between circulating mass and activity levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular diseases. Few studies have been large enough to provide reliable estimates in different circumstances, such as in different subgroups (e.g., by age group, sex, or smoking status) or at different Lp-PLA2 levels. Moreover, most published studies have related disease risk only to baseline values of Lp-PLA2 markers (which can lead to substantial underestimation of any risk relationships because of within-person variability over time) and have used different approaches to adjustment for possible confounding factors. OBJECTIVES: By combination of data from individual participants from all relevant observational studies in a systematic 'meta-analysis', with correction for regression dilution (using available data on serial measurements of Lp-PLA2), the Lp-PLA2 Studies Collaboration will aim to characterize more precisely than has previously been possible the strength and shape of the age and sex-specific associations of plasma Lp-PLA2 with coronary heart disease (and, where data are sufficient, with other vascular diseases, such as ischaemic stroke). It will also help to determine to what extent such associations are independent of possible confounding factors and to explore potential sources of heterogeneity among studies, such as those related to assay methods and study design. It is anticipated that the present collaboration will serve as a framework to investigate related questions on Lp-PLA2 and cardiovascular outcomes. METHODS: A central database is being established containing data on circulating Lp-PLA2 values, sex and other potential confounding factors, age at baseline Lp-PLA2 measurement, age at event or at last follow-up, major vascular morbidity and cause-specific mortality. Information about any repeat measurements of Lp-PLA2 and potential confounding factors has been sought to allow adjustment for possible confounding and correction for regression dilution. The analyses will involve age-specific regression models. Synthesis of the available observational studies of Lp-PLA2 will yield information on a total of about 15 000 cardiovascular disease endpoints.
ESTHER : Ballantyne_2007_Eur.J.Cardiovasc.Prev.Rehabil_14_3
PubMedSearch : Ballantyne_2007_Eur.J.Cardiovasc.Prev.Rehabil_14_3
PubMedID: 17301621
Gene_locus related to this paper: human-PLA2G7