Narrow your search

Library

KBR (1)

UCLouvain (1)


Resource type

book (1)

dissertation (1)


Language

English (1)

French (1)


Year
From To Submit

2022 (1)

2018 (1)

Listing 1 - 2 of 2
Sort by

Dissertation
Association of cardiovascular occlusive events with BCR-ABL tyrosine kinase therapy : identification, understanding and prediction
Authors: ---
ISBN: 9782390291565 Year: 2022 Publisher: Namur Presses universitaires de Namur

Loading...
Export citation

Choose an application

Bookmark

Abstract

The identification o fthe BCR-ABL tyrosine kinase as the main culprit in the pathology of chronic myeloid leukemia led to the development of one of the most successful cancer therapies, imatinib, an inhibitor designed to specifically target BCR-ABL. Imatinib reduces durably the number of leukemic cells, providing a life span of patients with chronic myeloid leukemia in chronic phase close to that ofthe general population. However, some patients are intolerant or resistant, inducing the development of three additional BCR-ABL tyrosine kinase inhibitors (i.e. dasatinib, nilotinib and bosutinib). Ponatinib, a BCR-ABL tyrosine kinase inhibitor classified as a third generation was finally designed to overcome a mutation in the bcr-abl gene which provides resistance to all the other BCR-ABL tyrosine kinase inhibitors. However, during the ponatinib clinical development, numerous patients had a vascular occlusion. The aim of this thesis is to investigate the vascular toxicity associated with BCR-ABL tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia. Through meta-analyses we highlighted that in addition to ponatinib, dasatinib and nilotinib also induce vascular toxicity, and more specifically arterial occlusion. Secondarily, through a review of the literature and in vitro experiments, we determined that these three treatments affect the vasculature differently. Ponatinib is highly toxic to endothelial cells, and this toxicity could be responsible for the arterial occlusion. Dasatinib impairs endothelial cells in a lesser extent, whereas nilotinib possesses a different vascular profile. It deregulates glucose and lipid metabolism and impacts platelet functions. The identification of the precise mechanisms underlying tyrosine kinase inhibitor-induced arterial occlusions is a central element as it influences the management ofthe vascular toxicity by guiding treatment selection, vascular monitoring and anticipating the vascular toxicity.

Keywords


Book
Efficacité et sécurité de l'utilisation concomitante des antiagrégants plaquettaires avec les nouveaux anticoagulants oraux
Authors: --- --- ---
Year: 2018 Publisher: Bruxelles: UCL. Faculté de pharmacie et des sciences biomédicales,

Loading...
Export citation

Choose an application

Bookmark

Abstract

Avec l’avènement des nouveaux anticoagulants oraux dans la prise en charge de la fibrillation auriculaire et l’augmentation des comorbidités de ce genre de maladies, leur utilisation concomitante avec les antiagrégants plaquettaires pose de plus en plus question. En effet, les risques de saignement d’une triple thérapie, prise en charge classique d’un syndrome coronarien aigu et/ou d’une intervention coronarienne percutanée, ne sont plus à démontrer et viennent à balancer l’efficacité d’une telle thérapie. Il devient alors impératif de définir quel traitement serait le plus judicieux dans une telle situation, question à laquelle ce mémoire a tenté de répondre en réalisant une revue systématique de la littérature à ce sujet et en proposant des pistes de traitements alternatifs moins dangereux. Ce mémoire conclut alors que le rivaroxaban en bithérapie avec le clopidogrel semble être l’alternative la plus sûre. Cependant, le manque d’étude sur le sujet renforce l’idée qu’il est plus que nécessaire d’investiguer davantage les différentes possibilités qui existent pour la prise en charge de patients souffrant à la fois de FA et d’un SCA. With the advent of new oral anticoagulants in the management of atrial fibrillation and the increase of comorbidities from this kind of diseases, their concomitant use with platelet aggregation inhibitors raise more and more the question. Indeed, the risks of bleeding from a triple therapy, conventional management of acute coronary syndrome and / or percutaneous coronary intervention, are well established and come to balance the effectiveness of such therapy. It then becomes imperative to define which treatment would be the most judicious in such situation, a question to which this essay has tried to answer by carrying out a systematic review of the literature on this subject and proposing less dangerous alternative treatment. This essay leads to the conclusion that rivaroxaban in dual therapy with clopidogrel seems to be safest alternative. However, the lack of study on the subject reinforces the idea that is more than necessary to fully investigate the different possibilities that exist for the management of patients suffering from both FA and SCA.

Listing 1 - 2 of 2
Sort by


Copyright ©2025 SemperTool