Jamie Pitlick

[Drake CPHS @DrakeCPHS]

Congrats to our faculty who received promotion/tenure!

Cassity Gutierrez - Professor
Stacy Gnacinski - Assoc. Professor + Tenure
Jon Hurdelbrink - Assoc. Professor + Tenure
Abebe Mengesha - Professor
Shankar Munusamy - Professor
Nate Newman - Professor
Jamie Pitlick - Professor

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci It really is one of the best things!

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci @JamesLeFevre_ Happy to be discuss this paper and this topic. This is a very exciting class of drugs for the T1D population! #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci Also find someone that can help you through the first one because it can be a confusing process.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci I've done several of these papers my PharmD APPE students and ideas have come about through topic discussions and every day patient discussions. Always keeping an eye open for these opportunities.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci @JamesLeFevre_ Agree

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A9 cont. I also think it would be prudent to evaluate the length of benefit of these drugs to understand if and when to possibly repeat the course of infusions. #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A9 cont. Some of the more exciting avenues include when only one antibody positive, LADA diagnosis, younger age groups, post-islet transplantation.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A9. There are several different avenues that could be studied that could expand the potential of this new drug class.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci Despite occurance of lymphopenia, the infection rates were often comparable between those who received treatment and those who did not. #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A7 cont. Transient lymphopenia is also very common, >70% of patients. Most patients would recover after the fifth day of treatment and return to pretreatment values within 14 days after completion.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A7 cont. It is recommended to monitor WBC during the treatment period. If prolonged severe lymphopenia develops, treatment should be discontinued. This was seen in 0.9% of the treated patients.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci Not many, especially if able to follow a protocol to premedicate. Interestingly, they are studying other administrations (PO/SQ) to see if that lowers this ADR

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A7 cont. In addition to fever, nausea, fatigue, headache, myalgia, and arthralgia, patients also present with increased ALT, AST, and total bili. These should be monitored during treatment and teplizumab should be discontinued if ALT or AST is > 5xULN or bili > 3xULN. #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci Longer follow up studies also included A1c and other common glucose measurements. #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci A variety of outcome measures were in the review including dose-escalation outcomes like time to target engagement. Important clinical outcomes included beta-cell function measured by C-peptide levels; insulin doses (units/kg/day), time to diagnosis of T1D, and adverse events.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci This is a long one because the review included 24 articles. It was a combination of phase I, II, and III RCT in those with recent onset of T1D or at high risk of T1D.

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci The Anti-CD3 mAbs help one step earlier in the progression of T1D in stage 2 when a person has 2 or more antibodies present and are showing glucose intolerance. They are meant to preserve beta-cells by preventing the destruction and delaying the onset and use of insulin #SCSSChat

[Jamie Pitlick @JamiePitlick]

@ASHP_EmergSci Treatment for T1D up until this point all happens after the full development, aka stage 3 T1D. At this point the person has lost most of the function of the beta-cells and has onset of hyperglycemia.