Musa Topel - Academia.edu (original) (raw)

Papers by Musa Topel

Research paper thumbnail of Changes in Treatment Adherence During the COVID-19 Pandemic in Patients with Severe Asthma Receiving Biologic Agent Treatment

Research paper thumbnail of Mepolizumab ile tedavi edilen ağır eozinofilik astımlı hastalarda gerçek yaşam verilerinin değerlendirilmesi

Journal of Medicine and Palliative Care

Amaç: Mepolizumabın astım alevlenmeleri, kan eozinofilleri, oral steroid bağımlılığı ve astım kon... more Amaç: Mepolizumabın astım alevlenmeleri, kan eozinofilleri, oral steroid bağımlılığı ve astım kontrolü üzerindeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışma, retrospektif analiz ile elde edilen gerçek yaşam verilerinden oluşturulmuş klinik gözlemsel bir çalışmadır. Kliniğimizde dört haftada bir 100 mg deri altı mepolizumab başlanan ve en az 16 hafta tedavi gören hastalar çalışmaya alındı. Bulgular: Ağır eozinofilik astımı olan 34 hasta çalışmaya dahil edildi. Ağır eozinofilik astımı olan hastalarda mepolizumab tedavisinin astım alevlenmelerinin sayısında, oral kortikosteroid idame ihtiyacında, kan eozinofil sayılarında ve akciğer fonksiyonlarında ve astım kontrol testi puanlarında iyileşme ile sonuçlandığını bulduk. 6 ayda mepolizumab tedavisine yanıt verenlerin ve süper yanıt verenlerin oranı sırasıyla %75 ve %17,9’du ve sonuç olarak genel yanıt oranı %92,9’du. Tedavinin ilk yılında, süper yanıt verenlerin oranı %58,3’e yükseldi ve genel yanıt oranı %91,7 ol...

Research paper thumbnail of Biyolojik Ajan Tedavisi Alan Ağır Astımlı Hastalarda COVID-19 Pandemisi Sırasında Tedaviye Uyumdaki Değişiklikler

Journal of Contemporary Medicine

Aim: This study aimed to evaluate the effects of the COVID-19 pandemic on treatment adherence in ... more Aim: This study aimed to evaluate the effects of the COVID-19 pandemic on treatment adherence in patients with severe asthma who were receiving omalizumab and mepolizumab treatment in our clinic. Material and Method: A total of 53 patients with severe asthma, 45 of whom were using omalizumab and 8 of whom were using mepolizumab, were included in the study. The medical records of the patients were recorded anonymously and retrospectively. Results: It was seen that the rate of patients using omalizumab in the study population decreased during the pandemic period compared to the 1-year period before the pandemic. It was observed that approximately 51% of the patients using omalizumab missed routine treatment doses. The major factor in skipping treatment doses was the fear of contracting COVID-19 upon admission to the hospital. In the mepolizumab group, the rate of using biologic agents during the pandemic period increased compared to 1 year before the pandemic. Dose skipping was observ...

Research paper thumbnail of Dahili ve Cerrahi Bilimler Araştırma Görevlilerinde Tükenmişlik Sendromu Oranlarının Karşılaştırılması ve İşyeri Doyumuyla Olan İlişkisinin Gösterilmesi

Burnout syndrome; is a psychosocial phenomenon that develops in employees against the intense str... more Burnout syndrome; is a psychosocial phenomenon that develops in employees against the intense stress situation in the workplace, especially seen in occupations working in face to face with people. It has been shown in many studies that the rate of development of burnout syndrome is high in healthcare workers, especially in occupational groups such as nurses and doctors. Job satisfaction is one of the most important factors that have positive reinforcing properties against burnout. The aim of this study is to compare the burnout levels of residents working in various fields of specialty under the departments of Medical and Surgical Sciences Divisions in Hacettepe University Hospitals and to show the relationship of burnout with job satisfaction. The research was carried out between the dates of 11/2018 - 04/2019 in Hacettepe University Adult and Oncology Hospital, 206 residents were included. As data collection forms; “Sociodemographic Data Form” consisting of 18 questions, “Maslach ...

Research paper thumbnail of Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with ... more Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7-13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.

Research paper thumbnail of Real-life adherence to subcutaneous immunotherapy: What has changed in the era of the COVID-19 pandemic

World Allergy Organization Journal, 2021

Background Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term mod... more Background Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term modifying effect. Adherence is a key to ensure effectiveness. The objective of this study was, first of all, to evaluate the adherence with subcutaneous immunotherapy (SCIT) and to identify the main causes of SCIT withdrawal in real-life practice in our clinic. Secondly, to investigate to what extent COVID-19 pandemic altered our SCIT receiving patients’ treatment adherence behaviors and the factors that affected their decisions. Methods Retrospective analysis of the medical records of patients ages ≥18 years, who had started SCIT in January 2014 or later until September 2020 in our department for the diagnosis of allergic rhinitis, allergic asthma or venom allergy were included in the study. Adherence was determined as the accomplishment of three years of SCIT. Results A total of 124 patients (72 female [58.1%]; median age, 35 [19-77] years) were included. The adherence rate to SCIT in our tertiary center’s real-life setting was 56.25% with a follow-up duration of 3 years before COVID-19 pandemic. Dose modification, defined as reducing patient's planned SCIT dose due to a systemic allergic/large local reaction or missed injection, and its frequency, which is the number of dose adjustments done throughout the SCIT, was found to be the only factor related to nonadherence. But with the pandemic only in 6 months, among 63 patients receiving SCIT, 15 patients (23.81%) dropped out and the most common reason was fear of being infected with COVID-19 virus during receiving SCIT in hospital (93.33%). The only independent predictor of drop-out during COVID-19 pandemic was short duration of AIT (p=0.012). When we compare the dropped-out cases before and after the start of pandemic AIT duration was significantly shorter in pandemic period (p= 0.005). Conclusion Adherence rate to SCIT in our real-world setting study was 56.25% before COVID-19 pandemic. Our results indicated that patients requiring dose modification were more prone to be non-adherent. Approximately a quarter of patients dropped-out with the start of pandemic, almost all due to fear of being infected during receiving SCIT in hospital. Since short SCIT follow-up time was found to be the only risk factor for drop-out during COVID-19 pandemic, we believe that patients who are in the early phases of their treatment should be observed more closely and their concerns should be answered by their doctors.

Research paper thumbnail of COVID-19 in patients with severe asthma using biological agents

Tuberk Toraks, 2021

COVID-19 in patients with severe asthma using biological agents As the COVID-19 pandemic continue... more COVID-19 in patients with severe asthma using biological agents As the COVID-19 pandemic continues, case reports have been published where patients with severe asthma using biological agents survived with a mild course of illness and encouraged the continuation of biological therapies in patients with severe asthma. However, contrary to previous information, a more severe course of COVID-19 has recently been reported in severe asthmatics using biological therapy compared to the general population. To evaluate the COVID-19 rate and disease severity in severe asthmatics using biological agents. A retrospective study was conducted in patients with severe asthma treated with biological agents. Data concerning whether the subjects had contracted COVID-19 and the severity of the disease were evaluated. Eihgty-four severe asthmatics using biological agents (omalizumab or mepolizumab) aged 48.3 ± 10.6 years (mean ± standard deviation) with female/male ratio: 53 (63.1%)/31 (36.9%) were included in the study. Among participants 13 (15.5%) had contracted COVID-19. The course of COVID-19 was mild in five (38.5%) and moderate in eight patients (61.5%), while none of the patients had a severe course of COVID-19. Mechanical ventilation or intensive care follow-up was not required in any of the six patients (46.2%) who were treated as inpatients. All participants survived COVID-19 in full recovery and no deaths occurred in the cases. A higher rate of COVID-19 was found in patients with severe asthma using biologics compared to those reported in previous reports. However, all patients with COVID-19 have a mild to moderate disease course.

Research paper thumbnail of COVID-19 in a patient with severe asthma using mepolizumab

Allergy and Asthma Proceedings, 2021

Background: There is a lack of information about the course of coronavirus disease 2019 (COVID-19... more Background: There is a lack of information about the course of coronavirus disease 2019 (COVID-19) in patients with severe asthma who were treated with biologics. Some reports indicated that treatment with benralizumab, dupilumab, and omalizumab in patients with severe asthma was not associated with significant adverse effects during COVID-19. Methods: Asthma itself or the biologic agents used to treat asthma can have a positive effect on the course of COVID-19. There seem not to be any cases that specifically reported the use of mepolizumab in a patient who was infected with COVID. Results: We reported of a 55-year-old woman with a diagnosis of severe asthma for; 3 years and who was being treated with mepolizumab, with no evidence of loss of asthma control, at the time of contracting COVID-19 and who had been followed up in the allergy clinic. In addition, there are no data on mepolizumab therapy in patients with elevated liver enzyme levels. Conclusion: With this case, we also rep...

Research paper thumbnail of Aerosol Medication Use in COVID-19 Pandemic

Asthma Allergy Immunology, 2020

Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transm... more Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.

Research paper thumbnail of Changes in Treatment Adherence During the COVID-19 Pandemic in Patients with Severe Asthma Receiving Biologic Agent Treatment

Research paper thumbnail of Mepolizumab ile tedavi edilen ağır eozinofilik astımlı hastalarda gerçek yaşam verilerinin değerlendirilmesi

Journal of Medicine and Palliative Care

Amaç: Mepolizumabın astım alevlenmeleri, kan eozinofilleri, oral steroid bağımlılığı ve astım kon... more Amaç: Mepolizumabın astım alevlenmeleri, kan eozinofilleri, oral steroid bağımlılığı ve astım kontrolü üzerindeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışma, retrospektif analiz ile elde edilen gerçek yaşam verilerinden oluşturulmuş klinik gözlemsel bir çalışmadır. Kliniğimizde dört haftada bir 100 mg deri altı mepolizumab başlanan ve en az 16 hafta tedavi gören hastalar çalışmaya alındı. Bulgular: Ağır eozinofilik astımı olan 34 hasta çalışmaya dahil edildi. Ağır eozinofilik astımı olan hastalarda mepolizumab tedavisinin astım alevlenmelerinin sayısında, oral kortikosteroid idame ihtiyacında, kan eozinofil sayılarında ve akciğer fonksiyonlarında ve astım kontrol testi puanlarında iyileşme ile sonuçlandığını bulduk. 6 ayda mepolizumab tedavisine yanıt verenlerin ve süper yanıt verenlerin oranı sırasıyla %75 ve %17,9’du ve sonuç olarak genel yanıt oranı %92,9’du. Tedavinin ilk yılında, süper yanıt verenlerin oranı %58,3’e yükseldi ve genel yanıt oranı %91,7 ol...

Research paper thumbnail of Biyolojik Ajan Tedavisi Alan Ağır Astımlı Hastalarda COVID-19 Pandemisi Sırasında Tedaviye Uyumdaki Değişiklikler

Journal of Contemporary Medicine

Aim: This study aimed to evaluate the effects of the COVID-19 pandemic on treatment adherence in ... more Aim: This study aimed to evaluate the effects of the COVID-19 pandemic on treatment adherence in patients with severe asthma who were receiving omalizumab and mepolizumab treatment in our clinic. Material and Method: A total of 53 patients with severe asthma, 45 of whom were using omalizumab and 8 of whom were using mepolizumab, were included in the study. The medical records of the patients were recorded anonymously and retrospectively. Results: It was seen that the rate of patients using omalizumab in the study population decreased during the pandemic period compared to the 1-year period before the pandemic. It was observed that approximately 51% of the patients using omalizumab missed routine treatment doses. The major factor in skipping treatment doses was the fear of contracting COVID-19 upon admission to the hospital. In the mepolizumab group, the rate of using biologic agents during the pandemic period increased compared to 1 year before the pandemic. Dose skipping was observ...

Research paper thumbnail of Dahili ve Cerrahi Bilimler Araştırma Görevlilerinde Tükenmişlik Sendromu Oranlarının Karşılaştırılması ve İşyeri Doyumuyla Olan İlişkisinin Gösterilmesi

Burnout syndrome; is a psychosocial phenomenon that develops in employees against the intense str... more Burnout syndrome; is a psychosocial phenomenon that develops in employees against the intense stress situation in the workplace, especially seen in occupations working in face to face with people. It has been shown in many studies that the rate of development of burnout syndrome is high in healthcare workers, especially in occupational groups such as nurses and doctors. Job satisfaction is one of the most important factors that have positive reinforcing properties against burnout. The aim of this study is to compare the burnout levels of residents working in various fields of specialty under the departments of Medical and Surgical Sciences Divisions in Hacettepe University Hospitals and to show the relationship of burnout with job satisfaction. The research was carried out between the dates of 11/2018 - 04/2019 in Hacettepe University Adult and Oncology Hospital, 206 residents were included. As data collection forms; “Sociodemographic Data Form” consisting of 18 questions, “Maslach ...

Research paper thumbnail of Successful desensitization under antihistamine suppression in a case with urticaria due to osimertinib

Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with ... more Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7-13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.

Research paper thumbnail of Real-life adherence to subcutaneous immunotherapy: What has changed in the era of the COVID-19 pandemic

World Allergy Organization Journal, 2021

Background Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term mod... more Background Allergen immunotherapy (AIT) must be continued for 3 years, to achieve a long-term modifying effect. Adherence is a key to ensure effectiveness. The objective of this study was, first of all, to evaluate the adherence with subcutaneous immunotherapy (SCIT) and to identify the main causes of SCIT withdrawal in real-life practice in our clinic. Secondly, to investigate to what extent COVID-19 pandemic altered our SCIT receiving patients’ treatment adherence behaviors and the factors that affected their decisions. Methods Retrospective analysis of the medical records of patients ages ≥18 years, who had started SCIT in January 2014 or later until September 2020 in our department for the diagnosis of allergic rhinitis, allergic asthma or venom allergy were included in the study. Adherence was determined as the accomplishment of three years of SCIT. Results A total of 124 patients (72 female [58.1%]; median age, 35 [19-77] years) were included. The adherence rate to SCIT in our tertiary center’s real-life setting was 56.25% with a follow-up duration of 3 years before COVID-19 pandemic. Dose modification, defined as reducing patient's planned SCIT dose due to a systemic allergic/large local reaction or missed injection, and its frequency, which is the number of dose adjustments done throughout the SCIT, was found to be the only factor related to nonadherence. But with the pandemic only in 6 months, among 63 patients receiving SCIT, 15 patients (23.81%) dropped out and the most common reason was fear of being infected with COVID-19 virus during receiving SCIT in hospital (93.33%). The only independent predictor of drop-out during COVID-19 pandemic was short duration of AIT (p=0.012). When we compare the dropped-out cases before and after the start of pandemic AIT duration was significantly shorter in pandemic period (p= 0.005). Conclusion Adherence rate to SCIT in our real-world setting study was 56.25% before COVID-19 pandemic. Our results indicated that patients requiring dose modification were more prone to be non-adherent. Approximately a quarter of patients dropped-out with the start of pandemic, almost all due to fear of being infected during receiving SCIT in hospital. Since short SCIT follow-up time was found to be the only risk factor for drop-out during COVID-19 pandemic, we believe that patients who are in the early phases of their treatment should be observed more closely and their concerns should be answered by their doctors.

Research paper thumbnail of COVID-19 in patients with severe asthma using biological agents

Tuberk Toraks, 2021

COVID-19 in patients with severe asthma using biological agents As the COVID-19 pandemic continue... more COVID-19 in patients with severe asthma using biological agents As the COVID-19 pandemic continues, case reports have been published where patients with severe asthma using biological agents survived with a mild course of illness and encouraged the continuation of biological therapies in patients with severe asthma. However, contrary to previous information, a more severe course of COVID-19 has recently been reported in severe asthmatics using biological therapy compared to the general population. To evaluate the COVID-19 rate and disease severity in severe asthmatics using biological agents. A retrospective study was conducted in patients with severe asthma treated with biological agents. Data concerning whether the subjects had contracted COVID-19 and the severity of the disease were evaluated. Eihgty-four severe asthmatics using biological agents (omalizumab or mepolizumab) aged 48.3 ± 10.6 years (mean ± standard deviation) with female/male ratio: 53 (63.1%)/31 (36.9%) were included in the study. Among participants 13 (15.5%) had contracted COVID-19. The course of COVID-19 was mild in five (38.5%) and moderate in eight patients (61.5%), while none of the patients had a severe course of COVID-19. Mechanical ventilation or intensive care follow-up was not required in any of the six patients (46.2%) who were treated as inpatients. All participants survived COVID-19 in full recovery and no deaths occurred in the cases. A higher rate of COVID-19 was found in patients with severe asthma using biologics compared to those reported in previous reports. However, all patients with COVID-19 have a mild to moderate disease course.

Research paper thumbnail of COVID-19 in a patient with severe asthma using mepolizumab

Allergy and Asthma Proceedings, 2021

Background: There is a lack of information about the course of coronavirus disease 2019 (COVID-19... more Background: There is a lack of information about the course of coronavirus disease 2019 (COVID-19) in patients with severe asthma who were treated with biologics. Some reports indicated that treatment with benralizumab, dupilumab, and omalizumab in patients with severe asthma was not associated with significant adverse effects during COVID-19. Methods: Asthma itself or the biologic agents used to treat asthma can have a positive effect on the course of COVID-19. There seem not to be any cases that specifically reported the use of mepolizumab in a patient who was infected with COVID. Results: We reported of a 55-year-old woman with a diagnosis of severe asthma for; 3 years and who was being treated with mepolizumab, with no evidence of loss of asthma control, at the time of contracting COVID-19 and who had been followed up in the allergy clinic. In addition, there are no data on mepolizumab therapy in patients with elevated liver enzyme levels. Conclusion: With this case, we also rep...

Research paper thumbnail of Aerosol Medication Use in COVID-19 Pandemic

Asthma Allergy Immunology, 2020

Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transm... more Administration of aerolized drugs to patients diagnosed with COVID-19 leads to the risk of transmission of patient-generated infectious aerosols to healthcare providers.While the COVID-19 pandemic is ongoing, in order to provide the best treatment for patients and at the same time to protect healthcare providers at the highest level, it is necessary to increase access to information and pay maximum attention to preventive measures.