Retrospective Chart Review Study Research Articles

Osilodrostat treatment of Cushing syndrome in a real-world, retrospective analysis: Findings from the ILLUSTRATE study

Abstract Context In clinical trials, osilodrostat (11β-hydroxylase inhibitor) effectively reduced cortisol levels in patients with endogenous Cushing syndrome (CS). Objectives Real-world study (ILLUSTRATE) evaluating osilodrostat use in patients with various etiologies of CS in the United States. Methods Retrospective chart-review study of adults with CS treated with osilodrostat between May 1, 2020 and October 29, 2021. Results 42 patients (Cushing disease, n=34; CS due to adrenal adenoma, n=5; ectopic adrenocorticotropic hormone syndrome [EAS], n=3) were included. Starting doses were 2 mg twice daily (BID) in 27/42 patients (64.3%), maintenance doses were 2 mg BID in 6/9 patients (66.7%) attaining them. During osilodrostat treatment, urinary free cortisol (UFC) decreased below the upper limit of normal (ULN) in 14/20 patients (70.0%) with pre-treatment UFC >ULN. Osilodrostat response was observed across a range of doses (2–20 mg/day). In Cushing disease, median UFC and late-night salivary cortisol decreased from 3.03 and 2.39 × ULN, respectively, to 0.71 and 1.13 × ULN at last assessment in those with available data (n=17 and 8, respectively). UFC decreased in all patients with adrenal CS or EAS with available data (n=2 each). There were no unexpected safety signals; the most common adverse events (incidence ≥20%) were fatigue, nausea, and lower-extremity edema. Glucocorticoid withdrawal syndrome and/or adrenal insufficiency were reported in 12/42 patients (28.6%) after osilodrostat initiation, resulting in treatment discontinuation in four. Conclusion In routine practice with dosing individualized according to clinical condition, response, and tolerability, osilodrostat was effective and well tolerated regardless of CS etiology and severity.

The Role of Routine Plain Film Imaging Post Cochlear Implantation.

We aimed to evaluate the efficacy of routine post-op X-ray in cochlear implantation patients. Retrospective chart review study. Primary or revision cochlear implant patients who had routine postoperative X-ray (XR) or had planned postoperative computed tomography (CT) due to clinical concerns for array malposition. All images were reviewed, and those were considered abnormal if there was a bent tip, kinking, incomplete insertion, or if the electrode array didn't follow the expected cochlear curvature. Postoperative CT scans were performed in patients with abnormal postoperation X-ray, or if there were abnormal surgical findings encountered during insertion which raised the suspicion for suboptimal placement. A total of 195 patients with a mean age of 64.8 ± 18.9 years were included. XRs were performed in 188 patients and others had CT scan from the beginning. Only 2 out of 188 patients had abnormal findings on XR, which showed malposition of the electrode in one patient and a tip fold over and incomplete insertion in the other one. Both patients with abnormal findings had labyrinthitis ossificans. The patient with tip fold over ultimately underwent re-implantation. Another patient with incomplete insertion had required extended basal turn drilling during implantation, and no additional measures were taken. Routine XR findings did not provide the reason for additional intervention, and its benefit for patients without demonstrable cochlear abnormalities was minimal. Post-op XR can be informative in selected high risk patients, but CT imaging is a reasonable alternative to better define anatomic array location in patients particularly at risk.

Evaluation of direct oral anticoagulant continuation versus switching to a parenteral anticoagulant in critically ill patients: a retrospective cohort study

BackgroundDirect oral anticoagulants (DOACs) are widely used as first-line agents in various clinical settings. However, there is very little evidence regarding their use in critically ill patients in the intensive care unit (ICU), given the gap in the literature regarding their safety in this population and the concerns of bleeding and alterations in pharmacokinetics. Therefore, this study aimed to evaluate the prescribing pattern and safety of DOAC use in critically ill patients.MethodsThis was a single-centre retrospective chart review study involving critically ill patients with confirmed prehospital use of DOACs who either continued their use of DOACs or switched to a therapeutic parenteral anticoagulant agent (enoxaparin or heparin) during the admission to the medical ICU and/or coronary care unit (CCU). The primary outcome was the incidence of major bleeding (MB) events. The secondary outcomes included the incidence of new thrombosis and medical ICU/CCU mortality and hospital and medical ICU/CCU lengths of stay (LOS).ResultsA total of 675 patients were screened for inclusion. A total of 302 patients were included in the final analysis, with 167 patients in the DOAC group and 135 patients in the parenteral anticoagulant group. There were no differences between the groups in terms of the incidence of MB (11% vs. 9%, p = 0.61) or new thrombosis (1% vs. 3%, p = 0.50). The overall medical ICU/CCU mortality rate was lower in the DOAC group compared to the parenteral anticoagulant group (7% vs. 15%, p = 0.03). Additionally, the DOAC group had shorter medical ICU/CCU stays (6 days [4–11] vs. 11 days [5–24], p < 0.001) and shorter hospital stays (7 days [5–13] vs. 13 days [7–35], p < 0.001), respectively.ConclusionCompared with the use of parenteral anticoagulants, the use of DOACs in critically ill patients was associated with a similar incidence of MB and new thrombotic events. The observed differences in mortality and LOS between the groups may be attributed to variability in physician decision-making regarding anticoagulation strategies, potentially influenced by patient-specific factors and severity of illness. Further prospective studies to determine the optimal anticoagulation strategy in critically ill patients are warranted.

The use of cannabidiol in patients with Lennox-Gastaut Syndrome and Dravet syndrome in the UK Early Access Program: A retrospective chart review study

The use of cannabidiol in patients with Lennox-Gastaut Syndrome and Dravet syndrome in the UK Early Access Program: A retrospective chart review study

A Retrospective Study of Outcomes in a Rural Pediatric Population Treated for Venous Insufficiency.

A Retrospective Study of Outcomes in a Rural Pediatric Population Treated for Venous Insufficiency.

Cardiovascular and Renal Biomarkers in Overweight and Obese Adults with Type 1 Diabetes Treated with Tirzepatide for 21 Months.

Introduction: Overweight (OW) and obesity (OB) affect nearly two thirds of adults with type 1 diabetes (T1D), contributing to suboptimal glucose control, cardiovascular disease (CVD), and diabetic kidney disease (DKD). Many newer drugs such as tirzepatide (a dual-incretin) and sodium-glucose cotransporter-2 inhibitors are approved for people with type 2 diabetes associated with CVD and DKD. We evaluated CVD and DKD biomarkers with off-label long-term (21 months) use of tirzepatide in OW/OB adults with T1D. Materials and Methods: In this retrospective chart review study, we analyzed data for 84 OW/OB adults with T1D who were prescribed tirzepatide since July 2022 and had used tirzepatide for at least 6 months. Controls (n = 38) were frequency matched for age, diabetes duration, sex, glycosylated hemoglobin (HbA1c), and body mass index (BMI). Data were collected from electronic medical records before initiating tirzepatide and over 21 months of treatment. Linear mixed effects models were used to examine the changes in lipids, blood pressure, and estimated glomerular filtration rate (eGFR) over time in tirzepatide-treated adults versus controls. Results: Baseline characteristics were similar except that tirzepatide users had a slightly higher baseline BMI than controls; 35.2 ± 4.8 kg/m2 and 33.3 ± 4.2 kg/m2 (P = 0.03), respectively. Patients using tirzepatide lost significantly more weight (-59 ± 4.6 lbs [-23.4%]) compared with a gain of (+1.7 ± 5.0 lbs [+1.8%]) in controls over 21 months. The HbA1c decreased more in patients using tirzepatide than controls (-0.50 ± 0.07% and -0.24 ± 0.09%, respectively, P = 0.017). Patients using tirzepatide significantly improved total and low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and eGFR; these changes remained significant even after adjusting for weight and HbA1c. The eGFR declined significantly in controls but not in the tirzepatide users. Conclusions: We conclude that long-term use of tirzepatide in OW/OB adults with T1D results in more than 23% weight loss and sustained improvement in glucose control. Irrespective of changes in weight and/or HbA1c, we observed significant improvement in cardiovascular biomarkers and preservation of kidney function. We strongly recommend a long-term randomized control trial with tirzepatide in patients with T1D.

Administering the Lidcombe Program to children who stutter with concomitant disorders: Insights from an exploratory retrospective chart review study.

Administering the Lidcombe Program to children who stutter with concomitant disorders: Insights from an exploratory retrospective chart review study.

The Effect of COVID-19 on Health Care Utilization Among Children with Medical Complexity: Retrospective Chart Review Study.

This study examines the trends, patterns, and potential health disparities in health care utilization among children with medical complexity, before and during COVID pandemic through a retrospective chart review. Our findings show significant differences in the average number of visits per patient over the years and support the adoption of telehealth consultations, while highlighting concerns about demographic disparities.

Healthcare resource utilization and costs associated with inadequate initial antibiotic treatment of bacteraemia produced by carbapenem-resistant Gram-negative bacilli (CRGNB): a descriptive, observational study in Spanish hospitals.

Carbapenem-resistant gram-negative bacilli (CRGNB) are one of the main causes of nosocomial infections, posing a major public health challenge. Blood stream infections (BSI) require special attention because of the higher morbidity and mortality associated. To assess the impact of initial adequate or inadequate antibiotic treatment on the length of stay (LOS) and healthcare resource utilisation of patients with bloodstream infections (BSI) caused by a Carbapenem-resistant gram-negative bacilli (CRGNB) in the Spanish clinical practice. A descriptive, observational, retrospective chart review study of patients diagnosed with CRGNB bacteriemia in 6 Spanish public hospitals. The overall median LOS of the total population (n=64) was 26.5 days (Q1: 16 days; Q3: 40 days). The median LOS for the initially adequately treated group was 27 days (Q1: 17; Q3: 50), and 24 days (Q1: 15; Q3: 38) for the initially inadequately treated (t-test p= 0.5031). In the Hospital Ward group (n=44), initially adequately treated patients spent hospitalised a median of 6 days less than the initially inadequately treated patients (18 days [Q1: 12; Q3: 27] vs 24 days [Q1: 15; Q3: 38] respectively, p=0.0269). In the total population analysis, initially adequately treated patients had a lower use of resources (20,895.02 € [Q1: 11,543.67 €; Q3: 61,773.17 €]) compared to initially inadequately treated patients (24,444.02 € [Q1: 11,571.63 €; Q3: 40,790.64 €). Results suggest that inadequate empirical treatment for BSI caused by CRGNB in the hospital ward could be associated with an increase in the LOS and resource utilization of these patients.

Ustekinumab for ulcerative colitis: a nationwide real-life observational cohort study.

This nationwide retrospective chart review study assessed ustekinumab treatment persistence and clinical outcomes of ustekinumab treatment in Finnish patients with ulcerative colitis in a real-world setting. Data was collected retrospectively until April 2022 from patient charts for all patients with ulcerative colitis who started ustekinumab between September 2019 and December 2021 in 16 Finnish inflammatory bowel disease centers. The primary outcomes were persistence on ustekinumab and clinical remission/steroid-free clinical remission, defined as partial Mayo score <3 and a combined stool frequency and rectal bleeding subscore of ≤1 at 16 weeks and 1 year. The study included 221 patients with an average follow-up of 14.7 months and a median disease duration of 5.5 years. Disease status was endoscopically evaluated as severely active in more than 91% of the patients at baseline. Treatment persistence was 87% at 16 weeks and 63% at 1 year. The clinical/steroid-free remission rate was 49%/46% at 16 weeks and 68%/62% at 52 weeks, respectively. Decreases in fecal calprotectin and partial Mayo scores were observed. Concomitant corticosteroid use decreased from 60% at baseline to 28% at 16 weeks and to 16% at 1 year during ustekinumab maintenance therapy. Antibodies to ustekinumab were detected in very few patients (<5, <21%), and discontinuation was observed due to adverse effects even less frequently (<5, <6%). This real-world study demonstrated that ustekinumab has sustained efficacy in the treatment of ulcerative colitis in a real-world setting.

Exit Strategy for Treatment of Neovascular Age-Related Macular Degeneration in a Real-World Setting: Wishful Thinking?

To analyze our outcome for patients with neovascular age-related macular degeneration (nAMD) treated with aflibercept in a treat-and-extend regimen pursuing an exit strategy (with best possible adherence to the "Bern" exit criteria) over 6 years in a real-world setting. The primary objective of the study was to investigate the proportion of patients who were able to achieve and maintain treatment exit. This is a retrospective chart review study of treatment-naïve patients diagnosed with nAMD receiving intravitreal aflibercept injections performed at our department with at least 2 years of follow-up visits. The primary outcome was the percentage of patients able to achieve and maintain the treatment exit regarding intravitreal anti-VEGF injections. Further outcome measures were best-corrected visual acuity (BCVA), incidence of recurrence after treatment cessation, duration of therapy, and number and intervals of injections. There were 31 eyes of 25 patients included in this retrospective study. The observation period was from September 1, 2017 to August 31, 2023. Of all included patient eyes, 22.6% (n = 7) reached exit criteria. Of all the "exit" patients, 28.6% (n = 2) suffered from disease relapse and therapy was restarted at a mean (± SD) of 41.5 ± 12.5 weeks (range: 29 to 54 weeks). Regarding the eyes that met treatment exit, 5 of 31 (16.1%) had no disease recurrence in the observed study period. The median BCVA (Snellen decimal; ± interquartile range: IQR) changed from 0.63 (0.27) at baseline to 0.63 (0.4) in the first year, 0.63 (0.3) in the second year, 0.63 (0.46) in the third year, 0.63 (0.3) in the fourth year, 0.63 (0.4) in the fifth year, and 0.4 (0.04) in the sixth year. The median number of injections (± IQR) per eye in the first year of treatment was 8 (2), in the second year 5 (2), in the third year 5 (2.5), in the fourth year 5 (1), in the fifth year 3 (0.8), and in the sixth year 3 (0). Extension of the treatment interval after the loading phase in weeks was achieved up to a median (± IQR) of 5.8 (4) in the first year, 8.4 (6) in the second year, 8 (5.7) in the third year, 9.4 (5.6) in the fourth year, 7 (6.9) in the fifth year, and 8.4 (3.1) in the sixth year of observation. Our study indicates a lower rate of patients reaching exit criteria with a treat-and-extend regimen compared to clinical study settings, and a similar recurrence rate of nAMD after treatment cessation. Nonadherence to a strict treat-and-extend protocol might influence the result.

Role of peak D-dimer in predicting mortality and venous thromboembolism in COVID-19 patients.

Covid 19 patients often present with elevated D-dimer levels. The purpose of this study is to evaluate the role of D-Dimer levels in Covid 19 patients to predict mortality and venous thromboembolism (VTE) events. This is a retrospective chart review study from 1 April 2020 to 30 June 2020, during the peak Covid pandemic. A total of 350 patients were enrolled in this study; 69 (19.7%) patients died; 12 (3.4%) had a deep venous thrombosis; and 8 (2.3%) had a pulmonary embolism outcome. Peak D-dimer levels were collected with median levels of 765 ng/ml (266, 3135). Patients with VTE outcomes had significantly higher levels of peak D-dimers than patients in the non-VTE group (4876 vs 680, p < 0.0001). Patients who died had higher peak D-dimer levels than those who survived (4690 vs 501, p < 0.0001). The optimal cutoff point in peak D-dimer in predicting VTE events was 1437, yielding a sensitivity of 84.2% and a specificity of 65.0%. The optimal cutoff point in peak D-dimer in predicting mortality was 2004, yielding a sensitivity of 71.0% and a specificity of 77.9%. This study suggests that D-dimer levels can be elevated in Covid 19 hospitalized patients and can serve as indicators for mortality and VTE events.

Characteristics, Incidence, and Management of Immune Checkpoint Inhibitors Related Cardiovascular Adverse Events in Real-World Practice-A Retrospective Study in Chinese Han Population.

This study aimed to elaborate on the incidence, clinical features, and management of immune checkpoint inhibitors (ICIs) related cardiovascular adverse events (CVAEs) in real-world practice. We performed a retrospective chart review study on patients receiving at least one dose of ICI therapy at a Chinese tertiary hospital from March 2020 to March 2021. CVAEs were identified through clinical assessment and the Naranjo algorithm. The management and outcomes of CVAEs were monitored over a median follow-up duration of 8 months. Among the included 203 patients, 4.4% (9/203) developed CVAEs, including heart failure (n = 3), arrhythmia (n = 2), myocarditis (n = 2), and pericardial disease (n = 2), with a proportion (6/9) tending to be severe (grade 3 or grade 4). CVAEs were more common in older patients (mean age: 73.6 ± 9.2 years) and those with hypertension (p = 0.02) or heart failure (p = 0.01). Adherence to the American Society of Clinical Oncology (ASCO) guidelines for managing CVAEs was low (44%), with most cases showing partial resolution by the last follow-up. We reported that the incidence of ICI-related CVAEs in the Chinese institution was higher than that in some prior studies. Adherence to guidelines for managing ICI-related CVAEs is found to be suboptimal in real-world practice and highlighted as a needed improvement.

Ocular surface disease related to tisotumab vedotin-tftv.

Ocular surface disease related to tisotumab vedotin-tftv.

The Frequency of Non-Scarring Alopecia in Autoimmune Connective Tissue Diseases.

Autoimmune connective tissue diseases (ACTDs) are relatively rare systemic diseases featured by immune dysregulation and often have prominent cutaneous manifestations. The most common is systemic lupus erythematosus (SLE), dermatomyositis (DM), systemic sclerosis (SSc), Sjogren syndrome (SJO), undifferentiated connective tissue disease (UCTD), and mixed connective tissue disease (MCTD). Alopecia is one of the most common symptoms of these diseases, with significant impact on the quality of life of these patients. Our aim is to better characterize non-scarring alopecia in ACTDs. A retrospective chart review study of patients seen at the Autoimmune Connective Tissue Diseases clinic at Massachusetts General Hospital, Boston, MA, was conducted from November 2012 to January 2018. The study was reviewed and approved by Partners IRB. A total number of 1486 visits where 734 were new patients, and 241 patients with ACTDs included in our analysis. Of the new patients, 80% were female and 20% were male, with an average age of 51 years. Of patients with MCTD, 46.6% presented with non-scarring alopecia at their initial evaluation. Of patients with SLE, 36% presented with non-scarring alopecia. Of the 32 patients with SJO, 28% reported diffuse non-scarring alopecia. Of patients with UCTD, 22% presented with diffuse non-scarring alopecia. Only 9.5% of our patients with DM and 9% of our patients with SSc presented with diffuse non-scarring alopecia. Alopecia is common in all ACTDs and often under evaluated. Treatment of alopecia in ACTDs can be challenging, and oftentimes patients require joint management and work-up. J Drugs Dermatol. 2025;24(3):246-249. doi:10.36849/JDD.7750.

Real-world outcomes in patients with melanoma brain metastasis: a US multisite retrospective chart review study of systemic treatments

ObjectiveThis study examined real-world treatment patterns and outcomes in patients with melanoma brain metastasis (MBM) treated with first-line immunotherapy consisting of nivolumab plus ipilimumab or anti-programmed death-1 (PD-1) monotherapy (nivolumab...

P-1129. Exploring Cost Savings through Reduced Sedation for Magnetic Resonance Imaging in Pediatric Osteomyelitis Diagnosis

Abstract Background Magnetic resonance imaging (MRI) is essential for the diagnostic workup of pediatric osteoarticular infection. In the pediatric population, sedation is often required to mitigate motion artifact and improve imaging quality, which contributes to cost, resource utilization, and risk to the patient. In 2021, our hospital implemented an evidence-based update to the pediatric osteomyelitis guideline adjusting MRI imaging sequences, which reduced sedation age requirements from 8 years to 3 years of age. This change was initiated in September 2021. This study evaluates economic implications of sedation reduction strategies in pediatric osteomyelitis imaging. Figure 1. Pre vs Post Guideline Sedation Rates. Methods This is a retrospective chart review study of pediatric patients evaluated for bone and joint infection by MRI at a free standing 299 bed hospital in Central Texas. Cases were pulled by MRI indication according to the hospital’s osteomyelitis guideline inclusion criteria between January 1, 2020 and December 31, 2023. Previously healthy children age 6 months to 18 years with physical exam suggestive of acute hematogenous osteomyelitis or septic joint and less than 14 days of symptoms were included. Cases were compared by year pre-guideline (2020-2021) and post-guideline (2022-2023) and reviewed for age, sex, need for sedation, and diagnosis after MRI. Cost savings estimates were based on an average per case cost of sedation. The cost of sedation was determined by hospital charges. Figure 2. Pre &amp; Post Guideline Sedated vs Non-Sedated Patients. Results 279 patients were included, (98 pre guideline change; 181 post guideline change). 61.3% male, 38.7% female, median age 6, IQR 6.5. A statistically significant reduction in sedation usage was observed after guideline implementation (50%-33%, p=0.0087) (fig 1). Among patients 3-8 years of age, 21 of 34 patients (62%) pre-guideline and 15 of 78 patients (19%) post- guideline received sedation (p&amp;lt; 0.001) (fig 2). An average estimated cost savings of $270,215 per year was found. There was no increase in repeat MRI rates seen with the implementation of the age requirement change. Conclusion Lowering the required age for sedation allows for individualized assessment of sedation needs in the 3-8 age group. This leads to improved patient care through decreased patient risk, reduction in overall rate of sedation and results in cost savings. Disclosures Brian Kaufman, MD, Johnson &amp; Johnson: Advisor/Consultant

P-2074. Evaluation of Adherence and Access to Booster COVID-19 Vaccination in Persons with HIV

Abstract Background COVID-19 disproportionately effects minority communities. Completion of the primary COVID-19 vaccination series (≥ 2 doses) is recommended for all American adults by the Centers for Disease Control and Prevention. A population with high mortality and morbidity related to COVID-19 is persons with HIV (PWH). The Infectious Diseases Practice (IDP) at University Hospital (UH) has been providing care to PWH for over 30 years, and it was one of the designated COVID-19 vaccination centers early in the pandemic. We compared rates of PWH who receive COVID-19 vaccine (incomplete: &amp;lt; 2, complete: ≥ 2) amongst different demographic factors to better understand subgroups that can benefit from additional messaging to promote vaccine uptake. Methods A retrospective chart review study was conducted at the IDP at UH, Newark. Adult PWH (18-88 years old) who had an office visit to the clinic between January 2021-December 2022 were included. Demographic variables and COVID vaccine count were collected. Results The IDP identified PWH (mean age 52, 75.4% Black, 20.4% Hispanic, 39.5% women) who had either complete (n=1085) or incomplete (n=815) primary vaccine schedules for COVID-19. The most common HIV risk factors were heterosexual contact (52.8%), homosexual contact (28.16%), and injection drug use (8.58%). 54% of patients had a CD4+ count &amp;gt; 499, 87.08% of patients had an HbA1c &amp;lt; 6.4, and 72.68% of patients had an HIV viral load that was undetectable. Notably, PWH who completed the primary vaccination series were more likely to be undetectable (80.6%) years compared to PWH who did not complete their vaccination series (62.1%). Furthermore, PWH who completed the primary vaccination series were more likely to have an HbA1c&amp;lt; 6.4 (83.1%) compared to PWH who did not complete their vaccination series (77.9%). PWH who completed the primary vaccination series were more likely to have a CD4 count &amp;gt; 499 (54.4%) compared to PWH who did not complete their vaccination series (44.4%). Conclusion Patients most at risk of not completing the primary COVID-19 vaccine schedule include PWH who are virally uncontrolled, persons with diabetes, or have a low CD4+ count. This indicates medical adherence should be targeted in such populations to improve their healthcare outcomes. Disclosures Shobha Swaminathan, MD, Viiv Healthcare: Advisor/Consultant

P-2313. Multinational, Retrospective Study Assessing Outcomes and Healthcare Resource Utilization in Hematopoietic Stem Cell Transplant Recipients with Cytomegalovirus Infection and Refractory, Resistance, or Intolerance to Anti-Cytomegalovirus Treatments: Analysis of Impact of Viremia Clearance on Outcomes

Abstract Background Cytomegalovirus (CMV) infection is a risk factor for morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. This real-world analysis describes the impact of viremia clearance on outcomes in HSCT recipients with refractory, resistant or intolerant (RRI) CMV infection to anti-CMV agents. Methods This multicenter, retrospective chart review study included adult HSCT recipients with RRI CMV infection. Data between 2014 and 2021 were collected from 14 centers in Europe and the USA. The analysis descriptively compared demographics, patient characteristics, clinical outcomes, and hospitalizations in patients who did versus did not achieve viremia clearance during the first RRI CMV episode. Results Among 247 patients with a first RRI CMV episode, 145 (59%) achieved viremia clearance and 102 (41%) did not. In patients with vs without viremia clearance, respectively, median age was 53 vs 60 years, and 46% vs 58% were male. Of the 145 and 102 first RRI CMV episodes with vs without viremia clearance, respectively, 52% vs 75% were identified as refractory, 61% vs 31% as intolerant, and 3% vs 9% as resistant (categories not mutually exclusive); 9% vs 15% of patients developed tissue invasive disease. CMV recurrence occurred in 35% vs 37% and graft failure in 3% vs 6% of patients with vs without viremia clearance, respectively (Table). Myelosuppression and nephrotoxicity events during CMV episodes were reported in 54% vs 44% and 26% vs 27% of patients with vs without viremia clearance, respectively (Table). CMV-related hospitalizations with/without emergency department visits occurred in 35% of patients with viremia clearance vs 43% of patients without viremia clearance (Table). Notably, the overall mortality within 1 year of RRI identification in patients without viremia clearance was higher than in those with viremia clearance (68% vs 30%, respectively). Conclusion These results highlight the high disease burden in HSCT recipients with RRI CMV infection. In this difficult-to-treat population, the mortality rate was higher in patients without viremia clearance than in patients with viremia clearance. Disclosures Kimberly Davis, RPh, MS, Takeda: Employee|Takeda: Stocks/Bonds (Public Company) Ines Mendonça, MSBiostats, CTI Clinical Trial &amp; Consulting Services: Employee (paid to provide consulting services including medical writing and statistical analysis) Tien Bo, PharmD, Takeda: Employee|Takeda: Stocks/Bonds (Public Company)

P-1441. Demographic and Clinical Characteristics of New Migrant Patients with HIV in a New York City Open Access HIV Primary Care Clinic

Abstract Background Since 2022, New York City has seen an influx of migrants, many seeking asylum due to political strife or discrimination. This study assessed the clinical characteristics of new migrant patients with HIV who sought care at an academic, open access clinic. Methods This is a retrospective chart review study of new clinic patients January 2022–March 2023. Patients were included in the study if they were ≥18 years of age, living with HIV, and had migrated to the United States within one year of first clinic visit. Results From January 2022 through March 2023, we identified 58 patients who met study criteria. 53 patients (91.4%) identified as male, and the mean age was 33 years (SD 8.8), see Table 1. Most patients were from South America, with just over half from Venezuela alone. 48.3% of patients were walk-ins and 43.1% were connected through an open access line, with a majority referred from community-based organizations. 37 patients (63.8%) were on ART (antiretroviral therapy) at first visit, see Table 2. 67% of patients had an HIV viral load of 200 copies/ml or less. 29.8% of patients had a reactive RPR (rapid plasma reagin) consistent with a current diagnosis of syphilis. 11.8% of patients screened had a positive IGRA (interferon gamma release assay), none with active tuberculosis. 17.9% and 10% of eligible patients were screened for Strongyloides and Schistosoma antibodies, respectively. Only 4 of 56 eligible patients received empiric treatment for helminthic infection. 46.6% of patients reported history of STI (sexually transmitted infection), see Table 3. Nearly all patients (93.1%) were linked to a care coordinator prior to or at first visit. 25 patients were identified as having a possible mental health disorder or history of trauma, and 44% were seen by a licensed social worker same day, see Figure 1. Conclusion Most new migrant patients were from South America, identified as male, and had suppressed HIV. There were missed opportunities to screen for and treat helminthic infections. There was a high burden of STIs and mental health disorders. Many patients utilized our open access line or walked into clinic and nearly all were connected to a care coordinator at or prior to first visit. Continued research is needed to better understand the needs of this vulnerable and growing patient population. Disclosures All Authors: No reported disclosures