Jan 30th, 2023 - A Mendelian randomization study employing data from nearly 300,000 individuals has linked elevated levels of the PCSK9 enzyme with an increased risk of psoriasis, suggesting it might be targetable as an intervention. Independent of low-density lipoprotein cholesterol (LDL-C), which is reduced when PCSK9 is inhibited, a reduction in PCSK9 levels appears to have a direct impact on lowering psoria.
MDedge Family Medicine; Timothy Mott, MD, FAAFP, Zachary Orme, DO
Jan 30th, 2023 - ILLUSTRATIVE CASE A 52-year-old woman presents to the emergency department complaining of dysuria and a fever. Her work-up yields a diagnosis of sepsis secondary to pyelonephritis and bacteremia.
Jan 30th, 2023 - Higher protein doses did not improve critically ill patient outcomes, and may even be detrimental to patients with high organ failure and acute kidney injury, the EFFORT trial found. In nutritionally high-risk adults undergoing mechanical ventilation, alive hospital discharge for those who received higher doses of protein reached 46.1% by 60 days after randomization, compared with the 50.2% rat...
Steven R. Feldman, MD, PhD
Jan 27th, 2023 - Steven R. Feldman, MD, PhD I suspect lebrikizumab is going to be another excellent atopic dermatitis (AD) treatment option.
Jan 27th, 2023 - Key clinical point: Recent phase 2 trials have recommended a 2-weekly schedule of pegylated liposomal doxorubicin (PLD) in patients with heavily treated metastatic breast cancer (BC); however, it failed to demonstrate any advantage in terms of efficacy or safety over the registered 4-weekly regimen of PLD. Major finding: The median progression-free survival was 3.
Jan 27th, 2023 - Key clinical point: In patients with early-stage triple-negative breast cancer (TNBC), adding capecitabine to classic anthracycline/taxane-based adjuvant chemotherapy improved overall survival (OS) and carboplatin/paclitaxel was the most effective regimen for improving disease-free survival (DFS). Major finding: Adjuvant chemotherapy with anthracyclines/taxanes plus capecitabine vs anthracyclin.
Jan 27th, 2023 - Key clinical point: Exemestane plus ovarian function suppression (OFS) led to a greater reduction in recurrence risk than tamoxifen+OFS in premenopausal women with estrogen or progesterone receptor-positive (ER/PgR+) early breast cancer (BC). Major finding: There was a significant improvement in 12-year disease-free survival (hazard ratio [ HR] 0.
MDedge Family Medicine; Katarzyna Jabbour, PharmD, BCPS, Lynn M. Wilson, DO, FACOFP, FAAFP et. al.
Jan 27th, 2023 - Evidence summary Mixed results on exercise’s effect on neuropsychiatric symptoms A 2020 systematic review and meta-analysis of 18 RCTs investigated the effect of home-based physical activity on several markers of behavioral and psychological symptoms of dementia (BPSD). These symptoms were measured using the caregiver-completed neuropsychiatric inventory (NPI), which includes agitation.
Jan 27th, 2023 - Circulating tumor DNA (ctDNA) analysis of KIT mutational status may be able to guide second-line treatment in patients with imatinib-resistant gastrointestinal stromal tumors (GIST), according to an exploratory analysis from the INTRIGUE trial. Specifically, patients with KIT exon 11 plus 17/18 (activation loop) mutations had superior responses and better survival outcomes with ripretinib (Qinl...
Jan 27th, 2023 - The FDA's vaccine advisors unanimously backed the agency's proposal to harmonize COVID-19 primary and booster vaccines to contain a single bivalent composition with components targeting BA.4/5 and the original SARS-CoV-2 strain. With a 21-0 vote on Thursday, members of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) supported FDA's plan, which aims to offer better prote...
Jan 27th, 2023 - Emory University has appointed Carlos del Rio, MD, an internationally known clinician and epidemiologist, as interim dean for the Emory University School of Medicine. He will also serve as interim chief academic officer for Emory Healthcare. He will begin his role on March 1, when Vikas Sukhatme, MD, ScD, steps down as dean to return to the Emory faculty. “Dr. Carlos Del Rio is an eminent globa...
Joan H. Schiller, MD
Jan 26th, 2023 - Several decades ago, a new patient came to my office with her family. She was elderly, in good health, spoke no English, and her extended family translated for her.
The Planet Health obesity prevention curriculum has prevented disordered weight control behavior (DWCB), including purging and abuse of diet pills, among middle-school girls in randomized trials, but the effects of the program on DWCB when implemented by schools under dissemination conditions are not known. Researchers attempted to determine the effects of the program by executing a 3-year obes...
Jan 26th, 2023 - Antipsychotic drug prescribing rates among people with dementia increased markedly during the early months of the COVID-19 pandemic, a multinational database study showed. Notably, those rates did not return to prepandemic levels after the acute phase of the pandemic had ended, Kenneth K.C. Man, PhD, of University College London School of Pharmacy, and colleagues reported in JAMA Psychiatry. In...
Jan 26th, 2023 - Key clinical point: Pre-existing radiographic damage was substantially prevalent in patients with psoriatic arthritis (PsA), with secukinumab therapy being associated with the inhibition of joint tenderness and swelling; however, high baseline radiographic damage reduced the likelihood of achieving minimal disease activity (MDA). Major finding: Overall, 86% and 60% of patients had erosion and j.
Jan 26th, 2023 - The Food and Drug Administration (FDA) has expanded the approval of Odactra® to include treatment of house dust mite (HDM)-induced allergic rhinitis in patients 12 to 17 years of age. Odactra is an allergen extract indicated as immunotherapy for the treatment of HDM-induced allergic rhinitis, with or without conjunctivitis, confirmed by positive in vitro testing for IgE antibodies to Dermatopha...
Jan 26th, 2023 - It did not take long after pregnancy for excess heart attacks and strokes to emerge in women with pre-eclampsia, according to national records from Denmark. Within 20 years of delivery, the cumulative incidence of acute myocardial infarction (MI) and ischemic stroke approached 2.0% in women who had a history of pre-eclampsia versus 1.2% who had no pre-eclampsia, reported Sara Hallum, MSc, a PhD...
Jan 26th, 2023 - The introduction of immune checkpoint inhibitors (ICIs) for advanced non-small cell lung cancer (NSCLC) in 2015 has resulted in meaningful survival gains for younger patients, but gains were far more modest among older patients, according to a large cohort study. In advanced NSCLC patients under 55, median overall survival (OS) increased on the order of 4.5 months from 2011 to 2019, roughly 4 y...
Jan 26th, 2023 - Almost half of patients with advanced solid tumors or lymphomas experienced disease control with a drug that reactivates the TP53 tumor suppressor, a first-in-human study showed. Overall, the oral murine double minute-2 (MDM2) inhibitor milademetan produced a disease control rate (DCR) of 45.8% in 107 patients, including 58.5% in a subgroup with dedifferentiated liposarcomas (DDLPS). Notably, a...
Jan 26th, 2023 - (Boston)—Knee osteoarthritis (OA) also known as degenerative joint disease of the knee is typically the result of progressive loss of cartilage and low grade inflammation. This common condition impacts approximately 500 million adults worldwide and is a leading cause of pain and disability. Despite this tremendous public health burden, there are no effective approved treatments that can prevent...