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News Brief from ASH 2021: News and Advances in CLL Treatment
The summary from the first day of the 63rd American Society of Hematology (ASH) Congress in Atlanta in December 2021 brought several new advancements in the treatment of chronic lymphocytic leukemia (CLL). Dr. Brian Koffman from the CLL Society provided commentary on these developments.
News Primum non nocere applies not only in medicine: an ecological look at inhalers
According to estimates from the World Health Organization (WHO), around 65 million people worldwide suffer from mild to moderate forms of chronic obstructive pulmonary disease (COPD). The cornerstone of therapy is the inhalation administration of bronchodilator drugs. While there is no doubt that this therapy helps patients, what impact do the propellants in inhalation systems have on the global climate? And is there a sensible solution to this problem?
News Ixekizumab administered for 5 years demonstrated high efficacy and a favorable safety profile in patients with moderate to severe psoriasis
Ixekizumab is a recombinant humanized monoclonal antibody against interleukin 17A, indicated for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis. At the 24th World Congress of Dermatology in Milan in June 2019, results were presented from a study evaluating the efficacy and safety of long-term administration of ixekizumab.
News Direct Comparison of the Efficacy and Safety of Anti-EGFR Antibodies in the Combined Therapy of Chemotherapy-Refractory Metastatic Colorectal Cancer
The combination of anti-EGFR therapy with irinotecan has brought benefits to patients with chemotherapy-refractory metastatic colorectal cancer (mCRC) in clinical studies. Results of a study directly comparing the efficacy of two different EGFR inhibitors, panitumumab and cetuximab, in combination with irinotecan have been published in the European Journal of Cancer.
News Effectiveness of Dietary Intervention in Irritable Bowel Syndrome – Results of a Network Meta-Analysis
A low FODMAP diet is often recommended to alleviate symptoms of irritable bowel syndrome (IBS). Although several randomized studies have been conducted to assess the effectiveness of this diet, a systematic evaluation has yet to be available, and individual studies have used various control interventions. Therefore, an international team of researchers decided to prepare a systematic literature review with a network analysis, recently published in the journal Gut.
News Fresh from ASH 2021: Promising results of the combination of azacitidine with venetoclax and magrolimab in the treatment of AML
Dr. Naval Daver and his colleagues from the Anderson Cancer Center in Houston presented an oral report during the December congress of the American Society of Hematology (ASH 2021) about a phase Ib/II study that evaluated the effects of the combination of azacitidine (AZA) + venetoclax (VEN) + magrolimab (magro) in various types of patients with acute myeloid leukemia (AML) – newly diagnosed in older or unfit individuals, high-risk, or relapsed/refractory cases (R/R AML).
News Safety of Urgent Initiation of Peritoneal Dialysis
In case of urgent need for kidney function replacement, hemodialysis (HD) with a temporary venous catheter has long been the standard solution. However, it has several disadvantages such as increased mortality or the risk of bacteremia and central venous stenosis. Additionally, multiple procedures are needed to create a permanent venous access. Therefore, there is a growing global interest in urgently initiated peritoneal dialysis (PD), with several clinical studies attesting to its safety, efficacy, and feasibility. However, little has been known about early PD complications and the long-term prognosis of patients in terms of technical and infectious complications.
News The Significance of Administering Gliflozins in Real Practice in Diabetics Without CV and Renal Disease
Current care standards recommend the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i, i.e., gliflozins) regardless of glycemic compensation in patients with type 2 diabetes (T2DM) and kidney disease, heart failure, or high cardiovascular (CV) risk. A recent study published in the Clinical Journal of the American Society of Nephrology (CJASN) assessed whether long-term use of SGLT2i brings benefits compared to dipeptidyl peptidase-4 inhibitors (DPP4i, i.e., gliptins) in diabetics without documented CV or renal disease using data from a large Israeli database.
News Long-term treatment of ozanimod in patients with moderate to severe ulcerative colitis
The immunosuppressive ozanimod was approved for the treatment of ulcerative colitis (UC) based on the results of the phase III clinical trial True North. An open-label study followed this and previous clinical evaluations, focusing particularly on the efficacy of long-term use of ozanimod. What insights did the subsequent monitoring bring?
News Dupilumab in the Treatment of Adolescent Patients with Severe and Refractory Atopic Dermatitis
An open multicenter study evaluating dupilumab in the treatment of moderate to severe atopic dermatitis in adolescents confirmed its long-term efficacy and safety in this age group. In addition to its results, we also summarize information on dosing and reimbursement conditions in the Czech Republic for the age group 12-18 years.
News Chemoimmunotherapy in the Treatment of Breast Cancer − Final Results of the IMpassion130 Study
According to international recommendations, treatment with the immune checkpoint inhibitor atezolizumab in combination with the cytostatic nab-paclitaxel is used for patients with locally advanced or metastatic breast cancer where PD-L1 protein expression is detected on the surface of tumor-infiltrating immune cells (IC). The final results regarding overall survival and long-term safety of this treatment in patients who participated in the registration study IMpassion130 were presented at this year's European Society for Medical Oncology (ESMO) congress, which was held virtually due to circumstances.
News Safety of Riociguat in the Treatment of Thromboembolic Pulmonary Hypertension in Common Practice
In March 2021, the final safety results of riociguat in the treatment of thromboembolic pulmonary arterial hypertension in real-world practice were published from the international EXPERT registry, which also included Czech patients. The safety profile of the therapy was consistent with the findings of previous clinical studies.
News Incidence of Thromboembolic Disease During Military Operations – Results of a 10-Year Review
In contemporary armed conflicts, limb injuries account for more than half of all injuries. In addition to the characteristically high incidence of infectious complications, injuries associated with military medicine also carry a high risk of thromboembolic disease. This is demonstrated by a study assessing the incidence of thromboembolic disease in American soldiers over 10 years of military operations in the Middle East.
News Current (and Future) Possibilities for Diagnosing Alpha-1-Antitrypsin Deficiency
Alpha-1-antitrypsin deficiency (AAT) is associated, among other things, with the development of chronic obstructive pulmonary disease (COPD) with emphysema. Most patients, however, remain undiagnosed and therefore do not receive adequate treatment. Below we summarize the current possibilities for diagnosing this genetic disorder.
News Transition from Risperidone to Lurasidone and Adjustment of Metabolic Profile in Patients with Stable Schizophrenia
Patients with schizophrenia have a higher risk of cardiometabolic diseases compared to the general population, which is further increased by certain antipsychotics. A recently published post hoc analysis assessed, among other things, the metabolic parameters of patients who switched from risperidone therapy to lurasidone.
News Pain Relief and Functional Score Improvement in Patients with Low Rheumatoid Arthritis Activity: Baricitinib vs. Adalimumab
In patients with rheumatoid arthritis, pain and functional impairment may persist even with good disease activity control. An exploratory analysis of the RA-BEAM study compared the effects of baricitinib, adalimumab, and placebo added to methotrexate on residual pain and functional scores in patients with rheumatoid arthritis (RA) who achieved remission or low disease activity with this treatment.
News Efficacy of Combination Therapy for Chronic Lymphocytic Leukemia in Patients with Complex Karyotype
A complex karyotype (presence of ≥ 3 chromosomal abnormalities) is a negative prognostic marker in chronic lymphocytic leukemia (CLL). An analysis of the impact of complex karyotype on the efficacy of targeted CLL therapy combining the monoclonal antibody against CD20 antigen obinutuzumab with the BCL2 inhibitor venetoclax or the alkylating cytostatic chlorambucil was published in the journal Blood.
News Intravenous Thrombolysis in Ischemic Stroke Patients on Dabigatran Treatment
What are the outcomes of performing intravenous thrombolysis in patients with acute ischemic stroke after reversing the anticoagulant effect of dabigatran with idarucizumab? The answer is provided by a data analysis from real-world clinical practice in stroke centers, published by Czech authors.
News Development and Benefits of Intestinal Gel LECIG for Patients with Parkinson's Disease
Patients with advanced Parkinson's disease, for whom the current regimen of orally and transdermally administered medications is insufficient for symptom relief, now have a new treatment option. It involves the continuous administration of an intestinal gel that combines three effective antiparkinsonian drugs.
News Augmentation of Clozapine with Lurasidone in Resistant Schizophrenia in Real Practice
Treatment-resistant schizophrenia remains a clinical and pharmacological challenge. Clozapine remains the gold standard in these cases. Unfortunately, a significant portion of patients respond only partially to it. The solution is often an augmentation strategy with another atypical antipsychotic. According to current findings, adjunctive therapy with lurasidone appears promising — two recently published studies have brought interesting data.
News Expanded Hemodialysis and Its Impact on Reducing Hospitalization Rates and Medication Usage
The number of patients with end-stage kidney disease is increasing. New approaches and technological advancements in recent decades have contributed to improving hemodialysis treatment. Does the use of so-called expanded hemodialysis lead to better outcomes?
News OCA in Second-Line Treatment of PBC: Analysis Results and Real-World Data
Ursodeoxycholic acid (UDCA) is the cornerstone treatment for PBC according to the guidelines of the European Association for the Study of the Liver (EASL). However, many patients (25–50%) do not achieve an adequate response to it, and some patients develop intolerance leading to the necessity of discontinuation (in the phase III POISE study, this concerned 7% of participants). Then, obeticholic acid (OCA) is indicated, which is recommended as the only registered second-line treatment option for PBC by current professional guidelines both European (EASL 2017) and Czech (2018). The latest data on OCA from clinical studies as well as real-world practice was also presented at this year's XLVIII May Hepatology Days.
News Longer survival without liver transplant in patients with PBC treated with OCA?
Obeticholic acid (OCA) is a second-line treatment for patients with primary biliary cholangitis (PBC) who have an inadequate response to ursodeoxycholic acid (UDCA) or intolerance to it. The study presented below, the results of which were recently published, examined the effectiveness of OCA in reducing cholestatic enzymes as well as the length of survival without liver transplant in patients with PBC.