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News How to Set Individual Treatment Goals for Type 2 Diabetes?
Treatment goals for type 2 diabetes should always be set individually. In practice, this mainly involves an indicator of the success of long-term compensation – glycated hemoglobin (HbA1c). Recommendations for the diagnosis and treatment of diabetes for general practitioners from 2020 list different target HbA1c values according to the risk of hypoglycemia and other parameters. They also recall different target values for fit, frail, and dependent seniors.
News Current ASH Guidelines for Management of ITP 2019 − Recommendations for Newly Diagnosed ITP in Adults
The American Society of Hematology (ASH) published current guidelines for immune thrombocytopenia (ITP) at the end of 2019, where a panel of experts attempted to define evidence-based recommendations for the management of these patients.
News Efficacy and Safety of Romosozumab in Postmenopausal Women with Osteoporosis and Renal Impairment
The coexistence of osteoporosis and chronic kidney disease (CKD) increases the risk of fractures and overall mortality in patients. A recent post-hoc analysis of two controlled randomized multicenter studies (FRAME and ARCH) investigated the efficacy and safety of romosozumab in postmenopausal women with osteoporosis and mild to moderate CKD.
News Fixed Combination of Trastuzumab and Pertuzumab for Subcutaneous Administration in Patients with Early Breast Cancer
At a symposium focused on breast cancer, held in December 2019 in San Antonio, Texas, preliminary results of the FeDeriCa clinical study were presented – comparing the pharmacokinetics, efficacy, and safety of a fixed combination of trastuzumab and pertuzumab for subcutaneous administration versus intravenous administration in patients with early-stage HER2-positive breast cancer. Based on the presented results, the drug received approval from the U.S. Food and Drug Administration (FDA).
News Different doses of LMWH in hospitalized patients with COVID-19 – interim experience
Many experts recommend administering heparin to patients with COVID-19 as part of anticoagulant prophylaxis, especially in severe forms of this infection. However, data on dosage, administration duration, and the effectiveness of this approach are limited. Therefore, authors from Bologna, Italy, investigated the relationship between various doses of low-molecular-weight heparin (LMWH) and mortality in patients hospitalized with COVID-19.
News Effect of Denosumab and Zoledronic Acid on Overall Survival in Patients with Metastatic Lung Cancer
In 30-40% of patients with non-small cell lung cancer (NSCLC), bone metastases develop during the course of the disease, causing so-called skeletal-related events (SREs). These events cause pain, increase morbidity, and reduce quality of life and mobility in patients. Antiresorptive agents, such as the bisphosphonate zoledronic acid or the osteoclast maturation and differentiation inhibitor denosumab, are used to prevent the occurrence of SREs. An exploratory analysis compared the effect of administering denosumab and zoledronic acid on the survival of patients with metastatic disease.
News Inhibitor of Activated Factor XII Garadacimab in Prophylaxis of HAE Attacks
Hereditary angioedema (HAE) is an autosomal dominant inherited disease characterized by a deficiency of C1 inhibitor. This condition leads to excessive production of bradykinin, which is responsible for the development of soft tissue edema. Garadacimab represents a human antibody, the first of its class, aimed at inhibiting activated factor XII, a key initiator of bradykinin formation. The phase II study presented below, whose results were recently published, evaluated the efficacy and safety of this innovative HAE therapy.
News Efficacy and Safety of an Activated FXII Inhibitor in Preventing HAE Attacks
Hereditary angioedema (HAE) is a rare, potentially life-threatening inherited disorder characterized by dysregulation of the kallikrein-kinin system. This results in excessive production of bradykinin, which is responsible for soft tissue edema. Garadacimab, a human antibody inhibiting activated factor XII, is utilized in the prevention of these attacks. Its efficacy and safety were verified in a phase III clinical trial.
News Adherence to Treatment of Multiple Sclerosis: How to Enhance It and What Interesting Insights Emerged from Current Research?
Therapeutic options for patients with multiple sclerosis (MS) utilizing disease-modifying drugs (DMDs) have continued to expand in recent years. However, achieving their full benefit is critically dependent on adherence to treatment. Nonadherence is demonstrably linked to an increased risk of relapses, faster progression of disability, higher treatment costs, and higher mortality. We present a summary of factors affecting adherence to treatment in MS patients, including the influence of the chosen therapy from a 2022 review and subsequent studies.
News HAE in the Otolaryngologist's Office: How to Handle a Laryngeal Attack?
Hereditary angioedema (HAE) can be encountered in emergency rooms and specialist offices. Patients with this rare disorder are often misdiagnosed with a more common condition, and they may learn their correct diagnosis only after many years. This is because HAE manifests with a combination of symptoms that are typical of various other diseases. What should pediatricians, otorhinolaryngologists, and gastroenterologists be aware of? Providing better understanding of HAE symptoms from different specializations' perspectives and emphasizing the importance of interdisciplinary collaboration for accurate diagnosis and patient care was the focus of a professional webinar we have summarized for you.
News How Does Erdosteine Perform in Combination with Antibiotics?
Erdosteine is an oral mucoactive drug that reduces mucus viscosity by degrading disulfide bonds in the mucin polymer. It achieves this effect through a free thiol group in its main active metabolite, N-thiodiglycolyl-homocysteine. In addition to its mucolytic action, erdosteine exhibits antioxidant and anti-inflammatory effects and reduces bacterial adhesion, thereby enhancing the effectiveness of certain antibiotics. We provide a summary of study results demonstrating its effect on enhancing the efficacy of drugs administered in the treatment of respiratory diseases.
News Educational Quiz (For Downtime)
The following quiz has been prepared for you as an activity for relaxation and unwinding from today's hectic days. In an easy manner, it will refresh your knowledge about immune cells and may even offer some education or entertainment.
News EULAR 2023: How does tofacitinib affect cardiovascular risk in rheumatoid arthritis?
At this year's European League Against Rheumatism (EULAR) congress, held at the turn of May and June in Milan, Italy, a study was presented that examined the impact of tofacitinib use on cardiovascular (CV) risk in patients with active rheumatoid arthritis (RA).
News Patient with Moderate Hemophilia A and Development of FVIII Inhibitor in Old Age and Atrial Fibrillation − Interactive Case Study
MUDr. Petr Smejkal, Ph.D., from the Department of Clinical Hematology, FN Brno, has prepared a case study for you of a patient born in 1941, diagnosed with hemophilia A at around 10 years of age. In 2013, he underwent surgery for right carotid stenosis with pdFVIII substitution and was started on acetylsalicylic acid.
Two weeks after discharge, subcutaneous and muscle bleeding was recognized, leading to the development of an FVIII inhibitor (high responder) with FVIII levels < 1%. Severe muscle bleeds continued approximately once every 2 months. Prophylactic treatments progressively included aPCC, pdFVIII, and emicizumab.
The patient also presents with cardiovascular comorbidities: atrial fibrillation (AF) accompanied by its dilatation, diastolic heart failure, and hypertension. In 2021, he also contracted COVID-19, requiring hospitalization.
News Combination of Targeted Therapy with Chemo in 1st Line in Patients with Left-Sided wtRAS mCRC
The preferred targeted therapy added to the combination with standard chemotherapy (CHT) for left-sided metastatic colorectal cancer (mCRC) with non-mutated RAS oncogene should be an antibody against the epidermal growth factor receptor (anti-EGFR), not against the vascular endothelial growth factor (anti-VEGF). This is based on a direct comparison of anti-EGFR panitumumab and anti-VEGF bevacizumab in the Japanese phase III PARADIGM study. The results were presented at the ASCO 2022 annual meeting.
News Regorafenib and Trifluridine/Tipiracil: Hospitalization and Clinical Outcomes in the Treatment of Metastatic Colorectal Cancer
Regorafenib and trifluridine/tipiracil are drugs that prolong overall survival (OS) in pre-treated patients with metastatic colorectal cancer (mCRC). The difference in the toxicity of these agents led to the hypothesis that treatment toxicity of individual drugs might increase the number of hospitalizations, thereby affecting patients' quality of life. The study presented below aimed to analyze the number of hospitalizations during treatment and their possible impact on OS.
News Comparison of Enoxaparin and Unfractionated Heparin in Hospitalized Patients in Terms of Clinical and Cost Effectiveness
Thromboembolic disease represents one of the severe complications in hospitalized patients. Low molecular weight and unfractionated heparin are most commonly used during hospitalization as part of pharmacological thromboprophylaxis. An extensive study conducted in the United States evaluated the clinical and cost-effectiveness and safety of both therapy modalities in hospitalized patients at risk of thromboembolic disease.
News The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
We summarize the results of a clinical study on the effect of probiotics containing Limosilactobacillus reuteri on the improvement of gingivitis in patients with diabetes. It has been proven that the supplementary administration of L. reuteri statistically significantly improves gum health and helps to suppress gingival inflammation.
News Current View on Obstacles in Proper Use of Antibiotics and the Role of Biomarkers in Infection Diagnosis
In the fight against antibiotic resistance, principles for the proper use of antibiotics (ATB) have been introduced globally. The following overview briefly describes the obstacles in leading rational antibiotic therapy and considers the use and benefits of biomarkers.
News MDT Board: a unique project for doctors caring for patients with lung diseases and other thoracic pathologies
A unique concept of a cooperative thoracic group has been created in the Czech Republic, involving specialists from several leading Prague clinics. The primary purpose of the so-called board is to provide the best diagnostic and treatment plan for a patient with lung disease and other pathologies in the thoracic area, shared by all members of the multidisciplinary team and based on current knowledge. The MDT Board project, which operates on the principle of online indication seminars, is intended for doctors of patients with common and rare lung diseases.
News How do patients perceive the treatment of ITP with romiplostim?
Romiplostim, along with eltrombopag and avatrombopag, belongs to the group of thrombopoietin receptor agonists (TPO-RA) used in the second line of treatment for immune thrombocytopenia (ITP). Its efficacy and safety are confirmed by numerous studies, but how do patients perceive its use and to what extent does it improve their quality of life? This was the focus of a review article by authors from the American Baylor College of Medicine.
News ICIS Report: Potential of TPO-RA as Early Immunomodulatory Treatment of Immune Thrombocytopenia
The report from the meeting of the Intercontinental Cooperative ITP Study Group (ICIS) in 2022 in Lenzerheide, Switzerland, published late last year in the British Journal of Haematology, discusses the potential of early treatment of immune thrombocytopenia with thrombopoietin receptor agonists (TPO-RA) in achieving a disease remission sustainable without further therapy.
News Lorlatinib in a Patient with Meningeal Carcinomatosis – Case Report
The prognosis of patients with meningeal carcinomatosis is unfavorable. The following case report demonstrates how a targeted mechanism of action and optimal drug penetration into the central nervous system (CNS) can not only quickly relieve patients from neurological problems associated with meningeal infiltration, but also prolong their survival.
News Acquired Hemophilia A Newly Diagnosed in an Elderly Patient − A Case Report
At the XXVIIIth Pařízek Days held in Ostrava, a case of acquired hemophilia A, recently addressed at this institution, was presented in the afternoon session on March 17, 2022, by Assoc. Prof. Petr Dulíček, MD, PhD., from the 4th Department of Internal Medicine, Charles University Faculty of Medicine and University Hospital in Hradec Králové.