Teriflunomide is one of the first-choice medications in the treatment of multiple sclerosis (MS) patients, not only in the Czech Republic. Conversely, the use of dimethyl fumarate is more limited here compared to other countries. Did the data from real-world clinical practice published this year actually demonstrate differences in the efficacy of both medications, and thus justify their classification?

Teriflunomide and dimethyl fumarate are disease-modifying drugs (DMDs) used in the treatment of multiple sclerosis (MS). Regarding the course, form, and severity of MS, their target groups are comparable in their characteristics. These DMDs are therefore ideal candidates for mutual comparison. Swedish authors decided to compare their effectiveness based on data from real clinical practice obtained through the Swedish National Registry.

As of June 1, 2020, general practitioners can prescribe antidiabetics from the group of so-called gliptins, inhibitors of the enzyme dipeptidyl peptidase 4 (DPP-4i), in addition to metformin. The cornerstone of type 2 diabetes mellitus treatment remains a comprehensive lifestyle modification (dietary measures, increased physical activity, weight reduction) and metformin as the first-line drug. In selected comorbidities or if these measures do not lead to the desired glycated hemoglobin (HbA1c) level after 3-6 months, the following recommendations can be followed. However, it is essential to remember that the recommendations of professional societies do not always correspond to the prescription limitations of the State Institute for Drug Control (SÚKL).

Bevacizumab is among the first targeted therapies used in oncology. For many indications where chemotherapy options had been exhausted and few other treatment modalities were available, it changed the treatment approach and brought patients prolonged progression-free survival or even overall survival. It has become a standard of care for many advanced cancers. What do we know today about this monoclonal antibody, first introduced in routine practice in 2005?

An observational study from a hospital in Liverpool, UK, was published in the journal Anaesthesia, where they implemented a bleeding management algorithm for obstetric procedures based on rotational thromboelastometry (ROTEM) testing. After 4 years of using this algorithm, it was found that selective administration of fibrinogen concentrates based on ROTEM results led to better clinical outcomes in the treatment of coagulopathy.

Allopurinol is a widely used drug for the treatment of hyperuricemia and gout. The retrospective study presented below investigated whether its long-term use is associated with an increased risk of developing subclinical hypothyroidism.

The recommended treatment for metastatic HER2-positive breast cancer in the 1st line involves dual blockade of the HER2 signaling pathway using trastuzumab and pertuzumab in combination with a taxane cytostatic. After the failure of this therapy, treatment with trastuzumab emtansine (T-DM1) is recommended. However, this recommendation is not supported by a prospectively designed controlled study examining the outcomes of this therapeutic sequence. Therefore, a group of Italian authors decided to publish the results of a patient cohort treated with this sequence in real clinical practice conditions.

Von Willebrand disease (vWD) is an autosomal hereditary bleeding disorder. Its detection and diagnosis require several steps, including the initial suspicion of the presence of this disease.

What is the perception and view of the treatment options for immune thrombocytopenia (ITP) from the patients' perspective, what do they fear, what approaches do they prefer, and why? Lozano et al. included a discussion on this topic in their review article for Expert Review of Hematology, which can be helpful in clinical practice for better understanding patients' needs and adjusting treatment algorithms.

Breast cancer is the most common malignant tumor disease in women, and its incidence sharply increases after the age of 50. Although its incidence shows a continuously increasing trend, the development of mortality is more favorable. Thanks to nationwide screening and more successful therapy, mortality has long been stable, even slightly decreasing. A relatively rare variant of this oncological disease is primary synchronously detected bilateral breast cancer (PSBBC). Experts from the Proton Therapy Center in Prague are focusing on the use of proton radiotherapy in the treatment of this clinical entity.

Ubiquitous and increasingly common obesity is a risk factor for many cancers. Over the past 20 years, studies have linked obesity to higher incidences of breast and colorectal cancers, as well as hepatocellular carcinoma (HCC) associated with nonalcoholic fatty liver disease (NAFLD). What is the efficacy and safety of sorafenib in this patient population, and does it differ from patients with liver cancers caused by viral infection or alcohol abuse? This intrigued a team of researchers from Melbourne, Australia.

Micronutrients are a key nutritional component, and this is also true for patients whose condition requires the administration of parenteral nutrition. An article published last year in the Journal of Parenteral and Enteral Nutrition summarizes the expert literature on this topic as well as current guidelines and addresses 14 clinically most relevant questions related to the importance, administration, and monitoring of micronutrients.

Study results suggest that the use of low molecular weight heparins during pregnancy could lead to better outcomes for women with thrombophilia and recurrent miscarriages. A group of authors from Israel compared the differences in efficacy when administering two different doses of enoxaparin to women with hereditary thrombophilia and a history of two or more spontaneous miscarriages or one fetal death without obvious cause.

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.