Current Medical Research and Opinion最新文献

{"title":"Real-world data in lupus nephritis: results from a European survey on renal function testing and burden of disease progression.","authors":"Francesco Pesce, Ancilla Fernandes, David Clamp, Beatriz Asin, Emily Goddard, Liane Gillespie-Akar, Alice Eberhardt","doi":"10.1080/03007995.2024.2425387","DOIUrl":"10.1080/03007995.2024.2425387","url":null,"abstract":"<p><strong>Objective: </strong>Patients with lupus nephritis (LN), a severe renal manifestation of systemic lupus erythematosus, should be monitored for progression of chronic kidney disease to end-stage renal disease but data on renal function testing in LN patients are limited. This real-world analysis aimed to evaluate nephrologists' use of renal function tests to support LN diagnosis and monitoring and to examine the impact of disease progression in LN patients in Europe.</p><p><strong>Methods: </strong>Data were drawn from the Adelphi Lupus Disease Specific Programme, a cross-sectional survey of nephrologists and their next five consulting patients with LN in France, Germany, Italy, Spain, and the United Kingdom in 2021. Nephrologists provided demographic and clinical information for each patient and the same patients completed a self-reported questionnaire. Using a checkbox, patients provided informed consent to take part in the survey.</p><p><strong>Results: </strong>Nephrologists (<i>n</i> = 72) provided data on 376 patients with LN. Estimated glomerular filtration rate (eGFR) or proteinuria testing was not undertaken in around 10% and 50% of these patients, respectively. Regression analysis predicted reduction in renal function (disease progression) following LN diagnosis whilst bivariate analyses showed significantly worse outcomes for patients with progressed disease: worse pain, fatigue, treatment satisfaction, and patient-reported health state and activity impairment.</p><p><strong>Conclusion: </strong>Our study revealed lower-than-expected nephrologist-reported use of renal function testing to support diagnosis/monitoring of patients with LN in real-world clinical settings in Europe. Lower quality of life (QoL) was observed in patients with more progressed disease. Increased use of renal function testing is needed so that all LN patients are monitored closely to manage disease progression and avoid the associated QoL impact.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2215-2222"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical burden and healthcare resource utilization associated with managing sickle cell disease with recurrent vaso-occlusive crises in France.","authors":"Jessica Baldwin, Chuka Udeze, Nanxin Li, Lyes Boulmerka, Lila Dahal, Giancarlo Pesce, Nadia Quignot, Heng Jiang, Frédéric Galactéros","doi":"10.1080/03007995.2024.2421287","DOIUrl":"10.1080/03007995.2024.2421287","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective, real-world claims database analysis described the clinical burden and healthcare resource utilization (HCRU) among patients with sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs) in France.</p><p><strong>Methods: </strong>The French National Health Data System database (système national des données de santé) was used to identify eligible patients from 1 January 2012 to 1 March 2019. Inclusion criteria were a SCD diagnosis, ≥2 VOCs/year for ≥2 consecutive years following the diagnosis, and ≥1 year of follow-up data to 1 March 2020. Patients with hereditary persistence of fetal hemoglobin or hematopoietic stem cell transplant in their medical records were excluded. Clinical complications, mortality, treatment use, and HCRU were evaluated during follow-up.</p><p><strong>Results: </strong>Overall, 4602 patients with SCD with recurrent VOCs were eligible; their mean (standard deviation [<i>SD</i>]) age was 19.8 (13.5) years, and 51.8% were female. Patients experienced a mean (SD) of 3.82 (3.57) VOCs per patient per year (PPPY). Prevalent complications were anemia or leukocytosis (44.1%), infections (42.0%), and organ failure (38.2%). In total, 101 (2.2%) patients died during follow-up (mean age of death [SD]: 39.3 [17.5] years; mortality rate: 0.64 deaths per 100 person-years). Most patients received opioids (89.1%) and hydroxycarbamide (72.8%). Patients had a mean of 5.7 inpatient hospitalizations, 6.0 emergency room visits, 6.6 outpatient visits, and 13.4 outpatient prescriptions PPPY.</p><p><strong>Conclusions: </strong>Patients with SCD with recurrent VOCs in France have substantial clinical complications, mortality, and HCRU despite currently available treatment options. Innovative treatments that reduce frequency of or eliminate VOCs are needed to alleviate the burden associated with SCD.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2117-2124"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why is applying artificial intelligence to pain so challenging?","authors":"Marco Cascella, Mohammed Naveed Shariff","doi":"10.1080/03007995.2024.2434078","DOIUrl":"10.1080/03007995.2024.2434078","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2021-2024"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onset of ANCA-positive EGPA with bilateral pleural effusion: a case report.","authors":"Alessandra Marchese, Rocco Accogli, Annalisa Frizzelli, Alessandro De Simoni, Olha Bondarenko, Roberta Pisi, Gaetano Caramori, Giovanna Pelà, Maria Majori, Letizia Gnetti, Agnese Aluia, Lorenzo D'Aloisio, Alfredo Chetta, Marina Aiello","doi":"10.1080/03007995.2024.2427882","DOIUrl":"10.1080/03007995.2024.2427882","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystemic, immune-mediated disease that occurs in patients with asthma and eosinophilia. It is characterized by inflammation of small- and medium-caliber blood vessels.</p><p><strong>Case report: </strong>This report presents an unusual clinical case of EGPA with positive anti-neutrophil cytoplasmic antibodies who manifested bilateral pleural effusion. The diagnosis was confirmed through laboratory assessments and bronchial biopsies. The patient was treated with methylprednisolone showing improvement in symptoms.</p><p><strong>Conclusions: </strong>Our case appear interesting considering the limited evidence of pleural effusion in patients with EGPA documented in the literature.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2209-2213"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of advanced systemic therapy in patients with moderate-to-severe atopic dermatitis in the TARGET-DERM AD Registry.","authors":"Michael A Haft, Keith D Knapp, Ami Claxton, Breda Munoz, Julie M Crawford, Sanjeev Balu, Yestle Kim, Shannon Schneider, Dawn Z Eichenfield, Jonathan I Silverberg, Lawrence F Eichenfield, Jerry Bagel, Jamie L W Rhoads, Amy S Paller","doi":"10.1080/03007995.2024.2427883","DOIUrl":"10.1080/03007995.2024.2427883","url":null,"abstract":"<p><strong>Background: </strong>Moderate-to-severe atopic dermatitis (AD) significantly impacts quality of life. Advanced systemic therapeutics (AST) represent a new generation of medications targeting AD pathogenesis, but many who may benefit from these medications are AST-naïve. We compared patients in the United States who had started AST with those who had not started AST to evaluate associated characteristics.</p><p><strong>Methods: </strong>TARGET-DERM AD, (NCT03661866, \"A Longitudinal Observational Study of Patients Undergoing Therapy for IMISC (TARGET-DERM)\" launched in 2019, is an ongoing, longitudinal, observational study of patients managed at 37 United States sites. Patients were aged 12 years and above, had moderate-to-severe AD based on validated Investigator Global Assessment (vIGA) at enrollment, at least one follow-up visit post-enrollment, and treatment with any of the following: a topical/systemic corticosteroid, immunomodulator, or phototherapy. AST included dupilumab and upadacitinib. Variables of interest gathered at enrollment included demographics, vIGA and Body Surface Area (BSA), patient-reported outcomes, and all recorded therapeutics.</p><p><strong>Results: </strong>Of 3,076 patients, 436 qualified for inclusion, 52 were AST-treated adolescents and 141 AST-treated adults. Both groups had increased likelihood of AST initiation if they had private insurance and higher BSA, vIGAxBSA, or Patient-Oriented SCORing Atopic Dermatitis scores. Adults were more likely to start AST based on minority/ethnicity, more severe vIGA, higher patient-reported outcomes, or if treated at a community clinic. Substantial numbers of adolescent and adult patients (47 and 58%, respectively) with severe disease were AST-naïve.</p><p><strong>Conclusions: </strong>Disease severity and patient access to AST are major factors driving AST initiation. However, some patients are undertreated. This analysis supports AD patient advocacy for those inadequately managed with conventional therapies. Further investigations are necessary to delineate AST initiation barriers and relevant outcomes.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2057-2066"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the safety of triiodothyronine in combination with levothyroxine for the management of hypothyroidism.","authors":"Ulrike Gottwald-Hostalek, Yorki Tayrouz","doi":"10.1080/03007995.2024.2435460","DOIUrl":"10.1080/03007995.2024.2435460","url":null,"abstract":"<p><p>There remains considerable interest in the therapeutic use of combinations of levothyroxine (LT4) and triiodothyronine (liothyronine, T3) in the management of hypothyroidism, especially where hypothyroid-like symptoms persist on optimised LT4 monotherapy. This interest appears to be increasing, despite the lack of consistent identification of clinical benefit in people with hypothyroidism in randomised trials going back two decades. Guidelines support an individualised trial of addition of T3 to LT4 for symptomatic patients on optimised LT4. A new generation of clinical trials seeks to address this issue, using thyroid-specific instruments to measure patient-reported outcomes, among other innovations. Safety is the other critical element of the therapeutic profile of a drug. In this article, we review the safety of treatment LT4 + T3, with an emphasis on side-effects suggestive of thyrotoxicosis (overtreatment with thyroid hormones). Randomised trials that evaluated LT4 + T3 did not raise clear or consistent safety issues with this treatment. This was despite the use of regimens with a lower ratio of LT4:T3 (usually 4-10:1) than recommended currently by clinical experts in the field. In addition, a real-world analysis of side-effects of a commercial LT4 + T3 treatment (LT4:T3 ratio 5:1) that were reported spontaneously to a pharmacovigilance database revealed a low rate of reports, both overall and with regard to symptoms possible reminiscent of thyrotoxicosis. Safety concerns regarding the possibility of iatrogenic thyrotoxicosis appear unlikely to limit the future guideline-driven therapeutic use of LT4:T3 combinations with a ratio of these ingredients of around 15:1.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2109-2116"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin or saxagliptin in pediatric type 2 diabetes: a plain language summary.","authors":"Naim Shehadeh","doi":"10.1080/03007995.2024.2418993","DOIUrl":"10.1080/03007995.2024.2418993","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2067-2076"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of same-day versus next-day administration of PEG-rhG-CSF for the prophylaxis of chemotherapy-induced neutropenia and febrile neutropenia in patients with breast cancer: a retrospective cohort study.","authors":"Yu-Fei Zhang, Rou-Mei Zhang, Wen-Xin Gu, Yi-Ting Jin, Chun-Lai Ma","doi":"10.1080/03007995.2024.2423736","DOIUrl":"10.1080/03007995.2024.2423736","url":null,"abstract":"<p><strong>Objectives: </strong>Polyethylene glycol recombinant human granulocyte colony-stimulating factors (PEG-rhG-CSFs) are used to prevent or treat chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN). This study aimed to compare the efficacy and safety of same-day versus next-day PEG-rhG-CSF administration following chemotherapy and the effects of 3 mg versus 6 mg dosages.</p><p><strong>Methods: </strong>We retrospectively analyzed cohort data of patients with breast cancer who underwent chemotherapy and received PEG-rhG-CSF either within 24 h (same-day group) or 24 h (next-day group) after chemotherapy. The incidences of CIN and FN were assessed in each chemotherapy cycle between the two groups. The primary endpoint was the incidence of FN in the first cycle and throughout all cycles. The secondary endpoints included the incidences of various grades of CIN (CIN1-CIN4), antibiotic use, chemotherapy regimen modifications, and overall safety.</p><p><strong>Results: </strong>Among the 2385 chemotherapy cycles with prophylactic PEG-rhG-CSF in 620 patients, 798 and 1587 cycleswere in the same-day and next-day group, respectively. No statistically significant differences were observed in the incidence of FN in the first cycle or across all cycles, CIN1-4, or adverse reactions between the two groups. However, the same-day group exhibited significantly higher rates of antibiotic use (2.88% vs. 0.42%, <i>p</i> = .03) and chemotherapy regimen modification (4.68% vs. 1.45%, <i>p</i> < .001). Subgroup analysis indicated no differences in outcomes for the 6 mg dosage, but a significantly lower incidence of CIN was observed in the same-day group receiving 3 mg (<i>p</i> = .025).</p><p><strong>Conclusions: </strong>These findings suggest that same-day administration of PEG-rhG-CSF is as effective and safe as next-day administration in preventing FN and CIN during chemotherapy.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2147-2154"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing immuno-oncology efficacy with H1-antihistamine in cancer therapy: a review of current research and findings.","authors":"Oday Hamid, Negar Hamidi","doi":"10.1080/03007995.2024.2427323","DOIUrl":"10.1080/03007995.2024.2427323","url":null,"abstract":"<p><p>Cancer remains a major global cause of death, posing significant treatment challenges. The interactions between tumor cells and the tumor microenvironment (TME) are crucial in influencing tumor initiation, progression, metastasis, and treatment response. There has been significant research and clinical interest in targeting the TME as a therapeutic approach in cancer, with advancements being made through drug development. Histamine binds to HRH1 receptors on the TME, which inhibit CD8+ T cell activity, promote tumor growth, and contribute to resistance against immunotherapy. By inhibiting CD8+ T cells, the effectiveness of immunotherapies targeting these cells is reduced. By blocking the HRH1 pathway, H1-antihistamines can mitigate this suppression and enhance the response to immunotherapies that target CD8+ T cells. Therefore, understanding the role of histamine and its potential impact on T cells and the role of H1-antihistamines in improving immune-oncology (I/O) agents' efficacy ultimately could lead to more effective cancer therapies. The objective of this review is to examine the current literature to investigate the potential role of H1-antihistamines on the effectiveness of I/O drugs and their role in enhancing treatment against cancer. We conducted a comprehensive literature search, which included multiple databases including PubMed, Google Scholar, and EMBASE, as well as a search of oncology congresses. Our literature review initially identified thirty studies. Twenty-three of these were excluded for failing to meet inclusion criteria, which varied from study design to the type of antihistamines and patient populations involved. The clinical studies investigated the effect of different generations of H1-antihistamines in combination with I/O treatments on patients' outcomes. The findings from these studies indicated that patients using H1-antihistamines concomitantly with I/O agents experienced longer median overall survival (mOS), progression-free survival (mPFS), or improved survival compared to those who did not use antihistamines. Additionally, these trials differentiated between cationic and non-cationic H1-antihistamines, revealing that users of cationic antihistamines had overall better outcomes in terms of longer mOS and mPFS. The assessed trials were consistent in their comparisons of quantitative and qualitative, efficacy, and safety outcomes.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2139-2146"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the utility of artificial intelligence for prediction, diagnosis, and progression of diabetic kidney disease: an evidence-based systematic review and meta-analysis.","authors":"Sagar Dholariya, Siddhartha Dutta, Amit Sonagra, Mehul Kaliya, Ragini Singh, Deepak Parchwani, Anita Motiani","doi":"10.1080/03007995.2024.2423737","DOIUrl":"10.1080/03007995.2024.2423737","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to conduct a systematic investigation of the potential of artificial intelligence (AI) models in the prediction, detection of diagnostic biomarkers, and progression of diabetic kidney disease (DKD). In addition, we compared the performance of non-logistic regression (LR) machine learning (ML) models to conventional LR prediction models.</p><p><strong>Methods: </strong>Until January 30, 2024, a comprehensive literature review was conducted by investigating databases such as Medline (<i>via</i> PubMed) and Cochrane. Research that is inclusive of AI or ML models for the prediction, diagnosis, and progression of DKD was incorporated. The area under the Receiver Operating Characteristic Curve (AUROC) served as the principal outcome metric for assessing model performance. A meta-analysis was performed utilizing MedCalc statistical software to calculate pooled AUROC and assess the performance differences between LR and non-LR models.</p><p><strong>Results: </strong>A total of 57 studies were included in the meta-analysis. The pooled AUROC of AI or ML model was 0.84 (95% CI = 0.81-0.86, <i>p</i> < 0.0001) for analyzing prediction of DKD, 0.88 (95%CI = 0.84-0.92, <i>p</i> < 0.0001) for detecting diagnostic biomarkers, and 0.80 (95% CI = 0.77-0.82, <i>p</i> < 0.0001) for analyzing progression of DKD. The pooled AUROC of LR and non-LR ML models exhibited no significant differences across all categories (<i>p</i> > 0.05), except for the random forest (RF) model, which displayed a statistically significant increase in predictive accuracy compared to LR for DKD occurrence (<i>p</i> < 0.04).</p><p><strong>Conclusion: </strong>ML models showed solid DKD prediction effectiveness, with pooled AUROC values over 0.8, suggesting good performance. These data demonstrated that non-LR and LR models perform similarly in overall CKD management, but the RF model outperforms the LR model, particularly in predicting the occurrence of DKD. These findings highlight the promise of AI technologies for better DKD management. To improve model reliability, future study should include extended follow-up periods as well as external validation.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"2025-2055"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}