Endocrine Practice最新文献_第6页

Patients With Persistent Hashimoto-Related Symptoms. Dilemmas in Advice-Giving and Self-Selection for Thyroidectomy. An Observational Study. 持续桥本相关症状的患者。甲状腺切除术中建议与自我选择的困境。一项观察性研究。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-21 DOI: 10.1016/j.eprac.2025.04.007

Geir Hoff, Tomm Bernklev, Jan Terje Kvaløy, Charlotte Gibbs, Laurens Cornelus Reitsma

{"title":"Patients With Persistent Hashimoto-Related Symptoms. Dilemmas in Advice-Giving and Self-Selection for Thyroidectomy. An Observational Study.","authors":"Geir Hoff, Tomm Bernklev, Jan Terje Kvaløy, Charlotte Gibbs, Laurens Cornelus Reitsma","doi":"10.1016/j.eprac.2025.04.007","DOIUrl":"10.1016/j.eprac.2025.04.007","url":null,"abstract":"Objective: Some Hashimoto-related symptoms, persistent despite medically obtained euthyroidism, are believed to be related to autoimmunity. Total thyroidectomy has proved beneficial for patient-reported outcome measures (PROMs), but with a certain risk of complications. Selection criteria for surgery have not been defined. Molecular evidence supporting an autoimmune cause is lacking, and a placebo effect of surgery cannot be excluded. Short of selection criteria for thyroidectomy and no pathophysiologic model to adequately explain persistent symptoms, we wanted to look into factors that may be related to patients' decision for surgery, thus aiming to facilitate patient-physician communication on treatment for persistent Hashimoto-related symptoms.Methods: A total of 177 patients with persistent Hashimoto disease-related symptoms and highly motivated for thyroidectomy completed an 18-month watchful waiting period with biannual consultations before being offered thyroidectomy. PROMs were monitored before and after surgery.Results: After 18 months of watchful waiting, 131 (74%) of 177 patients proceeded to thyroidectomy whereas 46 declined surgery. There was no difference between the surgery and no-surgery groups regarding sex, age, and thyroid peroxidase antibody levels at 18 months watchful waiting. Compared with the no-surgery group, PROM scores were consistently poorer in the surgery group for all domains in the PROM questionnaires used.Conclusions: A grace period of 18 months with biannual follow-up before thyroidectomy may be useful to modify exposure to surgery carrying a certain risk of complications. At 18 months, the fatigue score stands out as the most important factor influencing the odds for maintaining a choice to have surgery.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to Letter to the Editor on the 2025 AACE Clinical Practice Guideline on Pharmacologic Management of Adults With Dyslipidemia. 对2025年AACE成人血脂异常药理管理临床实践指南致编辑的回复

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-21 DOI: 10.1016/j.eprac.2025.04.009

Vishnu Priya Pulipati, Mihail Zilbermint, Shailendra B Patel

引用次数: 0

Disparities in Outcomes and Health Care Utilization for Diabetic Ketoacidosis Among Patients With Type 1 and Type 2 Diabetes Mellitus: A 6-Year National Retrospective Cohort Study. 1型和2型糖尿病患者糖尿病酮症酸中毒的结局和医疗保健利用差异：一项为期6年的全国回顾性队列研究

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-16 DOI: 10.1016/j.eprac.2025.04.002

Shellsea Portillo-Canales, John Peters, Garry Francis-Morel, Sandeep Dhindsa

{"title":"Disparities in Outcomes and Health Care Utilization for Diabetic Ketoacidosis Among Patients With Type 1 and Type 2 Diabetes Mellitus: A 6-Year National Retrospective Cohort Study.","authors":"Shellsea Portillo-Canales, John Peters, Garry Francis-Morel, Sandeep Dhindsa","doi":"10.1016/j.eprac.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.04.002","url":null,"abstract":"Objective: Diabetic ketoacidosis (DKA) represents a significant burden on the health care system. The impact of diabetes type on DKA outcomes remains unclear. This study aims to compare mortality, length of stay (LOS), and hospital costs between patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) hospitalized with DKA.Methods: We conducted a retrospective cohort study using data from the 2016-2021 National Inpatient Sample Healthcare Cost and Utilization Project database, focusing on patients admitted for acute care with a diagnosis of DKA. Patients were categorized into 2 cohorts: T1DM versus T2DM. The primary end point was mortality, assessed using multiple logistic regression. Secondary end points included LOS and total hospital charges, analyzed using multiple linear regression, adjusting for potential confounders. Multiple imputations accounted for missing data, and a Bonferroni correction was applied for multiple comparisons.Results: The study included 1 244 184 patients, with 770 109 (62%) T1DM and 474 075 (38%) T2DM. Mortality was significantly higher in patients with T2DM (0.91%) compared to patients with T1DM (0.22%; P < .001). LOS was longer for patients with T2DM (average 3.92 days vs 3.02 days for T1DM; P < .001), as were hospital charges ($10 146.78 for T2DM vs $7811.98 for T1DM; P < .001). Significant disparities were also observed in the demographic and hospital characteristics, including median household income, insurance type, and hospital region.Conclusion: In this national retrospective cohort study, patients with T2DM and DKA had higher mortality rates, longer LOS, and higher health care costs than those with T1DM. These findings highlight critical disparities that may guide future interventions to improve DKA outcomes in patients with T2DM.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sunscreen and 25-Hydroxyvitamin D Levels: Friends or Foes? A Systematic Review and Meta-Analysis. 防晒霜和25-羟基维生素D水平：是友是敌？系统回顾和荟萃分析。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-15 DOI: 10.1016/j.eprac.2025.03.014

Elisa Gatta, Carlo Cappelli

{"title":"Sunscreen and 25-Hydroxyvitamin D Levels: Friends or Foes? A Systematic Review and Meta-Analysis.","authors":"Elisa Gatta, Carlo Cappelli","doi":"10.1016/j.eprac.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.014","url":null,"abstract":"Objective: To evaluate the impact of sunscreen use on 25-hydroxyvitamin D (25(OH)D) levels, addressing conflicting findings from observational and interventional studies.Methods: Potentially eligible studies were identified from the PubMed/MEDLINE, Scopus, and Web of Science databases from inception to November 2024, utilizing a search strategy incorporating terms related to \"sunscreen\" and \"vitamin D.\" The studies eligible addressed the questions define based on the Population, Intervention, Comparator, Outcome framework: What are 25(OH)D levels in patients exposing to sun applying or not sunscreen? This review followed Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment and the risk of bias were analyzed using Quality Assessment of Diagnostic Accuracy Studies version 2.Results: We included 22 studies in the qualitative synthesis, and 7 in the quantitative one, encompassing a total of 9470 participants. In vitro studies consistently showed that sunscreen blocks UV-B radiation, crucial for vitamin D3 production, while population-based studies reported mixed findings. Some studies linked sunscreen use to lower 25(OH)D levels, particularly in individuals with limited sun exposure, while others observed no significant impact. Meta-analysis showed that the adoption of sunscreen is associated to a reduction of 25(OH)D serum concentration (standardized mean difference = -2 ng/mL, 95% confidence interval -3, -1) with a not important heterogeneity across studies (I-square = 37%, P = .15).Conclusion: The existing evidence supports that sunscreen can impair vitamin D3 synthesis, and as a result decrease serum 25(OH)D levels, but further research is necessary to determine the broader health implications and guide public health recommendations.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reassessing the Risk-Benefit Profile of Thiazolidinediones: Cardiovascular Risks and Stroke Prevention Through Real-World Data. 重新评估噻唑烷二酮类药物的风险-收益概况：通过真实世界数据的心血管风险和卒中预防。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-15 DOI: 10.1016/j.eprac.2025.04.004

Lu Fei, Yingjie Zhao

{"title":"Reassessing the Risk-Benefit Profile of Thiazolidinediones: Cardiovascular Risks and Stroke Prevention Through Real-World Data.","authors":"Lu Fei, Yingjie Zhao","doi":"10.1016/j.eprac.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.04.004","url":null,"abstract":"Objectives: Research has increasingly explored the benefits of thiazolidinediones (TZDs) beyond diabetes management, particularly in reducing stroke and dementia risks. However, concerns about cardiovascular adverse events, especially heart failure (HF), necessitate a re-evaluation of TZD-associated cardiovascular risks using real-world data.Methods: This study re-evaluates the cardiovascular risks of TZDs and their efficacy in stroke prevention. We conducted a real-world pharmacovigilance study using the US Food and Drug Administration Adverse Event Reporting System (FAERS) database (January 2004 to December 2023) to assess cardiovascular risks associated with TZDs, including myocardial infarction, HF, and stroke. Multivariable logistic regression adjusted the reporting odds ratio from the disproportional analysis. Additionally, a network meta-analysis of clinical studies (January 2000 to March 2024) examined the efficacy of TZDs in stroke prevention.Results: Our analysis of the FAERS database revealed significantly higher cardiovascular risks associated with TZDs. However, clear differences exist in cardiovascular risks between pioglitazone and rosiglitazone. Rosiglitazone was linked to a markedly increased incidence of myocardial infarction, HF, and stroke. In contrast, we didn't observe strong cardiovascular risks associated with pioglitazone. Instead, pioglitazone was shown to slightly heighten the risk of HF. Further, the network meta-analysis, based on SUCRA rankings and ranking probabilities also disclosed similar findings: when compared to placebo, rosiglitazone increased stroke risk, while pioglitazone reduced stroke incidence in individuals with diabetes and prediabetes.Conclusions: Our analysis shows that pioglitazone has potential therapeutic effects on stroke prevention and fewer cardiovascular adverse events compared to rosiglitazone, underscoring the importance of reassessing TZD safety for optimal patient outcomes.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computed Tomography Cardiac Angiography Findings in Patients With Sheehan Syndrome. 希恩综合征患者的计算机断层心脏血管造影表现。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-15 DOI: 10.1016/j.eprac.2025.04.006

Aqib Mohammad, Majid Jehangir, Shahnaz Ahmad Mir, Syeed Aalishan Fatima, Mohammad Salem Baba, Bashir Ahmad Laway, Javaid Ahmad Bhat, Nadia Shafi

{"title":"Computed Tomography Cardiac Angiography Findings in Patients With Sheehan Syndrome.","authors":"Aqib Mohammad, Majid Jehangir, Shahnaz Ahmad Mir, Syeed Aalishan Fatima, Mohammad Salem Baba, Bashir Ahmad Laway, Javaid Ahmad Bhat, Nadia Shafi","doi":"10.1016/j.eprac.2025.04.006","DOIUrl":"10.1016/j.eprac.2025.04.006","url":null,"abstract":"Objective: Sheehan Syndrome (SS), or postpartum pituitary necrosis, is associated with an elevated risk of atherosclerotic cardiovascular (CV) diseases, driven by factors such as dyslipidemia, chronic inflammation, and growth hormone deficiency. To better understand the prevalence and characteristics of atherosclerotic CV disease in this population, we conducted a noninvasive evaluation of the coronary arteries using computed tomography cardiac angiography.Methods: This observational cross-sectional study included women diagnosed with SS who were receiving standard replacement therapy including thyroxine and glucocorticoids. All participants underwent computed tomography cardiac angiography to identify the presence of coronary artery plaques.Results: The study included 30 patients with SS, with a mean age of 54.20 ± 8.27 years and a mean duration of pituitary disease of 22.67 ± 6.27 years. Coronary artery calcium (CAC) scoring revealed the following risk stratification for coronary artery disease: minimal risk (CAC 1-10) in 6.7% (n = 2), mild risk (CAC 11-100) in 16.7% (n = 5), and moderate risk (CAC 101-400) in 3.3% (n = 1). Coronary artery plaques were identified in 23.3% (n = 7) of patients. Among these, 4 patients had noncalcified plaques, 2 had calcified plaques, and 1 patient had both calcified and noncalcified plaques. A strong positive correlation was observed between CAC scores and percentage stenosis (r = 0.96, P = .01).Conclusion: Approximately one-fourth of patients with SS were found to have atherosclerotic plaques in their coronary arteries, highlighting their increased susceptibility to CV morbidity and mortality.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emerging and Established Adverse Events of Pasireotide: A Twelve-Year Pharmacovigilance Study. 帕西肽新出现和已确定的不良事件：一项为期12年的药物警戒研究。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-15 DOI: 10.1016/j.eprac.2025.04.005

Cong Zou, Xing Wang, Ruizhen Huang, Honglin Hu

{"title":"Emerging and Established Adverse Events of Pasireotide: A Twelve-Year Pharmacovigilance Study.","authors":"Cong Zou, Xing Wang, Ruizhen Huang, Honglin Hu","doi":"10.1016/j.eprac.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.04.005","url":null,"abstract":"Objectives: This study aimed to provide a comprehensive assessment of pasireotide's real-world safety profile by analyzing adverse events (AEs) reported in the FDA Adverse Event Reporting System (FAERS).Methods: FAERS data from Q4 2012 to Q3 2024 were retrospectively analyzed using disproportionality methods, including the reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker. Descriptive analyses evaluated clinical characteristics such as age, sex, country of report, and time to AE onset, while subgroup analyses assessed variations in AE occurrence across demographic groups.Results: A total of 7892 pasireotide-related AEs were identified across 27 system organ classes. Frequently reported AEs included hyperglycemia, cholelithiasis, and gastrointestinal disturbances, with hyperglycemia being the most common. Emerging safety signals were identified, including nephrolithiasis, sudden hearing loss, ptosis, and atrioventricular block. Subgroup analyses indicated that metabolic AEs were more prevalent in females, while males reported higher rates of gastrointestinal symptoms. Older patients were more susceptible to cardiovascular AEs.Conclusions: This study underscores the need for ongoing pharmacovigilance to detect both established and emerging AEs associated with pasireotide. Implementing personalized monitoring strategies based on demographic factors such as age and sex can help mitigate risks and optimize treatment outcomes, enhancing patient safety in clinical practice.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility of an Electronic Nose to Aid Biochemical Assessment of Adrenal Lesions. 电子鼻辅助肾上腺病变生化评估的可行性。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-15 DOI: 10.1016/j.eprac.2025.04.003

Charlotte L Viëtor, Odin V Sosef, Sam P J van Dijk, Isabelle Holscher, Jeffrey W Chen, Zaid Al-Difaie, Max H M C Scheepers, Richard A Feelders, Koen M A Dreijerink, Anton F Engelsman, Tessa M van Ginhoven

{"title":"Feasibility of an Electronic Nose to Aid Biochemical Assessment of Adrenal Lesions.","authors":"Charlotte L Viëtor, Odin V Sosef, Sam P J van Dijk, Isabelle Holscher, Jeffrey W Chen, Zaid Al-Difaie, Max H M C Scheepers, Richard A Feelders, Koen M A Dreijerink, Anton F Engelsman, Tessa M van Ginhoven","doi":"10.1016/j.eprac.2025.04.003","DOIUrl":"10.1016/j.eprac.2025.04.003","url":null,"abstract":"Objectives: Analysis of volatile organic compounds (VOCs) in exhaled breath has emerged as a promising noninvasive diagnostic tool for various diseases. The aim of this study was to evaluate the potential of an electronic nose to differentiate between functional adrenal lesions - pheochromocytoma (PHEO), primary hyperaldosteronism (PHA), and hypercortisolism (CS) - and nonfunctional adrenal lesions.Methods: A pilot study was conducted at 2 tertiary hospitals within the Netherlands. Patients with PHEO, PHA, CS, and nonfunctional adrenal lesions underwent breath testing with an electronic nose between May 2021 and June 2024. Each center employed a distinct electronic nose (device A and B). Comparability of data between the devices was assessed in a t-distributed stochastic neighbor embedding plot, and an artificial neural network was trained to classify breath patterns.Results: Data obtained from the 2 electronic noses were too heterogeneous for pooling and device B had an insufficient sample size for further analysis. Therefore, VOC patterns of 76 functional lesions (27 PHEO, 33 PHA, 16 CS) and 29 nonfunctional adrenal lesions measured exclusively with device A were analyzed. Moderate discriminative performance was observed in the training data: pooled functional lesions (area under the curve [AUC] 0.76), PHEO [AUC 0.76], PHA [AUC 0.72] and CS [AUC 0.58] versus nonfunctional lesions. However, model performance declined significantly when applying the model developed with training data on test data, with wide confidence intervals across all comparisons.Conclusions: While slight differences in VOC patterns were detected between functional and nonfunctional adrenal lesions, the electronic nose demonstrated limited discriminative value for clinical practice.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Virta Intervention in CommuniTies in ColORado (VICTOR) Pilot Study to Improve Diabetes and Cardiovascular Risk in Rural Communities - Primary Results. 科罗拉多州社区Virta干预（VICTOR）改善农村社区糖尿病和心血管风险的试点研究-初步结果。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-08 DOI: 10.1016/j.eprac.2025.03.013

Cecilia C Low Wang, Ray Estacio, Stephanie Coronel-Mockler, Nick Flattery, Pete D Hanson, Rebecca N Adams, Amy L McKenzie, David Harrison, Marc P Bonaca

{"title":"Virta Intervention in CommuniTies in ColORado (VICTOR) Pilot Study to Improve Diabetes and Cardiovascular Risk in Rural Communities - Primary Results.","authors":"Cecilia C Low Wang, Ray Estacio, Stephanie Coronel-Mockler, Nick Flattery, Pete D Hanson, Rebecca N Adams, Amy L McKenzie, David Harrison, Marc P Bonaca","doi":"10.1016/j.eprac.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.013","url":null,"abstract":"Objective: Innovative strategies combining local community health workers (CHWs) and digital health may improve type 2 diabetes (T2D) care and cardiovascular risk in rural communities. To conduct a cluster-randomized, open-label, multisite study to evaluate the hypothesis that in rural communities served by CHW in the Colorado Heart Healthy Solutions (CHHS) program, referral to a digital continuous care intervention (CCI) would improve hemoglobin A1c (A1c) in patients with T2D as compared with CHHS alone.Methods: Adults in the CHHS program with T2D taking at least 1 antihyperglycemic medication, A1c ≥ 7.5%, body mass index ≥25 kg/m2 and who provided electronic informed consent were cluster-randomized to CHHS vs CCI+CHHS. The primary outcome was change in A1c from baseline to end of phase 1 (3 months).Results: Fifty-one individuals had evaluable data. Mean ± SD age was 59.6 ± 10 years, body mass index 34.4 ± 7 kg/m2, and A1c 8.9 ± 1.3% at baseline. The change in A1c from baseline was not significant between groups. However, A1c decreased from baseline to end of phase 1 by -1.2% in CHHS and -1.5% in CCI+CHHS, P < .001 in each group. A higher proportion of individuals in CCI+CHHS achieved 5% or greater weight loss (P < .05), and significant net decrease in number and/or dose of antihyperglycemic medications (P < .05).Conclusions: Combining a CHW program with referral to CCI did not result in greater A1c reduction, but led to improvements in A1c, weight, and medication burden in individuals with T2D in a rural setting.","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rituximab Treatment as Second-Line Therapy in Glucocorticoid Nonresponsive Graves' Orbitopathy: A Nonrandomized, Controlled, Interventional Study 利妥昔单抗作为糖皮质激素无反应性Graves眼病的二线治疗：一项非随机、对照、介入性研究。

IF 3.7 3区医学

Endocrine Practice Pub Date : 2025-04-01 DOI: 10.1016/j.eprac.2024.12.007

Sofia Manousou PhD, MD , Mats Holmberg PhD, MD , Elin Ekdahl MD , Helge Malmgren MD , Helena Filipsson Nyström MD

{"title":"Rituximab Treatment as Second-Line Therapy in Glucocorticoid Nonresponsive Graves' Orbitopathy: A Nonrandomized, Controlled, Interventional Study","authors":"Sofia Manousou PhD, MD , Mats Holmberg PhD, MD , Elin Ekdahl MD , Helge Malmgren MD , Helena Filipsson Nyström MD","doi":"10.1016/j.eprac.2024.12.007","DOIUrl":"10.1016/j.eprac.2024.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>In moderate-to-severe Graves' orbitopathy, rituximab is recommended as second-line therapy in patients nonresponsive to intravenous glucocorticoids. We aimed to evaluate rituximab as early second-line therapy, as data are scarce and contradictory.</div></div><div><h3>Methods</h3><div>In this nonrandomized, controlled, interventional study, patients with Graves' orbitopathy started on intravenous glucocorticoids. After 4 weeks, patients with < 2 points improvement in clinical activity score (CAS) were switched to rituximab [Non-Responders Rituximab (NR-RTX) group] and were compared to the remaining patients who continued with intravenous glucocorticoids for 12 weeks [Responders-Glucocorticoid (R-GC) group]. A retrospective group of non-responsive patients who were provided regular care with intravenous glucocorticoids for 12 weeks was used as control [Non-Responders-Regular Care group]. Background data and CAS were recorded for all groups at 0, 4, 12, 18, and 68 weeks. Quality of life (QoL) and safety data were collected from the NR-RTX and R-GC groups.</div></div><div><h3>Results</h3><div>The NR-RTX group (n = 12) was similar to the others at baseline except for a 1-point lower median CAS compared to the NR-RC group (n = 12) (P = .03), and for having twice as many men compared to the R-GC group (n = 13) (P = .03). At 4 weeks, a linear mixed model indicated that the R-GC group had a 1.21-point (95% CI: −2.40 to −0.02) lower value for CAS compared to the NR-RTX group. CAS for all groups converged over time. Similar models for QoL revealed no treatment or time effects.</div></div><div><h3>Conclusion</h3><div>Switch to RTX early in the treatment course did not result in better CAS or QoL, compared to continuous intravenous glucocorticoids.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 447-454"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0