Endocrine Practice最新文献

{"title":"Dose-Response Relationship of Glucagon-like Peptide-1 Receptor Agonists on HbA1c and Body Weight in Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis","authors":"Qian-Qin Chen MD ,&nbsp;Yong Yang PhD ,&nbsp;Jian-Ya Xu MD ,&nbsp;Junyu Wang PhD ,&nbsp;Tuan-Yu Fang MD ,&nbsp;Yuan Yuan MD ,&nbsp;Chengji Wang PhD ,&nbsp;Li Zhang PhD","doi":"10.1016/j.eprac.2024.11.013","DOIUrl":"10.1016/j.eprac.2024.11.013","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the dose-response relationship of GLP-1 RAs in reducing glycated hemoglobin (HbA1c), body weight, and incidence of adverse events among type 2 diabetes mellitus (T2DM) patients.</div></div><div><h3>Methods</h3><div>This systematic review and network meta-analysis followed the PRISMA guidelines. We conducted a systematic search of PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and Web of Science for articles published up to October 20, 2024. Selected studies were randomized controlled trials focusing on adult T2DM patients treated with GLP-1 RAs. Primary outcomes included changes in HbA1c, body weight, and incidence of adverse events. Data extraction was performed by 2 independent researchers. Model-Based Network Meta-Analysis employing a random-effects Bayesian approach was used to synthesize the data.</div></div><div><h3>Results</h3><div>The analysis included 62 trials with 17 140 participants. The study revealed a nonlinear dose-response relationship for various GLP-1 RAs, indicating significant reductions in HbA1c and body weight. Tirzepatide (10 mg/wk) was found to be particularly effective, reducing HbA1c by −1.76% (95% credible intervals: −2.10 to −1.41) and body weight by −8.63 kg (95% credible intervals: −9.84 to −7.39) without a significant increase in adverse events, highlighting its optimal balance between efficacy and safety. Other GLP-1 RAs also showed significant efficacy, underscoring the overall benefits of this class of medications in managing T2DM.</div></div><div><h3>Conclusion</h3><div>Our findings indicate a nonlinear dose-response relationship for GLP-1 RAs in managing T2DM. Tirzepatide at a dose of 10 mg/wk is identified as an optimal clinical dose offering a balance between efficacy and safety, contributing to refining T2DM management strategies and potentially enhancing patient outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 188-197"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784623","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}

{"title":"Highlights of the 2025 American Association of Clinical Endocrinology Clinical Practice Guideline on Pharmacologic Management of Adults With Dyslipidemia","authors":"Ricardo Correa MD, EdD","doi":"10.1016/j.eprac.2024.11.006","DOIUrl":"10.1016/j.eprac.2024.11.006","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 263-265"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104953","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}

{"title":"Info for Readers/Subscription page","authors":"","doi":"10.1016/S1530-891X(25)00004-7","DOIUrl":"10.1016/S1530-891X(25)00004-7","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages A1-A2"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181300","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}

{"title":"Loss of Follow-up for Thyroid Nodules in Patients Living in Poverty","authors":"Zhixing Song MD ,&nbsp;Sanjana Balachandra MD ,&nbsp;Christopher Wu MD ,&nbsp;Ramsha Akhund MD ,&nbsp;Jessica Fazendin MD ,&nbsp;Brenessa Lindeman MD, MEHP ,&nbsp;Herbert Chen MD ,&nbsp;Andrea Gillis MD, MSPH","doi":"10.1016/j.eprac.2024.11.005","DOIUrl":"10.1016/j.eprac.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Inadequate surveillance of thyroid nodules can lead to cancer progression. This study examines patient characteristics that correlate with failure to follow up after thyroid nodule detection.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of patients who underwent fine needle aspiration for thyroid nodules and studied subsequent thyroid ultrasounds, clinic visits, and thyroidectomies longitudinally. Poverty areas are census tracts where at least 20% of residents live below the poverty line. Logistic regression was used to assess associations between patient characteristics and follow-ups, with results expressed as odds ratios (ORs) and 95% CIs.</div></div><div><h3>Results</h3><div>Of 2446 patients included, the majority were White (62.6%) and female (78.5%), with an average age of 55 ± 16 years. 28% patients were from high poverty areas. Benign findings (Bethesda II) were observed in 73.5% of the biopsies. 42.5% of patients underwent at least one follow-up ultrasound, 59% had at least one clinic visit, and 24.4% underwent a thyroidectomy, with a 34.8% malignancy rate on surgical pathology. Patients from high poverty areas were significantly less likely to receive follow-up ultrasounds (35.7% vs 45.9%, <em>P</em> &lt; .001) or clinic visits (53.7% vs 61.2%, <em>P</em> = .001). Multivariable analysis revealed that poverty was significantly associated with not having follow-up in all patients (OR = 0.78, 95% CI 0.64-0.96) and non-benign biopsy (Bethesda 3 or higher) results (OR = 0.44, 95% CI 0.24-0.81).</div></div><div><h3>Conclusion</h3><div>There is a notable disparity in the follow-up of thyroid nodules, with patients from high poverty areas being more susceptible to loss of follow-ups.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 169-175"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647015","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}

{"title":"Comparative Effectiveness of Abaloparatide and Teriparatide in Women 50 Years of Age and Older: Update of a Real-World Retrospective Analysis","authors":"Laila Tabatabai MD ,&nbsp;Felicia Cosman MD ,&nbsp;Jeffrey R. Curtis MD, MS, MPH ,&nbsp;Kristi T. DeSapri MD ,&nbsp;Clayton T. LaBaume PA-C, MPAS ,&nbsp;Jean-Yves Reginster MD, PhD ,&nbsp;René Rizzoli MD ,&nbsp;Bernard Cortet MD, PhD ,&nbsp;Yamei Wang PhD ,&nbsp;Joseph Chiodo III PharmD ,&nbsp;Bruce H. Mitlak MD","doi":"10.1016/j.eprac.2024.10.017","DOIUrl":"10.1016/j.eprac.2024.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Abaloparatide and teriparatide are osteoanabolic treatments indicated for postmenopausal women and men with osteoporosis at high risk of fracture. In the Abaloparatide Comparator Trial In Vertebral Endpoints study, bone mineral density improvements were significantly greater with abaloparatide compared to teriparatide at the total hip and femoral neck. We conducted a retrospective claims study to examine the incidences of hip and nonvertebral fractures and cardiovascular events in women aged ≥50 years initiating abaloparatide or teriparatide therapy, expanding on a previous retrospective claims study.</div></div><div><h3>Methods</h3><div>This retrospective observational study used anonymized claims data from ICON’s Symphony Health, PatientSource for women aged ≥ 50 years with ≥ 1 prescription fill for abaloparatide or teriparatide. The index date was the date of the initial prescription dispensed. Times to first hip fracture, nonvertebral fracture, and serious cardiovascular event were compared between logistic regression-based propensity score–matched cohorts and in predefined subgroups by age, prior antiresorptive use, and prior fracture using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Patients (21 676 per cohort) were well matched on 73 baseline parameters. Forty-five percent of patients in the abaloparatide arm and 47% in the teriparatide arm were exposed to treatment for longer than 12 months. Over 18 months (+ 30 days follow-up), 245 (1.1%) and 296 (1.4%) women in the abaloparatide and teriparatide cohorts, respectively, had a hip fracture (HR [95% CI] 0.83 [0.70, 0.98]; <em>P</em> = .027); 947 (4.4%) and 1078 (5.0%) had a nonvertebral fracture (0.88 [0.80, 0.96]; <em>P</em> = .003). There were no significant treatment-subgroup interactions (<em>P</em> ≥ .2). Cardiovascular events were similar between groups.</div></div><div><h3>Conclusions</h3><div>There were significantly lower rates of hip and nonvertebral fractures with abaloparatide compared to teriparatide, which were consistent across subgroups. No differences in cardiovascular safety were noted between cohorts.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 159-168"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All That Glistens Is not Gold: Neuropathy in Diabetic Patients May not Be Exclusively due to Diabetes","authors":"David S.H. Bell MB","doi":"10.1016/j.eprac.2024.08.011","DOIUrl":"10.1016/j.eprac.2024.08.011","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 266-267"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119272","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}

{"title":"Effects of Isoflavone Interventions on Bone Metabolism in Perimenopausal and Postmenopausal Women: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials","authors":"Lifang Zhuge MM ,&nbsp;Lanlan Chen MBBS ,&nbsp;Weiping Pan MBBS","doi":"10.1016/j.eprac.2024.08.009","DOIUrl":"10.1016/j.eprac.2024.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>Previous meta-analyses have investigated the effects of isoflavones on bone metabolism in perimenopausal or postmenopausal women. However, there were still conflicting results. Thereby, this umbrella review assessed the existing meta-analysis evidence of the effects of isoflavone interventions on bone metabolism in perimenopausal and postmenopausal women.</div></div><div><h3>Methods</h3><div>This study was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. From the inception until August 24, 2023, PubMed, Embase, Cochrane, and Web of Science databases were searched to identify meta-analyses of randomized controlled trials. The outcomes included bone mineral densities (BMDs), and bone turnover markers of osteocalcin, bone-specific alkaline phosphatase, pyridinoline, deoxypyridinoline, Procollagen Type 1 N-Terminal Propeptide, and C-telopeptide of Type 1 Collagen. The random-effects model was used to recalculate the extracted effect sizes. Mean difference (MD) was used as a summary effect measure.</div></div><div><h3>Results</h3><div>Ten meta-analyses of randomized controlled trials were included. The isoflavone intervention was associated with increased BMDs in lumbar spine (MD: 11.50 mg/cm², 95% confidence interval (CI): 6.46 to 16.55), femoral neck (MD: 2.03%, 95% CI: 0.57 to 3.50), and top hip (MD: 0.31%, 95% CI: 0.03 to 0.59) in perimenopausal and postmenopausal women.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that isoflavone interventions have the potential to improve BMD at different bone sites, including the lumbar spine, femoral neck, and total hip in perimenopausal and postmenopausal women. Isoflavone may be considered a complementary option in the bone loss of perimenopausal and postmenopausal women.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 226-235"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105428","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}

{"title":"Pharmacokinetic/Pharmacodynamic Modeling of Efficacy and Hypoglycemia Rate When Switching From Once-Daily Basal Insulin to Once-Weekly Insulin Icodec Without or With a One-Time Additional Dose in Insulin-Experienced Individuals With Type 2 Diabetes","authors":"Ildiko Lingvay MD, MPH, MSCS ,&nbsp;Björg Ásbjörnsdóttir MD, PhD ,&nbsp;Niels R. Kristensen PhD ,&nbsp;Christian Laugesen MD, PhD ,&nbsp;André Vianna MD, PhD ,&nbsp;Filip K. Knop MD, PhD","doi":"10.1016/j.eprac.2024.11.009","DOIUrl":"10.1016/j.eprac.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>Insulin icodec (icodec), a once-weekly basal insulin analog, has been investigated in the phase 3a ONWARDS clinical trial program. This pharmacokinetic (PK)/pharmacodynamic (PD) modeling analysis of data from the ONWARDS 2 and 4 trials investigated efficacy outcomes and hypoglycemia rate in insulin-experienced individuals with type 2 diabetes when switching from daily basal insulin to icodec without or with a 50% one-time additional dose for the first injection only.</div></div><div><h3>Methods</h3><div>Data from 2 randomized, 26-week, phase 3a trials of insulin-experienced individuals with type 2 diabetes on a basal (ONWARDS 2) or basal-bolus (ONWARDS 4) insulin regimen were used for PK/PD model development and validation. The effect of switching to icodec without versus with a 50% one-time additional dose on prebreakfast self-measured blood glucose, glycated hemoglobin, weekly insulin dose, and clinically significant hypoglycemia was assessed.</div></div><div><h3>Results</h3><div>Model predictions suggested that switching to icodec without versus with a 50% one-time additional dose would result in a mild, transient (1-2 weeks) increase in prebreakfast self-measured blood glucose after treatment initiation that would decrease to matching levels between groups by week 4 and remain similar between groups until end of treatment (week 26). There were no model-predicted differences between groups in glycated hemoglobin reduction or clinically significant hypoglycemia over the 26-week study period or in weekly icodec dose at week 26.</div></div><div><h3>Conclusions</h3><div>This PK/PD model analysis suggests that omitting administration of a 50% one-time additional dose when switching to icodec from daily basal insulin would not be predicted to result in any sustained effects.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 147-151"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Latent Adrenal Insufficiency in Elderly Patients With Nocturnal Hypoglycemia: A Retrospective Observational Study","authors":"Ken Kanazawa PhD,&nbsp;Mai Hijikata MD,&nbsp;Koichiro Kuwabara PhD","doi":"10.1016/j.eprac.2024.10.009","DOIUrl":"10.1016/j.eprac.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between nocturnal hypoglycemia (NH) and latent adrenal insufficiency (LAI) among elderly aged &gt;65 years.</div></div><div><h3>Methods</h3><div>This propensity-matched, retrospective observational study was conducted in an outpatient setting, assessing 1238 elderly aged &gt;65 years between November 2017 and February 2020. Of them, 430 patients with unassessed LAI were monitored for NH using continuous glucose monitoring with Freestyle Libre Pro. The primary outcome was the combined prevalence of newly diagnosed and suspected LAI in patients with NH.</div></div><div><h3>Results</h3><div>After propensity score matching, 192 patients were included (96 each in the NH and non-NH group). The overall incidence rate of NH was 28.8% (124/430). The association of NH with newly diagnosed and suspected LAI was significantly higher in the NH group (26.04%, 50/192) than in the non-NH (12.5%, 24/192) (odds ratio: 3.26; 95% confidence interval: 2.59-9.06; <em>P</em> &lt; .001). In the NH, compared with patients without LAI, those with new-diagnosed LAI had a higher incidence of hypoglycemia.</div></div><div><h3>Conclusions</h3><div>Diagnosing and treating LAI in the elderly with NH may prevent complications, including fatal diseases, and extend their life expectancy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 125-132"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497253","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}

{"title":"Nasolacrimal Duct Obstruction Following Radioactive Iodine: An Update on Counseling Recommendations for Thyroid Cancer Survivors","authors":"Natalie A. Homer MD ,&nbsp;Kaniksha Desai MD","doi":"10.1016/j.eprac.2024.11.001","DOIUrl":"10.1016/j.eprac.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Radioactive iodine (RAI) treatment for thyroid carcinoma may induce nasolacrimal duct obstruction. Evidence-based recommendations regarding nasolacrimal screening and prophylactic management in thyroid cancer survivors are lacking.</div></div><div><h3>Methods</h3><div>A case control study of patients treated with radioactive iodine for thyroid carcinoma was performed, comparing those who developed symptomatic nasolacrimal duct obstruction (group 1) to age- and gender-matched controls who did not develop nasolacrimal duct obstruction (group 2), to identify risk factors.</div></div><div><h3>Results</h3><div>Fifty patients with history of RAI treatment for thyroid carcinoma were reviewed, including 25 patients who subsequently developed epiphora and were diagnosed with nasolacrimal duct obstruction, and 25 age- and gender-matched RAI-treated patients who did not develop nasolacrimal duct obstruction. The mean cumulative RAI dose was 223.4 mCi (8.27 Gbq) for group 1 and 121.4 mCi (4.49 Gbq) for group 2 (<em>P</em> = .0092). The mean initial treatment dose was 128.9 mCi (4.77 Gbq) and 100.0 mCi (3.70 Gbq) for the 2 groups, respectively (<em>P</em> = .0317). The mean number of RAI treatment sessions in patients who developed nasolacrimal duct obstruction was 1.48 (range 1-3), compared to 1.16 (range 1-2) in the group that did not (<em>P</em> = .0387).</div></div><div><h3>Conclusions</h3><div>Higher initial and cumulative treatment dose of RAI, and multiple treatment sessions, increased likelihood of subsequent development of nasolacrimal duct obstruction. We recommend increased counseling and screening of thyroid cancer survivors undergoing RAI for thyroid carcinoma at lower doses than previously indicated, particularly in those who undergo multiple treatment sessions.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 2","pages":"Pages 176-179"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616678","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}