Cts-Clinical and Translational Science最新文献

{"title":"Effect of E7777 Immunogenicity on Pharmacokinetics, Efficacy, and Safety in Adult Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma","authors":"Theingi M. Thway,&nbsp;Jagadeesh Aluri,&nbsp;Bojan Lalovic,&nbsp;Chean E. Ooi,&nbsp;Nicholas Sauter,&nbsp;Dongyuan Xing,&nbsp;Myron Czuczman,&nbsp;Sanae Yasuda","doi":"10.1111/cts.70166","DOIUrl":"https://doi.org/10.1111/cts.70166","url":null,"abstract":"<p>E7777 is a therapeutic recombinant fusion protein comprised of diphtheria toxin fragments and human interleukin-2 (IL-2). Treatment with E7777 generates anti-drug antibodies (ADA). E7777-G000-302 assessed the efficacy and safety of E7777 in patients with relapsed or refractory cutaneous T-cell lymphoma (CTCL). Here, we describe the association between E7777 (at 9 μg/kg) and ADAs, and its effect on pharmacokinetics (PK), efficacy, and safety. Of 91 patients with immunogenicity results at baseline, 78.0% and 5.5% had preexisting anti-E7777 (E-ADAs) and anti-IL-2 antibodies (I-ADAs), respectively. The prevalence of E-ADAs and I-ADAs peaked at C3D1 (median titer 650,175) and C8D1 (median titer 32,805), respectively. However, I-ADA fold increases (1312-fold) were higher than E-ADA increases (181-fold). ADAs' effect on PK was assessed after treatment. E7777 reached C_max at 60 min after infusion, with clearance of 44.6 mL/min at C1D1 and 133 mL/min at C5D1. C_max and AUC_(0–t) decreased by 60% and 84%, respectively, at C5D1 compared with C1D1. Of patients in the safety analysis set (<i>n</i> = 84) evaluated for treatment-emergent (TE) ADAs, 92.9% were considered TE E-ADA positive and 82.1% were TE I-ADA positive. The objective response rate was 39.0% in TE E-ADA-positive patients and 42.6% in TE I-ADA-positive patients. Serious TE adverse events were reported by 32.1% of TE E-ADA-positive patients, 29.0% of TE I-ADA-positive patients, 100% of E-ADA-negative patients, and 73.3% of I-ADA-negative patients. These results indicate that the presence of ADAs decreased E7777 exposure over time but did not adversely impact efficacy and safety in patients with CTCL.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 3","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497000","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":"Integrating early response biomarkers in pharmacokinetic models: A novel method to individualize the initial infliximab dose in patients with Crohn's disease","authors":"Abigail Samuels,&nbsp;Kei Irie,&nbsp;Tomoyuki Mizuno,&nbsp;Jack Reifenberg,&nbsp;Nieko Punt,&nbsp;Alexander A. Vinks,&nbsp;Phillip Minar","doi":"10.1111/cts.70086","DOIUrl":"https://doi.org/10.1111/cts.70086","url":null,"abstract":"<p>The use of model-informed precision dosing to personalize infliximab has been shown to improve both the acquisition of concentration targets and clinical outcomes during maintenance. Current iterations of infliximab pharmacokinetic models include time-varying covariates of drug clearance, however, not accounting for the expected improvements in the covariates can lead to indiscriminate use of higher infliximab doses and imprecise drug exposure. The aim was to identify changes in the four biomarkers associated with infliximab clearance (Xiong et al. model) and determine if integration of these dynamic changes would improve model performance during induction and early maintenance. We analyzed two cohorts of children receiving infliximab for Crohn's Disease. The <i>E</i>_max method was used to assess time-varying changes in covariates. Model performance (observed vs. predicted infliximab concentrations) was evaluated using median percentage error (bias) and median absolute percentage error (precision). The combined cohorts included 239 Crohn's disease patients. We found from baseline to dose 4, the maximum changes in weight, albumin, erythrocyte sedimentation rate, and neutrophil CD64 were 4.7%, +11.7%, −62.4%, and −26.5%, respectively. We also found the use of baseline covariates alone to forecast future trough concentration was inferior to the <i>E</i>_max time-varying method with a significant improvement observed in bias (doses 2, 3, and 4) and precision (doses 2 and 4). The integration of the four time-varying biomarkers of drug clearance with pharmacokinetic modeling improved the accuracy and precision of the predictions. This novel strategy may be key to improving drug exposure, minimizing indiscriminate dosing strategies, and reducing healthcare costs.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471977","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":"Modeling the Interplay Between Viral and Immune Dynamics in HIV: A Review and Mrgsolve Implementation and Exploration","authors":"Alberto Vegas Rodriguez,&nbsp;Nieves Velez de Mendizábal,&nbsp;Sandhya Girish,&nbsp;Iñaki F. Trocóniz,&nbsp;Justin S. Feigelman","doi":"10.1111/cts.70160","DOIUrl":"https://doi.org/10.1111/cts.70160","url":null,"abstract":"<p>Since its initial discovery, HIV has infected more than 70 million individuals globally, leading to the deaths of 35 million. At present, the annual number of deaths has significantly decreased due to 75% of HIV-positive individuals being on antiretroviral therapy. Although there is no cure yet, available treatments extend life expectancy, enhance quality of life, and reduce transmission by maintaining viral load below the detection limit of 50 copies/mL, making the individual's levels undetectable and untransmittable. HIV has attracted considerable attention in the computational modeling area, with various models having been developed with different degrees of complexity in an attempt to explain the viral dynamics of the disease. It is important to note that no single model can fully incorporate and predict all the critical factors influencing the dynamics of the disease and its response to treatments. Since the number of published models is large, the purpose of this article is to review several relevant models found in the literature that describe biologically plausible scenarios of HIV infection, including key features of disease progression with or without treatment. A total of 15 models are described, with some implemented in the mrgsolve package in R Studio and shared for the benefit of the scientific community. The modeling framework concerning HIV infection aids in identifying the most impactful parameters within the system and their implications in the model outcomes. Insights provided by these models may help in confirming targets for current and novel therapies, thereby contributing to the exploration of new strategies.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455954","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":"Low Proarrhythmic Risk of Imetelstat, a Novel Oligonucleotide Telomerase Inhibitor: A Translational Analysis","authors":"Ashley L. Lennox,&nbsp;Libo Sun,&nbsp;Fei Huang,&nbsp;Melissa Kelly Behrs,&nbsp;Robert Kleiman,&nbsp;Hongqi Xue,&nbsp;Neha Bhise,&nbsp;Ying Wan,&nbsp;Tymara Berry,&nbsp;Faye Feller,&nbsp;Peter N. Morcos","doi":"10.1111/cts.70169","DOIUrl":"https://doi.org/10.1111/cts.70169","url":null,"abstract":"<p>Evaluation of the proarrhythmic potential of imetelstat, a novel oligonucleotide telomerase inhibitor, in nonclinical and clinical studies is presented. In vitro, imetelstat sodium ≤ 750 μg/mL and negative (vehicle) and positive (cisapride) controls were evaluated for hERG channel current inhibition. In vivo, cynomolgus monkeys received a single vehicle control or imetelstat sodium (5 mg/kg [2-h infusion], 10 mg/kg [6-h infusion], or 15 mg/kg [6- or 24-h infusion]); cardiovascular parameters were collected before and after drug administration. A ventricular repolarization substudy of the IMerge phase III study evaluated patients with lower-risk myelodysplastic syndromes administered imetelstat 7.1 mg/kg active dose every 4 weeks; intensive electrocardiograms and pharmacokinetic samples were collected for concentration-QTc and by-time point analyses after a single dose. In vitro, imetelstat did not inhibit the hERG channel (IC₅₀ &gt; 750 μg/mL). In monkeys, imetelstat demonstrated no treatment-related changes in cardiac parameters, including QTc using Fridericia correction (QTcF). In the IMerge QTc substudy, 45 patients received imetelstat (<i>n</i> = 29) or placebo (<i>n</i> = 16). The concentration-QTc relationship was described by a linear mixed-effects model; at the geometric mean maximum plasma concentration (C_max) for imetelstat 7.1 mg/kg of 89.5 μg/mL, the predicted effect on placebo-corrected change from baseline QTcF was 2.36 ms (90% confidence interval, −3.04 to 7.76), supporting no evidence of QTcF prolongation. By-time point analysis demonstrated no clinically significant effect of imetelstat on QTc. Nonclinical studies demonstrated no proarrhythmic risk at &gt; 140× (in vitro) and &gt; 2.6× (in vivo) imetelstat 7.1 mg/kg C_max. Clinical evaluations showed no significant effects on QTcF or other electrocardiogram parameters at 7.1 mg/kg. Collectively, this integrated risk assessment supports the low proarrhythmic potential of imetelstat.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455955","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":"Effect of a Supratherapeutic Dose of Omaveloxolone on the Corrected QT Interval in Healthy Participants: A Randomized, Double-Blind, Placebo- and Active-Controlled, Three-Way Crossover Study","authors":"Hamim Zahir,&nbsp;Masako Murai,&nbsp;Lucy Wu,&nbsp;Michelle Valentine,&nbsp;Scott M. Hynes","doi":"10.1111/cts.70139","DOIUrl":"https://doi.org/10.1111/cts.70139","url":null,"abstract":"<p>Omaveloxolone is approved for the treatment of Friedreich ataxia (FA) in patients aged ≥ 16 years at a dose of 150 mg once daily. This double-blind, randomized, placebo- and active-controlled, three-way crossover, thorough corrected QT interval (QTc) study (NCT05927649) evaluated the effect of supratherapeutic omaveloxolone exposure on QTc to exclude a clinically significant prolongation (defined as &gt; 10 ms). Healthy adults were randomized to one of six sequences of three single oral doses (omaveloxolone 450 mg, placebo, or moxifloxacin 400 mg [open-label positive control]) administered with an FDA high-fat meal. Serial pharmacokinetic blood sampling and time-matched electrocardiogram assessments were performed. The primary endpoint was placebo-corrected change from baseline in QTcF (ΔΔQTcF) following omaveloxolone administration. Secondary endpoints included pharmacokinetic parameters of omaveloxolone and its major plasma metabolites (M17 and M22) and safety. All 30 enrolled participants completed the study. The mean omaveloxolone <i>C</i>_max was 319 ng/mL in this study (4.5-fold the mean steady-state <i>C</i>_max [71.5 ng/mL] with the approved dose). The mean QTcF intervals were &lt; 450 ms, and mean changes from baseline were &lt; 10 ms at all timepoints following all doses. The upper limit of the 90% CIs of ΔΔQTcF following omaveloxolone administration was &lt; 10 ms at all timepoints. At the <i>C</i>_max of omaveloxolone, M17, and M22, alone or combined, the upper limits of the 90% CIs of the model-predicted ΔΔQTcF were all &lt; 10 ms. No safety concerns were identified. Supratherapeutic omaveloxolone exposure that covers the worst-case clinical exposure did not cause a clinically significant QTc prolongation and was generally well tolerated.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447204","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":"Decentralized Clinical Trials in the Era of Real-World Evidence: A Statistical Perspective","authors":"Jie Chen,&nbsp;Junrui Di,&nbsp;Nadia Daizadeh,&nbsp;Ying Lu,&nbsp;Hongwei Wang,&nbsp;Yuan-Li Shen,&nbsp;Jennifer Kirk,&nbsp;Frank W. Rockhold,&nbsp;Herbert Pang,&nbsp;Jing Zhao,&nbsp;Weili He,&nbsp;Andrew Potter,&nbsp;Hana Lee","doi":"10.1111/cts.70117","DOIUrl":"https://doi.org/10.1111/cts.70117","url":null,"abstract":"<p>There has been a growing trend that activities relating to clinical trials take place at locations other than traditional trial sites (hence decentralized clinical trials or DCTs), some of which are at settings of real-world clinical practice. Although there are numerous benefits of DCTs, this also brings some implications on a number of issues relating to the design, conduct, and analysis of DCTs. The Real-World Evidence Scientific Working Group of the American Statistical Association Biopharmaceutical Section has been reviewing the field of DCTs and provides in this paper considerations for decentralized trials from a statistical perspective. This paper first discusses selected critical decentralized elements that may have statistical implications on the trial and then summarizes regulatory guidance, framework, and initiatives on DCTs. More discussions are presented by focusing on the design (including construction of estimand), implementation, statistical analysis plan (including missing data handling), and reporting of safety events. Some additional considerations (e.g., ethical considerations, technology infrastructure, study oversight, data security and privacy, and regulatory compliance) are also briefly discussed. This paper is intended to provide statistical considerations for decentralized trials of medical products to support regulatory decision-making.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447094","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":"National Prescribing Practices for Pediatric Dystonia Among Providers in the United States","authors":"Sarah Paige W. Davis,&nbsp;Natalie Kane,&nbsp;Haley E. Botteron,&nbsp;Rose Gelineau-Morel","doi":"10.1111/cts.70171","DOIUrl":"https://doi.org/10.1111/cts.70171","url":null,"abstract":"<p>While multiple oral medications are used to treat dystonia, limited information exists on current prescribing practices. This study analyzes real-world prescribing practices for pediatric dystonia in the United States, evaluating prescription frequency, dosing, and the impact of comorbidities. Oracle electronic health record real-world data were queried from 2014 to 2019 for encounters of patients under age 18 with a dystonia diagnosis and available medication records. Information was extracted on prescriptions for dystonia medications (baclofen, clonidine, carbidopa-levodopa, gabapentin, tetrabenazine, trihexyphenidyl, and select benzodiazepines), dosing, and comorbid diagnoses of cerebral palsy (CP), epilepsy, or spasticity. A total of 4010 pediatric patients with dystonia were included. Benzodiazepines were most commonly prescribed (midazolam in 53.5% of patients, diazepam 46.7%, lorazepam 41.9%, clonazepam 28.3%). This was followed by baclofen (33.4%), clonidine (26.3%), and gabapentin (19.7%). Dystonia patients with epilepsy were more commonly prescribed benzodiazepines than patients without epilepsy (diazepam 79.1% vs. 29%; clonazepam 50.9% vs. 16%) and baclofen was more often prescribed in patients with CP (59.4%) or spasticity (63.8%) than those without (17%). All medications showed decreased milligram per kilogram dosage as patient weight increased. Benzodiazepines, baclofen, and clonidine were the most common medications prescribed to pediatric patients with dystonia in the United States, although medical comorbidities impact prescribing practices. There was significant variability in weight-based dosing of all medications. There remains a need to determine which dystonia medications are most effective for each patient and the necessary drug exposure to maximize therapeutic efficacy and minimize adverse effects.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447101","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":"Participant-Centered Engagement for Sustained Adherence to Smartwatches: A 12-Month Prospective Decentralized Digital Health Study","authors":"Angelina R. Wilton,&nbsp;Christina T. Saliba,&nbsp;Jean Marrero-Polanco,&nbsp;Katharine Sheffield,&nbsp;Quantia Wilkes,&nbsp;Miriam Anacker,&nbsp;Paul E. Croarkin,&nbsp;Mohit Chauhan,&nbsp;Liselotte N. Dyrbye,&nbsp;Sherry Chesak,&nbsp;William V. Bobo,&nbsp;Arjun P. Athreya","doi":"10.1111/cts.70155","DOIUrl":"https://doi.org/10.1111/cts.70155","url":null,"abstract":"<p>Adherence in digital health studies with extended observation periods (≥ 12 months) is limited, and participant retention considerably reduces with time. The US Food and Drug Administration has issued guidelines for improving participant engagement, adherence, and diversity in digital health studies combined with decentralized procedures. A decentralized digital health study on well-being was designed with protocolized procedures to study the feasibility of participant engagement and technology support to facilitate adherence (wearing the smartwatch ≥ 70% of time) sustained over a 12-month period. At the end of the study, participants were asked about their ease of participation and free-response questions about how wearing the smartwatches impacted their physical wellness. An inductive thematic analysis (ITA) was performed to assess themes of those responses and association with adherence. A total of 298 participants were recruited between 2022 and 2023 (<i>n</i> = 129 in Cohort A in October 22, <i>n</i> = 169 in Cohort B in April 23), with 23% non-white participants accrued. Among the 298 participants accrued, 273 (92% of accrued participants) completed the 12-month study with an average overall adherence of 77.4% (SD = 32.64) wear-time across 12 months. Median adherence of participants whose responses exemplified an ITA theme encompassing perceived behavior changes in sleep and physical activity was higher than those who did not have a response exemplifying that theme. Conversely, those expressing perceived discomfort or intrusiveness of the smartwatch had a statistically lower adherence. These results highlight the crucial roles of technology support and robust engagement efforts to enable sustained adherence over extended follow-up periods in decentralized digital health studies.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423699","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":"Risk of major adverse cardiovascular events in CYP2C19 LoF genotype guided clopidogrel against alternative antiplatelets for CAD patients undergoing PCI: Meta-analysis","authors":"Mohitosh Biswas,&nbsp;Murshadul Alam Murad,&nbsp;Maliheh Ershadian,&nbsp;Most Sumaiya Khatun Kali,&nbsp;Chonlaphat Sukasem","doi":"10.1111/cts.70080","DOIUrl":"https://doi.org/10.1111/cts.70080","url":null,"abstract":"<p>Selection of rational antagonists of P2Y₁₂ receptor for CAD patients who inherit <i>CYP2C19</i> LoF alleles remains still conflicting. This study compared the clinical outcomes in CAD patients inheriting <i>CYP2C19</i> LoF alleles undergoing PCI and treated with clopidogrel against alternative antagonists of P2Y₁₂ receptor. A thorough literature search was performed across multiple scientific databases following the PRISMA guidelines and PICO model. Setting the statistical significance at <i>p</i> &lt; 0.05 and RevMan software was used to calculate the risk ratios (RRs). Estimation of the pooled analysis revealed a significant 62% increased risk of major adverse cardiovascular events (MACE) in CAD patients inheriting <i>CYP2C19</i> LoF alleles and treated with clopidogrel against those treated with alternative P2Y₁₂ receptor antagonists such as prasugrel or ticagrelor (RR 1.62; 95% CI 1.42–1.86; <i>p</i> &lt; 0.00001). In addition, Asian CAD patients were found at a significantly higher risk of MACE (RR 1.93; 95% CI: 1.49–2.49; <i>p</i> &lt; 0.00001) juxtaposed to CAD patients of other ethnicities (RR 1.51; 95% CI: 1.29–1.78; <i>p</i> &lt; 0.00001). Conversely, between these two treatment groups, taking clopidogrel against prasugrel/ticagrelor, who possess <i>CYP2C19</i> LoF alleles, no significant differences in bleeding events were observed (RR 0.94; 95% CI 0.79–1.11; <i>p</i> = 0.47). CAD patients undergoing PCI who inherited <i>CYP2C19</i> LoF alleles and treated with clopidogrel were associated with significantly higher risk of MACE against those treated with alternative antagonists of P2Y₁₂ receptor, that is, prasugrel or ticagrelor.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423741","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":"Global Trends in the Value of Author Order Across Medical Publications: A Cross-Sectional Bibliometric Study","authors":"Hidenori Hashimoto,&nbsp;Miwa Sekine,&nbsp;Yuji Nishizaki,&nbsp;David Aune,&nbsp;Atsushi Mizuno,&nbsp;Yasuhiro Homma,&nbsp;Yasuhiko Kiyama,&nbsp;Shoji Sanada,&nbsp;Shigeki Aoki","doi":"10.1111/cts.70157","DOIUrl":"https://doi.org/10.1111/cts.70157","url":null,"abstract":"<p>This study aimed to analyse the value of author order across countries, within the ‘Medicine General Internal’ and ‘Surgery’ fields, to enhance transparency and fairness in academic evaluations, particularly in international collaborative research. A cross-sectional bibliometric study was conducted using data from 2,845,748 papers published in 2022 across over 18,000 journals listed on Web of Science. The study focused on 124,736 papers from the ‘Medicine General Internal’ and ‘Surgery’ fields published in the top 19 countries. The analysis examined the position of the corresponding author relative to other co-authors by country and specialty. Hierarchical clustering was applied to identify patterns and group countries based on author order. Three distinct clusters were identified with regard to the corresponding author's position. In Cluster A (South Korea, China and Taiwan), the corresponding author was often the last author. In Cluster B (India, Japan, Italy, Türkiye and Spain), the corresponding author was frequently the second author. Cluster C (the United States, England and Germany) included countries where the corresponding author was typically the first author. The findings underscore the need for clear, internationally accepted author order standards. Establishing such standards is crucial for promoting fairness, transparency and efficiency in international collaborative research and for ensuring equitable scientific communication.</p>","PeriodicalId":50610,"journal":{"name":"Cts-Clinical and Translational Science","volume":"18 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cts.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396833","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}