Dexamethasone or Surgery for Chronic Subdural Hematoma?
Dexamethasone treatment failed to demonstrate noninferiority to surgery for chronic subdural hematoma and was associated with more complications and a greater risk of later surgery, according to results of a randomized study terminated early due to safety and outcome concerns. In the DECSA trial, the odds ratio of a better functional outcome score with dexamethasone […]
Upfront Transplant Prevails Again in Newly Diagnosed Myeloma
An immunomodulatory-free carfilzomib (Kyprolis)-based triplet regimen failed to prove non-inferior to autologous hematopoietic stem-cell transplantation (HSCT) for the upfront treatment of newly diagnosed multiple myeloma, a randomized trial from the U.K. found. The open-label phase II CARDAMON study included nearly 300 patients, with 57.7% achieving at least a very good partial response (VGPR) with the […]
Can Erectile Dysfunction Drugs Reduce Dementia Risk?
New research failed to support the hypothesis that phosphodiesterase-5 (PDE5) inhibitors like sildenafil (Viagra) and tadalafil (Cialis) are promising drug repurposing candidates for Alzheimer’s disease and dementia. Using four analytic approaches designed to address potential biases, PDE5 inhibitors did not reduce the risk of Alzheimer’s and related dementia compared with other drugs used for pulmonary […]
Targeted Combo Flops as First-Line Treatment in Advanced Breast Cancer
PARIS — A novel combination failed to improve the clinical benefit rate (CBR) in advanced triple-negative breast cancer (TNBC) compared with chemoimmunotherapy, a randomized trial showed. Adding the anti-CD73 antibody oleclumab to durvalumab (Imfinzi) and chemotherapy led to clinical benefit (response plus stable disease) in 43% of patients by 24 weeks as compared with 44% […]
After Cardiac Arrest, No ‘Best’ Blood Pressure, Oxygen Target
BARCELONA — Shifting blood pressure and oxygen targets failed to budge outcomes for comatose survivors of out-of-hospital cardiac arrest, the BOX trial showed. A higher mean arterial blood-pressure target of 77 mm Hg — hypothesized to potentially maintain better cerebral perfusion — had no impact on the proportion of patients who died or left the […]
End of the Line for a Failed Prostate Cancer Drug
The androgen synthesis inhibitor orteronel failed to improve survival in metastatic hormone-sensitive prostate cancer (mHSPC) despite a twofold improvement in progression-free survival (PFS) versus standard androgen-deprivation therapy (ADT), a large randomized trial showed. Patients randomized to ADT plus orteronel had a median overall survival (OS) of 81 months compared with 70.2 months with ADT plus […]
Largest Ivermectin Trial Fails to Show Benefit in COVID Outpatients
Early use of ivermectin in COVID-19 patients at high-risk for severe disease failed to lower the risk of hospitalization or prolonged emergency department (ED) observation, a large randomized trial showed. In an adaptive platform trial in Brazil, an intention-to-treat (ITT) analysis found that 14.7% of patients in the ivermectin group and 16.3% of patients in […]
High-Dose HBV Revaccination Better Protects HIV Patients
In HIV patients who failed to achieve protection from the hepatitis B virus (HBV) vaccine, a high-dose revaccination schedule led to better serological responses versus standard dosing, a randomized single-center trial in Chile showed. In an intention-to-treat analysis involving over 100 patients, 72% of those revaccinated with three doses of a high-dose recombinant HBV vaccine […]
Another Bioresorbable Stent Hits a Snag
A novel bioresorbable stent failed to meet the threshold for noninferiority compared with durable devices in the OPTIMIZE trial, and researchers suggested rising troponin use may have played a role. The Svelte stent, designed to facilitate direct stenting and transradial access in percutaneous coronary intervention (PCI), did not differ significantly from metallic everolimus-eluting stents with […]
Could Docetaxel Have Role in Unfavorable-Risk Prostate Cancer?
Adding docetaxel to androgen deprivation therapy (ADT) plus radiation therapy (RT) failed to improve survival in unfavorable-risk prostate cancer, though the combination may hold benefit for certain patients, long-term results of a randomized trial found. While the regimen did not prolong overall survival (OS) among all men with unfavorable-risk nonmetastatic cancer after a median of […]