DOAC Cuts Stroke Risk From Subclinical Afib
PHILADELPHIA — For patients with subclinical atrial fibrillation (Afib, AF) detected by their pacemaker or defibrillator, direct oral anticoagulation brought their already low stroke risk even lower — but at a cost in bleeding events, the ARTESiA trial showed. Apixaban (Eliquis) treatment cut risk of stroke or systemic embolism 37% compared with low-dose aspirin over […]
Heart Injuries Suggest Reconsideration of Holding BP Meds for Surgery
The practice of taking some patients briefly off their antihypertensive medications before non-cardiac surgery did not work as intended, and in fact led to excess acute hypertension in the SPACE trial. Myocardial injury rates were no worse, even numerically better, for people randomized to stay on their renin-angiotensin system (RAS) inhibitors (41.3%) compared with peers […]
Sparsentan Bests Irbesartan for Preserving Kidney Function in IgA Nephropathy
PHILADELPHIA — Sparsentan (Filspari) outperformed irbesartan in patients with IgA nephropathy over the 2-year phase III PROTECT trial. Over a 110-week treatment period, those on sparsentan had an average 42.8% (95% CI -49.8 to -35.0) reduction in urine protein-to-creatinine ratio compared with a 4.4% (95% CI −15.8 to 8.7%) reduction with irbesartan (geometric least-squares mean […]
Efgartigimod Offers Hope in Chronic Inflammatory Demyelinating Polyneuropathy
PHOENIX — A subcutaneous infusion of efgartigimod cut the risk of relapse in patients with a rare but serious immune-mediated neuropathy, according to the phase II ADHERE trial. Patients with diagnosed chronic inflammatory demyelinating polyneuropathy (CIDP) treated with efgartigimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo) saw a 61% reduction in the risk of relapse versus placebo, […]
Rozanolixizumab Maintains Efficacy Among Generalized Myasthenia Gravis Subgroups
PHOENIX – Across subgroups, patients who had their generalized myasthenia gravis (gMG) treated with rozanolixizumab (Rystiggo) maintained their responses through multiples cycles of treatment, based on extension data from the phase III MycarinG clinical trial. Those with anti-acetylcholine receptor (AChR)-positive gMG receiving the higher dose of rozanolixizumab saw average Myasthenia Gravis-Activities of Daily Living (MG-ADL) […]
Thalidomide Reduced Episodes of Recurrent GI Bleeding
Treatment with thalidomide led to a reduction in bleeding among patients with recurrent bleeding due to small-intestinal angiodysplasia (SIA), a randomized trial showed. In 150 patients, 68.6% of those who received 100-mg thalidomide daily for 4 months experienced a reduction of 50% or more in bleeding episodes in the year after treatment compared with 51% […]
Vitamin C Flops for Severe COVID-19
Intravenous vitamin C did little to increase days free of organ support in adult patients hospitalized with COVID-19, two harmonized clinical trials known as LOVIT-COVID and REMAP-CAP found. Among critically ill patients given vitamin C, the median number of organ-support free days was 7 versus 10 in the control group, with an adjusted OR of […]
Convalescent Plasma Improves Survival in COVID Patients with ARDS, New Trial Shows
Convalescent plasma reduced mortality in COVID-19 patients with acute respiratory distress syndrome (ARDS) when provided within 5 days of invasive mechanical ventilation, the randomized open-label CONFIDENT trial showed. Mortality at 28 days was 35.4% among patients who received donated convalescent plasma with at least 1:160 neutralizing antibody titer, compared with 45% in patients who received […]
House Members Mull Bills to Cut Red Tape and Improve Docs’ Medicare Pay
A House hearing on ways to increase payments and cut red tape for physicians who treat Medicare patients also included a discussion over whether Republicans wanted to cut Medicare benefits for seniors. “Just yesterday, in a speech on the House floor nominating [Rep.] Jim Jordan (R-Ohio) as their candidate for Speaker, Republicans expressed concern with […]
Emicizumab Can Delay Immunosuppressive Tx in Acquired Hemophilia A
Early emicizumab (Hemlibra) prophylaxis alone prevented clinically relevant bleeds in patients with newly diagnosed acquired hemophilia A, while avoiding the infectious complications of immunosuppressive therapy in this vulnerable population, a phase II study showed. Over 12 weeks of therapy, a high-dose regimen of the factor VIIIa mimetic antibody yielded a low mean breakthrough bleeding rate […]