Category: Medicine

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Treprostinil Improves Walk Distance in Pulmonary HTN

Patients with interstitial lung disease–associated pulmonary hypertension who were treated with inhaled treprostinil (Tyvaso) had significantly greater improvement in exercise capacity over 16 weeks, compared with patients who used a placebo inhaler, results of a phase 3 trial showed.

Among 326 patients with pulmonary hypertension (PH) associated with interstitial lung disease (ILD), those who were randomly assigned to treatment with treprostinil had a placebo-corrected median difference from baseline in 6-minute walk distance of 21 m (P = .004), reported Steven D. Nathan, MD, from Inova Fairfax Hospital in Falls Church, Va., on behalf of coinvestigators in the INCREASE study (NCT02630316).

“These results support an additional treatment avenue, and might herald a shift in the clinical management of patients with interstitial lung disease,” he said in the American Thoracic Society’s virtual clinical trial session.

“This was an outstanding presentation and outstanding results. I personally am very excited, because this is a field where I work,” commented Martin Kolb, MD, PhD, from McMaster University, Hamilton, Ont., the facilitator for the online presentation.

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Injection Beats Pill For Long-Lasting HIV Prevention

Injections of cabotegravir (ViiV Healthcare) given every other month are more effective in blocking HIV transmission than the once-a-day combination of tenofovir disoproxil fumarate and emtricitabine (Truvada, Gilead Science), new data from the HPTN 083 trial show.

The findings “could transform the HIV prevention landscape for so many people,” said Megan Coleman, DNP, from Whitman-Walker Health in Washington, DC, who regularly prescribes Truvada as pre-exposure prophylaxis (PrEP).

At Whitman-Walker alone, about 3000 people were taking the pill in early 2020, but “for some people, taking a pill every day just isn’t a viable option,” said Coleman. “To have something that can support a patient’s choice and a patient’s ability to reduce their own risk of HIV is amazing.”

Final results from the trial — which looked at the drug in cisgender men and transgender women who have sex with men — were presented at the International AIDS Conference 2020.

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Blood Biomarker Detects Concussion, Shows Severity & Predicts Recovery

Concentrations of neurofilament light (NfL) chain in blood can detect concussion, its severity and help predict recovery in patients with mild traumatic brain injury (TBI), new research indicates.

“Blood NfL may be used to aid in the diagnosis of patients with concussion or mild TBI [and] to identify individuals at increased risk of developing persistent post-concussive symptoms following TBI,” lead author Pashtun Shahim, MD, PhD, National Institutes of Health Clinical Center, Bethesda, Maryland, told Medscape Medical News.

“This study is the first to do a detailed assessment of serum NfL chain and advanced brain imaging in multiple cohorts, brain injury severities, and time points after injury. The cohorts included professional athletes and nonathletes, and over time up to 5 years after TBI,” Shahim added.

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COVID-19 : Managing Liver Dysfunction During The Pandemic

Patients with COVID-19 may develop abnormal liver function and it’s important to consider the potential impact of COVID-19 on the liver, especially in the Asia-Pacific region where chronic liver diseases are prevalent, say the authors of a position statement.

The statement, from the Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic, provides 36 recommendations covering the use of drug therapy for COVID-19 in the case of liver dysfunction, and assessment and management of patients with chronic hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, and liver transplantation.

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Minimally Invasive Surgery & Risk of Capsule Rupture for Women With Early-Stage Ovarian Cancer

Ovarian cancer remains the deadliest gynecologic malignant neoplasm in the United States. Salpingo-oophorectomy with the intact removal of the ovary and fallopian tube is the standard approach for suspected ovarian malignant neoplasm apparently confined to the ovary. Surgery for early-stage ovarian cancer has historically been performed via laparotomy. However, in recent years, more women with ovarian cysts and masses have been treated with minimally invasive surgery (MIS), including laparoscopy. To date, there are limited data to support the safety and oncologic outcomes of MIS for early-stage ovarian cancer. The objective of this study was to examine the association between MIS use, capsule rupture, and survival of women with stage I epithelial ovarian cancer.

 
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