Therapeutic Advances in Chronic Disease

Take vedolizumab home: transition from intravenous to subcutaneous treatment
Huang K, Yao L, Liu J and Cao Q
In 2020, the European Medicines Agency approved subcutaneous (SC) vedolizumab (VDZ) for the maintenance treatment of adult patients with moderate to severe inflammatory bowel disease (IBD). This article reviews the efficacy, safety, persistence, pharmacology, patient satisfaction, and economic implications of transitioning to SC VDZ treatment and explores whether SC formulations can be recommended by the same guidelines as intravenous (IV) formulations. Clinical trials and real-world evidence indicate that transitioning from IV to SC VDZ in patients with IBD maintains clinical, biochemical, and patient-reported clinical remission and is well-tolerated, with no new safety issues identified, except for injection site reactions. Moreover, SC VDZ has an exposure-response relationship and low immunogenicity, is economical, and provides a high level of patient satisfaction. Owing to these advantages, transitioning may be advisable. In the future, more studies are needed to clarify the exact role of SC VDZ in IBD treatment, including optimization and transitioning strategies and individualized treatments based on baseline characteristics.
Willingness to start insulin therapy among insulin-naïve persons with type 2 diabetes mellitus at Gulu Regional Referral Hospital, Gulu City, Uganda
Nakitto B, Opedo M, Nansubuga F, Omondi E, Musinguzi E, Otile EC, Ekak S, Nannungi C, Apiyo P, Pebolo PF and Bongomin F
Most patients with type 2 diabetes mellitus (DM2) will require insulin for glycemic control during their disease.
Golimumab and certolizumab pegol for the treatment of hidradenitis suppurativa: a literature review and future perspective
Heidari A, Ghane Y, Heidari N, Hosseini S and Goodarzi A
Hidradenitis suppurativa (HS) is an inflammatory skin condition with an underlying inflammatory process. Due to the limited efficacy of available treatments, HS remains a therapeutic challenge. The safety and efficacy of tumor necrosis factor-α (TNF-α) inhibitors, adalimumab, infliximab, and etanercept, are well studied in this patient population, and in some cases, HS was unresponsive to them. In recent years, evidence has been growing regarding the application of other anti-TNFs, including certolizumab pegol (CPZ) and golimumab. We sought to evaluate the overall safety and efficacy of golimumab and CPZ in the management of HS. A comprehensive search was performed on the PubMed, Scopus, Web of Science, and Ovid Embase databases, as well as the Google Scholar search engine from initiation to 31 August 2023. A total of nine and four studies used CPZ and golimumab to treat HS, respectively. Individuals with concomitant inflammatory immune-mediated diseases, pregnant females, and patients who were refractory to previous treatments achieved a Hidradenitis Suppurativa Clinical Response following CPZ administration. Also, golimumab showed promise in treating recalcitrant HS after the failure of other treatments, such as adalimumab and anti-interleukin-1. CPZ and golimumab can be efficacious treatment options for moderate-to-severe HS, especially in patients who are unresponsive to other TNF inhibitors, such as adalimumab.
Real-world non-interventional post-authorization safety study of long-term use of burosumab in children and adolescents with X-linked hypophosphatemia: first interim analysis
M Boot A, Ariceta G, Beck-Nielsen SS, Brandi ML, Briot K, Collantes CL, Giannini S, Haffner D, Keen R, Levtchenko E, Mughal MZ, Makitie O, Nilsson O, Schnabel D, Tripto-Shkolnik L, Zillikens MC, Liu J, Tudor A and Emma F
X-linked hypophosphatemia (XLH) is a rare, progressive disorder characterized by excess fibroblast growth factor 23 (FGF23), causing renal phosphate-wasting and impaired active vitamin D synthesis. Burosumab is a recombinant human monoclonal antibody that inhibits FGF23, restoring patient serum phosphate levels. Safety data on long-term burosumab treatment are currently limited.
Patient preferences for active ulcerative colitis treatments and fecal microbiota transplantation
Marshall DA, MacDonald KV, Kao D, Bernstein CN, Kaplan GG, Jijon H, Hazlewood G, Panaccione R, Nasser Y, Raman M and Moayyedi P
Fecal microbiota transplantation (FMT) is a promising treatment for active ulcerative colitis (UC). Understanding patient preferences can identify treatment features that may impact treatment decisions, improve shared decision-making, and contribute to patient-centered care, which is especially important in the context of novel treatments like FMT.
Quantitative evaluation of risk factors for low back pain in young patients using synthetic magnetic resonance imaging and proton density fat fraction analyses
Yang Y, Lin WS, Wen HQ, Luo XW, Zhou X, Zou FY, Zhong SS, Deng YY, Shen LS, Zhang Y, Li QL and Guo RM
Lumbar intervertebral disc and paravertebral muscle degeneration are common causes of chronic low back pain (CLBP). However, the exact etiology of CLBP in young patients remains unclear. Identifying the risk factors for CLBP in young patients could expedite the development of effective preventive recommendations.
Hispanic adults with type 2 diabetes mellitus using lipid-lowering agents have better periodontal health than non-users
Andriankaja OM, Joshipura KJ, Levine MA, Ramirez-Vick M, Rivas-Agosto JA, Duconge JS and Graves DT
Recent studies suggest that lipid-lowering agents (LLA) may reduce chronic periodontitis, but it is unknown whether this benefit extends to people with type 2 diabetes (T2D).
Dynamic shifts in lung cytokine patterns in post-COVID-19 interstitial lung disease patients: a pilot study
Oatis D, Herman H, Balta C, Ciceu A, Simon-Repolski E, Mihu AG, Lepre CC, Russo M, Trotta MC, Gravina AG, D'Amico M and Hermenean A
The pathogenesis of post-COVID interstitial lung disease, marked by lung tissue scarring and functional decline, remains largely unknown.
Deep and unbiased proteomics, pathway enrichment analysis, and protein-protein interaction of biomarker signatures in migraine
Woldeamanuel YW, Sanjanwala BM and Cowan RP
Currently, there are no biomarkers for migraine.
Ultrasound therapy for pain reduction in musculoskeletal disorders: a systematic review and meta-analysis
Guan H, Wu Y, Wang X, Liu B, Yan T and Abedi-Firouzjah R
Ultrasound therapy is a non-invasive technique used to address a variety of health issues.
Optimal treatment targets for lupus nephritis using per-protocol repeat kidney biopsy findings at 2 years and clinical data up to 5 years: a single-center observational study
Kagawa H, Yamanaka R, Matsubara A, Inoue T, Hayashi R, Kubota N and Hiromasa T
The criteria for remission in both clinical and pathological contexts for lupus nephritis (LN) remain controversial.
The early diagnostic value of serum renalase level in diabetic kidney disease and diabetic macroangiopathy: a retrospective case-control study
Jin L, Wang W, Zhang R, Shen J, Li Y and Zhang Y
Diabetic kidney disease (DKD) is a severe complication of diabetes mellitus and is associated with an increased risk of end-stage renal disease (ESRD) and cardiovascular events. Early diagnosis and monitoring of DKD are crucial for implementing appropriate interventions. This study aimed to investigate the relationship between serum renalase (RNLS) levels, DKD, and diabetic macroangiopathy in patients with type 2 diabetes mellitus (T2DM).
Association between serum pyridoxal 5'-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in adults: a population-based cohort study
Xuan C, Liu RH, Zhao C, Li J, Zhou TT, Tian QW and He GW
The association between pyridoxal 5'-phosphate (PLP) and cardiovascular disease (CVD) remains a topic of discussion.
Untimely surgery for stent-fracture-related death after transjugular intrahepatic portosystemic shunt: a case report
Li Y, Sun J, Zhou T, Wang W, Wang G, Hou Q, Chen Z, Wang Q, Xu K, Ye Y and Bao J
Transjugular intrahepatic portosystemic shunt (TIPS) is a life-saving procedure for patients with severe portal hypertension and persistent variceal bleeding. Stent fracture is a rare and severe complication; however, its cause and mechanisms remain poorly defined. This case helps understand the factors contributing to its occurrence, complications, and subsequent poor outcomes. A 63-year-old male was presented with ruptured bare stent after a TIPS procedure. The upper edge of the bare stent was ruptured, and its fraction subsequently migrated to the entrance of the right atrium. Meanwhile, a mural thrombus was formed in the inferior vena cava. A surgery for the removal of free fracture was planned for preventing the form of pulmonary embolism. Before the surgery, the fracture was shifted to the right inferior pulmonary artery. Therefore, the surgery was canceled for further evaluation. Then, hematemesis suddenly occurred with a high possibility of variceal bleeding and/or gastric ulcer bleeding. Despite comprehensive treatments, the patient symptoms were still worsened with the development of chest tightness, shortness of breath, severe hypoxia, and heart failure. Finally, the patient succumbed to systemic multiorgan failure and death. Taken together, a ruptured unstable stent should be removed as early as the patient is hemodynamically stable, as it is difficult to balance between hemostasis therapy and anticoagulation treatment in patients with liver-cirrhosis-related severe portal hypertension. Physicians should be on high alert of the potential complications of bare stent rapture after TIPS.
The impact of elexacaftor/tezacaftor/ivacaftor on cystic fibrosis health-related quality of life and decision-making about daily treatment regimens: a mixed methods exploratory study
Basile M, Polo J, Henthorne K, DeCelie-Germana J, Galvin S and Wang J
Elexacaftor/tezacaftor/ivacaftor (ETI) has reduced many symptoms of cystic fibrosis (CF).
Impact of cytomegalovirus on outcomes in acute severe ulcerative colitis: a retrospective observational study
Huang D, Rennie M, Krasovec A, Nagubandi S, Liu S, Ge E, Khehra B, Au M, Sivagnanam S, Kwan V, Rogge C, Mitrev N and Kariyawasam V
Concomitant cytomegalovirus (CMV) is highly prevalent in acute severe ulcerative colitis (ASUC) but data for outcomes of CMV positivity in ASUC and the benefit of antiviral therapy remain unclear.
Lack of awareness and ethnic polarity is a major cause of metabolic associated fatty liver disease in high-risk diabetes population in South London
Ajaz S, Chamley M, Lok J, Soliman R, Khan R, Ahir K, Curtis M, Guerra-Veloz MF and Agarwal K
Metabolic associated fatty liver disease (MAFLD) stands as the leading cause of chronic liver disease globally. Notably, individuals with metabolic risk factors, such as diabetes and obesity, exhibit a staggering prevalence of MAFLD, with estimates reaching up to 70%. However, despite its widespread occurrence, there's a noticeable gap in understanding and awareness about MAFLD among these high-risk groups.
Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes?
Stanisławska-Kubiak M, Majewska KA, Krasińska A, Wais P, Majewski D, Mojs E and Kȩdzia A
The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.
Long-term outcomes and associated factors of Crohn's disease patients achieving transmural healing based on magnetic resonance enterography: a Chinese retrospective cohort study
Lu Y, Xiong S, Zhang M, Zu X, Li J, Mao R, Zeng Z, Li X, Chen M and He Y
Transmural healing (TH) has emerged as a potential treatment goal for Crohn's disease (CD). However, further research is needed to confirm its benefits and risk factors associated with TH remain unclear.
Comparison of different medical treatments for primary hyperaldosteronism: a systematic review and network meta-analysis
Ho WY, Hsiao CC, Wu PH, Chen JY, Tu YK, Wu VC and Chen JJ
The effectiveness and side effects between different medical treatments in patients with primary hyperaldosteronism have not been systematically studied.
Synchronized application of closed-loop NMES and precision tACS in post-stroke hand rehabilitation: a protocol of neurorehabilitation trial
Tashiro S, Takemi M, Yamada S and Tsuji T
Severe upper extremity paresis due to stroke is a significant clinical sequela. Neuromuscular electrical stimulation (NMES)-based rehabilitation has demonstrated promising results along with cortical plasticity. Transcranial alternating current stimulation (tACS) has gained attention due to its unique ability to entrain endogenous oscillatory brain rhythms with injected AC frequency, offering the potential for modifying brain conditions to enhance rehabilitative interventions. Because repetitive motor execution in rehabilitation training requires a smooth transition of the brain state despite often being impaired secondary to stroke, combining NMES and tACS may offer better treatment efficacy.