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Articles of Interest

JournalDoc is proud to work with a team of experts who understand the challenges faced by Healthcare Professionals and pleased to offer a weekly article of interest representing trends and new information affecting the study and practice of medicine.

An Oral Interleukin-23-Receptor Antagonist Peptide for Plaque Psoriasis

February 9, 2024 | 0 Comments
NEJM Original Article The New England Journal of Medicine, February 9, 2024 Data from a multicenter, randomized, dose-finding trial of 255 patients with moderate-to-severe plaque psoriasis. Patients were randomly assigned to receive treatment at varying dosages with a novel orally administered interleukin-23-receptor antagonist peptide that selectively blocks interleukin-23 signaling and downstream cytokine production or a placebo for 16 weeks.

What’s Interesting about this article?

  • The use of monoclonal antibodies has changed the treatment of several immune-mediated inflammatory diseases, including psoriasis.
  • However, monoclonal antibodies are large proteins, which must be administered by injection.
  • The treatment of patients with this new orally administered drug showed greater efficacy than placebo.

JournalDoc Comments:

  • Development of an effective psoriasis drug that can be taken by mouth is a great benefit for patients.
  • In an accompanying editorial by Joel M. Gelfand, M.D., the doctor points out that advances in bioengineering have made it possible to administer large complex proteins by mouth, with semiglutide being a notable example.
  • This study focused on changes in the skin. It is not known what effect this drug will have on other organs or disorders affected by psoriasis, such as arthritis.
CLICK HERE FOR MORE INFORMATION ON THIS STUDY Disclaimer:  Article of the Week selections by JournalDoc physicians are independent, unbiased and have no commercial conflict of interest. JournalDoc does not support or endorse the findings or opinions expressed in the article. Findings in the article may need to be supported by further research and/or the consensus of experts.

Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease

February 1, 2024 | 0 Comments

NEJM Original Article

The New England Journal of Medicine, January 4, 2024

Data from a multicenter, randomized, controlled trial (RCT) of 261 patients with chronic limb-threating ischemia and Infrapopliteal artery disease. Patients were randomly assigned to receive treatment with an everolimus-eluting resorbable scaffold or angioplasty.

What’s Interesting about this article?

  • Peripheral artery disease is a global health problem affecting more than 230 million people, including 7-12 million people in the U.S.
  • Treatment with angioplasty for chronic limb-threating ischemia is frequently associated with frequent reintervention and adverse limb outcomes from restenosis.
  • The treatment of patients with Infrapopliteal artery disease with the everolimus-eluting resorbable scaffold was superior to angioplasty in this study.

JournalDoc Comments:

  • Untreated limb-threatening ischemia of the legs is a serious health problem with resting pain in the limb and a high rate of ulceration gangrene and amputation.
  • As noted in an accompanying editorial by Joshua A. Beckman, MD, device therapy in peripheral artery disease may be “coming of age” with the use of resorbable scaffolds that provide support to the vessel wall and prevent acute and subacute vessel closure.
  • This study focused both on device success and clinical outcomes, which are the hall marks of  evidence-based medicine. Future studies should always include clinical outcomes.

CLICK HERE FOR MORE INFORMATION ON THIS STUDY

Disclaimer:  Article of the Week selections by JournalDoc physicians are independent, unbiased and have no commercial conflict of interest. JournalDoc does not support or endorse the findings or opinions expressed in the article. Findings in the article may need to be supported by further research and/or the consensus of experts.

Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity

January 24, 2024 | 0 Comments

JAMA Original Investigation

Journal of the American Medical Association, January 2, 2024

Data from the SURMOUNT-4 Randomized Clinical Trial, a phase 3 open label withdrawal trial with 670 participants at 70 sites in 4 countries. Participants received once weekly subcutaneous injections of Tirzepatide for 36 weeks and then half were randomized to continue receiving drug or placebo for 52 weeks.

What’s Interesting about this article?

  • Tirzepatide is a single molecule that combines glucose -dependent insulintropic polypeptide (GIP) and GLP-1 receptor agonism resulting in synergistic effects on appetite, food intake and metabolism.
  • Tirzepatide was recently approved in the U.S. by the FDA, marketed as ZepboundTM.
  • Withdrawing Tirzepatide resulted in substantial regain of lost weight, whereas continued treatment maintained and augmented weight reduction.

JournalDoc Comments:

  • These findings are consistent with other studies that found that patients must remain on the new weight loss drugs or substantial weight gain occurs.
  • The requirement for long term use of Tirzepatide is worrisome because of loss of muscle and GI adverse effects reported with this class of drugs.
  • Until the need for maintenance therapy is solved, the new weight loss drugs should only be prescribed for patients with obesity and either/or diabetes or cardiovascular disorders.

CLICK HERE FOR MORE INFORMATION ON THIS STUDY

Disclaimer: Article of the Week selections by JournalDoc physicians are independent, unbiased and have no commercial conflict of interest. JournalDoc does not support or endorse the findings or opinions expressed in the article. Findings in the article may need to be supported by further research and/or the consensus of experts.

Testosterone Treatment and Fractures in Men with Hypogonadism

January 17, 2024 | 0 Comments

NEJM Original Article

New England Journal of Medicine, January 18, 2024

Data from a subtrial of an RCT that assessed the cardiovascular safety of testosterone treatment  in 5204 men ages 45 to 80 years of age with preexisting or high  risk of cardiovascular disease and one or more symptoms of hypogonadism and low testosterone levels. Participants were randomly assigned to apply a testosterone or placebo gel daily, and then asked at each visit if they had had a fracture since the previous visit. The median follow-up was 3.19 years.

What’s Interesting about this article?

  • Testosterone treatment in men with hypogonadism improves bone density and quality. However, there is no data on incidence of fractures with extended use in a large sample of middle-aged or older men.
  • Numerically, there was a higher incidence of fractures in men who received testosterone in this study.
  • In the original study of this group of men, there was no difference in adverse cardiovascular events in those that received testosterone rather than placebo.

JournalDoc Comments:

  • The increase in incidence of fractures in the testosterone group was a surprising result.
  • The increase in fracture risk was not large – 3.50% in the testosterone group versus 2.46% in the placebo group and most fractures were associated with trauma rather than osteoporosis.
  • However, in an accompanying editorial by Mathis Grossmann, MD, Ph.D and Bradley Anawalt, the authors recommended that older men with obesity and low testosterone should be considered at higher risk of fracture if prescribed testosterone therapy.

CLICK HERE FOR MORE INFORMATION ON THIS STUDY

Disclaimer:  Article of the Week selections by JournalDoc physicians are independent, unbiased and have no commercial conflict of interest. JournalDoc does not support or endorse the findings or opinions expressed in the article. Findings in the article may need to be supported by further research and/or the consensus of experts.

Changes in Hospital Adverse Events and Patient Outcomes Associated with Private equity Acquisition

January 11, 2024 | 0 Comments

JAMA Original Investigation Article

Journal of the American Medical Association, December 26,2023

Data from 100% Medicare Part A claims for 662,095 hospitalizations at 51 private equity-acquired hospitals were compared with data for 4,160,720 hospitalizations at 259 matched control hospitals for hospital stays between 2009 and 2019. Hospital-acquired events were compared for three years before private equity acquisition and three years after acquisition.

What’s Interesting about this article?

  • Hospital- acquired adverse events included falls, infections and other adverse events as defined by the US Centers for Medicare & Medicaid Services.
  • Private equity acquisition was associated with increased falls, central line-associated bloodstream infections and surgical site infections.
  • A small decrease in in-hospital mortality at private equity hospitals may be explained by a case shift to younger Medicare beneficiaries and increased transfers to other hospitals.

JournalDoc Comments:

  • This is an impressive study by doctors from the Massachusetts General Hospital, one of the top hospitals in the US.
  • In the past, US hospitals were urged to become more “business-like” to decrease health care costs. The findings in this article raise significant concerns that this transition may decrease the quality of care and  patient outcomes.
  • It is not clear whether the increase in falls and hospital-acquired infections were related to reduced staffing or other cost-cutting measures employed to increase profitability.

CLICK HERE FOR MORE INFORMATION ON THIS STUDY

Disclaimer:  Article of the Week selections by JournalDoc physicians are independent, unbiased and have no commercial conflict of interest. JournalDoc does not support or endorse the findings or opinions expressed in the article. Findings in the article may need to be supported by further research and/or the consensus of experts.

An Oral Interleukin-23-Receptor Antagonist Peptide for Plaque Psoriasis

February 9, 2024

Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease

February 1, 2024

Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity

January 24, 2024

Testosterone Treatment and Fractures in Men with Hypogonadism

January 17, 2024

Changes in Hospital Adverse Events and Patient Outcomes Associated with Private equity Acquisition

January 11, 2024

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

December 15, 2023

Adenotonsillectomy for Snoring and Mild Sleep Apnea in Children: A Randomized Clinical Trial

December 7, 2023

Risk of Gastrointestinal Adverse Events Associated with Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss

November 30, 2023

Relationship Between Clinician Language and the Success of Behavioral Weight Loss Intervention

November 16, 2023

Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes of Patients with Acute Myocardial Infarction:
The CTS-AMI Randomized Clinical Trial

November 9, 2023

Nonhormonal Therapies for Menopausal Vasomotor Symptoms

November 2, 2023

Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged U.S. Women

October 26, 2023

Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity

October 19, 2023

Sedentary Behavior and Incident Dementia among Older Adults

October 12, 2023

Single-Dose Psilocybin Treatment for Major Depressive Order

October 5, 2023

Addressing the Complex Driving Needs of an Aging Population

September 28, 2023

Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons

September 21, 2023

The Effect of Low-Dose Glucocorticoids Over Two years on Weight and Blood Pressure in Rheumatoid Arthritis

September 14, 2023

Participation of Children in American Football

September 4, 2023

Donanemab in Early Symptomatic Alzheimer Disease

August 31, 2023

Time-Restricted Eating Without Calorie Counting for Weight Loss in a Racially Diverse Population

August 24, 2023

The Consequences and Future of Prior-Authorization Reform

August 21, 2023

Association of Low Dose Colchicine with Incidence of Knee and Hip Replacements

June 30, 2023