The Proportion of Regulatory T cells in Patients with Sjogren's syndrome: A Meta-Analysis
Sjogren's syndrome is a common autoimmune condition marked by eye dryness, exhaustion, and pain. Regulatory T cells play a role in the disease pathogenesis. Patients with SS had a lower proportion of Tregs in their peripheral blood (P0.001). The number of CD4+ and CD25+ Treg cells in SS patients was considerably lower than in the control group.
Upadacitinib or Adalimumab in Patients with Rheumatoid Arthritis: Safety and Efficacy
In phase 3 trial of SELECT-COMPARE, upadacitinib 15 mg daily showed improvement in clinical symptoms of RA compared to adalimumab plus MTX at week 12. Over a 3-year period, the trial compared the safety and efficacy of UPA versus ADA with an added dose of MTX. A higher proportion of patients taking UPA achieved disease activity & higher rates of ACR responses. UPA+MTX showed better response .
Prof. David Matthews (EASD 2019) - Verify Trial
Professor Emeritus David Matthews research focuses on many aspects of type 2 diabetes and he has been involved in many trials, including CANVAS and CANVAS-R and the VERIFY trial. He discusses Verify Trial aiming to determine whether early combination therapy could provide better glycemic control than metformin in patients with newly diagnosed type 2 diabetes.
ESH 2019: New Guidelines on Hypertension
Prof. Massimo Volpe is Professor at Cardiovascular Dept. Univ. of Rome Sapienza, Italy. He is Chief of the Cardiology Division, Dept. of Cardiovascular and Respiratory Science, and Hypertension Unit at Sant’Andrea Hospital, Italy. He discusses hypertension guidelines focusing on the need to control BP in 3 months using combination therapy.
Prof. John McMurray - Contraindications for Empagliflozin
Professor John McMurray's research interests are in heart failure, coronary heart disease, atrial fibrillation and the cardiovascular consequences of diabetes and chronic kidney disease. He advises caution while administering Empagliflozin to patients with type 1 diabetes, history of diabetic ketoacidosis, or genital mycotic infections. However, there is no concern about Kidney function.
EMPEROR Preserved trial - Empagliflozin reduces heart failure hospitalization risk
John McMurray is a professor of Medical Cardiology and Deputy Director of the Institute of Cardiovascular and Medical Sciences at the Queen Elizabeth University Hospital, Glasgow. He discusses the outcomes of the EMPEROR-Preserved trial which shows that empagliflozin (10 mg once daily) reduces the risk of CV death and Heart Failure hospitalization by 21%.
ADA 2020 - Conference at glance
Key highlights: A study by Dr. Phil Schwabs presented showed minor differences in clinical and cost outcomes between Canagliflozin, Empagliflozin and Dapagliflozin. Yaling Tang presented his finding of ACCORD trial highlighting the benefits of intensive glycemic and BP control in T2D patients. Prof. McMurray presented about effect of Antihyperglycemic medication on heart failure.
Emperor preserved trial - Prof Stefan Anker
Dr. Stefan Anker MD, PhD, FESC, Professor of Homeostasis in Cardiology & Metabolism (2017). Dr. Anker total citations exceed 46,000, including 50 papers with over 200 citations, and he has an h-index of 174. His myriad research interests include the pathophysiology of heart failure, the pathophysiology of cachexia and sarcopenia in chronic heart failure, stroke.
First line of therapy in newly Diagnosed patients by Prof. David Matthews(President EASD 2019)
Emeritus David Matthews is a Professor of Diabetic Medicine, Consultant Physician and Fellow of Harris Manchester College. Prof. Matthews’ research focuses on type 2 diabetes, including mathematical modeling of insulin resistance and the analysis of pulsatile insulin (and other hormones, especially Growth Hormone) using time-series analysis.
Dr DeFronzo with Dr. Akshay Jain - GLP-1 analogs for diabetes management
Dr DeFronzo, a known researcher & endocrinologist, is credited with development of metformin and dapagliflozin. His interests focus on the pathogenesis and treatment of T2DM and Insulin Resistance Syndrome. He summarizes GLP-1 analog benefits: reduces A1C levels, preserves beta-cell function, no risk of hypoglycemia, weight loss, safety profile with cardioprotection.
Replacing the pill: Future of CVD therapy
Gene replacement therapy involves augmenting calsequestrin in cDNA plasma & injecting in AAV virus and delivered to heart. It leads to reduced percentage of arrhythmias. Although gene therapy has advanced in several fields, cardiac gene therapy has been slowed down due to challenges faced by CUPID studies. Further studies are needed to understand delivery/vectors/dosing.
Quantum Genomics Firibastat (QGC001) or Ramipril to prevent left ventricular dysfunction
The primary objective of QUORUM trial was to compare the effects of two oral doses of Firibastat to those of Ramipril in Left Ventricular Ejection Fraction (LVEF). The study concluded that Firibastat (100mg or 500mg BID) was not superior to active comparator ramipril (5 mg BID) to prevent left ventricular dysfunction after first acute anterior MI
ACCOST-HH: Adrecizumab in cardiogenic shock
Cardiogenic shock is a serious medical condition with high mortality and morbidity. ACCOST-HH trial evaluated the safety, tolerability and efficacy of Adrecizumab on top of standard of care in patients with cardiogenic shock. Adrecizumab was found to be well-tolerated in patients with cardiogenic shock. But it did not reduce the need for cardiovascular organ support or improve survival.
Effect of Dapagliflozin on mortality in HFrEF patients
The DAPA-HF trial examined the effect of Dapagliflozin on ventricular arrhythmia, resuscitated cardiac arrest or sudden death in HFrEF patients. The study shows the beneficial impacts of SGLT2i in HFrEF and generates one prospective procedure for how these drugs reduce mortality in HFrEF.
Relationship between different IGG and IGA Anti-Modified Protein Autoantibodies in RA
The study analyzes 30 different IgG and IgA AMPA reactivities to Cit, Carb, KAc, and MAA antigens. It concludes that autoantibodies exhibiting different patterns of ACPA fine-specificities as well as Carb & KAc reactivity are present in RA. MAA is not related to citrulline reactivity. While Carb & KAc reactivities could belong to same autoreactivity family as ACPA fine-specificities.
Eular Recommendations for Implementation of Self-Management Strategies in Patients with IA
The recommendations include: patient education should be the start point; HCPs should promote physical activity; emotional and mental health should be assessed; encourage self-management interventions into the daily routine including problem solving, goal setting, and cognitive behavioural therapy. These should be used alongside the medical management guidelines to support patients in their care.
Success and Failures of Therapies for Hyperinflammation in COVID-19
Immunomodulators should not be given early in COVID-19 infection. Corticosteroid (dexamethasone 6-10mg/day) should be given in patients requiring oxygen, high flow oxygen or mechanical ventilation. A recent meta-analysis shows efficacy of Tocilizumab if associated with DXM in patients requiring oxygen. Combination of immunomodulators & antivirals with interferon can be explored further.
Mechanisms of Hyperinflammation in COVID-19 and Beyond
Hyperinflammatory syndrome & MAS contribute to disease severity and mortality in COVID-19. Viral escape & dysregulated host innate immune response contribute to this complication. Cytokine storm is promoted by pyroptosis, activation of pattern recognition receptors, immune cell infiltration & macrophage activation (Th1 and M1 polarized response).
Shared Decision-Making Improves Treatment Adherence
International recommendations and T2T concept strongly recommend treatment based on shared decisions in daily practice. Shared decisions and appropriate drug profiles are the factors for treatment adherence. Treatment adherence leads to disease modification & treatment adaptation with good long-term responses, and better patient monitoring.
Common Issues in Pregnancy Management in Lupus & Anti-Phospholipid Syndrome
SLE should be considered a severe risk factor for pregnancy. Main risk factors for adverse pregnancy outcomes in SLE such as active disease within 6 months before conception, active lupus nephritis, chronic hypertension, pre-existing renal disease, antiphospholipid antibody syndrome. Hydroxychloroquine reduces the risk of pregnancy loss, pre-eclampsia in lupus pregnancies.
