A recent study found that administration of a monthly dose (60,000 IU) of vitamin D supplementation during the early stages of pregnancy demonstrated a notable decrease in the occurrence of preeclampsia. The study results were published in the journal, BMC pregnancy and childbirth.

This randomised clinical trial included 1300 primigravid women (median maternal age: 21 years; the median gestational age: 15 weeks) who were randomly assigned in a 1:1 ratio to either the supplemented (A) or control (B) group. Pregnant women in group A received a monthly dose of cholecalciferol (60,000 IU) orally for 6 months during antenatal care, while the control group (B) did not receive any vitamin D supplementation or placebo. Serum 25(OH)D levels were checked at the beginning and at 34 weeks of gestation, with outcomes assessed monthly until delivery.

In the intervention group, there was a significant decrease in the risk of preeclampsia (RR = 0.36) and preterm delivery (RR = 0.5). Moreover, an RR of 0.43 was identified for low birth weight and the RR for caesarean section was 0.63. The supplemented group demonstrated significantly higher APGAR scores at the 5th minute and a larger size of newborns.

The above results demonstrate that a single monthly dosage of vitamin D supplementation in early pregnancy had a substantial impact on lowering the occurrence of preeclampsia, as well as mitigating the associated complications experienced by both the mother and the fetus.

According to a recent study, sacituzumab govitecan was safe and significantly beneficial over chemotherapy in treating metastatic breast cancer. This study's result were published in the journal, Lancet.

The TROPiCS-02 was a randomized, phase 3, multi-centre, open-label trial that included 543 patients with confirmed hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+ and HER2-). They were randomly assigned in a 1:1 ratio to receive either sacituzumab govitecan (n=272) or chemotherapy (n=271; eribulin, vinorelbine, capecitabine, or gemcitabine). The patients had received at least one previous endocrine therapy, a taxane, as well as a CDK4/6 inhibitor in any setting and 2-4 previous chemotherapy regimens for metastatic disease. The study's primary endpoint was progression-free survival while the secondary endpoints included objective response rate (ORR), overall survival, and patient-reported outcomes.

At the end of the study, it was observed that sacituzumab govitecan significantly improved overall survival. Also, ORR was significantly improved with sacituzumab govitecan as was time to deterioration of global health status and quality of life. The safety profile of sacituzumab govitecan was in accordance with those of the ASCENT trial and primary analysis of TROPiCS-02.

Based on the results of this study, it can be concluded that sacituzumab govitecan may be used as a new treatment option for patients with  pretreated metastatic breast cancer as it may demonstrate statistically significant and clinically meaningful benefits with a manageable safety profile.

According to a recent study, dupilumab demonstrated notable improvements in the quality of life of young children who suffer from severe atopic dermatitis (AD), while maintaining an acceptable level of safety. The study’s findings were published in the journal, Advances in therapy.

In this pre-specified subgroup analysis, data of 125 patients aged 6 months to 5 years with severe AD at baseline (Investigator's Global Assessment [IGA] = 4) from a randomized, double-blind, placebo-controlled, phase III trial of dupilumab was examined. Patients were assigned randomly to receive either subcutaneous dupilumab (200/300 mg) [n=63] or a placebo [n=62] every 4 weeks, in addition to low-potency topical corticosteroids for a duration of 16 weeks. The study’s co-primary endpoints at week 16 included the proportion of patients displaying a ≥ 75% improvement from the baseline in Eczema Area and Severity Index (EASI-75) and the proportion of patients achieving IGA ≤ 1 (representing clear or almost clear skin). Secondary endpoints at week 16 included pruritis, mean changes in EASI, sleep loss, skin pain, and quality of life.

At week 16, a significantly higher percentage of patients who were given dupilumab compared to those who were given a placebo had achieved IGA ≤ 1 (14.3% vs. 1.6%) and EASI-75 (46.0% vs. 6.6%). Notable enhancements with dupilumab were seen in all secondary endpoints measured, with a least squares mean reduction of 48.9% in pruritus. The overall occurrence of adverse events (AEs) was comparable in both the dupilumab group (66.7%) and the placebo group (73.8%). No AEs related to dupilumab were severe or led to treatment discontinuation.

Based on the above results, it can be concluded that dupilumab may lead to significant improvement in the signs, symptoms, and overall quality of life for children between the ages of 6 months and 5 years with severe AD. Furthermore, the dupilumab treatment exhibited an acceptable level of safety.

A recent study found that ticagrelor- acetylsalicylic acid (ASA) conferred more benefit to patients with elevated homocysteine levels, especially women, among patients with minor ischemic stroke or transient ischemic attack (TIA). The results of this study were published in the journal, CMAJ (Canadian Medical Association Journal).

A post hoc analysis was carried out on the CHANCE-2 trial (The Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events-II). Participants were randomly assigned to receive treatment with either ticagrelor-ASA (n=2740) or clopidogrel-ASA (n=2700). The primary efficacy outcome of the study was recurrent stroke within 90-day follow-up while the primary safety outcome of the study was severe or moderate bleeding within 90 days.

It was observed that use of ticagrelor-ASA was linked to a reduced risk of recurrent stroke among participants with increased homocysteine levels (74 v. 119). The benefits of ticagrelor-ASA with regard to recurrent stroke seemed to increase with increasing homocysteine levels. Also, a significant interaction between homocysteine levels and therapy was found with regard to recurrent stroke in female participants.

Based on the above comparison between clopidogrel-ASA and ticagrelor-ASA, it can be concluded that more benefit may be conferred to patients with elevated homocysteine levels, particularly to females among patients with minor ischemic stroke or TIA.

A recent study suggests that that infertile men with obesity and low vitamin D status can attain adequate serum calcidiol (25OHD) levels through the supplementation of high-dose cholecalciferol (vitamin D3). This study’s findings were published in The British journal of nutrition.

The study was a double-blinded, randomized clinical trial conducted at a single center, with 307 infertile men assigned to either active treatment or a placebo for a period of 150 days. Participants in the active group were given an initial oral bolus of 300 000 mg of vitamin D3, followed by daily supplementation of 1400 mg of vitamin D3 and 500 mg of calcium.

At baseline, it was observed that men with a normal weight (BMI < 25 kg/m²) had notably higher levels of serum 25OHD compared to men who were overweight (BMI 25-30 kg/m²) and obese (BMI > 30 kg/m²) (48 nmol/l vs. 45 nmol/l and 39 nmol/l, respectively). Subsequently, after the intervention, it was found that men with normal weight, overweight, and obesity who received vitamin D3 treatment exhibited significantly higher levels of serum 25OHD in comparison to men in the corresponding placebo group (92 nmol/l vs. 53 nmol/l, 87 nmol/l vs. 49 nmol/l, and 85 nmol/l vs. 48 nmol/l; respectively).

Based on the above results, it can be concluded that high-dose vitamin D3 supplementation in obese infertile men with low vitamin D levels is effective in attaining optimal serum 25OHD levels.

According to a recent study, ultrasound guidance in radiofrequency ablation (RFA) targeting knee nerves has been shown to significantly decrease pain caused by knee osteoarthritis (KOA), enhance the function of the knee joint, improve patient satisfaction, and present a practical, safe, and successful minimally invasive procedure for elderly patients with moderate to severe KOA. This study’s findings were published in the journal, Pain Physician.

This prospective randomized controlled study included 120 patients who were aged 50 years or older, experiencing chronic knee joint pain for a minimum of 6 months, with a numeric rating scale (NRS) score of at least 4, and classified as grade III-IV based on the Kellgren-Lawrence system. The principle for selecting the target nerves was as follows: for medial knee pain, the inferior medial genicular nerve (IMGN) branch and superomedial genicular nerve (SMGN) branch of the saphenous nerve were chosen; for lateral pain, the superolateral genicular nerve (SLGN) branch of the femoral nerve was selected; and for total knee pain, the SMGN, IMGN, and SLGN branches were selected. The main outcomes measured were the NRS pain score (including the most severe pain), the percentage of patients who achieved a pain reduction of more than 2 points, and the average pain. The Western Ontario McMaster University Osteoarthritis Index (WOMAC) score was the secondary outcome measure. In the RFA group, RFA at 70ºC was conducted for 120 seconds per patient, while knee nerve blocks were administered in the control group.

At the end of the study, significant variations were observed in the mean NRS scores and worst pain levels among the treatment groups during the first, third, and, sixth months post-treatment. The mean WOMAC pain, physical function, and total scores differed significantly between the treatment groups and over time. Following treatment, the proportion of patients needing analgesic drugs was notably lower in the RFA group than in the control group.

Thus, it can be concluded that ultrasound guidance in RFA-applied knee nerves has been found to significantly alleviate pain caused by KOA. This minimally invasive procedure is considered safe and efficacious for elderly patients with moderate to severe KOA.

According to a recent study, first-line nivolumab plus chemotherapy increased overall survival in patients with advanced or metastatic esophageal adenocarcinoma (EAC) or gastric/gastroesophageal junction cancer (GC/GEJC) when compared to chemotherapy alone. This study’s results were published in the Journal of Clinical Oncology.

The CheckMate 649 trial included 1,581 patients who were concurrently randomly assigned to nivolumab plus chemotherapy or chemotherapy in a 1:1 ratio. The EQ-5D and Functional Assessment of Cancer Therapy-Gastric (FACT-Ga), which comprised the Gastric Cancer subscale (GaCS) and FACT-General (FACT-G), were used to measure health-related quality of life (HRQoL). Longitudinal changes in HRQoL were measured in the PRO analysis population which included patients with baseline and ≥1 postbaseline assessments.

It was found that in the PRO analysis population (n=1,360) PRO questionnaire completion rates were mostly >80% during treatment. Nivolumab plus chemotherapy did not result in an increase in the patient-reported symptom burden. Mean improved changes for FACT-Ga total, GaCS, and EQ-5D visual analog scale in patients with a combined positive score (CPS) of ≥5 from baseline were greater with nivolumab plus chemotherapy. Based on the FACT-Ga total score and GaCS, nivolumab plus chemotherapy decreased the risk of symptom deterioration compared to chemotherapy in CPS ≥5 and all randomly assigned populations. Also, the time to deterioration was longer and the risk of definitive deterioration in HRQoL was reduced with nivolumab plus chemotherapy.

Based on the above results, it can be concluded that first-line nivolumab plus chemotherapy may demonstrate stable or better on-treatment HRQoL in patients with advanced/metastatic non-HER2-positive GC/GEJC/EAC and may also show decreased risk of definitive HRQoL deterioration.

According to a recent study, alirocumab may reduce low-density lipoprotein cholesterol (LDL-C) and other lipid parameters in pediatric patients with heterozygous familial hypercholesterolemia (HeFH) who have not achieved sufficient control with statins. This study’s findings were published in the journal, JAMA pediatrics.

In this phase 3, randomized clinical trial, 153 pediatric patients aged 8-17 years with HeFH, LDL-C levels of 130 mg/dL or higher, and undergoing statin or other lipid-lowering therapy (LLT) were randomly assigned to receive subcutaneous alirocumab or a placebo and dosed every 2 weeks (Q2W) or every 4 weeks (Q4W). The dosage depended on weight (if <50 kg then 40 mg for Q2W or 150 mg for Q4W; if ≥50 kg then 75 mg for Q2W or 300 mg for Q4W) and was adjusted at week 12 if LDL-C was 110 mg/dL or higher at week 8. Following the 24-week double-blind phase, patients could continue alirocumab treatment in an 80-week open-label phase. The primary endpoint of the study was the percentage change in LDL-C from baseline to week 24 in each group.

Alirocumab demonstrated statistically significant decreases in LDL-C compared to the placebo in both groups at week 24. The least squares mean difference in percentage change from baseline was -43.3% for the Q2W group and -33.8% for the Q4W group. A hierarchical analysis of secondary efficacy endpoints revealed notable enhancements in other lipid parameters at weeks 12 and 24 with alirocumab. The findings from the open-label period were consistent with those from the double-blind period.

Based on the above results, it can be concluded that alirocumab dosed every two weeks or every four weeks may lower LDL-C levels and improve other lipid parameters in pediatric patients with HeFH who have not achieved adequate control with statins.