A recent study found that initial oral treprostinil improved survival while those who started treprostinil after a clinical worsening in the placebo group and tolerated the drug for up to 48 weeks, enjoyed substantial functional gains. This study was published in the journal, Advances in Therapy.

This trial was an open-label extension (OLE) of the FREEDOM-EV study which enrolled 470 patients who had experienced an investigator-assessed clinical worsening event. All OLE participants were kept on open-label oral treprostinil. Those participants who had previously been assigned to placebo or previously assigned treprostinil, continued with the dose titration. Assessments included measured N-terminal pro-brain natriuretic peptide (NT-proBNP) at week 48, functional class, and 6-min walk distance (6MWD) at 12-week intervals. Survival was studied using the Kaplan-Meier analysis while hazard ratio (HR) was measured using Cox proportional hazards.

At the end of the study, it was seen that initial administration of oral treprostinil reduced mortality. Those who were randomized to the placebo group and initiated on oral treprostinil after clinical worsening, showed a reduction in NT-proBNP of - 778 pg/mL, functional class shifts, and 6MWD improvements of + 84 m when compared to the OLE baseline. Modest trends were observed in those participants who were initially assigned placebo and did not show clinical worsening and also those participants who were on the study drug without clinical worsening but continued with the drug through week 48.

Based on the above results, it can be concluded that with initial treprostinil, improved survival in the entire data set may be observed while those participants in the placebo arm, who were kept on treprostinil after a clinical worsening and tolerated the drug at week 48, may exhibit substantial functional gains.

According to a recent study, the pulmonary hypertension (pH) due to left heart disease (LHD) noninvasive nomogram demonstrates exceptional diagnostic value and clinical applicability, enabling a more precise assessment of the risk of pH in individuals with LHD. This study’s results were published in the journal, Heart & Lung.

In this study, a total of 361 patients with left heart disease (LHD) who had undergone right heart catheterization were enrolled. These patients were then randomly divided into two groups: a training cohort consisting of 253 patients (70%) and a validation cohort consisting of 108 patients (30%). The presence of pH was determined by a resting mean pulmonary arterial pressure (mPAP) of ≥25 mmHg, as measured through the right heart catheterization (RHC) examination. To analyze the data, the Lasso regression model was used for dimension reduction and feature selection. Subsequently, a nomogram was constructed based on multivariable logistic regression analysis.

175 individuals with left heart disease were diagnosed with pulmonary hypertension during their hospitalization, accounting for 48.5% of the sample cohort. Factors such as elevated New York Heart Association functional class, excessive resting heart rate, increased red blood cell distribution width, pulmonary artery systolic pressure, and right ventricular end-diastolic diameter assessed via echocardiography were independently linked to the prevalence of pH-LHD. The incorporation of these 5 variables in the nomogram demonstrated optimal calibration (Hosmer-Lemeshow test, P = 0.791) and strong discrimination (AUC = 0.866 [95% CI, 0.820-0.911]) for the validation set.

The above study demonstrated that the noninvasive nomogram for pH-LHD exhibits excellent diagnostic efficacy and clinical applicability, facilitating a more accurate evaluation of the pH risk in individuals with LHD.

A new study found that standard dose triple combination therapy of chlorthalidone 25 mg with telmisartan 80 mg plus amlodipine 5 mg was safe and effective for treating primary hypertension. This study’s results were published in the Journal of Clinical Hypertension.

This phase 3, multicenter, randomized, double-blind, active-controlled trial enrolled 374 patients. The participants were randomized to TEL/AML/CHTD group (triple combination), receiving telmisartan 40 mg/amlodipine 5 mg/chlorthalidone 12.5 mg or TEL/AML group (dual combination), receiving telmisartan 40 mg/amlodipine 5 mg. This was followed by dose up titration to TEL 80/AML5/CHTD25mg and TEL80/AML5, respectively. Change of mean sitting systolic blood pressure (MSSBP) at week 8 was the primary endpoint of the study.

It was observed that the baseline MSSBPs/diastolic BPs were 149.9 ± 12.2/88.5 ± 10.4 mm Hg. 8 weeks post-treatment, the change of MSSBPs was found to be -19.1 ± 14.9 mm Hg (TEL/AML/CHTD) and -11.4 ± 14.7 mm Hg (TEL/AML). The achievement rates of target BP and responder rate were significantly higher in TEL/AML/CHTD. No adverse events due to medication were reported. Among the triple combination group, female patients or those aged≥ 65 years old showed a higher rate of target BP achievement than relatively young males.

Based on the above results, it was evident that the standard dose triple combination was safe and efficacious in treating primary hypertension and may be more pronounced in females or older patients.

According to a recent study, early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy can improve patient outcomes. This study was published in the Journal of cardiothoracic surgery.

This prospective, randomized clinical trial enrolled 106 patients, who were scheduled for thoracoscopic and laparoscopic esophagectomy due to esophageal cancer. The participants were assigned to either the control group (n=53) which consisted of traditional postoperative care or study group (n=53), which included traditional postoperative care with early bronchoscopic sputum aspiration and lavage. The study outcomes were length of hospital stay, medical expenses, and postoperative complications.

At the end of the study, it was found that length of hospital stay was shorter and the medical expenses were lower during hospitalization in the study group when compared to the control group. Moreover, the incidences of overall complications in study group were also fewer than the control group.

From the above results, it can be concluded that early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy may result in shorter length of hospital stay, lower medical expense, and fewer incidence of postoperative complications.