Impact of insulin-like growth factors on cardio-renal outcomes in type 2 diabetic individuals

A recent study found that insulin-like growth factors (IGFs) were associated with cardio-renal outcomes among persons with type 2 diabetes. The results of this study were published in the journal, Cardiovascular Diabetology.

This study included 2627 individuals, having type 2 diabetes and chronic kidney disease, who were randomized to receive either canagliflozin or placebo. Primary outcome included end-stage kidney disease, cardio-renal death, or doubling of the serum creatinine level. IGF-1, IGF binding protein-3 (IGFBP-3), and the ratio of IGF-1/IGFBP-3 were assessed at baseline, year-1, and year-3, using Cox proportional hazard regression.

On analysis, it was found that elevated IGF-1 was linked with primary composite outcome, renal composite outcome, and all-cause mortality. Elevated levels of IGFBP-3 were not found to be associated with any clinical outcomes. Additionally, the IGF-1/IGFBP-3 ratio also indicated a higher risk of the primary composite outcome. Based on the above results, it may be concluded that IGF plays a crucial role in regulating cardio-renal outcomes in people who have type 2 diabetes along with chronic kidney disease.

Intravesical chondroitin sulphate solution is safe and superior to antibiotics in treatment of recurrent urinary tract infection

A retrospective study based in Netherlands found data that showed efficacy and safety of intravesical chondroitin sulphate (CS) solution in patients with recurrent urinary tract infections (rUTIs). The results of the study were published in the journal, BMC Urology.

The study aimed to evaluate the efficacy of intravesical therapy with 0.2% CS in patients suffering rUTIs in comparison to a treatment with a low-dose long-term antibiotics (LDLTAB) and a combination of both (LDLTABCS). Of the total 151 patients included, 50 patients were treated with CS, 51 received LDLTAB, and 50 received a combination therapy. Data recorded was evaluated for baseline, after 6, and 12 months of treatment. Comparisons between and within groups were performed using one-tailed and paired t-tests. Patients also filled in a standardized quality of life questionnaire (QoL).

It was found that the number of infections reduced significantly after 12 months therapy with CS compared to 12 months therapy with LDLTAB. The number of visits to the urologist significantly decreased in the CS group, additionally there was a significant increase in QoL seen in CS-group. These results suggest the superiority of CS to antibiotics in patients with rUTIs, and may be considered as a safe and effective option.

Vitamin D supplementation reduces severity of stress urinary incontinence in premenopausal women

The findings of a recent study on premenopausal women with vitamin D deficiency suggest that the severity of stress urinary incontinence (SUI) can be reduced greatly through vitamin D supplementation.

The randomized controlled trial included 60 premenopausal women and the results were published in the journal, BMC Womens Health. Women eligible for the study either received a 5000-unit vitamin D supplement or placebo for 3 months on a weekly basis. To assess the extent of SUI, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) was filled.

Based on the data, it was found that after 8-12 weeks of taking vitamin D supplementation, women showed decrease in the number of SUI cases and urinary leakage symptoms. Hence, vitamin D supplementation can improve SUI in premenopausal women.

Sulopenem followed by oral sulopenem etzadroxil or probenecid was not noninferior to ertapenem for complicated UTIs

A recent study found that the administration of sulopenem intravenously followed by oral administration is an effective treatment for complicated urinary tract infections (cUTIs). These formulations were found not to be inferior to ertapenem followed by oral step-down therapy for the treatment of cUTIs. The results of this study were published in the journal, Clinical Infectious Diseases.

This phase 3 trial randomized 1392 hospitalized adults with symptoms of cUTIs to 5 days of IV sulopenem followed by oral sulopenem etzadroxil/probenecid or 5 days of IV ertapenem followed by oral ciprofloxacin or amoxicillin-clavulanate, depending on uropathogen susceptibility. The primary end point was overall combined clinical and microbiologic response at the test-of-cure visit (day 21).

Sulopenem's noninferiority to the comparator regimen was not demonstrated for the primary end point. The difference was due to a lower rate of asymptomatic bacteriuria in the ertapenem-treated patients who switched to ciprofloxacin. There was no substantial difference in overall response at any other time point.

Thus, sulopenem followed by oral sulopenem-etzadroxil/probenecid is not noninferior to ertapenem followed by oral step-down therapy for the treatment of cUTIs.