A recent study suggests that patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations showed clinically relevant outcomes when treated with niraparib plus abiraterone acetate and prednisone (AAP). This study’s results were published in the Annals of Oncology.

The phase 3, MAGNITUDE trial included 212 HRR+ patients with/without BRCA1/2 alterations. They were randomized in a 1:1 ratio to receive 200mg of niraparib orally plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At the second prespecified interim analysis (IA2), the secondary endpoints assessed were time to symptomatic progression, time to initiation of cytotoxic chemotherapy and overall survival (OS).

It was found that at IA2 with 24.8 months of median follow-up, niraparib plus AAP showed significantly prolonged radiographic progression-free survival (rPFS) (19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78] consistent with the first prespecified interim analysis. Similarly, in the total HRR+ population, rPFS was also prolonged. In the niraparib plus AAP group, time to symptomatic progression and time to initiation of cytotoxic chemotherapy showed improvements. Even the analysis of OS with niraparib plus AAP in the BRCA1/2 subgroup demonstrated a lower hazard ratio.

From the above results, it is clear that niraparib plus AAP in patients with BRCA1/2-altered mCRPC, may demonstrate an improved rPFS and other clinically relevant outcomes.

A recent study found that both the combinations of tamsulosin/finasteride and tadalafil/finasteride are comparably effective in enhancing lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) within 3 months. Tamsulosin/finasteride demonstrated a significantly better maximum urinary flow rate (Qmax) only during the fourth week. Tadalafil/finasteride improved sexual performance compared to the alternative combination. This study’s results were published in the World Journal of Urology.

In this study, the selection criteria included prostate volume greater than 40 ml and IPSS scores exceeding 7. Patients with severe erectile dysfunction (IIEF-erectile functions ≤ 10) were not included in the study. The patients were randomly assigned to two groups: tamsulosin/finasteride (Group I) and tadalafil/finasteride (Group II). The primary endpoint of the study included the changes in urinary and sexual function within each group, as measured by IPSS, urinary flow rates, IPSS-quality of life, and IIEF domains. The secondary endpoint involved comparing the treatment-induced changes between the two groups.

The number of patients in each group was 131 and 127 at the 4th and 12th weeks, respectively. Significant improvement in LUTS was observed in both groups, with IPSS changes of - 4.9 ± 2.7 and - 4.3 ± 2.9 at the 4th week, and - 6.1 ± 3 and - 5.4 ± 2.8 points at the 12th week in both groups, respectively. Group I showed improved average flow rates during both follow-up sessions. At the 12th week, maximum flow rates were comparable in both groups (13.5 ± 3.9 vs 12.6 ± 3.7). In group I, all IIEF domains showed a significant decrease at both visits. During the 4th and 12th weeks, Group II displayed a significant improvement in IIEF-erectile function scores (1.3 ± 1.1 and 1.8 ± 1.2, respectively). However, there was a temporary reduction in IIEF-orgasm and sexual desire, which was only observed at the 4th week (- 0.8 ± 0.4 and - 0.6 ± 0.4, respectively).

The above study demonstrated that within a span of 3 months, both the tamsulosin/finasteride and tadalafil/finasteride combinations have demonstrated equal effectiveness in enhancing LUTS associated with BPH. During the fourth week, tamsulosin/finasteride exhibited a significantly better Qmax. The combination of tadalafil/finasteride showed a positive impact on sexual performance when compared to the alternative combination.

A recent study showed that the standard narrow focal zone (FZ) demonstrates similar safety and superior treatment efficacy when compared to the extended FZ during extracorporeal shockwave lithotripsy (SWL) for renal stones. This study’s findings were published in Journal of Endourology.

In this prospective randomized study, 276 patients diagnosed with renal stones were assigned to receive SWL using either standard or extended FZ. The treatment was administered using a Modulith SLX-F2 lithotripter, delivering a maximum of 3000 shocks at a frequency of 1.5 Hz. The primary outcome of the study assessed the success of the treatment 12 weeks after a single SWL session, which was determined by the absence of a stone or stone fragment smaller than 4 mm on computed tomography. Secondary outcomes included the incidence of the stone-free rate (SFR), perinephric hematoma, and changes in the levels of acute renal injury markers in the urine.

Similar baseline parameters were observed in both groups. The standard FZ group achieved a significantly higher treatment success rate (74.3%) than the extended FZ group (59.3%). Additionally, standard FZ exhibited a significantly better SFR (Grade-A, 36.8% vs. 23.0%,) and lower post-treatment pain levels. Both groups had comparable rates of perinephric hematoma formation, changes in urinary acute renal injury markers, and unplanned hospital admissions.

The above results demonstrated that the standard narrow FZ shows comparable safety and improved treatment efficacy in comparison to the extended FZ in extracorporeal SWL for renal stones.

According to a recent study, erenumab (140 mg) demonstrated long-lasting effectiveness over a period of 3 years in individuals with episodic migraine (EM) who had 2-4 unsuccessful attempts at preventive treatment. This study’s findings were published in the journal, Neurology.

Following the 12-week double-blind treatment phase (DBTP) of the LIBERTY study, 240/246 (97.6%) participants entered the Open-Label Extension Phase (OLEP) and received a monthly dosage of 140 mg of erenumab for a period of 3 years. The main outcomes of this study included determining the percentage of participants who achieved a reduction of 50% or more in monthly migraine days (MMDs), analyzing the mean change in MMDs from the baseline, and assessing the tolerability and safety of the treatment.

At week 168, a total of 79 out of 151 participants (52.3%) in the overall population, who had valid data points, achieved a reduction of at least 50% in MMDs and were considered responders. In the continuous erenumab group, 35 out of 117 participants (29.9%) were ≥50% responders at week 12 of the double-blind treatment period, and 26 out of 35 (74.3%) remained responders in at least half of the visits during the open-label extension period. Among the 82 out of 117 participants (70.1%) in the continuous erenumab group who did not achieve responder status at week 12, 17 out of 82 (20.7%) converted to ≥50% responders in at least half of the open-label extension phase visits. In the placebo-erenumab group, out of the 103 out of 120 participants (85.8%) who did not achieve responder status at week 12, 42 out of 103 (40.8%) converted to ≥50% responders in at least half of the open-label extension phase visits after switching to erenumab treatment. The mean (SD) change in MMD from baseline over 3 years showed a sustained improvement of -4.4 [3.9] days at week 168. The safety and tolerability profile remained consistent with previous studies.

The above study demonstrated that in individuals with episodic migraine (EM) who had previously encountered 2-4 unsuccessful preventive treatment attempts experienced long-lasting efficacy with erenumab (140 mg) over a period of 3 years.