Articles: disease.
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Pol. Arch. Med. Wewn. · Jun 2024
ReviewTherapeutic strategies in preclinical stages of rheumatoid arthritis.
Modern therapies and treatment algorithms, such as the treat‑to‑target strategy, have significantly improved outcomes in patients with rheumatoid arthritis (RA) over the past decades. Moreover, the concept of the "window of opportunity" has led to earlier diagnosis and better treatment outcomes. ⋯ The initiation of treatment in preclinical phases of RA is expected to delay, halt, or even prevent the disease onset or progression in the long term. This review summarizes this new concept, discusses current studies including an overview of therapeutic algorithms and findings, and provides a critical evaluation of pharmacologic approach in the preclinical stages of RA.
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Randomized Controlled Trial Multicenter Study
Dupilumab for COPD with Blood Eosinophil Evidence of Type 2 Inflammation.
Dupilumab, a fully human monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation, has shown efficacy and safety in a phase 3 trial involving patients with chronic obstructive pulmonary disease (COPD) and type 2 inflammation and an elevated risk of exacerbation. Whether the findings would be confirmed in a second phase 3 trial was unclear. ⋯ In patients with COPD and type 2 inflammation as indicated by elevated blood eosinophil counts, dupilumab was associated with fewer exacerbations and better lung function than placebo. (Funded by Sanofi and Regeneron Pharmaceuticals; NOTUS ClinicalTrials.gov number, NCT04456673.).
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Pol. Arch. Med. Wewn. · Jun 2024
A systematic screening and heart team approach contributes to unravel novel risk factors in revascularisation candidates of complex coronary artery disease: a machine learning approach.
The baseline characteristics affecting mortality following percutaneous or surgical revascularization in patients with left main and / or 3‑vessel coronary artery disease (CAD) observed in real‑world practice differ from those established in randomized controlled trials (RCTs) due to the constraints of inclusion / exclusion criteria. ⋯ A machine learning approach improved the detection of registry‑specific risk factors in all‑comer patients amenable to surgical or percutaneous revascularization who were evaluated by a heart team. The risk factors identified in RCTs are not necessarily the same as those detected in real clinical practice when systematic screening is applied.