Articles: treatment.
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Critical care medicine · Jan 2025
Randomized Controlled Trial Multicenter StudyHeterogeneity in the Effect of Early Goal-Directed Therapy for Septic Shock: A Secondary Analysis of Two Multicenter International Trials.
The optimal approach for resuscitation in septic shock remains unclear despite multiple randomized controlled trials (RCTs). Our objective was to investigate whether previously uncharacterized variation across individuals in their response to resuscitation strategies may contribute to conflicting average treatment effects in prior RCTs. ⋯ Treatment response to EGDT varied across patients in two multicenter RCTs with large benefits for some patients while others were harmed. Patient characteristics, including albumin, were most important in identifying HTE.
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Randomized Controlled Trial
The Heidelberg Decision Aid for Patients with Lung Cancer (HELP)—Findings of a Randomized, Controlled Trial.
Advanced lung cancer typifies the challenges of participatory decision-making in oncology. With a limited prognosis for survival, the increasingly numerous and complex treatment options must continually be weighed against issues of fragility, quality of life, and the end of life. ⋯ Even though the intervention was perceived as helpful preparation for decision-making, it did not bring about any improvement in the high level of decisional conflict. With the continual development of new treatments and the associated increase in prognostic uncertainty, there is an important role for individualized patient information and the training of physicians in how to deal with uncertainty.
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Randomized Controlled Trial Multicenter Study
Ponsegromab for the Treatment of Cancer Cachexia.
Cachexia is a common complication of cancer and is associated with an increased risk of death. The level of growth differentiation factor 15 (GDF-15), a circulating cytokine, is elevated in cancer cachexia. In a small, open-label, phase 1b study involving patients with cancer cachexia, ponsegromab, a humanized monoclonal antibody inhibiting GDF-15, was associated with improved weight, appetite, and physical activity, along with suppressed serum GDF-15 levels. ⋯ Among patients with cancer cachexia and elevated GDF-15 levels, the inhibition of GDF-15 with ponsegromab resulted in increased weight gain and overall activity level and reduced cachexia symptoms, findings that confirmed the role of GDF-15 as a driver of cachexia. (Funded by Pfizer; ClinicalTrials.gov number, NCT05546476.).
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Randomized Controlled Trial Multicenter Study
Zerlasiran-A Small-Interfering RNA Targeting Lipoprotein(a): A Phase 2 Randomized Clinical Trial.
Elevated lipoprotein(a) increases the risk of atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis. ⋯ Zerlasiran was well-tolerated and reduced time-averaged lipoprotein(a) concentration by more than 80% during 36 weeks of treatment in patients with ASCVD.
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Randomized Controlled Trial Comparative Study
Effect of Tui-Na versus positional release techniques on pregnancy-related low back pain in the third-trimester: A randomized comparative trial.
Researchers are prioritizing the development of an effective treatment approach for third-trimester pregnancy-related low back pain (LBP), a prevalent and costly disorder. Therefore, this study aimed to examine the effects of Tui-Na (TN) versus positional release techniques (PRT) on third trimester pregnancy-related LBP. ⋯ Although both TN and PRT are beneficial treatments for third trimester pregnancy-related LBP, TN leads to more beneficial outcomes.