Incidence Of New Cases Research Articles

P0796THE PREVALENCE AND INCIDENCE OF COGNITIVE IMPAIRMENT IN A COHORT OF CHRONIC KIDNEY DISEASE PATIENTS WITH CONCOMITANT DIABETES ATTENDING A SPECIALIST NEPHROLOGY CLINIC

Abstract Background and Aims Chronic kidney disease (CKD) is a global healthcare problem associated with several comorbid conditions including, cardiovascular disease, and diabetes, all of which are strong risk factors for the development of significant cognitive impairment. We recently reported the baseline outcomes of our older adult cohort with mild to moderate CKD (stages 3-4) and diabetes, where 48% were found to have a cognitive impairment ranging from mild to severe symptoms. [1] This study reports the outcomes at 36-months post baseline of the prevalence and incidence of cognitive impairment in this cohort the patients who at baseline were considered to have normal cognitive function. Method Cognitive function was assessed in patients over aged 55 years, with an estimated glomerular filtration rate < 45ml/min/1.73m 2, attending a renal and diabetes outpatient clinic, at baseline and at 36-months. The diagnosis of cognitive impairment was based upon patient and informant interview, case note review, neuropsychological assessment and application of Diagnostic and Statistical Manual of Mental disorders version 5 (DSM-5) and Petersen’s criteria for mild cognitive impairment (MCI). The incidence of cognitive impairment was calculated by dividing the number of new cases during study follow-up, by the person-time at risk throughout the observation period. Since it is not possible to precisely determine when a person actually develops cognitive impairment between baseline and follow-up, the midpoint of time between having normal cognition and becoming a case is assumed. Results Ninety-two patients without cognitive impairment at baseline, were included in this investigation (mean age of 75.8 + 9.1; 49 males: 43 female). Upon neuropsychological assessment and the application of DSM-5 criteria at follow-up, it was revealed that 25/92 (27%) of the cohort had developed a cognitive impairment ranging from MCI (n=19), to major symptoms (n = 6). The crude prevalence for MCI was 20.6%, and for dementia it was 6.5%. The total person years in the study were 237.38 years, with an overall incidence rate of 10.53 (95% Confidence interval 6.82-15.55) per 100 person-years. Conclusion This longitudinal cohort investigation reports the prevalence and incidence of new cases of cognitive impairment ranging from MCI to dementia in CKD. The crude prevalence in the current investigation for the development of cognitive impairment was 27%. The overall incidence rate for new cases of NCD was just over 10%. In other words, for every 100 patients in our current investigation we would estimate that around 10 will develop some a cognitive impairment ranging from MCI to dementia per year. Our findings from this and our previous investigation suggest that a significant number of CKD patients are at risk for the development of significant neurodegenerative conditions and in view of this cognitive function should be screened and monitored routinely in clinical practice. This will assist with appropriate health service planning, service development, clinical interventions and the assessment of the effectiveness of new and existing treatments services.

COVID-19 Outbreak in a Large Hemodialysis Center in Lombardy, Italy

COVID-19 Outbreak in a Large Hemodialysis Center in Lombardy, Italy

COVID-19, Australia: Epidemiology Report 16 (Reporting week to 23:59 AEST 17 May 2020).

Confirmed cases in Australia notified up to 17 May 2020: notifications = 7,075; deaths = 100. The incidence of new cases of COVID-19 has reduced dramatically since a peak in mid-March. Social distancing measures, public health action and the reduction in international travel have likely been effective in slowing the spread of the disease, in the Australian community. Testing rates over the past week have increased markedly, with a continued very low proportion of people testing positive. These low rates of detection are indicative of low levels of COVID-19 transmission. It is important that testing rates and community adherence to public health measures remain high to support the continued suppression of the virus, particularly in vulnerable high-risk groups and settings. New cases of COVID-19 are currently being reported by by only some jurisdictions, albeit at relatively low rates. Although case numbers are low, new cases tend to still be a mix of overseas-acquired and locally-acquired infections. Most locally-acquired cases can be linked back to a known case or cluster. Although the proportion of locally-acquired cases has increased, the overall rate of new cases, regardless of place of acquisition, continues to decrease. The crude case fatality rate in Australia remains low (1.4%), compared with the WHO reported global rate (6.9%). The low case fatality rate is likely reflective of high case detection and high quality of health care services in Australia. Deaths from COVID-19 in Australia have occurred predominantly among the elderly and those with comorbidities, with no deaths occurring in those under 40 years. The highest rate of COVID-19 continues to be among people aged 60-79 years. One third of all cases in this age group have been associated with several outbreaks linked to cruise ships. The lowest rate of disease is in young children, a pattern reflected in international reports. Internationally, while the number of new cases each day remains relatively stable at the global level, some areas such as Brazil and India are showing a dramatic rise in reported cases. Although some low-income countries have so far reported few cases, it is possible that this is due to limited diagnostic and public health capacity, and may not be reflective of true disease incidence.

Financial toxicity in patients with multiple myeloma participating in clinical trials: A U.S. Food and Drug Administration pooled analysis.

e19370 Background: Financial toxicity (FT) is a major concern for patients receiving standard cancer treatment, and FT can lead to worse cancer outcomes. However, little is known about the FT of patients enrolled in clinical trials (CT). While investigational treatment may be provided by sponsors free of charge, patients are subject to increased clinic visits (ie, missed workdays, travel costs) and still bear the cost of usual care. This analysis evaluates patient-reported FT in multiple myeloma (MM) trials submitted to US FDA and explores the relationship between baseline FT and overall response rate (ORR). Methods: We pooled data from 9 MM registration CTs submitted to the FDA that included the EORTC Quality of Life questionnaire (QLQ-C30). The QLQ-C30 includes an item asking patients “Has your physical condition or medical treatment caused you financial difficulties?”. We looked at proportion of patients at baseline reporting any FT and their ORR. We also report prevalence, incidence and change from baseline FT at 3 and 6 months. Results: 5,667 patients answered the FT item. Mean age of patients was 65 years, 55% were male, 85% were white and 6% were enrolled in the US. Approximately a third of patients reported experiencing any FT at baseline, 3 and 6 months. When compared to their baseline, 69% of patients had unchanged FT and 14% had worse FT at both 3 and 6 months. The incidence of new cases of FT at 3 months was 17% and at 6 months 7%. The ORR in patients who reported any FT at baseline was 69% compared to 72% in patients with no baseline FT, and was similar regardless of the degree of FT. Conclusions: Few studies have investigated FT in a large sample of CT participants. In this pooled analysis of patients enrolled in MM CTs, approximately a third of patients reported FT associated with their physical condition or medical treatment at baseline and throughout the trial. A small percentage of patients experienced worsening FT during the trial and a small percentage went from no FT to reporting any FT. The impact of baseline FT on ORR was small. Limitations of this preliminary analysis include missing patient level or group level insurance status, socio-economic status and other important determinants of health.

COVID-19, Australia: Epidemiology Report 15 (Reporting week to 23:59 AEST 10 May 2020).

Confirmed cases in Australia notified up to 10 May 2020: notifications = 6,971; deaths = 98. The incidence of new cases of COVID-19 has reduced dramatically since a peak in mid-March. The reduction in international travel, social distancing measures and public health action have likely been effective in slowing the spread of the disease, in the Australian community. Cases of COVID-19 continue to be notified by jurisdictions, albeit at a slowed rate. Testing rates over the past week have increased markedly, with a very low proportion of people testing positive. These low rates of detection are indicative of low levels of COVID-19 transmission. It is important that testing rates and community adherence to public health measures remain high to support the continued suppression of the virus, particularly in vulnerable high-risk groups and settings. In the past reporting week new cases in Australia are mostly considered to be locally acquired, consistent with the drop in international travel. Most locally-acquired cases can be linked back to a known case or cluster. Although the proportion of locally-acquired cases has increased, the overall rate of cases, regardless of place of acquisition, continues to decrease. The crude case fatality rate in Australia remains low (1.4%), compared with the WHO reported global rate (6.9%). The low case fatality rate is likely reflective of high case detection and high quality of health care services in Australia. Deaths from COVID-19 in Australia have occurred predominantly among the elderly and those with comorbidities, with no deaths occurring in those under 40 years. The highest rate of COVID-19 continues to be among people aged 60-79 years, with a third of these cases associated with several outbreaks linked to cruise ships. The lowest rate of disease is in young children, a pattern reflected in international reports. Internationally, cases continue to increase, with some areas such as Brazil and India showing a dramatic rise in reported cases. Although some low-income countries have currently reported few cases, it is possible that this is due to limited diagnostic and public health capacity, and may not be reflective of disease occurrence.

Ramping Up Delivery of Cardiac Surgery During the COVID-19 Pandemic: A Guidance Statement From The Society of Thoracic Surgeons COVID-19 Task Force

The coronavirus disease 2019 (COVID-19) pandemic has had a profound global impact. Its rapid transmissibility has transformed healthcare delivery and forced countries to adopt strict measures to contain its spread. The vast majority of the United States cardiac surgical programs have deferred all but truly emergent/urgent operative procedures in an effort to reduce the burden on the healthcare system and to mobilize resources to combat the pandemic surge. While the number of COVID-19 cases continue to increase worldwide, the incidence of new cases has begun to decline in many North American cities. This “flattening of the curve” has prompted interest in reopening the economy, relaxing public health restrictions, and resuming nonurgent healthcare delivery. The following document provides a template whereby adult cardiac surgical programs may begin to ramp-up the care delivery in a deliberate and graded fashion as the COVID-19 pandemic burden begins to ease. “Resuscitating” the timely delivery of care is guided by three principles: (1) Collaborate to permit increased case volumes, balancing the clinical needs of patients awaiting surgical procedures with the local resources available within each healthcare system. (2) Prioritize patients awaiting elective procedures while proactively engaging all stakeholders, focusing on those with high-risk anatomy, changing/symptomatic clinical status, and, once these variables have been addressed, prioritizing by waiting times. (3) Reevaluate local conditions continuously to assess for any increase in admissions due to a recrudescence of cases, to assure adequate resources to care for patients, and to monitor in-hospital infectious transmissions to both patients and healthcare workers.

Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus.

Diabetes mellitus is a group of metabolic disorders with high mortality and morbidity associated with complications such as cardiovascular disease, kidney disease, and stroke. The prevalence of diabetes is 9.4% in US adults, and prevalence increases markedly with age, with 1 in 4 adults aged ≥65years affected by diabetes. The estimated number of adults with type 2 diabetes globally almost tripled between 2002 and 2017, reflecting increases seen in the USA and elsewhere. This increase raises concerns about the increased morbidity and mortality associated with the complications of diabetes, including periodontal disease and tooth loss. There is a reciprocal adverse relationship between diabetes and periodontal disease, with diabetes as a major risk factor for periodontal disease, and in those patients with diabetes who also have periodontal disease then there are adverse effects on glycemic control and complications such as cardiovascular disease and end stage renal disease. In this review, those studies detailing the adverse effects of periodontal disease and diabetes will be discussed. Also, evidence is accumulating that periodontitis may play a role in increasing the incidence of new cases of type 2 diabetes, and possibly gestational diabetes. Of course, these studies need to be expanded to better understand the effects of periodontitis on diabetes glycemic control, complications, prediabetes, and the incidence of new cases. However, given the tremendous burden of diabetes on society, the dental profession should be proactive in preventing and treating periodontal disease, not only to preserve the dentition, but also to minimize the adverse effects of periodontitis on diabetes and its complications.

Uneventful Course in Patients With Inflammatory Bowel Disease During the Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in Northern Italy

Uneventful Course in Patients With Inflammatory Bowel Disease During the Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in Northern Italy

The Efficacy, Safety and Adherence to Treatment when New Anticoagulants Taking in Over 75 Years Old Patients with Atrial Fibrillation

Aim. To study the efficacy, safety, and adherence to therapy with new oral anticoagulants in patients older than 75 years with atrial fibrillation.Material and methods. Patients (n=431) over 75 years old (82.7±3.4 years) with various types of atrial fibrillation/flutter (AF) were included in a nonrandomized observational study of new oral anticoagulants (NOAC) in real clinical practice. A history of cardiac surgery was in 27.6% of patients. All patients had >3 risk factors for ischemic stroke (CHA2DS2-VASс 4.81±0.4 points) and >1 risk factor for bleeding (HAS-BLED 3.01±0.2 points). The duration of the observation study was from 12 to 42 (26.9±4.9) months. Dabigatran was taken in 38.5% (n=166) of patients, rivaroxaban – in 41.3% (n=178), apixaban – in 20.2% (n=87) of patients.Results. The incidence of new cases of myocardial infarction was 0.8% per year, surgical revascularization – 0.9% per year, cardiovascular death – 0.8% per year. The frequency of ischemic stroke was 1.1% per year, transient ischemic attacks – 0.4% per year, all thromboembolic episodes – 1.77% per year. The incidence of intracranial hemorrhage was 0.2% per year, of minor bleeding – 4.4% per year, of the combined cardiac point (the total frequency of all strokes, major bleeding, myocardial infarction, mortality from cardiovascular causes, revascularization procedures) – 4.2% per year. Significant differences in the frequency of endpoints depending on the drug of NOAC taken by patients were not found. Violations of the regimen and doses were more often observed with twice daily intake (63.9% for dabigatran and 59.8% for apixaban) than with a single dosage regimen per day (45.5% for rivaroxaban). The leading causes of non-adherence to NOAC therapy in patients over 75 years of age included skipping the next scheduled dose (43.6%) and changing the frequency of the drug taking (16.9%). For NOAC with a double dose per day, dabigatran and apixaban, the frequency of administration was violated in 27.7% and 28.7%, respectively, and with a single dose per day, rivaroxaban – in 1.1%.Conclusion. Therapy with NOAC in patients older than 75 years with AF is effective and safe. There were no statistically significant differences in the incidence of thromboembolic or hemorrhagic events during three NOACs treatment in patients with AF older than 75 years. The incidence of non-adherence was less

Assessing the level of Knowledge and attitude of the young couples about HIV in Shiraz, Iran.

Introduction: HIV infection is one of the main public health problems in the world. This study aimed to assess the knowledge and attitudes of young couples married in the city of Shiraz, and eventually suggest an Operational Program for the prevention of HIV in Iran. Method: the data collection tool was a questionnaire consisted of 32 questions on transmission and prevention of HIV infection. The young couples were selected through simple random sampling, and the sample size was The data analysis was performed using SPSS 19 software. Results: Of the total of 400 cases, 201 (50.25%) were male and 199 (49.75%) were female. The mean age of the couples was 25.96±5.95 years. The most frequent correct answer was related to the knowledge of transmission through sharing needles among drug users (87.4%). Regarding attitude, 94.6% of the subjects agreed with the struggle against HIV. Examining the relationship between knowledge and age showed that they had a significant relationship (P=0.002). There was also a significant relationship between attitude and gender (P=0.004). Conclusion: One of the important ways to stop the epidemic and prevent the incidence of new cases of HIV is educating people at an early age.

Smoking cessation for improving mental health

Smoking cessation for improving mental health

Chronic Heart Failure in Rheumatoid Arthritis Patients (Part III): Effects of Antirheumatic Drugs

Chronic autoimmune inflammation is one of the leading risk factors for the development of chronic heart failure (CHF) in rheumatoid arthritis (RA). The purpose of the review is to analyze the results of investigations on the effects of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), biological disease-modifying anti-rheumatic drugs (bDMARDs), and targeted csDMARDs on cardiac function and the risk of developing CHF in patients with RA. Methotrexate may reduce the CHF risk and have a positive effect on the course of this condition in patients with RA. Despite the data on the presence of leflunomide effects that impede myocardial remodeling, there is no evidence of the role of the drug in the prevention of CHF in RA patients. Hydroxychloroquine may contribute to the prevention of CHF, but the risk of developing severe cardiotoxicity should be considered when taking the drug for a long time. Most studies have not revealed the negative effect of tumor necrosis factor inhibitors on the prevalence and incidence of new cases of CHF in RA patients, and an improvement in the structure and function of the heart during therapy has been shown. Inhibitors of interleukin (IL) -1, inhibitors of IL-6, inhibitors of T-cell co-stimulation, anti-B-cell therapy, targeted csDMARDs do not increase the risk of CHF and may have cardioprotective effects, including slowing the progression of left ventricle myocardial dysfunction. Due to the high risk of CHF and CHF-associated mortality in RA patients, early diagnosis of cardiac dysfunction, development of a prevention and treatment strategies are needed, including high-quality prospective studies to assess the effect of anti-rheumatic therapy on myocardial function, risk of developing and decompensation of CHF in RA patients. It is possible that some drugs may possess protective effects on cardiomyocytes so they could become the first-line drugs in patients with CHF or the risk of its development.

Hydroxychloroquine: the story of one drug during the COVID-19 pandemic

<h3></h3> Новый коронавирус (SARS-CoV-2) представляет собой серьезную угрозу для общественного здравоохранения во всем мире. С момента обнаружения вируса до настоящего времени наблюдается рост заболеваемости. До сих пор не найдено ни одного препарата с доказанной противовирусной эффективностью. Многие препараты уже прошли этапы от <i>in vitro</i> исследований до рандомизированных клинических испытаний <i>in vivo</i>. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Выполнить обзор литературы по применению гидроксихлорохина для профилактики и лечения новой коронавирусной инфекции (COVID-19) за период с момента применения препарата до июня 2020 г.

Anti-PD-1 immunotherapy in advanced metastatic melanoma: State of the art and future challenges

Immunotherapy with immune checkpoint inhibitors, such as anti-PD-1 drugs, is an area in increasing development for its efficacy and advantages in the treatment of advanced metastatic melanoma. In fact, immunotherapy has been the target of several and recent studies in different types of cancer, namely in melanoma, a globally growing threat. Contributing to the increasing incidence of this cancer is climate change, particularly global warming of the past century, which has increased the tendency to spend more time outdoors and, consequently, exposure to sunlight and ultraviolet radiation. Among the most relevant risk factors for melanoma is the increase in ultraviolet radiation due to ozone layer depletion, one of the main factors responsible for the incidence of new cases. Anti-PD-1 agents like Nivolumab and Pembrolizumab allow a more effective treatment, enhancing the duration of the responses to therapy and prolonging the survival of the patient. However, recent studies about safety and tolerability have stated that, although these drugs present less adverse effects and toxicity, they may lead to specific autoimmune-mediated adverse events. Overall, immunotherapy with anti-PD-1 agents represents a highly promising area in the treatment of some types of cancer such as melanoma.

Directions for research and development of anti-tuberculosis drugs

The increasing incidence of new cases of tuberculosis, of latent forms and with multiple and extended resistance, required the acceleration of the research and elaboration of the anti-tuberculosis drugs by elucidating new targets. The main directions of study of the new compounds focused on the influence on the cell wall, the synthesis of proteins and nucleic acids, the energy metabolism, as well as on the immune status of the host. At the base of these strategies were the data regarding the structural components and the particularities of the life cycle of mycobacteria at different stages of disease evolution.

Recruitment methods in obtaining a prospective, general population cohort after environmental exposure

TPS 691: Methods of measurement, design and data analysis, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM Background: In 2013 the Tonawanda Coke Corporation was convicted of illegally releasing coke oven emissions, which include benzene and polycyclic aromatic hydrocarbons, into the environment. In response to health concerns, a prospective cohort study was designed to assess the cause-specific prevalence of morbidity and mortality in the community, to biomonitor residents for current exposures, and to ascertain incidence of new cases of disease. Other longitudinal cohort health studies have reported successful recruitment using online and digital methods, compared to traditional epidemiological methods. Methods: After completing two pilot studies on optimal recruitment methods, we used the gold-standard epidemiological approach of a repeated, mailed questionnaire, and added an online questionnaire option. We sent out a test mailing (N=2,919) followed by a full mailing (N=103,544) using the following protocol: A pre-notification postcard was mailed to every resident 18 years and older living in the catchment area. A 15-page paper questionnaire followed one week later. For non-responders, a second 15-page questionnaire was mailed after two weeks, followed by a final, shorter, 3-page questionnaire two weeks later. A link to the online questionnaire was included in each mailing, which remained open during recruitment. We mailed a $10 incentive to participants after completion. Results: As of March 2019, there were 11,997 complete and 222 partially completed questionnaires returned (N=12,219). Adjusting for bad addresses (N=12,798) yielded an overall response of 13%. Participation by postal code was proportional and representative of the local population. Among responders, 10,255 (84%) used a print questionnaire (N=1,520 returned 3-page version); 1,887 (12%) used only the online questionnaire; and 77 (0.6%) used both online and print (N=12 returned 3-page version) methods. Conclusions: Despite advantages of flexibility and mobility provided online, and the environmental savings on paper and postage, successful enumeration of the cohort was obtained through the standard epidemiological approach of mailed surveys.

Primary cutaneous melanoma: correlation between clinical and histologic aspects in a retrospective Italian study.

In Italy, the incidence of new cases of melanoma is roughly 10,000 cases per year, with an average rate of mortality of 5-6 per 100,000 population per year respectively. The objective of this retrospective study was to evaluate the epidemiological incidence of primitive melanoma, including the incidence of multiple melanomas occurring in the same patient. Furthermore, we studied all histological different types of melanoma focusing on the presence of an association nevus-melanoma. A clinical epidemiologic retrospective study from January 2010 to March 2015 was recorded. For each lesion, mitotic rate, Breslow's index, ulceration, presence of regression, vascular and perineural invasion, lymphocytic infiltrate, microsatellitosis and presence of pre-existencing nevus were also studied. Five hundred eighty primitive cutaneous melanomas (CMs) were removed from 525 patients with an incidence of 18-20 new melanomas/100,000 habitants/year. Eighty percent of these were at stage T0-1. Among other melanomas, SSM was the predominant subtype (85% of cases). Only 18 cases had lymph node metastases and 13 (2%) lymph node and/or distant metastases (stage IV) at time of diagnosis. Mitotic figures were present in 25% of cases (143 cases out of 580) without significant gender differences. The incidence of new melanomas founded is close to the CM's incidence in US population in 2016 with a high percentage of superficial melanomas highlighting the importance of prevention campaigns. The presence of melanoma on a preexisting nevus in only 16% of cases allow to conclude that this association is overestimated in literature. On the contrary the high incidence of a second melanoma in the 7% of cases in a relatively short period of survey leads to the conclusion that this data is underestimated.

Carbapenem-Resistant Enterobacteriaceae Outbreak in a Medical Ward in Spain: Epidemiology, Control Strategy, and Importance of Environmental Disinfection.

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) are a growing public health problem. We describe an outbreak by CRE and the measures to control it in a hospitalization unit in Spain. Methods: In June 2015, the system of prevention and control of CRE implemented in the hospital detected an increase in the incidence of patients with CRE in a mixed hospitalization facility (geriatrics, internal medicine, and pneumology), with the appearance of four related patients in 2 weeks, three of them being nosocomial cases. A multidisciplinary group was created and carried out: weekly screenings, general cleaning, four training sessions for personnel, two hand hygiene observation studies and environmental sampling. A higher incidence of new cases was detected in three adjoining rooms, in which environmental decontamination was performed with vaporized hydrogen peroxide. Results: In 5 months, a total of 18 cases were detected, 14 of them were nosocomial. Four different clones of Klebsiella pneumoniae OXA-48 were responsible for 83.3% of the cases. Adherence to hand hygiene increased from 36% to 85% after the training sessions. Seven percent of the environmental samples were positive for CRE in rooms with high incidence, moving to 0% after decontamination with hydrogen peroxide. Three patients died, one of them possibly associated with clinical infection due to CRE. Conclusions: Multidisciplinary information strategies, personnel training, and control of environmental reservoirs are effective to address outbreaks of CRE.

UNCHECKED HYPERPARATHYROIDISMAND VON RECKLINGHAUSEN’S DISEASE OF BONE: GREAT MIMICKER IN DIAGNOSIS

Incidence of new cases of a severe form of unchecked primary hyperparathyroidism is decreasing day by day. Here, we report the case&nbsp;of a 40-year-old female patient of primary hyperparathyroidism with a maiden visit to the hospital with multiple osteolytic lesions and&nbsp;multiple pathological fractures. The diagnosis was installed and managed accordingly.

Abstract 2013: A carbonic anhydrase inhibitor methazolamide potentiates efficacy of gemcitabine by modulating anti-proliferative activity and cancer stem cell markers in pancreatic carcinoma

Abstract Pancreatic cancer is the fourth cause for cancer related deaths globally. By 2020, incidence of new cases is expected to be 420,000 with equal number of associated mortalities. Overall 5-year survival has marginally improved over past despite of our growing understanding of the disease. Surgery remains standard of care for resectable tumors followed by adjuvant chemotherapy which resulted in median survival of 26 months. Newer therapies targeting stroma and immunotherapies hold promise for the future. Noticeably, a high unmet medical need warrant novel therapy to extend survival over a year in metastatic settings. Drug repositioning holds promise over the conventional drug discovery, as it reduces development time and cost. Using this approach, we report promising anticancer activity of Methazolamide (MZM) in pancreatic cancer. MZM, a synthetic derivative of sulphonamide and a carbonic anhydrase IX (CA) inhibitor is used for the treatment of ocular conditions for lowering intraocular pressure. Overexpression of CA is implicated in acidification of tumor microenvironment leading to hypoxia which in turn promotes growth and metastasis of the tumor. Therefore, modulation of extracellular tumor pH via inhibition of CA represents a promising course to anticancer therapy. Here, we report anti-proliferative activity of MZM in 12 pancreatic cell lines including patient derived (PDX) in 2D models and anchorage independent growth inhibition in 3D models. Combination treatment with GEM yielded significant growth inhibition than drug alone in all tested cell lines. Additive effects were observed for the combination in PDX-1986, PDX-546, Capan-2, Mia-Pa-Ca and PANC-1 cells. Further, in vivo efficacy of MZM in combination with GEM was performed using PDX-546 in nude mice. Combination group showed significant tumor growth inhibition (72%, p&amp;lt;0.05) as against drug alone, MZM at 60 mg/kg, p.o. (50%, p&amp;lt;0.05) and GEM at 50 mg/kg i.v. (61%, p&amp;lt;0.05). There was no significant body weight loss. For PK/PD studies, MZM levels were measured in tumors and PD effect was evaluated using various markers in tumor samples. Expression of target genes was measured by qRT-PCR. Significant reduction in expression of stem cell markers viz. RAC1, OCT4, CD34, CD14, Nanog and proliferation marker (Ki67) was observed in combination group as compared to drug alone. In addition, anti-angiogenic potential viz. would healing, tube formation and expression of important anti-angiogenic markers like HIF1α, VEGF were profoundly modulated in MZM and combination group. Thus, our study indicates that the combination of MZM, a CA inhibitor with GEM is a promising novel approach for the treatment of pancreatic cancer especially in metastatic settings. Citation Format: Kalpana Joshi, Jeevan D. Ghosalkar, Vinay R. Sonawane, Siddhika R. Raut, Geena Malhotra. A carbonic anhydrase inhibitor methazolamide potentiates efficacy of gemcitabine by modulating anti-proliferative activity and cancer stem cell markers in pancreatic carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2013.