Treatment Option For People Research Articles

Efficacy and Safety of Long-Acting Subcutaneous Lenacapavir in Heavily Treatment-Experienced People with Multi-Drug Resistant HIV-1: Week 104 Results of a Phase 2/3 Trial.

Lenacapavir is a long-acting HIV-1 capsid inhibitor for treatment of HIV-1 infection. We evaluated the efficacy and safety of lenacapavir in combination with an investigator-selected optimized background regimen (OBR) after 104 weeks in adults with multidrug-resistant HIV-1. This ongoing, international, Phase 2/3 trial at 42 sites included 72 adults living with multidrug-resistant HIV-1. Following a 2-week oral lenacapavir loading phase, participants received subcutaneous lenacapavir every 26 weeks with an OBR. HIV-1 RNA, CD4 cell counts, and adverse events were assessed over 104 weeks. One participant did not enter the extension phase. At Week 104, 44 of 71 participants (62%, 95% CI 50; 73) had HIV-1 RNA <50 copies/mL via US Food & Drug Administration (FDA) snapshot algorithm. When missing data (including discontinuations) were excluded, 44 of 54 participants (82%) had HIV-1 RNA <50 copies/mL at Week 104, mean CD4 cell count increased by 122 cells/µL (95% CI 80; 165), and the proportion of participants with CD4 cell count <200 cells/µL decreased from 64% (46 of 72) at Baseline to 29% (16 of 55). Fourteen participants had treatment-emergent lenacapavir resistance; seven resuppressed (HIV-1 RNA <50 copies/mL) while maintaining lenacapavir use. There were no Grade 4 or serious treatment-related adverse events. One participant discontinued study drug due to an injection site reaction. Treatment with subcutaneous lenacapavir in combination with an OBR was well tolerated and resulted in a high rate of virological suppression over 104 weeks. Lenacapavir represents an important treatment option in people with multidrug-resistant HIV-1.

Abemaciclib plus endocrine therapy for HR+, HER2-, node-positive, high-risk early breast cancer: a plain language summary of the monarchE study.

This article summarizes the most recent results of the monarchE study. This study was completed in participants with a type of breast cancer called HR+, HER2-, node-positive, high-risk early breast cancer. In this study, abemaciclib, a non-chemotherapy treatment, was administered with standard of care endocrine therapy after curative surgery. Most participants had received prior chemotherapy and/or radiotherapy. The study investigated if abemaciclib helped participants live longer without their cancer returning compared with participants who only received standard of care endocrine therapy. The study participants were assigned to 1 of 2 treatment groups. Participants in Group A were assigned to receive standard of care endocrine therapy with abemaciclib for 2years, followed by endocrine therapy for a total of at least 5years. Participants in Group B were assigned to receive standard of care endocrine therapy only for at least 5years. The effect of treatment was compared between these 2 groups. Overall, the results showed that the cancer was 34% less likely to come back after surgery in the participants in Group A (abemaciclib plus endocrine therapy) compared with those in Group B (endocrine therapy only). At 4years since the start of the study treatment, more participants who received the combination of abemaciclib plus endocrine therapy remained free of cancer compared with participants who received endocrine therapy alone (86% versus 79%). Participants who received abemaciclib plus endocrine therapy had more side effects than those who received endocrine therapy alone, but most of these effects were mild to moderate and reversible upon the end of therapy. The most common side effects in the abemaciclib group were diarrhea, infections, low number of white blood cells, and tiredness. This study found that administering abemaciclib in combination with standard endocrine therapy after curative breast surgery helped lower the risk of cancer returning in people with HR+, HER2-, node-positive, high-risk early breast cancer. Abemaciclib is a new treatment option for people with this diagnosis. People with high-risk early breast cancer should always talk to their doctors and nurses before making any decisions about their treatment.Clinical Trial Registration: NCT03155997 (monarchE study).

Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer: a plain language summary of the DESTINY-Lung01 study.

This is a summary of the publication about the DESTINY-Lung01 study, which was published in the New England Journal of Medicine in September 2021. The DESTINY-Lung01 study includes 181 adults with metastatic non-small-cell lung cancer (NSCLC) that could not be treated with surgery and who have had previous standard anticancer treatment. The publication includes information and results about 91 of the 181 study participants. These 91 participants had HER2-mutant NSCLC. Researchers wanted to learn if the drug trastuzumab deruxtecan (T-DXd) could help treat participants with HER2-mutant NSCLC. At the time of this publication, this study is ongoing. Results from the study showed that 55% of participants responded to treatment with T-DXd. The median length of time participants continued to respond to T-DXd was 9.3months.After receiving T-DXd, 92% of participants had disease control. After receiving T-DXd, half of the participants lived for at least 17.8months. After receiving T-DXd, half of the participants lived for 8.2months before their cancer got worse.During the study, 97% of participants had drug-related adverse events, with nausea being the most common. There were 20% of participants with serious drug-related adverse events. Based on these results, T-DXd could be a treatment option for people with HER2-mutant NSCLC that has been previously treated.Clinical Trial Registration: NCT03505710 (DESTINY-Lung01) (ClinicalTrials.gov).

Moving towards Normalization of haemostasis and health equity: Evolving treatment goals for haemophilia A.

Treatment options for people with haemophilia are evolving at a rapid pace and a range of prophylactic treatment options using various technologies are currently available, each with their own distinct safety and efficacy profile. The access to replacement therapy and prophylaxis has driven a dramatic reduction in mortality and resultant increase in life expectancy. Beyond this, the abolition of bleeds and preservation of joint health represent the expected, but rarely attained, goals of haemophilia treatment and care. These outcomes also do not address the complexity of health-related quality of life impacted by haemophilia and its treatment. Capitalizing on the major potential of therapeutic innovations, 'Normalization' of haemostasis, as a concept, should include the aspiration of enabling individuals to live as normal a life as possible, free from haemophilia-imposed limitations. To achieve this-being supported by the data reviewed in this manuscript-the concept of haemostatic and life Normalization needs to be explored and debated within the wider multidisciplinary teams and haemophilia community.

Identification of ethanol analgesia quantitative trait loci and candidate genes in BXD recombinant inbred mouse lines.

Alcohol consumption produces acute analgesic effects, and people experiencing pain conditions may drink alcohol to alleviate discomfort. However, tolerance to the analgesic properties of alcohol could prompt escalating consumption and dependence. Both nociception and alcohol-induced analgesia are under significant genetic control. Understanding the genetic architecture of these processes could inform better treatment options for people with pain conditions. This study aims to identify quantitative trait loci (QTL) driving variation in ethanol-induced analgesia across BXD recombinant inbred mouse lines. Male and female mice from 62 BXD strains received ethanol or saline oral gavage for five days and were tested for hot plate (HP) latency at baseline, Day 1, and Day 5. QTL mapping of HP phenotypes identified a significant provisional QTL on chromosome 17 for Day 1 HP latency in mice receiving ethanol. An additional highly suggestive QTL was present on chromosome 9 for the difference in pre- and post-ethanol thermal nociception. Candidate genes within QTL support intervals were provisionally identified using HP phenotypic correlations to transcriptomic database, expression QTL analysis, and other bioinformatics inquiries. The combined behavioral and bioinformatic analyses yielded strong ethanol analgesia candidate genes, specifically Myo6. Thus, the results of this genetic study of ethanol-induced analgesia in BXD mouse strains may contribute significantly to our understanding of the molecular basis for individual variation in the analgesic response to acute ethanol.

Liraglutide-Induced Depression with Suicidality in an Obese Adult: A Case Report

Obesity is a major health issue worldwide. Treating adults with obesity often involves lifestyle and diet changes and sometimes medication. Liraglutide is a drug that is being closely studied for treating obesity. However, the potential side effects of liraglutide, particularly its impact on mood and the development of depression, may be of concern. Given the frequent co-occurrence of obesity and depression, it is important to understand how obesity treatments like liraglutide might affect a person’s mood. A 47-year-old schoolteacher with no personal or family history of mental illness or chronic physical condition sought help for his steadily increasing weight. Despite having a sedentary job and reporting no major stress or substance use, he did not attempt to change his diet or activity level, occasionally experiencing sleep difficulties. He was overweight, with a body mass index of 42. The patient was diagnosed with adult obesity and prescribed liraglutide, diet changes, and exercise. Initially, he lost weight, but he also developed depressive symptoms, including fatigue, loss of interest, sleep disturbances, and suicidal ideation. Following cessation of liraglutide treatment, his depression symptoms got better, but his weight slightly increased. This case sheds light on the possible link between liraglutide and depression in managing obesity. It is crucial for healthcare providers to be aware of potential mental health side effects of obesity drugs like liraglutide. Although the exact reasons behind these mood changes are not fully understood, this case emphasizes the need for careful observation and decision-making in treatment. Understanding these issues can help balance the benefits and risks of liraglutide and ensure better care and treatment options for people with obesity.

Plain language summary of the CheckMate 76K study results: nivolumab given after stage 2B/2Cmelanoma is removed by surgery.

In this article, we summarize results from the ongoing phase 3 CheckMate 76K clinical study published online in Nature Medicine in October 2023. The study goal was to learn whether nivolumab works as an adjuvant therapy (that is, helps to keep cancer from coming back when it is given after surgery) for stage 2 melanoma (skin cancer) that has not spread to other parts of the body. Nivolumab is an immunotherapy that activates a person's immune system so it can destroy cancer cells. In melanoma, staging describes the severity of the cancer. Melanoma staging ranges from 0 (very thin and confined to the upper layer of the skin) to 4 (spread to distant parts of the body), with earlier stages removed by surgery. The people in this study had stage 2 melanoma that had not spread to the lymph nodes or other organs in the body. People 12years and older with stage 2 melanoma that had not spread and had been removed by surgery were included in CheckMate 76K. People were randomly assigned to receive either nivolumab (526 patients) or placebo (264 patients). A placebo resembles the test medicine but does not contain any active medicines. The researchers assessed whether people who received nivolumab lived longer without their cancer returning and/or spreading to other parts of their bodies (compared with placebo) and if nivolumab was well tolerated. Researchers found that people who received nivolumab were 58% less likely to have their cancer return and 53% less likely of having their cancer spread to distant parts of their body, compared with placebo. These reductions in risk with nivolumab were seen in different subgroups of people with a range of characteristics, and regardless of how deep the melanoma had gone into the skin. People taking nivolumab had more side effects than those taking placebo, but most were mild to moderate and manageable. Results from CheckMate 76K support the benefit of using nivolumab as a treatment option for people with stage 2 melanoma post-surgery.

Mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of fostemsavir

The Food and Drug Administration (FDA) has licensed many antiretroviral medications to treat human immunodeficiency virus type 1 (HIV-1), however, treatment options for people with multi-drug resistant HIV remain limited. Medication resistance, undesirable effects, prior tolerance, and previous interlacement incapacity to deliver new drug classes all lead to the requirement for new medication classes and drug combination therapy. Fostemsavir (FTR) is a new CD-4 attachment inhibitor medicine that was recently authorized by the United States FDA to treat HIV-1. In individuals with multidrug-resistant (MDR) HIV-1, FTR is well tolerated and virologically active. According to recent investigations, drug combination therapy can positively affect MDR-HIV. The mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of FTR has been highlighted in this review.

A plain language summary of the PHAROS study: the combination of encorafenib and binimetinib for people with BRAF V600E-mutant metastatic non-small-cell lung cancer.

This is a summary of the results of a study called PHAROS. This study looked at combination treatment with encorafenib (BRAFTOVI®) and binimetinib (MEKTOVI®). This combination of medicines was studied in people with metastatic non-small-cell lung cancer (NSCLC). NSCLC is the most common type of lung cancer. Metastatic means that the cancer has spread to other parts of the body. All people in this study had a type of NSCLC that has a change in a gene called BRAF termed a BRAF V600E mutation. A gene is a part of the DNA that has instructions for making things that your body needs to work, and the BRAF V600E mutation contributes to the growth of the lung cancer. In this study, 98 people with BRAF V600E-mutant metastatic NSCLC were treated with the combination of encorafenib and binimetinib (called encorafenib plus binimetinib in this summary). Before starting the study, 59 people had not received any treatment for their metastatic NSCLC, and 39 people had received previous anticancer treatment. At the time of this analysis, 44 (75%) out of 59 people who did not receive any treatment before taking encorafenib plus binimetinib had their tumors shrink or disappear. Eighteen (46%) out of 39 people who had received treatment before starting encorafenib plus binimetinib also had their tumors shrink or disappear. The most common side effects of encorafenib plus binimetinib were nausea, diarrhea, fatigue, and vomiting. These results support the use of encorafenib plus binimetinib combination treatment as a new treatment option in people with BRAF V600E-mutant metastatic NSCLC. The side effects of encorafenib plus binimetinib in this study were similar to the side effects seen with encorafenib plus binimetinib in people with a type of skin cancer called metastatic melanoma.

Two studies to learn if avacincaptad pegol works and is safe in people with geographic atrophy: a plain language summary of the GATHER1 and GATHER 2 studies.

This is a summary of two publications. One publication is about the GATHER1 study, which was published in the journal Ophthalmology in 2021. The other publication is about the GATHER2 study, which was published in the journal The Lancet in 2023. Both studies included adult participants with geographic atrophy (GA). GA is an advanced form of dry age-related macular degeneration (dry AMD). The participants in both studies each received treatment in one of their eyes. In both studies, the researchers wanted to learn if avacincaptad pegol (ACP) could help to slow the worsening of the participants' GA over time. In these studies, the researchers found that ACP helped to slow the growth of the GA area in the participants' eyes compared with a sham injection. Participants who received ACP had a similar ability to read differently sized letters on a chart 1year after treatment compared with participants who received no ACP through a sham injection. In the GATHER1 study, none of the participants had serious medical problems in the eye that received the injection. In the GATHER2 study, 2 out of 225 participants (less than 1%) who received ACP had serious medical problems in the eye that received the injection. In the group who received the sham injection, 2 out of the 222 participants (less than 1%) had serious medical problems in the eye that received the sham injection. ACP could be a treatment option for people with GA. The results from several studies are needed to decide which treatments work best and are safest. Other studies may provide new information or different results. Always talk to a doctor before making any treatment changes.

The Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19): Italian language translation and validation.

Epilepsy surgery can be proposed as a treatment option in people with focal epilepsy, however satisfaction with epilepsy surgery in Italy remains unknown. We aimed to validate in Italy an instrument to measure patient satisfaction with epilepsy surgery, the 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19). Consecutive patients with epilepsy who received epilepsy surgery between the years 2018-2021 at Modena Academic Hospital were recruited and provided clinical and demographic data. The Italian version of the ESSQ-19 and other three questionnaires were completed to assess construct validity. To evaluate the validity and reliability of the tool Spearman's rank correlation, and internal consistency analysis were performed. 66 out of 79 eligible patients participated in the study (22 females; median age 37years). The mean values of satisfaction for each domain of the IT-ESSQ-19 were: seizure control 83.4; (SD 16.7), psychosocial functioning 79.3 (SD 17.1), surgical complications 90.8 (SD 14.9), and recovery from surgery 81.4 (SD 16.9). The mean summary score was 83.7 (SD 13.3). The questionnaire was shown to have high internal consistency in the four domains (Cronbach's alpha = 0.82-0.93), and no significant floor/ceiling effects of the summary score. The ESSQ-19 scores significantly correlated with other instruments to support construct validity. It also demonstrated good discriminant validity for being seizure free [AUC 0.72; 95% CI = 0.56-0.88], and to endorse depression [AUC 0.76, 95% CI = 0.56-0.96]. The Italian version of the ESSQ-19 is a reliable and valid self-reported questionnaire for assessing patient satisfaction with epilepsy surgery.

Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer: a plain language summary of the DESTINY-Breast03 study.

This is a summary of a publication about the DESTINY-Breast03 study, which was published in the New England Journal of Medicine in March 2022. The study included 524 adults with advanced breast cancer that is HER2-positive, which means it has high levels of a protein called HER2. All of the participants in this study had their cancer worsen after previously receiving treatment. The treatment that was previously given to participants was a combination of a drug called trastuzumab with a type of chemotherapy called a taxane. The researchers wanted to know whether a drug called trastuzumab deruxtecan (T-DXd) could improve participants' cancer more than the standard treatment. The standard treatment is a drug called trastuzumab emtansine (T-DM1). The researchers looked at the results of this study before it was finished. This is a summary of those results. Researchers in this study found that the risk of dying or the participants' cancer getting worse was reduced by 72% in the T-DXd group compared with the T-DM1 group. This is also called progression-free survival. 79.7% of participants in the T-DXd group had their tumors shrink significantly or disappear, compared to 34.2% of those in the T-DM1 group. During the study, 10.9% of participants who received T-DXd had serious drug-related medical problems, compared to 6.1% who received T-DM1. Of the participants who received T-DXd, 10.5% experienced drug-related interstitial lung disease (ILD) or pneumonitis, compared to 1.9% of those who received T-DM1. ILD and pneumonitis are potentially serious lung problems. When the researchers first looked at the results, they could not yet be certain that T-DXd helped participants survive longer overall than T-DM1. But, when they looked at the results later in the study, they found that T-DXd did help participants to survive longer overall than T-DM1. These newer results were published separately and are not part of this summary. A link to more information about the newer results can be found at the end of this summary. T-DXd gave participants a meaningful benefit overall compared to T-DM1. T-DXd could be a treatment option for people with advanced HER2-positive breast cancer that has been previously treated. Clinical Trial Registration: NCT03529110 (DESTINY-Breast03) (ClinicalTrials.gov).

Recent guidelines addressing chronic rhinosinusitis with nasal polyps: practical aspects.

Chronic rhinosinusitis (CRS) is common in adults. It is diagnosed based on a high index of suspicion alongside objective means of assessing sinus inflammation. Determining the impact of CRS on patient quality of life is an important starting point for discussions regarding treatment, and is critical for longitudinal assessment of response to specific treatments. CRS can be further categorized by the presence or absence of nasal polyps. Recent Joint Task Force on Practice Parameters Grading of Recommendations Assessment, Development, and Evaluation guidelines for the management of CRS with nasal polyps (CRSwNP) focused on 3 treatment options: intranasal corticosteroids with multiple delivery methods, biologics (monoclonal antibodies targeting type 2 inflammation), and aspirin therapy after desensitization, which only applies to the subset of patients with CRSwNP who experience acute respiratory reactions following nonsteroidal anti‑inflammatory drug ingestion. The authors of the guidelines made conditional recommendations in favor of each of these 3 treatment options, highlighting the importance of shared decision‑making when choosing appropriate therapy for individuals with CRSwNP.

Use of Virtual Reality in Interdisciplinary Multimodal Pain Treatment With Insights From Health Care Professionals and Patients: Action Research Study.

Chronic pain is a widespread global health problem. Interdisciplinary multimodal pain treatment (IMPT) is a treatment option for people with chronic pain. Virtual reality (VR) could be used to broaden IMPT programs. However, despite the advantages of VR, it is rarely used in daily clinical practice. This research aimed to explore how, when, and with whom VR can be used meaningfully during IMPT, either as an addition or substitution as a component of IMPT. This research used an action research design to help health care professionals and patients learn how, when, and with whom they can use VR. Data were collected through reflection sessions with health care professionals and semistructured interviews with patients in 2 specialized centers that provide IMPT for chronic pain. Two researchers performed direct content analyses. In total, 4 physiotherapists, 1 occupational therapist, 3 psychologists, and 22 patients participated in this research. Three iteration cycles, including 9 reflection sessions and 8 semistructured interviews, were performed. Both health care professionals and patients considered VR to be useful in therapy as an addition but not a substitution. VR was used as a diagnostic and intervention tool with all patients at the rehabilitation center or home. VR was used to gain insight into patients' pain beliefs, cognitions, and irrational cognitions about additional damage and physical abilities. Considering VR as an intervention tool, the health care professionals had 3 goals: balancing relaxation and competition, grading activities, and exposure in vivo. VR could be a valuable addition to IMPT for both patients with chronic pain and health care professionals. More research should be performed to assess the additional effects of VR on patients' participation in daily life.

Plain language summary of erdafitinib in locally advanced or metastatic urothelial carcinoma: a phase 2 study with long-term follow-up.

This is a plain language summary of two articles describing the results from a study called BLC2001. The study examined the effect of a medication called erdafitinib on participants with a type of cancer known as urothelial carcinoma that had either spread beyond the bladder or urinary tract into surrounding organs and/or nearby muscles (locally advanced) and was not removable by surgery (unresectable) or had spread to other parts of the body (metastatic). In this study, researchers wanted to learn if erdafitinib was safe and effective at stopping or reducing tumor growth in participants with locally advanced and unresectable or metastatic urothelial carcinoma with certain genetic alterations (changes in DNA sequence) in two related genes called fibroblast growth factor receptor 2 (FGFR2) and 3 (FGFR3). Treatment options for people with this disease are very limited; some may not have responded to other therapies, or their tumors continued to grow after they received other treatments. 212 participants took part in the study. 111 participants were treated with oral (by mouth) erdafitinib at different doses to find a recommended dose regimen. 101 additional participants then received the recommended starting dose of erdafitinib at 8mg daily with possible increase to 9mg daily, these participants make up the 8mg regimen group. Researchers found that tumors decreased in size or completely disappeared in 40% of participants. With approximately 1year of follow-up, an estimated 55% of participants were still alive, and after 2years, an estimated 31% of participants were still alive. Common side effects of erdafitinib included high phosphate levels in the blood (hyperphosphatemia), an inflamed and sore mouth, diarrhea, and dry mouth. Participants had locally advanced and unresectable or metastatic urothelial carcinoma with certain FGFR gene alterations that had been treated with erdafitinib after previous chemotherapy and/or a type of medicine that uses the immune system to help the body fight cancer (immunotherapy). The BLC2001 study found that some participants treated with 8mg erdafitinib had the benefit of a longer period without their cancer growing or spreading to other parts of the body. About 80% of participants achieved some level of disease control where their tumor shrank or remained stable.

Trastuzumab deruxtecan in previously treated HER2-positive gastric cancer: a plain language summary of the DESTINY-Gastric01 study.

This is a summary of the publication about the DESTINY-Gastric01 study, which was published in the New England Journal of Medicine in May 2020. The study included 187 adults in Japan and South Korea with gastric cancer or gastroesophageal junction cancer that had high levels of a protein called HER2 (HER2-positive). All the participants' cancer had spread to nearby or distant parts of the body and had worsened after receiving at least 2 previous cancer treatments or treatment combinations. The researchers wanted to know whether a drug called trastuzumab deruxtecan (T-DXd) could improve participants' cancer more than standard chemotherapy drugs. Researchers in this study found that just over half (51%) of participants who received T-DXd had their cancer shrink significantly or disappear, compared to around 1 out of 7 participants (14%) who received standard chemotherapy. In addition, T-DXd reduced the risk of death by 41% compared to standard chemotherapy. Half of the participants who received T-DXd had died after 12.5months. Half of the participants who received standard chemotherapy had died after 8.4months. Just under half (44%) of participants who received T-DXd had serious medical problems during the study, also called serious adverse events, compared to about a quarter (24%) of participants who received standard chemotherapy. Of the participants who received T-DXd, 1 out of 10 (10%) got interstitial lung disease or pneumonitis that was potentially related to the study treatment. None of the participants who received standard chemotherapy got interstitial lung disease or pneumonitis. T-DXd could be a treatment option for people who have HER2-positive gastric cancer that has been previously treated without success.

Budget impact of introducing oral semaglutide to the public healthcare benefit package in Saudi Arabia

BackgroundThe Kingdom of Saudi Arabia (KSA) has embarked on a Health Sector Transformation Program as part of the Kingdom’s Vision 2030 initiatives with the facilitation of access to healthcare services for the millions in KSA with diabetes an essential part of the Program. Decision-making tools, such as budget impact models, are required to consider the addition of new medications like oral semaglutide that have multifaceted health benefits and address barriers related to therapeutic inertia to reduce diabetes-related complications.ObjectiveTo determine the financial impact of the introduction of oral semaglutide as a treatment option for people with type 2 diabetes mellitus (T2DM) in KSA.MethodsFrom the public payer’s perspective, the budget impact model estimates the costs before and after the introduction of oral semaglutide over a 5-year time horizon. The budget impact of introducing oral semaglutide (primary comparator) compared with three different classes of diabetes medicines: glucagon-like peptide-1 receptor agonists (GLP-1), sodium-glucose transport protein 2 inhibitors (SGLT 2i) and dipeptidyl peptidase 4 inhibitors (DDP-4i) have been calculated based on the projected market shares. The model includes the cost of care through the incorporation of health outcomes that have an impact on the national payer’s budget in Saudi Riyals (SAR).ResultsThe budget impact over the five-year time horizon indicates a medication cost increase (17,424,788 SAR), and cost offsets which include a difference in diabetes management costs (-3,625,287 SAR), CV complications costs (-810,733 SAR) and weight loss savings of 453,936 SAR. The cumulative total cost difference is 12,427,858 SAR (0.66%).ConclusionThe introduction of oral semaglutide 14 mg as a second-line treatment option after metformin is indicated as budget-neutral to slightly budget-inflating for the public pharmaceutical formulary of KSA. The price difference is offset by positive health outcomes and costs. This conclusion was confirmed through a probabilistic sensitivity analysis.

Are Advanced Clinical Practitioners perfectly placed to re-report neuroimages to support clinical diagnosis of dementia?

With the ageing population, the prevalence of dementia is increasing worldwide. There is an emphasis on early, timely diagnosis and treatment options for people with a dementia yet wait times from referral to diagnosis have increased. Neuroimaging performed by radiologists is utilised to support dementia diagnosis and some patients will already have a CT scan from a pre-existing condition such as stroke. The purpose of this commentary is to consider whether ACPs who specialise in dementia, are perfectly placed to re-report on pre-existing neuroimages to support the clinical diagnosis of dementia.

Plain language summary of the TOPAZ-1 study: durvalumab and chemotherapy for advanced biliary tract cancer.

This is a summary describing the results of a Phase III study called TOPAZ-1. The study looked at treatment with durvalumab (a type of immunotherapy) and chemotherapy to treat participants with advanced biliary tract cancer (BTC). Advanced BTC is usually diagnosed at late stages of disease, when it cannot be cured by surgery. This study included participants with advanced BTC who had not received previous treatment, or had their cancer come back at least 6months after receiving treatment or surgery that aimed to cure their disease. Participants received treatment with durvalumab and chemotherapy or placebo and chemotherapy. The aim of this study was to find out if treatment with durvalumab and chemotherapy could increase the length of time that participants with advanced BTC lived, compared with placebo and chemotherapy. Participants who took durvalumab and chemotherapy had a 20% lower chance of experiencing death at any point in the study compared with participants who received placebo and chemotherapy. The side effects experienced by participants were similar across treatment groups, and less than 12% of participants in either treatment group had to stop treatment due to treatment-related side effects. Overall, these results support durvalumab and chemotherapy as a new treatment option for people with advanced BTCs. Based on the results of this study, durvalumab is now approved for the treatment of adults with advanced BTCs in combination with chemotherapy by government organizations in Europe, the United States and several other countries.

When Familiar Faces Seem Unknown: Face Blindness

Think about the people in your life whose faces you could pick out in a crowd. It might surprise you to learn that some people are unable to recognize faces—even the faces of people they see often like their friends, family, and teachers. This happens with a condition called prosopagnosia, which is also known as face blindness. Prosopagnosia affects one’s ability to understand facial expressions, judge someone’s age or gender, and follow where people are looking. The fusiform face area (FFA) is a part of the brain that is responsible for facial recognition. When the FFA is underdeveloped or becomes damaged, it can lead to prosopagnosia. Currently, there is no treatment for prosopagnosia, but people affected by this condition can practice relying on other cues like sounds and smells to help them recognize others. Researchers are looking into treatment options for people with prosopagnosia.