Key clinical point: Disease burden of atopic dermatitis (AD) is associated with multiple factors, with the strongest association being with disease severity, time spent managing AD symptoms, and comorbid depression.

Major finding: Disease burden was strongly associated with AD severity (moderate: odds ratio [OR] 4.13; 95% CI 2.94-5.79 or severe: OR 13.63; 95% CI 8.65-21.5 vs mild AD), time spent managing AD symptoms (11-20 hours/week: OR 2.67; 95% CI 1.77-4.03 or ≥21 hours/week: OR 5.34; 95% CI 3.22-8.85 vs 0-4 hours/week), and comorbid depression (OR 1.44; 95% CI 1.04-2.00).

Study details: Findings are from a survey study that analyzed the responses of 1065 adults with mostly moderate or severe AD.

Disclosures: This study was partly supported by National Eczema Association. The authors declared serving as fiscal agents or receiving grants, sponsorships, honoraria, or other compensation from several sources, including the National Eczema Association.

Source: Elsawi R et al. The multidimensional burden of atopic dermatitis among adults: Results from a large national survey. JAMA Dermatol. 2022 (Jun 29). Doi: 10.1001/jamadermatol.2022.1906

Key clinical point: Disease burden of atopic dermatitis (AD) is associated with multiple factors, with the strongest association being with disease severity, time spent managing AD symptoms, and comorbid depression.

Major finding: Disease burden was strongly associated with AD severity (moderate: odds ratio [OR] 4.13; 95% CI 2.94-5.79 or severe: OR 13.63; 95% CI 8.65-21.5 vs mild AD), time spent managing AD symptoms (11-20 hours/week: OR 2.67; 95% CI 1.77-4.03 or ≥21 hours/week: OR 5.34; 95% CI 3.22-8.85 vs 0-4 hours/week), and comorbid depression (OR 1.44; 95% CI 1.04-2.00).

Study details: Findings are from a survey study that analyzed the responses of 1065 adults with mostly moderate or severe AD.

Disclosures: This study was partly supported by National Eczema Association. The authors declared serving as fiscal agents or receiving grants, sponsorships, honoraria, or other compensation from several sources, including the National Eczema Association.

Source: Elsawi R et al. The multidimensional burden of atopic dermatitis among adults: Results from a large national survey. JAMA Dermatol. 2022 (Jun 29). Doi: 10.1001/jamadermatol.2022.1906

Key clinical point: Disease burden of atopic dermatitis (AD) is associated with multiple factors, with the strongest association being with disease severity, time spent managing AD symptoms, and comorbid depression.

Major finding: Disease burden was strongly associated with AD severity (moderate: odds ratio [OR] 4.13; 95% CI 2.94-5.79 or severe: OR 13.63; 95% CI 8.65-21.5 vs mild AD), time spent managing AD symptoms (11-20 hours/week: OR 2.67; 95% CI 1.77-4.03 or ≥21 hours/week: OR 5.34; 95% CI 3.22-8.85 vs 0-4 hours/week), and comorbid depression (OR 1.44; 95% CI 1.04-2.00).

Study details: Findings are from a survey study that analyzed the responses of 1065 adults with mostly moderate or severe AD.

Disclosures: This study was partly supported by National Eczema Association. The authors declared serving as fiscal agents or receiving grants, sponsorships, honoraria, or other compensation from several sources, including the National Eczema Association.

Source: Elsawi R et al. The multidimensional burden of atopic dermatitis among adults: Results from a large national survey. JAMA Dermatol. 2022 (Jun 29). Doi: 10.1001/jamadermatol.2022.1906

INDIANAPOLIS – When adolescents present with acne that is not responding to isotretinoin, make sure to ask if they’re taking the medication when eating fatty food – which is known to increase the drug’s bioavailability, advises James R. Treat, MD, a pediatric dermatologist at Children’s Hospital of Philadelphia.

“We see lots of teenagers who are on a restrictive diet,” which is “certainly one reason they could be failing isotretinoin,” Dr. Treat said at the annual meeting of the Society for Pediatric Dermatology.

Often, patients say that they have been referred to him because they had no response to 20 mg or 30 mg per day of isotretinoin. But after a dose escalation to 60 mg per day, their acne worsened.

If the patient’s acne is worsening with a cystic flare, “tripling the dose of isotretinoin is not something that you should do,” Dr. Treat said. “You should lower the dose and consider adding steroids.” For evidence-based recommendations on managing acne fulminans, he recommended an article published in the Journal of the American Academy of Dermatology in 2017.

Skin picking is another common reason for failure of isotretinoin, as well as with other acne therapies. These patients may have associated anxiety, which “might be a contraindication or at least something to consider before you put them on isotretinoin,” he noted.

In his experience, off-label use of N-acetylcysteine, an antioxidant and cysteine prodrug, has been “extremely effective” for patients with excoriation disorder. In a randomized trial of adults 18-60 years of age, 47% patients who took 1,200-3,000 mg per day doses of N-acetylcysteine for 12 weeks reported that their skin picking was much or very much improved, compared to 19% of those who took placebo (P = .03). The authors wrote that N-acetylcysteine “increases extracellular levels of glutamate in the nucleus accumbens,” and that these results support the hypothesis that “pharmacologic manipulation of the glutamate system may target core symptoms of compulsive behaviors.”

The tumor necrosis factor (TNF)-alpha blocker adalimumab is a reasonable option for patients with severe cystic inflammatory acne who fail isotretinoin, Dr. Treat said. In one published case, clinicians administered adalimumab 40 mg every other week for a 16-year-old male patient who received isotretinoin for moderate acne vulgaris, which caused sudden development of acne fulminans and incapacitating acute sacroiliitis with bilateral hip arthritis. Inflammatory lesions started to clear in 1 month and comedones improved by 3 months of treatment. Adalimumab was discontinued after 1 year and the patient remained clear.

“There are now multiple reports as well as some case series showing TNF-alpha agents causing clearance of acne,” said Dr. Treat, who directs the hospital’s pediatric dermatology fellowship program. A literature review of adalimumab, etanercept, and infliximab for treatment-resistant acne found that all agents had similar efficacy after 3-6 months of therapy. “We see this in our GI population, where TNF-alpha agents are helping their acne also,” he said. “We just have to augment it with some topical medications.”

Certain medications can drive the development of acne, including phenytoin, phenobarbital, lithium, MEK inhibitors, EGFR inhibitors, systemic steroids, and unopposed progesterone contraceptives. Some genetic conditions also predispose patients to acne, including mutations in the NCSTN gene and trisomy 13.

Dr. Treat discussed one of his patients with severe acne who had trisomy 13. The patient failed 12 months of doxycycline and amoxicillin in combination with a topical retinoid. He also failed low- and high-dose isotretinoin in combination with prednisone, as well as oral dapsone at a dose of 1 mg/kg per day for 3 months. He was started on adalimumab, but that was stopped after he flared. The patient is now maintained on ustekinumab monthly at a dose of 45 mg.

“I’ve only had a few patients where isotretinoin truly has failed,” Dr. Treat said. He described one patient with severe acne who had a hidradenitis-like appearance in his axilla and groin. “I treated with isotretinoin very gingerly in the beginning, [but] he flared significantly. I had given him concomitant steroids from the very beginning and transitioned to multiple different therapies – all of which failed.”

Next, Dr. Treat tried a course of systemic dapsone, and the patient responded nicely. “As an anti-inflammatory agent, dapsone is very reasonable” to consider, he said. “It’s something to add to your armamentarium.”

Dr. Treat disclosed that he is a consultant for Palvella and Regeneron. He has ownership interests in Matinas Biopharma Holdings, Axsome, Sorrento, and Amarin.

INDIANAPOLIS – When adolescents present with acne that is not responding to isotretinoin, make sure to ask if they’re taking the medication when eating fatty food – which is known to increase the drug’s bioavailability, advises James R. Treat, MD, a pediatric dermatologist at Children’s Hospital of Philadelphia.

“We see lots of teenagers who are on a restrictive diet,” which is “certainly one reason they could be failing isotretinoin,” Dr. Treat said at the annual meeting of the Society for Pediatric Dermatology.

Often, patients say that they have been referred to him because they had no response to 20 mg or 30 mg per day of isotretinoin. But after a dose escalation to 60 mg per day, their acne worsened.

If the patient’s acne is worsening with a cystic flare, “tripling the dose of isotretinoin is not something that you should do,” Dr. Treat said. “You should lower the dose and consider adding steroids.” For evidence-based recommendations on managing acne fulminans, he recommended an article published in the Journal of the American Academy of Dermatology in 2017.

Skin picking is another common reason for failure of isotretinoin, as well as with other acne therapies. These patients may have associated anxiety, which “might be a contraindication or at least something to consider before you put them on isotretinoin,” he noted.

In his experience, off-label use of N-acetylcysteine, an antioxidant and cysteine prodrug, has been “extremely effective” for patients with excoriation disorder. In a randomized trial of adults 18-60 years of age, 47% patients who took 1,200-3,000 mg per day doses of N-acetylcysteine for 12 weeks reported that their skin picking was much or very much improved, compared to 19% of those who took placebo (P = .03). The authors wrote that N-acetylcysteine “increases extracellular levels of glutamate in the nucleus accumbens,” and that these results support the hypothesis that “pharmacologic manipulation of the glutamate system may target core symptoms of compulsive behaviors.”

The tumor necrosis factor (TNF)-alpha blocker adalimumab is a reasonable option for patients with severe cystic inflammatory acne who fail isotretinoin, Dr. Treat said. In one published case, clinicians administered adalimumab 40 mg every other week for a 16-year-old male patient who received isotretinoin for moderate acne vulgaris, which caused sudden development of acne fulminans and incapacitating acute sacroiliitis with bilateral hip arthritis. Inflammatory lesions started to clear in 1 month and comedones improved by 3 months of treatment. Adalimumab was discontinued after 1 year and the patient remained clear.

“There are now multiple reports as well as some case series showing TNF-alpha agents causing clearance of acne,” said Dr. Treat, who directs the hospital’s pediatric dermatology fellowship program. A literature review of adalimumab, etanercept, and infliximab for treatment-resistant acne found that all agents had similar efficacy after 3-6 months of therapy. “We see this in our GI population, where TNF-alpha agents are helping their acne also,” he said. “We just have to augment it with some topical medications.”

Certain medications can drive the development of acne, including phenytoin, phenobarbital, lithium, MEK inhibitors, EGFR inhibitors, systemic steroids, and unopposed progesterone contraceptives. Some genetic conditions also predispose patients to acne, including mutations in the NCSTN gene and trisomy 13.

Dr. Treat discussed one of his patients with severe acne who had trisomy 13. The patient failed 12 months of doxycycline and amoxicillin in combination with a topical retinoid. He also failed low- and high-dose isotretinoin in combination with prednisone, as well as oral dapsone at a dose of 1 mg/kg per day for 3 months. He was started on adalimumab, but that was stopped after he flared. The patient is now maintained on ustekinumab monthly at a dose of 45 mg.

“I’ve only had a few patients where isotretinoin truly has failed,” Dr. Treat said. He described one patient with severe acne who had a hidradenitis-like appearance in his axilla and groin. “I treated with isotretinoin very gingerly in the beginning, [but] he flared significantly. I had given him concomitant steroids from the very beginning and transitioned to multiple different therapies – all of which failed.”

Next, Dr. Treat tried a course of systemic dapsone, and the patient responded nicely. “As an anti-inflammatory agent, dapsone is very reasonable” to consider, he said. “It’s something to add to your armamentarium.”

Dr. Treat disclosed that he is a consultant for Palvella and Regeneron. He has ownership interests in Matinas Biopharma Holdings, Axsome, Sorrento, and Amarin.

INDIANAPOLIS – When adolescents present with acne that is not responding to isotretinoin, make sure to ask if they’re taking the medication when eating fatty food – which is known to increase the drug’s bioavailability, advises James R. Treat, MD, a pediatric dermatologist at Children’s Hospital of Philadelphia.

“We see lots of teenagers who are on a restrictive diet,” which is “certainly one reason they could be failing isotretinoin,” Dr. Treat said at the annual meeting of the Society for Pediatric Dermatology.

Often, patients say that they have been referred to him because they had no response to 20 mg or 30 mg per day of isotretinoin. But after a dose escalation to 60 mg per day, their acne worsened.

If the patient’s acne is worsening with a cystic flare, “tripling the dose of isotretinoin is not something that you should do,” Dr. Treat said. “You should lower the dose and consider adding steroids.” For evidence-based recommendations on managing acne fulminans, he recommended an article published in the Journal of the American Academy of Dermatology in 2017.

Skin picking is another common reason for failure of isotretinoin, as well as with other acne therapies. These patients may have associated anxiety, which “might be a contraindication or at least something to consider before you put them on isotretinoin,” he noted.

In his experience, off-label use of N-acetylcysteine, an antioxidant and cysteine prodrug, has been “extremely effective” for patients with excoriation disorder. In a randomized trial of adults 18-60 years of age, 47% patients who took 1,200-3,000 mg per day doses of N-acetylcysteine for 12 weeks reported that their skin picking was much or very much improved, compared to 19% of those who took placebo (P = .03). The authors wrote that N-acetylcysteine “increases extracellular levels of glutamate in the nucleus accumbens,” and that these results support the hypothesis that “pharmacologic manipulation of the glutamate system may target core symptoms of compulsive behaviors.”

The tumor necrosis factor (TNF)-alpha blocker adalimumab is a reasonable option for patients with severe cystic inflammatory acne who fail isotretinoin, Dr. Treat said. In one published case, clinicians administered adalimumab 40 mg every other week for a 16-year-old male patient who received isotretinoin for moderate acne vulgaris, which caused sudden development of acne fulminans and incapacitating acute sacroiliitis with bilateral hip arthritis. Inflammatory lesions started to clear in 1 month and comedones improved by 3 months of treatment. Adalimumab was discontinued after 1 year and the patient remained clear.

“There are now multiple reports as well as some case series showing TNF-alpha agents causing clearance of acne,” said Dr. Treat, who directs the hospital’s pediatric dermatology fellowship program. A literature review of adalimumab, etanercept, and infliximab for treatment-resistant acne found that all agents had similar efficacy after 3-6 months of therapy. “We see this in our GI population, where TNF-alpha agents are helping their acne also,” he said. “We just have to augment it with some topical medications.”

Certain medications can drive the development of acne, including phenytoin, phenobarbital, lithium, MEK inhibitors, EGFR inhibitors, systemic steroids, and unopposed progesterone contraceptives. Some genetic conditions also predispose patients to acne, including mutations in the NCSTN gene and trisomy 13.

Dr. Treat discussed one of his patients with severe acne who had trisomy 13. The patient failed 12 months of doxycycline and amoxicillin in combination with a topical retinoid. He also failed low- and high-dose isotretinoin in combination with prednisone, as well as oral dapsone at a dose of 1 mg/kg per day for 3 months. He was started on adalimumab, but that was stopped after he flared. The patient is now maintained on ustekinumab monthly at a dose of 45 mg.

“I’ve only had a few patients where isotretinoin truly has failed,” Dr. Treat said. He described one patient with severe acne who had a hidradenitis-like appearance in his axilla and groin. “I treated with isotretinoin very gingerly in the beginning, [but] he flared significantly. I had given him concomitant steroids from the very beginning and transitioned to multiple different therapies – all of which failed.”

Next, Dr. Treat tried a course of systemic dapsone, and the patient responded nicely. “As an anti-inflammatory agent, dapsone is very reasonable” to consider, he said. “It’s something to add to your armamentarium.”

Dr. Treat disclosed that he is a consultant for Palvella and Regeneron. He has ownership interests in Matinas Biopharma Holdings, Axsome, Sorrento, and Amarin.

Key clinical point: Use of beta-adrenergic receptor blockers is associated with prolonged survival in patients with hepatocellular carcinoma (HCC).

Major finding: Beta-blocker use was associated with better overall survival (hazard ratio 0.69; P  =  .0031), with no significant heterogeneity across studies (I²  =  41%; P  =  .18).

Study details: The data come from a meta-analysis of 3 cohort studies involving 5148 patients with HCC that analyzed the association between the use of beta-blockers (including propranolol) and overall survival of the patients.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Chang H and Lee SH. Beta-adrenergic receptor blockers and hepatocellular carcinoma survival: A systemic review and meta-analysis. Clin Exp Med. 2022 (Jun 23). Doi: 10.1007/s10238-022-00842-z

Key clinical point: Use of beta-adrenergic receptor blockers is associated with prolonged survival in patients with hepatocellular carcinoma (HCC).

Major finding: Beta-blocker use was associated with better overall survival (hazard ratio 0.69; P  =  .0031), with no significant heterogeneity across studies (I²  =  41%; P  =  .18).

Study details: The data come from a meta-analysis of 3 cohort studies involving 5148 patients with HCC that analyzed the association between the use of beta-blockers (including propranolol) and overall survival of the patients.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Chang H and Lee SH. Beta-adrenergic receptor blockers and hepatocellular carcinoma survival: A systemic review and meta-analysis. Clin Exp Med. 2022 (Jun 23). Doi: 10.1007/s10238-022-00842-z

Key clinical point: Use of beta-adrenergic receptor blockers is associated with prolonged survival in patients with hepatocellular carcinoma (HCC).

Major finding: Beta-blocker use was associated with better overall survival (hazard ratio 0.69; P  =  .0031), with no significant heterogeneity across studies (I²  =  41%; P  =  .18).

Study details: The data come from a meta-analysis of 3 cohort studies involving 5148 patients with HCC that analyzed the association between the use of beta-blockers (including propranolol) and overall survival of the patients.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Chang H and Lee SH. Beta-adrenergic receptor blockers and hepatocellular carcinoma survival: A systemic review and meta-analysis. Clin Exp Med. 2022 (Jun 23). Doi: 10.1007/s10238-022-00842-z

Key clinical point: First-line lenvatinib plus idarubicin-loaded drug-eluting bead transarterial chemoembolization (IDADEB-TACE) is safe and offers a better safety profile than lenvatinib alone in patients with advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving lenvatinib plus IDADEB-TACE vs lenvatinib alone had a significantly higher objective response rate (57.7% vs 25.7%; P < .001), longer median overall survival (15.7 vs 11.3 months; hazard ratio 0.50; P < .001), and comparable toxicity profile, with most adverse events being mild and manageable.

Study details: Findings are from a multicenter, retrospective cohort study that propensity-score matched patients with advanced HCC who received lenvatinib plus IDADEB-TACE (n = 78) with those who received lenvatinib alone (n = 78).

Disclosures: This study was sponsored by the National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Fan W et al. Idarubicin-loaded DEB-TACE plus lenvatinib versus lenvatinib for patients with advanced hepatocellular carcinoma: A propensity score-matching analysis. Cancer Med. 2022 (Jun 13). Doi: 10.1002/cam4.4937

Key clinical point: First-line lenvatinib plus idarubicin-loaded drug-eluting bead transarterial chemoembolization (IDADEB-TACE) is safe and offers a better safety profile than lenvatinib alone in patients with advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving lenvatinib plus IDADEB-TACE vs lenvatinib alone had a significantly higher objective response rate (57.7% vs 25.7%; P < .001), longer median overall survival (15.7 vs 11.3 months; hazard ratio 0.50; P < .001), and comparable toxicity profile, with most adverse events being mild and manageable.

Study details: Findings are from a multicenter, retrospective cohort study that propensity-score matched patients with advanced HCC who received lenvatinib plus IDADEB-TACE (n = 78) with those who received lenvatinib alone (n = 78).

Disclosures: This study was sponsored by the National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Fan W et al. Idarubicin-loaded DEB-TACE plus lenvatinib versus lenvatinib for patients with advanced hepatocellular carcinoma: A propensity score-matching analysis. Cancer Med. 2022 (Jun 13). Doi: 10.1002/cam4.4937

Key clinical point: First-line lenvatinib plus idarubicin-loaded drug-eluting bead transarterial chemoembolization (IDADEB-TACE) is safe and offers a better safety profile than lenvatinib alone in patients with advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving lenvatinib plus IDADEB-TACE vs lenvatinib alone had a significantly higher objective response rate (57.7% vs 25.7%; P < .001), longer median overall survival (15.7 vs 11.3 months; hazard ratio 0.50; P < .001), and comparable toxicity profile, with most adverse events being mild and manageable.

Study details: Findings are from a multicenter, retrospective cohort study that propensity-score matched patients with advanced HCC who received lenvatinib plus IDADEB-TACE (n = 78) with those who received lenvatinib alone (n = 78).

Disclosures: This study was sponsored by the National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Fan W et al. Idarubicin-loaded DEB-TACE plus lenvatinib versus lenvatinib for patients with advanced hepatocellular carcinoma: A propensity score-matching analysis. Cancer Med. 2022 (Jun 13). Doi: 10.1002/cam4.4937

Key clinical point: Direct-acting antiviral (DAA) therapy prevents recurrence and improves overall survival (OS) in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), especially in those with a sustained virologic response (SVR).

Major finding: Patients receiving DAA vs no therapy had a significantly reduced recurrence (adjusted hazard ratio [aHR] 0.55; P < .001) and improved OS (aHR 0.36; P  =  .017). After DAA therapy, patients with SVR vs nonresponders had significantly lower recurrence rates (hazard ratio [HR] 0.37; P  =  .017) and mortality (HR 0.17; P  =  .001).

Study details: This was a meta-analysis of 23 cohort studies that evaluated the effects of DAA therapy, interferon therapy, or no intervention on recurrence or OS in patients with HCV-related HCC.

Disclosures: This study was sponsored by the Taishan Scholars Program for Young Expert of Shandong Province, China, among others. The authors declared no conflicts of interest.

Source: Liu H et al. Clinical benefits of direct-acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022 (Jun 20). Doi: 10.1111/jgh.15915

Key clinical point: Direct-acting antiviral (DAA) therapy prevents recurrence and improves overall survival (OS) in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), especially in those with a sustained virologic response (SVR).

Major finding: Patients receiving DAA vs no therapy had a significantly reduced recurrence (adjusted hazard ratio [aHR] 0.55; P < .001) and improved OS (aHR 0.36; P  =  .017). After DAA therapy, patients with SVR vs nonresponders had significantly lower recurrence rates (hazard ratio [HR] 0.37; P  =  .017) and mortality (HR 0.17; P  =  .001).

Study details: This was a meta-analysis of 23 cohort studies that evaluated the effects of DAA therapy, interferon therapy, or no intervention on recurrence or OS in patients with HCV-related HCC.

Disclosures: This study was sponsored by the Taishan Scholars Program for Young Expert of Shandong Province, China, among others. The authors declared no conflicts of interest.

Source: Liu H et al. Clinical benefits of direct-acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022 (Jun 20). Doi: 10.1111/jgh.15915

Key clinical point: Direct-acting antiviral (DAA) therapy prevents recurrence and improves overall survival (OS) in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), especially in those with a sustained virologic response (SVR).

Major finding: Patients receiving DAA vs no therapy had a significantly reduced recurrence (adjusted hazard ratio [aHR] 0.55; P < .001) and improved OS (aHR 0.36; P  =  .017). After DAA therapy, patients with SVR vs nonresponders had significantly lower recurrence rates (hazard ratio [HR] 0.37; P  =  .017) and mortality (HR 0.17; P  =  .001).

Study details: This was a meta-analysis of 23 cohort studies that evaluated the effects of DAA therapy, interferon therapy, or no intervention on recurrence or OS in patients with HCV-related HCC.

Disclosures: This study was sponsored by the Taishan Scholars Program for Young Expert of Shandong Province, China, among others. The authors declared no conflicts of interest.

Source: Liu H et al. Clinical benefits of direct-acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022 (Jun 20). Doi: 10.1111/jgh.15915

Key clinical point: Statin use is associated with a lower risk for hepatocellular carcinoma (HCC) incidence in dialysis patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.

Major finding: Statin users vs nonusers had a 41% reduced risk for HCC (subdistribution hazard ratio 0.59; P  =  .001) and a lower weighted HCC incidence rate (incidence rate difference −3.7; P < .001), with the incidence rate ratio being 0.56 (P < .001).

Study details: This retrospective observational study included 6165 patients aged ≥ 19 and < 85 years with HBV or HCV infection who were on maintenance dialysis and received ≥28 cumulative defined daily doses of statins (users; n = 2655) or did not receive statins (nonusers; n = 3510) in the first 3 months after dialysis commencement.

Disclosures: No financial support was reported. The authors declared no conflicts of interest.

Source: Kim HW et al. Association of statin treatment with hepatocellular carcinoma risk in end-stage kidney disease patients with chronic viral hepatitis. Sci Rep. 2022;12:10807 (Jun 25. Doi: 10.1038/s41598-022-14713-w

Key clinical point: Statin use is associated with a lower risk for hepatocellular carcinoma (HCC) incidence in dialysis patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.

Major finding: Statin users vs nonusers had a 41% reduced risk for HCC (subdistribution hazard ratio 0.59; P  =  .001) and a lower weighted HCC incidence rate (incidence rate difference −3.7; P < .001), with the incidence rate ratio being 0.56 (P < .001).

Study details: This retrospective observational study included 6165 patients aged ≥ 19 and < 85 years with HBV or HCV infection who were on maintenance dialysis and received ≥28 cumulative defined daily doses of statins (users; n = 2655) or did not receive statins (nonusers; n = 3510) in the first 3 months after dialysis commencement.

Disclosures: No financial support was reported. The authors declared no conflicts of interest.

Source: Kim HW et al. Association of statin treatment with hepatocellular carcinoma risk in end-stage kidney disease patients with chronic viral hepatitis. Sci Rep. 2022;12:10807 (Jun 25. Doi: 10.1038/s41598-022-14713-w

Key clinical point: Statin use is associated with a lower risk for hepatocellular carcinoma (HCC) incidence in dialysis patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.

Major finding: Statin users vs nonusers had a 41% reduced risk for HCC (subdistribution hazard ratio 0.59; P  =  .001) and a lower weighted HCC incidence rate (incidence rate difference −3.7; P < .001), with the incidence rate ratio being 0.56 (P < .001).

Study details: This retrospective observational study included 6165 patients aged ≥ 19 and < 85 years with HBV or HCV infection who were on maintenance dialysis and received ≥28 cumulative defined daily doses of statins (users; n = 2655) or did not receive statins (nonusers; n = 3510) in the first 3 months after dialysis commencement.

Disclosures: No financial support was reported. The authors declared no conflicts of interest.

Source: Kim HW et al. Association of statin treatment with hepatocellular carcinoma risk in end-stage kidney disease patients with chronic viral hepatitis. Sci Rep. 2022;12:10807 (Jun 25. Doi: 10.1038/s41598-022-14713-w

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Lenvatinib-based combination therapies are associated with a significantly longer progression-free survival (PFS) and better objective response (OR) than lenvatinib monotherapy in patients with hepatocellular carcinoma (HCC).

Major finding: Lenvatinib combination therapy vs monotherapy was associated with a significantly longer PFS (Response Evaluation Criteria in Solid Tumours [RECIST] v1.1: 7.77 vs 4.43 months; P  =  .045; modified RECIST [mRECIST]: 6.97 vs 5.27 months; P  =  .067) and a higher OR rate (RECIST v1.1: 37% vs 5%; P < .001; mRECIST: 53% vs 11%; P < .001) but no significant overall survival benefit (P  =  .71).

Study details: Findings are from a retrospective study that included 215 patients with HCC who received lenvatinib-based therapies.

Disclosures: This study was funded by the National Key R&D Program of China and National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Chen J et al. The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study. J Cancer Res Clin Oncol. 2022 (Jun 25). Doi: 10.1007/s00432-022-04082-2

Key clinical point: Radiotherapy (RT) plus monoclonal antibody against programmed cell death 1 (anti-PD1) has a better efficacy and safety profile than transcatheter arterial chemoembolization (TACE) plus sorafenib for the treatment of advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving RT+anti-PD1 vs TACE+sorafenib showed significantly higher objective response (54.05% vs 12.20%; P < .001), disease control (70.27% vs 46.34%; P  =  .041), and 9-month overall survival (75.50% vs 60.60%; P < .001) rates. They also had a longer progression-free survival (hazard ratio 0.51; P  =  .017); and a lower grade ≥3 treatment-related adverse event rate (29.70% vs 75.60%; P < .001).

Study details: Findings are from a retrospective real-world study that included 78 adult patients with advanced HCC who received RT+anti-PD1 (n = 37) or TACE+sorafenib (n = 41).

Disclosures: This study was sponsored by the Development and Application Project for the Appropriate Technology of Health of Guangxi Province, China, among others. The authors declared no conflicts of interest.

Source: Li JX et al. Efficacy and safety of radiotherapy plus anti-PD1 versus transcatheter arterial chemoembolization plus sorafenib for advanced hepatocellular carcinoma: a real-world study. Radiat Oncol. 2022;17:106 (Jun 11. Doi: 10.1186/s13014-022-02075-6

Key clinical point: Radiotherapy (RT) plus monoclonal antibody against programmed cell death 1 (anti-PD1) has a better efficacy and safety profile than transcatheter arterial chemoembolization (TACE) plus sorafenib for the treatment of advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving RT+anti-PD1 vs TACE+sorafenib showed significantly higher objective response (54.05% vs 12.20%; P < .001), disease control (70.27% vs 46.34%; P  =  .041), and 9-month overall survival (75.50% vs 60.60%; P < .001) rates. They also had a longer progression-free survival (hazard ratio 0.51; P  =  .017); and a lower grade ≥3 treatment-related adverse event rate (29.70% vs 75.60%; P < .001).

Study details: Findings are from a retrospective real-world study that included 78 adult patients with advanced HCC who received RT+anti-PD1 (n = 37) or TACE+sorafenib (n = 41).

Disclosures: This study was sponsored by the Development and Application Project for the Appropriate Technology of Health of Guangxi Province, China, among others. The authors declared no conflicts of interest.

Source: Li JX et al. Efficacy and safety of radiotherapy plus anti-PD1 versus transcatheter arterial chemoembolization plus sorafenib for advanced hepatocellular carcinoma: a real-world study. Radiat Oncol. 2022;17:106 (Jun 11. Doi: 10.1186/s13014-022-02075-6

Key clinical point: Radiotherapy (RT) plus monoclonal antibody against programmed cell death 1 (anti-PD1) has a better efficacy and safety profile than transcatheter arterial chemoembolization (TACE) plus sorafenib for the treatment of advanced hepatocellular carcinoma (HCC).

Major finding: Patients receiving RT+anti-PD1 vs TACE+sorafenib showed significantly higher objective response (54.05% vs 12.20%; P < .001), disease control (70.27% vs 46.34%; P  =  .041), and 9-month overall survival (75.50% vs 60.60%; P < .001) rates. They also had a longer progression-free survival (hazard ratio 0.51; P  =  .017); and a lower grade ≥3 treatment-related adverse event rate (29.70% vs 75.60%; P < .001).

Study details: Findings are from a retrospective real-world study that included 78 adult patients with advanced HCC who received RT+anti-PD1 (n = 37) or TACE+sorafenib (n = 41).

Disclosures: This study was sponsored by the Development and Application Project for the Appropriate Technology of Health of Guangxi Province, China, among others. The authors declared no conflicts of interest.

Source: Li JX et al. Efficacy and safety of radiotherapy plus anti-PD1 versus transcatheter arterial chemoembolization plus sorafenib for advanced hepatocellular carcinoma: a real-world study. Radiat Oncol. 2022;17:106 (Jun 11. Doi: 10.1186/s13014-022-02075-6

Key clinical point: Sustained virologic response (SVR) decreases the risk for hepatic decompensation in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) receiving nonsurgical treatment.

Major finding: Patients with SVR vs viremia had a significantly lower likelihood of hepatic decompensation (adjusted odds ratio 0.18; 95% CI 0.06-0.59).

Study details: Findings are from a multicenter, retrospective cohort study including adult patients with HCV cirrhosis and treatment-naive HCC who had active viremia (n = 431) or SVR before HCC diagnosis (n = 135).

Disclosures: This study was sponsored by the US National Institutes of Health. Some authors reported serving as consultants, advisory board members, speakers for, or receiving research funding or consulting fees from various sources.

Source: Parikh ND et al. Association between sustained virological response and clinical outcomes in patients with hepatitis C infection and hepatocellular carcinoma. Cancer. 2022 (Jul 7). Doi:  10.1002/cncr.34378

Key clinical point: Sustained virologic response (SVR) decreases the risk for hepatic decompensation in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) receiving nonsurgical treatment.

Major finding: Patients with SVR vs viremia had a significantly lower likelihood of hepatic decompensation (adjusted odds ratio 0.18; 95% CI 0.06-0.59).

Study details: Findings are from a multicenter, retrospective cohort study including adult patients with HCV cirrhosis and treatment-naive HCC who had active viremia (n = 431) or SVR before HCC diagnosis (n = 135).

Disclosures: This study was sponsored by the US National Institutes of Health. Some authors reported serving as consultants, advisory board members, speakers for, or receiving research funding or consulting fees from various sources.

Source: Parikh ND et al. Association between sustained virological response and clinical outcomes in patients with hepatitis C infection and hepatocellular carcinoma. Cancer. 2022 (Jul 7). Doi:  10.1002/cncr.34378

Key clinical point: Sustained virologic response (SVR) decreases the risk for hepatic decompensation in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) receiving nonsurgical treatment.

Major finding: Patients with SVR vs viremia had a significantly lower likelihood of hepatic decompensation (adjusted odds ratio 0.18; 95% CI 0.06-0.59).

Study details: Findings are from a multicenter, retrospective cohort study including adult patients with HCV cirrhosis and treatment-naive HCC who had active viremia (n = 431) or SVR before HCC diagnosis (n = 135).

Disclosures: This study was sponsored by the US National Institutes of Health. Some authors reported serving as consultants, advisory board members, speakers for, or receiving research funding or consulting fees from various sources.

Source: Parikh ND et al. Association between sustained virological response and clinical outcomes in patients with hepatitis C infection and hepatocellular carcinoma. Cancer. 2022 (Jul 7). Doi:  10.1002/cncr.34378