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Expanded Treatment Options for Lupus Nephritis
Lupus nephritis (LN) affects approximately 25%-60% of patients with systemic lupus erythematosus. Currently, guideline-directed therapy recommends a combination of steroids plus either mycophenolate mofetil or cyclophosphamide. Despite treatment, about 10%-30% of LN patients will progress to end-stage kidney disease.
Fortunately, over the past 2 years, the FDA approved two novel agents that expand treatment options for patients with active disease who have received standard-of-care therapy.
In this ReCAP, Dr Joan Merrill, of the University of Oklahoma Health Sciences Center, reports on the B-lymphocyte stimulator–specific inhibitor belimumab, which was evaluated in the BLISS-LN trial, and the oral calcineurin inhibitor voclosporin, which was assessed in the AURORA trials.
Dr Merrill discusses how these recently approved medications fit into the standard of care for LN patients.
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Joan Merrill, MD, Professor, Department of Medicine, Division of Rheumatology, University of Oklahoma Health Sciences Center; Director of Clinical Projects, Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma
Joan Merrill, MD, has disclosed the following relevant financial relationships:
Serve(d) as a speaker or a member of a speakers bureau for: Biogen
Received research grant from: Bristol-Myers Squibb; GlaxoSmithKline
Received income in an amount equal to or greater than $250 from: AbbVie; Alexion; Amgen; AstraZeneca; Aurinia; Bristol-Myers Squibb; EMD Serono; Genentech; Gilead; GlaxoSmithKline; Lilly; Merck; Provention; RemeGen; Sanofi; UCB; Zenas
Received research grant from: AbbVie; AstraZeneca; BeiGene; Pharmacyclics; TG Therapeutics
Lupus nephritis (LN) affects approximately 25%-60% of patients with systemic lupus erythematosus. Currently, guideline-directed therapy recommends a combination of steroids plus either mycophenolate mofetil or cyclophosphamide. Despite treatment, about 10%-30% of LN patients will progress to end-stage kidney disease.
Fortunately, over the past 2 years, the FDA approved two novel agents that expand treatment options for patients with active disease who have received standard-of-care therapy.
In this ReCAP, Dr Joan Merrill, of the University of Oklahoma Health Sciences Center, reports on the B-lymphocyte stimulator–specific inhibitor belimumab, which was evaluated in the BLISS-LN trial, and the oral calcineurin inhibitor voclosporin, which was assessed in the AURORA trials.
Dr Merrill discusses how these recently approved medications fit into the standard of care for LN patients.
--
Joan Merrill, MD, Professor, Department of Medicine, Division of Rheumatology, University of Oklahoma Health Sciences Center; Director of Clinical Projects, Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma
Joan Merrill, MD, has disclosed the following relevant financial relationships:
Serve(d) as a speaker or a member of a speakers bureau for: Biogen
Received research grant from: Bristol-Myers Squibb; GlaxoSmithKline
Received income in an amount equal to or greater than $250 from: AbbVie; Alexion; Amgen; AstraZeneca; Aurinia; Bristol-Myers Squibb; EMD Serono; Genentech; Gilead; GlaxoSmithKline; Lilly; Merck; Provention; RemeGen; Sanofi; UCB; Zenas
Received research grant from: AbbVie; AstraZeneca; BeiGene; Pharmacyclics; TG Therapeutics
Lupus nephritis (LN) affects approximately 25%-60% of patients with systemic lupus erythematosus. Currently, guideline-directed therapy recommends a combination of steroids plus either mycophenolate mofetil or cyclophosphamide. Despite treatment, about 10%-30% of LN patients will progress to end-stage kidney disease.
Fortunately, over the past 2 years, the FDA approved two novel agents that expand treatment options for patients with active disease who have received standard-of-care therapy.
In this ReCAP, Dr Joan Merrill, of the University of Oklahoma Health Sciences Center, reports on the B-lymphocyte stimulator–specific inhibitor belimumab, which was evaluated in the BLISS-LN trial, and the oral calcineurin inhibitor voclosporin, which was assessed in the AURORA trials.
Dr Merrill discusses how these recently approved medications fit into the standard of care for LN patients.
--
Joan Merrill, MD, Professor, Department of Medicine, Division of Rheumatology, University of Oklahoma Health Sciences Center; Director of Clinical Projects, Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma
Joan Merrill, MD, has disclosed the following relevant financial relationships:
Serve(d) as a speaker or a member of a speakers bureau for: Biogen
Received research grant from: Bristol-Myers Squibb; GlaxoSmithKline
Received income in an amount equal to or greater than $250 from: AbbVie; Alexion; Amgen; AstraZeneca; Aurinia; Bristol-Myers Squibb; EMD Serono; Genentech; Gilead; GlaxoSmithKline; Lilly; Merck; Provention; RemeGen; Sanofi; UCB; Zenas
Received research grant from: AbbVie; AstraZeneca; BeiGene; Pharmacyclics; TG Therapeutics
Hepatitis C: Essential Treatment Considerations
Until recently, chronic hepatitis C virus (HCV) treatment had poor efficacy and was provided only by specialists such as hepatologists and gastroenterologists. However, the introduction of safe, effective direct-acting antivirals (DAAs) has revolutionized HCV treatment.
One pivotal transformation has been the expansion of treatment to nonspecialist physicians. Nevertheless, various factors must be considered when initiating treatment for HCV.
Dr Elizabeth Verna, director of hepatology research at Columbia University in New York City, examines the essential treatment considerations for chronic HCV in treatment-naive patients.
First, she outlines recommended first-line therapies and the simplified HCV treatment algorithm recently issued by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. She then discusses patient-specific factors, such as cirrhosis, co-infections, age, and pregnancy, that can create treatment challenges and change the algorithm.
In closing, she talks about changes in HCV screening recommendations and how diagnosis and treatment of this infectious disease largely rest in the hands of general practitioners who are the first line of defense in controlling HCV spread.
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Associate Professor of Medicine, Director of Hepatology Research, Associate Physician, Department of Medicine, Columbia University, New York, NY
Elizabeth Verna, MD, has disclosed the following relevant financial relationships:
Received research grant from: Salix
Until recently, chronic hepatitis C virus (HCV) treatment had poor efficacy and was provided only by specialists such as hepatologists and gastroenterologists. However, the introduction of safe, effective direct-acting antivirals (DAAs) has revolutionized HCV treatment.
One pivotal transformation has been the expansion of treatment to nonspecialist physicians. Nevertheless, various factors must be considered when initiating treatment for HCV.
Dr Elizabeth Verna, director of hepatology research at Columbia University in New York City, examines the essential treatment considerations for chronic HCV in treatment-naive patients.
First, she outlines recommended first-line therapies and the simplified HCV treatment algorithm recently issued by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. She then discusses patient-specific factors, such as cirrhosis, co-infections, age, and pregnancy, that can create treatment challenges and change the algorithm.
In closing, she talks about changes in HCV screening recommendations and how diagnosis and treatment of this infectious disease largely rest in the hands of general practitioners who are the first line of defense in controlling HCV spread.
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Associate Professor of Medicine, Director of Hepatology Research, Associate Physician, Department of Medicine, Columbia University, New York, NY
Elizabeth Verna, MD, has disclosed the following relevant financial relationships:
Received research grant from: Salix
Until recently, chronic hepatitis C virus (HCV) treatment had poor efficacy and was provided only by specialists such as hepatologists and gastroenterologists. However, the introduction of safe, effective direct-acting antivirals (DAAs) has revolutionized HCV treatment.
One pivotal transformation has been the expansion of treatment to nonspecialist physicians. Nevertheless, various factors must be considered when initiating treatment for HCV.
Dr Elizabeth Verna, director of hepatology research at Columbia University in New York City, examines the essential treatment considerations for chronic HCV in treatment-naive patients.
First, she outlines recommended first-line therapies and the simplified HCV treatment algorithm recently issued by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. She then discusses patient-specific factors, such as cirrhosis, co-infections, age, and pregnancy, that can create treatment challenges and change the algorithm.
In closing, she talks about changes in HCV screening recommendations and how diagnosis and treatment of this infectious disease largely rest in the hands of general practitioners who are the first line of defense in controlling HCV spread.
--
Associate Professor of Medicine, Director of Hepatology Research, Associate Physician, Department of Medicine, Columbia University, New York, NY
Elizabeth Verna, MD, has disclosed the following relevant financial relationships:
Received research grant from: Salix
Treating High-Risk, Early-Stage HR+/HER2- Breast Cancer
Many patients with early-stage HR+/HER2- breast cancer are at high risk for disease recurrence within just a few years of first-line treatment. In this ReCAP, Michelle Melisko, MD, of the University of San Francisco Medical Center, discusses strategies for reducing recurrence rates in these patients.
Dr Melisko begins by identifying the traditional criteria for selecting treatment, including age, comorbidities, tumor size, and nodal status, along with proper utilization of genomic assays. She notes that the RxPONDER and TAILORx trials have demonstrated benefits of chemotherapy plus endocrine therapy in premenopausal patients on the basis of Oncotype DX recurrence scores between 0 and 25.
Next, Dr Melisko discusses how the 2021 FDA approval of abemaciclib plus endocrine therapy in the adjuvant setting mandates that patients have a Ki-67 score of 20%. This is a more restrictive patient population than those who saw benefit in the monarchE clinical trial and presents a challenge for physicians selecting therapy for their patients.
Dr Melisko concludes by sharing 3-year data from the OlympiA trial supporting the use of olaparib in patients with BRCA1 and BRCA2 mutations, as well as findings from the SOFT/TEXT trials that demonstrated the benefit of ovarian suppression in younger patients.
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Michelle E. Melisko, MD, Associate Clinical Professor, Department of Medicine, Division of Hematology-Oncology, University of San Francisco Medical Center; UCSF Bakar Precision Cancer Medicine, San Francisco, California
Michelle E. Melisko, MD, has disclosed no relevant financial relationships
Many patients with early-stage HR+/HER2- breast cancer are at high risk for disease recurrence within just a few years of first-line treatment. In this ReCAP, Michelle Melisko, MD, of the University of San Francisco Medical Center, discusses strategies for reducing recurrence rates in these patients.
Dr Melisko begins by identifying the traditional criteria for selecting treatment, including age, comorbidities, tumor size, and nodal status, along with proper utilization of genomic assays. She notes that the RxPONDER and TAILORx trials have demonstrated benefits of chemotherapy plus endocrine therapy in premenopausal patients on the basis of Oncotype DX recurrence scores between 0 and 25.
Next, Dr Melisko discusses how the 2021 FDA approval of abemaciclib plus endocrine therapy in the adjuvant setting mandates that patients have a Ki-67 score of 20%. This is a more restrictive patient population than those who saw benefit in the monarchE clinical trial and presents a challenge for physicians selecting therapy for their patients.
Dr Melisko concludes by sharing 3-year data from the OlympiA trial supporting the use of olaparib in patients with BRCA1 and BRCA2 mutations, as well as findings from the SOFT/TEXT trials that demonstrated the benefit of ovarian suppression in younger patients.
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Michelle E. Melisko, MD, Associate Clinical Professor, Department of Medicine, Division of Hematology-Oncology, University of San Francisco Medical Center; UCSF Bakar Precision Cancer Medicine, San Francisco, California
Michelle E. Melisko, MD, has disclosed no relevant financial relationships
Many patients with early-stage HR+/HER2- breast cancer are at high risk for disease recurrence within just a few years of first-line treatment. In this ReCAP, Michelle Melisko, MD, of the University of San Francisco Medical Center, discusses strategies for reducing recurrence rates in these patients.
Dr Melisko begins by identifying the traditional criteria for selecting treatment, including age, comorbidities, tumor size, and nodal status, along with proper utilization of genomic assays. She notes that the RxPONDER and TAILORx trials have demonstrated benefits of chemotherapy plus endocrine therapy in premenopausal patients on the basis of Oncotype DX recurrence scores between 0 and 25.
Next, Dr Melisko discusses how the 2021 FDA approval of abemaciclib plus endocrine therapy in the adjuvant setting mandates that patients have a Ki-67 score of 20%. This is a more restrictive patient population than those who saw benefit in the monarchE clinical trial and presents a challenge for physicians selecting therapy for their patients.
Dr Melisko concludes by sharing 3-year data from the OlympiA trial supporting the use of olaparib in patients with BRCA1 and BRCA2 mutations, as well as findings from the SOFT/TEXT trials that demonstrated the benefit of ovarian suppression in younger patients.
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Michelle E. Melisko, MD, Associate Clinical Professor, Department of Medicine, Division of Hematology-Oncology, University of San Francisco Medical Center; UCSF Bakar Precision Cancer Medicine, San Francisco, California
Michelle E. Melisko, MD, has disclosed no relevant financial relationships
Reducing Attacks and Neuropathic Pain in NMOSD
Patients with neuromyelitis optica spectrum disorder (NMOSD) experience unpredictable episodes of inflammation involving the optic nerve, spine, or both. Debilitating neuropathic pain accompanies the healing process, which lasts anywhere from 2 to 6 months after an attack.
In this ReCAP, Dr Michael Levy, of Harvard Medical School in Boston, Massachusetts, outlines the heavy psychological and economic burdens associated with NMOSD and reports on three new targeted therapies that have been approved to prevent relapse and delay disease progression.
He then looks at current pharmaceutical treatments for NMOSD pain, before reporting promising trial data exploring transcutaneous electrical nerve stimulation as a safe and cost-effective treatment for neuropathic pain.
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Michael Levy, MD, PhD, Associate Professor, Department of Neurology, Harvard Medical School, Boston, Massachusetts
Michael Levy, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Alexion; Horizon; Genentech; UCB; Sanofi; Quest
Received research grant from: National Institutes of Health; Sanofi; Genentech; Horizon; Alexion
Patients with neuromyelitis optica spectrum disorder (NMOSD) experience unpredictable episodes of inflammation involving the optic nerve, spine, or both. Debilitating neuropathic pain accompanies the healing process, which lasts anywhere from 2 to 6 months after an attack.
In this ReCAP, Dr Michael Levy, of Harvard Medical School in Boston, Massachusetts, outlines the heavy psychological and economic burdens associated with NMOSD and reports on three new targeted therapies that have been approved to prevent relapse and delay disease progression.
He then looks at current pharmaceutical treatments for NMOSD pain, before reporting promising trial data exploring transcutaneous electrical nerve stimulation as a safe and cost-effective treatment for neuropathic pain.
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Michael Levy, MD, PhD, Associate Professor, Department of Neurology, Harvard Medical School, Boston, Massachusetts
Michael Levy, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Alexion; Horizon; Genentech; UCB; Sanofi; Quest
Received research grant from: National Institutes of Health; Sanofi; Genentech; Horizon; Alexion
Patients with neuromyelitis optica spectrum disorder (NMOSD) experience unpredictable episodes of inflammation involving the optic nerve, spine, or both. Debilitating neuropathic pain accompanies the healing process, which lasts anywhere from 2 to 6 months after an attack.
In this ReCAP, Dr Michael Levy, of Harvard Medical School in Boston, Massachusetts, outlines the heavy psychological and economic burdens associated with NMOSD and reports on three new targeted therapies that have been approved to prevent relapse and delay disease progression.
He then looks at current pharmaceutical treatments for NMOSD pain, before reporting promising trial data exploring transcutaneous electrical nerve stimulation as a safe and cost-effective treatment for neuropathic pain.
--
Michael Levy, MD, PhD, Associate Professor, Department of Neurology, Harvard Medical School, Boston, Massachusetts
Michael Levy, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Alexion; Horizon; Genentech; UCB; Sanofi; Quest
Received research grant from: National Institutes of Health; Sanofi; Genentech; Horizon; Alexion
Selecting Between CDK4/6 Inhibitors in Advanced HR+/HER2- Breast Cancer
Patients diagnosed with advanced hormone receptor–positive (HR+) and human epidermal growth factor receptor 2–negative (HER2-) breast cancer have significantly improved outcomes with the combination of a cyclin-dependent kinase (CDK) 4/6 inhibitor and endocrine therapy compared with endocrine therapy alone.
Dr Sara Hurvitz, director of the Breast Cancer Clinical Trials Program at UCLA, discusses the efficacy, tolerability, and patient quality-of-life factors to consider when deciding which of the three available CDK4/6 inhibitors — palbociclib, ribociclib, or abemaciclib — is appropriate for your patient in the frontline setting.
Reporting on data from the ongoing MONALEESA, MONARCH, and PALOMA trials, Dr Hurvitz spotlights the differences and similarities between agents that may help steer treatment decisions for pre- or perimenopausal patients
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Associate Professor, David Geffen School of Medicine at UCLA; Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit; Co-director, Santa Monica-UCLA Outpatient Oncology Practices; Director, Breast Cancer Clinical Trials Program, UCLA, Los Angeles, California
Sara A. Hurvitz, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Ambrx; Amgen; Arvinas; Bayer; BioMarin; Cascadian Therapeutics; Daiichi Sankyo; Dignitana; Genentech/Roche; Gilead Sciences; GlaxoSmithKline; Immunomedics; Lilly; MacroGenics; Merrimack; Novartis; OBI Pharma; Pfizer; Phoenix Molecular Designs; Pieris; Puma Biotechnology; Radius; Samumed; Sanofi; Seattle Genetics; Zymeworks
Has been reimbursed for travel, accommodations, or other expenses by Lilly
Patients diagnosed with advanced hormone receptor–positive (HR+) and human epidermal growth factor receptor 2–negative (HER2-) breast cancer have significantly improved outcomes with the combination of a cyclin-dependent kinase (CDK) 4/6 inhibitor and endocrine therapy compared with endocrine therapy alone.
Dr Sara Hurvitz, director of the Breast Cancer Clinical Trials Program at UCLA, discusses the efficacy, tolerability, and patient quality-of-life factors to consider when deciding which of the three available CDK4/6 inhibitors — palbociclib, ribociclib, or abemaciclib — is appropriate for your patient in the frontline setting.
Reporting on data from the ongoing MONALEESA, MONARCH, and PALOMA trials, Dr Hurvitz spotlights the differences and similarities between agents that may help steer treatment decisions for pre- or perimenopausal patients
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Associate Professor, David Geffen School of Medicine at UCLA; Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit; Co-director, Santa Monica-UCLA Outpatient Oncology Practices; Director, Breast Cancer Clinical Trials Program, UCLA, Los Angeles, California
Sara A. Hurvitz, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Ambrx; Amgen; Arvinas; Bayer; BioMarin; Cascadian Therapeutics; Daiichi Sankyo; Dignitana; Genentech/Roche; Gilead Sciences; GlaxoSmithKline; Immunomedics; Lilly; MacroGenics; Merrimack; Novartis; OBI Pharma; Pfizer; Phoenix Molecular Designs; Pieris; Puma Biotechnology; Radius; Samumed; Sanofi; Seattle Genetics; Zymeworks
Has been reimbursed for travel, accommodations, or other expenses by Lilly
Patients diagnosed with advanced hormone receptor–positive (HR+) and human epidermal growth factor receptor 2–negative (HER2-) breast cancer have significantly improved outcomes with the combination of a cyclin-dependent kinase (CDK) 4/6 inhibitor and endocrine therapy compared with endocrine therapy alone.
Dr Sara Hurvitz, director of the Breast Cancer Clinical Trials Program at UCLA, discusses the efficacy, tolerability, and patient quality-of-life factors to consider when deciding which of the three available CDK4/6 inhibitors — palbociclib, ribociclib, or abemaciclib — is appropriate for your patient in the frontline setting.
Reporting on data from the ongoing MONALEESA, MONARCH, and PALOMA trials, Dr Hurvitz spotlights the differences and similarities between agents that may help steer treatment decisions for pre- or perimenopausal patients
--
Associate Professor, David Geffen School of Medicine at UCLA; Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit; Co-director, Santa Monica-UCLA Outpatient Oncology Practices; Director, Breast Cancer Clinical Trials Program, UCLA, Los Angeles, California
Sara A. Hurvitz, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Ambrx; Amgen; Arvinas; Bayer; BioMarin; Cascadian Therapeutics; Daiichi Sankyo; Dignitana; Genentech/Roche; Gilead Sciences; GlaxoSmithKline; Immunomedics; Lilly; MacroGenics; Merrimack; Novartis; OBI Pharma; Pfizer; Phoenix Molecular Designs; Pieris; Puma Biotechnology; Radius; Samumed; Sanofi; Seattle Genetics; Zymeworks
Has been reimbursed for travel, accommodations, or other expenses by Lilly
Communicating Statin Safety to Patients With Hypercholesterolemia
Dr James de Lemos, professor of internal medicine at the University of Texas Southwestern Medical Center, presents a framework to address the most common questions that patients have about the reported muscular, cognitive, and hepatotoxic side effects of statin therapy.
To start, he presents clinical data to address areas of patient concern. Next, he discusses ways to develop — from the first visit — a partnership with patients and encourage their informed decision-making by guiding them to reliable medical sources.
Finally, Dr de Lemos presents strategies that clinicians can use to improve adherence to statin therapy to reach LDL-C treatment goals
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James de Lemos, MD, PhD
Professor, Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
James de Lemos, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; Regeneron; AstraZeneca
Dr James de Lemos, professor of internal medicine at the University of Texas Southwestern Medical Center, presents a framework to address the most common questions that patients have about the reported muscular, cognitive, and hepatotoxic side effects of statin therapy.
To start, he presents clinical data to address areas of patient concern. Next, he discusses ways to develop — from the first visit — a partnership with patients and encourage their informed decision-making by guiding them to reliable medical sources.
Finally, Dr de Lemos presents strategies that clinicians can use to improve adherence to statin therapy to reach LDL-C treatment goals
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James de Lemos, MD, PhD
Professor, Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
James de Lemos, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; Regeneron; AstraZeneca
Dr James de Lemos, professor of internal medicine at the University of Texas Southwestern Medical Center, presents a framework to address the most common questions that patients have about the reported muscular, cognitive, and hepatotoxic side effects of statin therapy.
To start, he presents clinical data to address areas of patient concern. Next, he discusses ways to develop — from the first visit — a partnership with patients and encourage their informed decision-making by guiding them to reliable medical sources.
Finally, Dr de Lemos presents strategies that clinicians can use to improve adherence to statin therapy to reach LDL-C treatment goals
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James de Lemos, MD, PhD
Professor, Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
James de Lemos, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Amgen; Regeneron; AstraZeneca
Treatment Advances in Moderate to Severe Active Ulcerative Colitis
Treatment for moderate to severe active ulcerative colitis (UC) has evolved, and with more effective treatment comes higher standards for disease control.
The initial goal is clinical response, followed by clinical remission, endoscopic remission, and — the ultimate goal — histologic remission.
The majority of UC medications have been studied for clinical and endoscopic remission. Recent clinical trials, however, have evaluated the emerging targeted therapies ustekinumab and ozanimod for histologic remission and found positive results.
Dr Bincy Abraham, director of the Fondren Inflammatory Bowel Disease Program at Houston Methodist in Houston, Texas, reports on UC treatment milestones and how emerging targeted therapies can help achieve these goals.
She also discusses patient monitoring to ensure response to therapy as well as medication adjustments should response prove inadequate.
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Professor of Clinical Medicine, Department of Internal Medicine and Gastroenterology; Director, Fondren Inflammatory Bowel Disease Program, Underwood Center for Digestive Disorders, Houston Methodist, Houston, Texas
Bincy Abraham, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; BMS; Janssen; Pfizer; Takeda; Medtronic
Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; BMS; Janssen; Pfizer; Takeda
Received research grant from: Takeda; BMS; Genentech
Treatment for moderate to severe active ulcerative colitis (UC) has evolved, and with more effective treatment comes higher standards for disease control.
The initial goal is clinical response, followed by clinical remission, endoscopic remission, and — the ultimate goal — histologic remission.
The majority of UC medications have been studied for clinical and endoscopic remission. Recent clinical trials, however, have evaluated the emerging targeted therapies ustekinumab and ozanimod for histologic remission and found positive results.
Dr Bincy Abraham, director of the Fondren Inflammatory Bowel Disease Program at Houston Methodist in Houston, Texas, reports on UC treatment milestones and how emerging targeted therapies can help achieve these goals.
She also discusses patient monitoring to ensure response to therapy as well as medication adjustments should response prove inadequate.
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Professor of Clinical Medicine, Department of Internal Medicine and Gastroenterology; Director, Fondren Inflammatory Bowel Disease Program, Underwood Center for Digestive Disorders, Houston Methodist, Houston, Texas
Bincy Abraham, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; BMS; Janssen; Pfizer; Takeda; Medtronic
Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; BMS; Janssen; Pfizer; Takeda
Received research grant from: Takeda; BMS; Genentech
Treatment for moderate to severe active ulcerative colitis (UC) has evolved, and with more effective treatment comes higher standards for disease control.
The initial goal is clinical response, followed by clinical remission, endoscopic remission, and — the ultimate goal — histologic remission.
The majority of UC medications have been studied for clinical and endoscopic remission. Recent clinical trials, however, have evaluated the emerging targeted therapies ustekinumab and ozanimod for histologic remission and found positive results.
Dr Bincy Abraham, director of the Fondren Inflammatory Bowel Disease Program at Houston Methodist in Houston, Texas, reports on UC treatment milestones and how emerging targeted therapies can help achieve these goals.
She also discusses patient monitoring to ensure response to therapy as well as medication adjustments should response prove inadequate.
--
Professor of Clinical Medicine, Department of Internal Medicine and Gastroenterology; Director, Fondren Inflammatory Bowel Disease Program, Underwood Center for Digestive Disorders, Houston Methodist, Houston, Texas
Bincy Abraham, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; BMS; Janssen; Pfizer; Takeda; Medtronic
Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; BMS; Janssen; Pfizer; Takeda
Received research grant from: Takeda; BMS; Genentech
HIV Management: Insights Into ART and Weight Gain
Antiretroviral therapy (ART) regimens provide long-lasting suppression of HIV replication and have helped people with HIV live healthier lives for decades.
Today's ART regimens are associated with fewer serious and intolerable adverse effects than those used in the past, but weight gain remains a concern in clinical practice.
In this ReCAP, Dr David Wohl, from the University of North Carolina at Chapel Hill, reports on the relationship between ART and weight gain, as well as the implications of excessive weight gain in HIV management.
He shares data from multiple studies, including the ADVANCE trial, which offer insight on how different HIV therapies affect patient weight.
Dr Wohl also discusses the steps clinicians should take if weight gain does occur in people who are on HIV therapy.
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Professor of Medicine; Medical Director, UNC COVID-19 Vaccine Clinic, COVID-19 Monoclonal Antibody Infusion Clinic, University of North Carolina at Chapel Hill
David Wohl, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Gilead; ViiV; Janssen; Merck
Serve(d) as a speaker or a member of a speakers bureau for: Gilead
Received research grant from: Gilead; Merck; ViiV
Antiretroviral therapy (ART) regimens provide long-lasting suppression of HIV replication and have helped people with HIV live healthier lives for decades.
Today's ART regimens are associated with fewer serious and intolerable adverse effects than those used in the past, but weight gain remains a concern in clinical practice.
In this ReCAP, Dr David Wohl, from the University of North Carolina at Chapel Hill, reports on the relationship between ART and weight gain, as well as the implications of excessive weight gain in HIV management.
He shares data from multiple studies, including the ADVANCE trial, which offer insight on how different HIV therapies affect patient weight.
Dr Wohl also discusses the steps clinicians should take if weight gain does occur in people who are on HIV therapy.
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Professor of Medicine; Medical Director, UNC COVID-19 Vaccine Clinic, COVID-19 Monoclonal Antibody Infusion Clinic, University of North Carolina at Chapel Hill
David Wohl, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Gilead; ViiV; Janssen; Merck
Serve(d) as a speaker or a member of a speakers bureau for: Gilead
Received research grant from: Gilead; Merck; ViiV
Antiretroviral therapy (ART) regimens provide long-lasting suppression of HIV replication and have helped people with HIV live healthier lives for decades.
Today's ART regimens are associated with fewer serious and intolerable adverse effects than those used in the past, but weight gain remains a concern in clinical practice.
In this ReCAP, Dr David Wohl, from the University of North Carolina at Chapel Hill, reports on the relationship between ART and weight gain, as well as the implications of excessive weight gain in HIV management.
He shares data from multiple studies, including the ADVANCE trial, which offer insight on how different HIV therapies affect patient weight.
Dr Wohl also discusses the steps clinicians should take if weight gain does occur in people who are on HIV therapy.
--
Professor of Medicine; Medical Director, UNC COVID-19 Vaccine Clinic, COVID-19 Monoclonal Antibody Infusion Clinic, University of North Carolina at Chapel Hill
David Wohl, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Gilead; ViiV; Janssen; Merck
Serve(d) as a speaker or a member of a speakers bureau for: Gilead
Received research grant from: Gilead; Merck; ViiV
Early Diagnosis and Management of Tardive Dyskinesia
Tardive dyskinesia (TD) is a delayed movement disorder resulting from treatment with dopamine receptor–blocking medications, Dr Karen Anderson of Georgetown University School of Medicine explains. TD is most commonly associated with long-term use of antipsychotic drugs.
TD is characterized by involuntary, jerking movements of the tongue, lips, face, trunk, extremities, or the whole body. Although its characteristic movements are sometimes viewed as cosmetic, TD can interfere with patients’ quality of life and add to the stigma of mental illness.
The sooner TD is diagnosed, the more likely it is for patients to achieve remission spontaneously and without treatment. To that end, patients who are prescribed antipsychotic medication should be evaluated at baseline and regularly thereafter using the Abnormal Involuntary Movement Scale (AIMS), which rates abnormal movements.
The optimal first step in TD management is to stop the dopamine receptor–blocking medication, but this option may not be possible in patients with chronic conditions, such as manic depression and schizophrenia. In these patients, dose reduction or switching to a newer antipsychotic may provide relief.
Two vesicular monoamine transporter 2 (VMAT2) inhibitors are approved to treat TD and have been found to not worsen patients’ underlying psychiatric condition. Dr Anderson cautions that patients treated with a VMAT2 inhibitor will require monitoring because side effects of these agents include suicidal ideation.
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Karen Anderson, MD, Professor, Department of Psychiatry and Neurology, Georgetown University School of Medicine; Washington, DC
Karen Anderson, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Neurocrine; Teva
Tardive dyskinesia (TD) is a delayed movement disorder resulting from treatment with dopamine receptor–blocking medications, Dr Karen Anderson of Georgetown University School of Medicine explains. TD is most commonly associated with long-term use of antipsychotic drugs.
TD is characterized by involuntary, jerking movements of the tongue, lips, face, trunk, extremities, or the whole body. Although its characteristic movements are sometimes viewed as cosmetic, TD can interfere with patients’ quality of life and add to the stigma of mental illness.
The sooner TD is diagnosed, the more likely it is for patients to achieve remission spontaneously and without treatment. To that end, patients who are prescribed antipsychotic medication should be evaluated at baseline and regularly thereafter using the Abnormal Involuntary Movement Scale (AIMS), which rates abnormal movements.
The optimal first step in TD management is to stop the dopamine receptor–blocking medication, but this option may not be possible in patients with chronic conditions, such as manic depression and schizophrenia. In these patients, dose reduction or switching to a newer antipsychotic may provide relief.
Two vesicular monoamine transporter 2 (VMAT2) inhibitors are approved to treat TD and have been found to not worsen patients’ underlying psychiatric condition. Dr Anderson cautions that patients treated with a VMAT2 inhibitor will require monitoring because side effects of these agents include suicidal ideation.
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Karen Anderson, MD, Professor, Department of Psychiatry and Neurology, Georgetown University School of Medicine; Washington, DC
Karen Anderson, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Neurocrine; Teva
Tardive dyskinesia (TD) is a delayed movement disorder resulting from treatment with dopamine receptor–blocking medications, Dr Karen Anderson of Georgetown University School of Medicine explains. TD is most commonly associated with long-term use of antipsychotic drugs.
TD is characterized by involuntary, jerking movements of the tongue, lips, face, trunk, extremities, or the whole body. Although its characteristic movements are sometimes viewed as cosmetic, TD can interfere with patients’ quality of life and add to the stigma of mental illness.
The sooner TD is diagnosed, the more likely it is for patients to achieve remission spontaneously and without treatment. To that end, patients who are prescribed antipsychotic medication should be evaluated at baseline and regularly thereafter using the Abnormal Involuntary Movement Scale (AIMS), which rates abnormal movements.
The optimal first step in TD management is to stop the dopamine receptor–blocking medication, but this option may not be possible in patients with chronic conditions, such as manic depression and schizophrenia. In these patients, dose reduction or switching to a newer antipsychotic may provide relief.
Two vesicular monoamine transporter 2 (VMAT2) inhibitors are approved to treat TD and have been found to not worsen patients’ underlying psychiatric condition. Dr Anderson cautions that patients treated with a VMAT2 inhibitor will require monitoring because side effects of these agents include suicidal ideation.
--
Karen Anderson, MD, Professor, Department of Psychiatry and Neurology, Georgetown University School of Medicine; Washington, DC
Karen Anderson, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Neurocrine; Teva
Use of Biomarkers to Optimize Treatment of NSCLC
Benjamin Cooper, MD, Director of Proton Therapy at NYU Langone Health, discusses how physicians who treat patients with non-small cell lung cancer (NSCLC) can use genetic profiling results to select effective therapy. Although the current list of therapies is not applicable to all genetic mutations, there are approved treatments for several biomarkers and agents targeting other biomarkers are in clinical trials.
Dr. Cooper explains that biomarkers in NSCLC either boost the immune system’s capability to destroy oncogenes or they block driver and escape mutations that advance disease.
Immunotherapies that target either PD-1 or PD-L1 are now mainstays of NSCLC treatment. To gauge whether these therapies have potential effectiveness for a given patient, oncologists test for the presence of PD-L1 in the tumor. Higher expression of PD-L1 indicates stronger potential response to therapy.
Dr. Cooper then turns to a discussion of oncogenic driver mutations, focusing on EGFR, ALK, ROS1, BRAF, NTRK, RET, MET, KRAS, and HER2. Although there are hundreds of oncogenic driver mutations, not all are currently actionable. Effective therapy options have been available for EGFR, ALK, and BRAF for more than a decade, and treatments for other drivers such as NTRK, MET, KRAS, and HER2 have shown promising results in recent trials.
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Benjamin Cooper, MD is an Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine,
New York, New York
Benjamin Cooper, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca.
Benjamin Cooper, MD, Director of Proton Therapy at NYU Langone Health, discusses how physicians who treat patients with non-small cell lung cancer (NSCLC) can use genetic profiling results to select effective therapy. Although the current list of therapies is not applicable to all genetic mutations, there are approved treatments for several biomarkers and agents targeting other biomarkers are in clinical trials.
Dr. Cooper explains that biomarkers in NSCLC either boost the immune system’s capability to destroy oncogenes or they block driver and escape mutations that advance disease.
Immunotherapies that target either PD-1 or PD-L1 are now mainstays of NSCLC treatment. To gauge whether these therapies have potential effectiveness for a given patient, oncologists test for the presence of PD-L1 in the tumor. Higher expression of PD-L1 indicates stronger potential response to therapy.
Dr. Cooper then turns to a discussion of oncogenic driver mutations, focusing on EGFR, ALK, ROS1, BRAF, NTRK, RET, MET, KRAS, and HER2. Although there are hundreds of oncogenic driver mutations, not all are currently actionable. Effective therapy options have been available for EGFR, ALK, and BRAF for more than a decade, and treatments for other drivers such as NTRK, MET, KRAS, and HER2 have shown promising results in recent trials.
--
Benjamin Cooper, MD is an Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine,
New York, New York
Benjamin Cooper, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca.
Benjamin Cooper, MD, Director of Proton Therapy at NYU Langone Health, discusses how physicians who treat patients with non-small cell lung cancer (NSCLC) can use genetic profiling results to select effective therapy. Although the current list of therapies is not applicable to all genetic mutations, there are approved treatments for several biomarkers and agents targeting other biomarkers are in clinical trials.
Dr. Cooper explains that biomarkers in NSCLC either boost the immune system’s capability to destroy oncogenes or they block driver and escape mutations that advance disease.
Immunotherapies that target either PD-1 or PD-L1 are now mainstays of NSCLC treatment. To gauge whether these therapies have potential effectiveness for a given patient, oncologists test for the presence of PD-L1 in the tumor. Higher expression of PD-L1 indicates stronger potential response to therapy.
Dr. Cooper then turns to a discussion of oncogenic driver mutations, focusing on EGFR, ALK, ROS1, BRAF, NTRK, RET, MET, KRAS, and HER2. Although there are hundreds of oncogenic driver mutations, not all are currently actionable. Effective therapy options have been available for EGFR, ALK, and BRAF for more than a decade, and treatments for other drivers such as NTRK, MET, KRAS, and HER2 have shown promising results in recent trials.
--
Benjamin Cooper, MD is an Assistant Professor, Department of Radiation Oncology, Director, Proton Therapy Services, NYU Grossman School of Medicine,
New York, New York
Benjamin Cooper, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca.