Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

A newly developed risk score using national Organ Procurement and Transplantation Network (OPTN) data demonstrated fair accuracy in predicting short-term mortality among > 147,000 adult kidney transplant waitlist candidates.

The Mortality Estimation in Renal Disease (MERD) score aims to help guide the allocation of expanded criteria donor kidneys to candidates at the highest mortality risk, while acknowledging further prospective validation and model refinement are warranted.

“In this study, we aim to develop an index score utilizing variables from the OPTN database to predict mortality among adult kidney transplant candidates within 3 years of being on the waitlist,” wrote Aisha Albu Mustaf, MBBS, University of Baghdad College of Medicine, and colleagues.

Kidney transplant candidates face a risk of mortality while on the waitlist before receiving an allograft. Despite existing risk prediction tools, there is currently no widely adopted system that reliably identifies patients at the highest risk of waitlist mortality, particularly given the ongoing shortage of living donor organs.

To address this, investigators conducted a retrospective analysis of adult kidney transplant candidates using data from the OPTN database between 2018 and 2023.

Investigators evaluated 16 demographic and clinical variables using univariate logistic regression to identify factors associated with kidney transplant waitlist mortality. Variables demonstrating statistical significance were subsequently entered into a multivariable logistic regression model to develop the MERD score, a predictive tool designed to estimate short-term waitlist mortality risk. Model performance was assessed using receiver operating characteristic (ROC) curve analysis, with discrimination quantified by the C-statistic.

Investigators randomly divided kidney transplant candidates into training and validation cohorts to evaluate internal validity. Mortality risk stratification was further examined by categorizing candidates into MERD score quartiles, with cumulative mortality compared across quartiles over time.

The study included data from 147,307 adults ≥ 18 years of age who were waitlisted kidney transplant candidates. The age of the patient population ranged between 45 and 54 years (21.21%). Only 6.67% of candidates were ≥ 70 years, while 9.46% were young adults aged 18 to 34 years.

Among the adult kidney transplant candidates included from the OPTN database, Mustaf and colleagues identified 10 variables as significant predictors of waitlist mortality and incorporated them into the Mortality Estimation in Renal Disease (MERD) score. These included age, ABO blood type, ethnicity, dialysis duration, presence of peripheral vascular disease, serum albumin level, functional status, prior kidney malignancy, primary etiology of kidney disease, and insurance type.

The investigators reported age and etiology of kidney disease accounted for the largest proportion of the model’s predictive contribution. In multivariable analyses, Mustaf and colleagues found young adults 18 to 34 years, blood types A and AB, African American, Hispanic Latino, and Asian ethnicity relative to White ethnicity, preserved functional status, and higher serum albumin levels were associated with lower waitlist mortality.

In contrast, age >55 years, White ethnicity, longer dialysis duration, reduced functional status, low albumin levels, diabetes, and the presence of peripheral vascular disease were associated with an increased risk of mortality.

According to the investigators, the MERD score demonstrated fair discriminatory performance for predicting waitlist mortality, with an area under the curve (AUC) of 0.6657 in the training cohort and 0.6580 in the validation cohort. Model performance was consistent between cohorts, supporting internal validity.

When candidates were stratified by MERD score quartiles, the investigators observed cumulative mortality increased progressively with higher scores. Candidates in the highest MERD quartile experienced the greatest proportion of mortality over follow-up, indicating the model’s ability to stratify short-term mortality risk among kidney transplant waitlist candidates.

“The MERD score provides proof of concept for short-term mortality prediction for kidney transplant waitlist candidates. Further prospective validation and model refinement are warranted,” concluded investigators.

Albu Mustaf A, Ramirez J, Montgomery A, Henry G, Rana A. Mortality Estimation in Renal Disease (MERD Score): A Model Predicting Waitlist Mortality in Kidney Transplant Candidates. 

. Published online January 8, 2026. doi:https://doi.org/10.1016/j.transproceed.2025.11.010

Bergler T, Hutchinson JA. Tools for Predicting Kidney Transplant Outcomes. 

. 2017;101(9):1958-1959. doi:https://doi.org/10.1097/tp.0000000000001891

Articles

A newly developed risk score, the Mortality Estimation in Renal Disease (MERD) score, utilizes data from the Organ Procurement and Transplantation Network to predict short-term mortality among adult kidney transplant waitlist candidates. The study analyzed over 147,000 candidates, identifying ten significant predictors of mortality, including age, blood type, and dialysis duration. The MERD score demonstrated fair accuracy, with an AUC of 0.6657 in the training cohort. Further validation and refinement are needed to enhance its utility in guiding donor kidney allocation to high-risk candidates.

The Mortality Estimation in Renal Disease (MERD) score may help identify transplant candidates at highest risk of waitlist mortality.


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New MERD Risk Score May Predict Mortality for Kidney Transplant Waitlist Patients

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

Ritlecitinib is effective across various subgroups of patients with 

This drug was evaluated in a recent study authored by investigators such as Yuji Yamaguchi, the Executive Director of Clinical Research at Pfizer. Yamaguchi and colleagues highlighted ritlecitinib’s use as an oral, selective, dual inhibitor of JAK3 and the TEC family kinases.

The drug is currently under phase 3 investigation for its use in treating non-segmental vitiligo. Prior research noted by the investigators points to ritlecitinib’s demonstrated efficacy and safety in a phase 2b analysis.

“...[Data] are limited on how other demographic and clinical characteristics affect the efficacy of ritlecitinib in patients with NSV,” the investigative team wrote.

 “This post hoc analysis explored the efficacy of ritlecitinib in patients with NSV stratified by baseline demographic and clinical characteristics.”

Previous information reported in a phase 2b clinical study was used in this post hoc evaluation (NCT03715829). This trial had looked at treatment with ritlecitinib among adult patients living with active non-segmental vitiligo. The study had consisted of a 24-week dose-ranging phase, a period then followed by a 24-week extension phase. Those between the ages of 18 - 65 years of age were deemed eligible, provided they had active non-segmental vitiligo.

The presence of patient disease was defined by the observation of at least a single active vitiligo-related lesion. In terms of activity criteria, examples included newly appearing or enlarging lesions within the prior 3 months and/or confetti-like, trichrome, or Koebner lesions. Yamaguchi et al did not include historical isomorphic reactions.

All of those involved as participants were also required to have facial involvement of their vitiligo, with the disease affecting .25% of body surface area (BSA) at minimum. In the study’s initial 24-week dose-ranging period, those evaluated were treated with a maintenance dose of ritlecitinib at 50 mg once-per-day. The drug was administered either alone or after the conclusion of a 4-week loading regimen of 200 mg or 100 mg, taking place once daily.

Within the investigators’ subsequent extension period, trial subjects at Week 16 who had not succeeded in attaining at least an improvement of 50% from the point of baseline in their Total Vitiligo Area Scoring Index (T-VASI) were shifted to 1 of several different potential treatment strategies. These strategies would include open-label ritlecitinib 200/50 mg combined with narrowband UVB phototherapy, open-label brepocitinib, or blinded ritlecitinib on a 200/50 mg dosing regimen.

In Yamaguchi and coauthors’ present analysis, they focused on individuals featured in the extension phase who were randomized to the blinded ritlecitinib 200/50 mg arm of the study. In this particular cohort, trial participants were given a 200-mg loading dose over 4 weeks followed by 50 mg on a once-per-day regimen. Efficacy of ritlecitinib’s use was assessed by the investigators through a determination of the percentage of individuals attaining at least a 75% improvement from the point of baseline on their centrally read Facial Vitiligo Area Scoring Index (F-VASI75) score at the 24 and 48-week marks. Outcomes were then further evaluated across baseline demographic and clinical subgroups.

Findings on Ritlecitinib in Non-Segmental Vitiligo

There were 184 patients in total from the dose-ranging phase and 90 individuals from the extension phase who Yamaguchi and colleagues involved in their post hoc analysis. The proportion of those showing a F-VASI75 score was 8.7% at 24 weeks and rose to 26.7% by the 48-week mark. The investigative team noted, across all of the subgroups of patients with non-segmental vitiligo, ritlecitinib demonstrated clinically meaningful levels of facial re-pigmentation.

By the 24-week mark, the team highlighted numerical but statistically non-significant differences in subjects’ responses, specifically among certain subgroups. Yamaguchi et al observed increased rates of disease response among men versus women. These greater rates were also observed in individuals with Fitzpatrick skin types III–VI as opposed to I–II.

Other subgroups in this category were those with facial BSA involvement of at least 0.5% versus less than 0.5%, patients without leukotrichia versus those with leukotrichia, and treatment-naïve individuals versus those previously given treatment. These subgroup differences were noted by the team as less apparent by the 48-week mark.

By the extension period’s conclusion, there remained only modest, non-significant trends. These data favored patients with a body mass index of 30 kg/m² or lower, individuals without leukotrichia, and those without comorbid conditions. There were no notable distinctions detected by the investigative team across the remaining baseline characteristics.

“Overall, ritlecitinib was efficacious across different patient subgroups up to 48 weeks,” the team concluded.

 “These findings contribute to the understanding of how demographic and clinical characteristics affect clinical response to ritlecitinib in patients with active vitiligo, potentially guiding more personalized therapeutic approaches and improving patient outcomes.”

Pandya AG, Hamzavi I, Yamaguchi Y, et al. Efficacy of Ritlecitinib for Vitiligo Treatment Stratified by Baseline Demographic and Clinical Characteristics: Post Hoc Analysis of a Phase 2b Study. JEADV Clinical Practice. 

Ezzedine K, Peeva E, King B, et al. Efficacy and safety of oral ritlecitinib for the treatment of active nonsegmental vitiligo: A randomized phase 2b clinical trial. J Am Acad Dermatol. 2023 Feb;88(2):395-403. doi: 10.1016/j.jaad.2022.11.005. Epub 2022 Nov 9. Erratum in: J Am Acad Dermatol. 2023 Sep;89(3):639. doi: 10.1016/j.jaad.2023.04.001. PMID: 36370907.

Ritlecitinib has shown efficacy in treating non-segmental vitiligo across various patient subgroups up to 48 weeks. The drug, a selective dual inhibitor of JAK3 and TEC family kinases, is under phase 3 investigation. A post hoc analysis of a phase 2b study evaluated its efficacy based on baseline demographic and clinical characteristics. Results indicated clinically meaningful facial re-pigmentation, with some subgroup differences noted at 24 weeks but less apparent by 48 weeks. These findings may guide personalized therapeutic approaches and improve patient outcomes.

Ritlecitinib was evaluated for the treatment of non-segmental vitiligo (NSV) in different subgroups, stratified by demographics as well as various clinical characteristics.

Vitiligo

Vitiligo condition center page is a comprehensive resource for clinical news and insights on the dermatologic condition. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for the affected skin of vitiligo patients.

Dermatology

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Ritlecitinib Efficacious for Non-Segmental Vitiligo Across Various Subgroups

Stone is professor of medicine at Harvard Medical School and the Edward A Fox Chair in Medicine at the Massachusetts General Hospital. He has treated IgG4-related disease (IgG4-RD) since its emergence in recent years and is passionate about educating patients and fellow healthcare providers (HCPs) about the indolent and systemic nature of this disease.

Clinical Experience with Tocilizumab and Upadacitinib in GCA Treatment

This video covers the following questions:

Please share your clinical experience with tocilizumab and upadacitinib.

Let’s discuss treatment selection criteria for approved therapies. What patient subgroups would you consider for targeted agents, and what factors would contribute towards selecting one treatment over another?

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Clinical Experience with Tocilizumab and Upadacitinib in GCA Treatment 

Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

A new study demonstrated the association between inhaled corticosteroid discontinuation and a transient increase in moderate-to-severe exacerbations during the first quarter among patients with 

chronic obstructive pulmonary disease (COPD)

“This study reveals for the first time that [long-acting muscarinic antagonists (LAMA)] discontinuation results in potent withdrawal effects on exacerbations, while also reinforcing evidence of [inhaled corticosteroid] withdrawal effects,” wrote study investigator Alexander G. Mathioudakis, MD, PhD, from the biology department at The University of Manchester, and colleagues.

COPD affected approximately 480 million adults worldwide in 2020 and ranks as the 5th leading cause of years lost due to disability-adjusted life expectancy.

 By 2050, this number is projected to reach 600 million, driven by an aging population and increased exposure to air pollution and biomass.

Medication adherence in COPD is low, with only 20–30% of patients following prescribed treatments.

 Low medication adherence exacerbates disease progression, increases hospitalization risk, and worsens symptoms and quality of life. Poor adherence often leads to treatment discontinuation.

Discontinuing inhaled corticosteroids can trigger withdrawal effects and, consequently, a transient increase in exacerbations. Investigators performed a post-hoc analysis of the 52-week double-blind trial, Effect of Indacaterol Glycopyrronium versus Fluticasone Salmeterol on COPD Exacerbations (FLAME), which compared the long-acting beta-2 agonist (LABA) plus long-acting muscarinic antagonists (LAMA) with LAMA plus inhaled corticosteroids in 3362 patients with moderate-to-severe COPD and exacerbation history.

The trial stratified participants by baseline use of these therapies and compared outcomes between the first and subsequent quarters among those who continued versus discontinued each treatment. Multivariable mixed-effects models were used to evaluate differences in exacerbation rates, with temporal variations in treatment effects suggesting potential withdrawal effects.

The study found that discontinuing LAMA was associated with a transient increase in moderate-to-severe exacerbations during the first quarter versus subsequent quarters (

 =.001; rate ratio up to 2.2 (95% confidence interval [CI], 1.2 to 4.1) in the subgroup least influenced by concomitant ICS use. The study did not confirm this observation for only severe exacerbations, likely due to the low number of events.

However, the study found that discontinuing inhaled corticosteroids was associated with a significantly earlier increase in severe exacerbations (P = .023), though the difference in moderate-to-severe events was not statistically significant. Due to the insignificant data, the study could not demonstrate the inhaled corticosteroid withdrawal effect on moderate to severe exacerbations. The analysis saw consistent inhaled corticosteroid withdrawal effects regardless of baseline blood eosinophil count.

“These early peaks in exacerbations likely reflect withdrawal effects from LAMA and ICS, respectively,” investigators wrote.

The study observed a potentially strong LAMA withdrawal effect among patients who were only receiving LAMA (risk ratio, 2.7 to 3.7) or inhaled corticosteroids (risk ratio, 0.23 to 0.33) at baseline.

 Additionally, investigators said that inhaled corticosteroid withdrawal effects persisted beyond 4 weeks.

A sensitivity analysis, which only included participants who completed ≥ 300 days of trial treatment, also showed early peaks in exacerbations, although this was a less pronounced finding.

“Our results indicate that both LAMA and ICS have a potential treatment withdrawal effect on exacerbations that needs to be prospectively validated,” investigators concluded.

 “These findings emphasize the critical role of monitoring treatment adherence at every clinical visit and increasing awareness among both patients and healthcare professionals about the risks associated with intermittent use of maintenance COPD therapies. Finally, our study highlights the importance of accounting for potential withdrawal effects when evaluating treatment efficacy or effectiveness in clinical research.”

Mathioudakis AG, Bate S, Chatzimavridou-Grigoriadou V, et al. Disproportionate increase in COPD exacerbation risk for 3 months after discontinuing LAMA or ICS: insights from the FLAME trial. 

Medication adherence as the keystone in COPD management success. 

https://acarepro.abbott.com/articles/general-topics/medication-adherence-copd-management-success/

Inhaled corticosteroid (ICS) discontinuation in COPD patients is linked to a transient rise in moderate-to-severe exacerbations, particularly in the first quarter post-discontinuation. The study also highlights the withdrawal effects of long-acting muscarinic antagonists (LAMA), with a notable increase in exacerbations upon discontinuation. Medication adherence remains a challenge, with only 20-30% of COPD patients adhering to prescribed treatments, exacerbating disease progression. The findings underscore the importance of monitoring treatment adherence and considering withdrawal effects when evaluating treatment efficacy in clinical research.

Post-hoc analysis of the FLAME trial shows treatment discontinuation in COPD is associated with transient withdrawal effects and increased exacerbation risk.

Pulmonology

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Stopping Inhaled Corticosteroids or LAMA in COPD Linked to Early Exacerbations

Reflecting on the Trial Landscape in GCA and History of Approved Agents

Please provide an overview of clinical trial data for FDA-approved targeted therapies for GCA (such as tocilizumab and upadacitinib). (

Reflecting on the Trial Landscape in GCA and History of Approved Agents 

Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

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Diana Isaacs, PharmD, and Natalie Bellini, DNP, are joined by Susan Weiner, MS, to discuss the recently released US Dietary Guidelines.

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Strategic Alliance Partnership

Diabetes Dialogue: Reviewing the New US Dietary Guidelines with Susan Weiner, MS

Once-daily treatment of atopic dermatitis with oral ICP-332 showed a favorable safety profile and meaningful efficacy in a new study.

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ICP-332 Effective, Safe for Treating Moderate to Severe Atopic Dermatitis

Victoria Johnson joined the MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and now HCPLive. You can reach her at vjohnson@mjhlifesciences.com

Experts discussed how biologics revolutionize asthma and COPD management, emphasizing personalized treatment strategies and proactive care.

From GOLD to Ground Level: Navigating Biologic Use in COPD Care

A retrospective analysis does not link gentamicin with decreased risks of urinary tract infections after kidney transplantation.


Chronic Kidney Disease

Gentamicin May Not Reduce Post Kidney Transplant Urinary Tract Infection Risk 

A study found that bronchodilator responsiveness more accurately forecasts FEV₁ decline and COPD development than polygenic risk scores.

Bronchodilator Response Outperforms Genetic Risk in Predicting COPD Progression

Jamie Scott, PhD, is an EiC senior chemist at the University of Edinburgh.

Scott describes current unmet needs in IBD diagnosis and monitoring but points to the potential of a new GzmA activity-based optical assay.

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Advancing Noninvasive Diagnostics for Inflammatory Bowel Disease, With Jamie Scott, PhD

Despite an OTC approval in 2023, recent data highlights a carry rate of only 10% in the general population.

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FDA Approves New Narcan Packaging, Aiming to Boost Carry Rates

Roxana Mehran, MD, is a professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at the Icahn School of Medicine at Mount Sinai.

Mehran addresses roadblocks to inclusivity in new drug trials, emphasizing the need for a more diverse patient population for more broadly applicable evidence.

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Making Cardiology Trials Work for Every Patient, With Roxana Mehran, MD

Global analysis links elevated BMI and low physical activity to rising hypertension-related chronic kidney disease burden, with deaths projected to increase through 2050.


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The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.

Elevated BMI and Physical Inactivity Drive Rising Global Hypertension-CKD Burden

Both ethnicity and skin phototype were found in this analysis not to independently influence patients’ level of atopic dermatitis severity or their quality of life (QoL).

Latest News

New MERD Risk Score May Predict Mortality for Kidney Transplant Waitlist Patients

Ritlecitinib Efficacious for Non-Segmental Vitiligo Across Various Subgroups

Clinical Experience with Tocilizumab and Upadacitinib in GCA Treatment

Stopping Inhaled Corticosteroids or LAMA in COPD Linked to Early Exacerbations

Reflecting on the Trial Landscape in GCA and History of Approved Agents