New Insight with Dr. Veeral Sheth

Relatable Rheumatology: From Stories to Studies

Diabetes Dialogue

Don’t Miss a Beat

Abigail Brooks is an assistant editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Vitamin D may affect clinical and endoscopic outcomes in patients with inflammatory bowel disease (IBD) treated with vedolizumab, according to findings from a retrospective study.

Greater pretreatment vitamin D levels were associated with an increase in endoscopic improvement among patients with ulcerative colitis (UC) and greater nutritional and supplementation improvements in patients with Crohn disease (CD).

“Treatment failure may be due to alternate immune pathways not targeted by current mediations, low drug levels, antibody formation to a biologic, or suboptimal nutrition. Ideally, we would be able to personalize the care for our patients by identifying factors that predict response to therapy, thus allowing us to choose the appropriate medication with the best efficacy,” wrote investigators.

Patients with IBD are at risk for micronutrient deficiencies as a result of active bowel inflammation, food avoidance, and medical or surgical treatments, potentially leading to other health complications and impacting treatment outcomes. Vitamin D plays an important role in modulating the immune system, raising questions regarding its impact on clinical and endoscopic responses to therapy.

Bincy Abraham, MD, MS, distinguished professor and director of the Fondren Inflammatory Bowel Disease Program at the Underwood Center for Digestive Disorders at Houston Methodist Hospital, and colleagues sought to determine the impact of vitamin D levels on clinical response and endoscopic improvement among patients with IBD treated with vedolizumab. Patients between 18 and 80 years of age with UC or CD who were seen at the Fondren IBD program at Houston Methodist and treated with vedolizumab for at least 6 months from 2018 to 2022 were included in the study. Patients diagnosed with indeterminate colitis or short bowel syndrome, on total parental nutrition, on vedolizumab less than 6 months, or considering discontinuing vedolizumab within the next 4 months were excluded from the study.

In total, 88 patients were enrolled in the study, half (n = 44) with CD and half (n = 44) with UC. The median age of the cohort was 39.5 (Interquartile range [IQR], 31.0- 53.25) years, 30 (34%) patients were male, and 71 (80.7%) were Caucasian. Investigators noted there were no statistically significant differences in age, gender, race, or number of prior therapies between the CD and UC groups.

All participants received an induction dose of 300 mg vedolizumab at 0, 2, and 6 weeks, then maintenance dosing as standard of care thereafter. Disease outcome was examined based on clinical, lab, and endoscopic assessments. Investigators assessed factors prior to the initiation of therapy that best predicted treatment response, including clinical information on disease location and severity, nutritional status, prior medications, and levels of vedolizumab therapy.

Of the 44 patients with UC, 34 had pre-vedolizumab vitamin D levels. In patients with UC with vitamin D ≥ 30 ng/mL at the initiation of vedolizumab therapy, investigators noted UC Endoscopic Index of Severity (UCEIS) scores after 6 months of therapy were significantly decreased compared to those with low pretreatment vitamin D levels (1.5 vs 3.87; 

 = .037). No statistically significant difference between groups in ESR, clinical scores, CRP, fecal markers, iron, vitamin B12, folate, or zinc was observed prior to vedolizumab therapy or after treatment, regardless of vitamin D status.

After treatment, statistically significant decreases in the UC Activity Index and UCEIS scores were observed (both 

 < .001). Vitamin D levels improved significantly from 33.2 (IQR, 25.0-38.8) to 45.0 (IQR, 29.5-60.0) (

 = .008) ng/mL after vedolizumab initiation. Of note, improvements in vitamin D levels were more significant in the greater pretreatment vitamin D group compared to the lower pretreatment vitamin D group (

Of the 44 patients with CD, 31 had pre-vedolizumab vitamin D levels. Patients with CD with vitamin D ≥ 30 ng/mL at the initiation of vedolizumab therapy had greater iron saturation (12% vs 25%; 

 = .008) and vitamin B12 levels (433.5 vs 885 pg/mL; 

 = .003) than those with vitamin D < 30 ng/mL. After treatment, patients with greater pretreatment vitamin D levels had significantly greater vedolizumab levels (27.35 μg/mL) compared to those with low pretreatment vitamin D (14.35 μg/mL; 

Statistically significant improvements in the Harvey–Bradshaw Index (

 = .004) were observed. As in the UC group, the vitamin D levels in patients with CD improved after the initiation of vedolizumab, increasing from 23.0 (IQR, 17.0-36.0) to 31.0 (IQR, 24.0-51.7) ng/mL (

 = .007). Iron and iron saturation levels also improved significantly with vedolizumab therapy (both 

 < .001), although iron saturation improved more significantly in the greater vitamin D group (24 vs 35.5 ng/mL; 

 = .007). Investigators pointed out pre- and post-treatment clinical scores, inflammatory markers, endoscopic scores, and folate and zinc levels were similar regardless of the vitamin D levels.

Although there was a statistically significant decrease in CRP among patients with CD with baseline CRP > 5 mg/dL who had greater improvements in vitamin D (R2 = 0.3; 

 = .03), the same was not true among patients with UC (R2 = 0.03; 

 = .589). No other parameters correlated with changes in vitamin D levels.

“This study suggests that vitamin D can play a role in clinical and endoscopic outcomes and should be assessed routinely and optimized in patients with IBD in a prospective study,” concluded investigators.

Abraham BP, Fan C, Thurston T, et al. The Role of Vitamin D in Patients with Inflammatory Bowel Disease Treated with Vedolizumab. 

Crohn’s & Colitis Foundation. Common Micronutrient Deficiencies in IBD. January 2017. Accessed November 29, 2023. 

https://www.crohnscolitisfoundation.org/sites/default/files/legacy/science-and-professionals/nutrition-resource-/micronutrient-deficiency-fact.pdf

Articles

Pretreatment vitamin D levels were associated with endoscopic improvement in patients with UC and decreased C-reactive protein levels in patients with CD.

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On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

Vitamin D Linked to Clinical, Endoscopic Outcomes of Vedolizumab Treatment for IBD

Connor Iapoce is an associate editor for 

 and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at 

A new analysis of ophthalmology registry data revealed greater macular fluid volume after initial anti-VEGF treatment correlates with poorer vision outcomes and requires more intravitreal injections in eyes with 

neovascular age-related macular degeneration (nAMD)

Using real-world data obtained from the Fight Retinal Blindness! Registry, a team of investigators observed consistent outcomes across eyes with intraretinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (RPE), leading to a greater burden on both patients and health institutions.

“Identification of patients with high and low fluid volumes and the use of their information to personalize treatment regiments may be keys to improving management of nAMD in the real world,” wrote the investigative team, led by Ursula Schmidt-Erfurth, MD, of the department of ophthalmology and optometry at the Medical University of Vienna.

Intravitreal anti-VEGF therapy often lacks effectiveness in visual outcomes in the real-world, compared with clinical trials, with nonadherence and diminished treatment frequencies as potential factors.

 Artificial intelligence algorithms can identify subtle patterns and individual treatment responses in retinal diseases, but the need to train and validate these algorithms for further testing has proven challenging.

Fluid dynamics are important in treatment requirements and prognosis in nAMD and could assist in the personalization nAMD treatment regimens.

 Advances in automated deep learning algorithms have allowed for reliable determination of fluid quantity and location. Fluid measures, including IRF, SRF, and RPE, are important biomarkers in the prediction of visual outcomes, treatment needs, and late-stage outcomes in clinical trials and daily practice.

For this analysis, Schmidt-Erfurth and colleagues investigated the effect of post-initial treatment volumes on short- and long-term treatment frequency, visual acuity, and structural changes for each fluid type.

 A total 209 treatment-naive eyes with nAMD from the Fight Retinal Blindness! Registry treated with a treat-and-extend regimen were included. Medical records were reviewed for demographic data, BCVA, number of anti-VEGF treatments, and the development of macular atrophy or fibrosis over 12 and 48 months.

Macular fluid on optical coherence tomography (OCT) was automatically quantified using an approved AI algorithm. The high-fluid-volume subgroup was defined as those with the highest 25% quartile of mean residual fluid volumes after 2 initial treatments, while the remaining 75% were classified as the low-fluid-volume subgroup.

After initial treatment, patient with high IRF volumes differed by 2.6 letters (

 = .007) at months 12 and 48, respectively, compared with low IRF volumes. Those eyes with high IRF additionally received significantly more treatments, with mean differences of +1.6 (

 = .002) injections at months 12 and 48, respectively.

Meanwhile, patients with high SRF volumes after initial treatment had no statistically significant differences in BCVA outcomes, compared with the low-SRF subgroup. There were, however, significantly more injections in the high-SRF subgroup, showing mean differences of +2.4 injections (

 <.001) at months 12 and 48, respectively.

Analysis of PED outcomes showed similar results as SRF, with a lack of statistically significant differences in BCVA outcomes between high- and low-volume subgroups, but an increased treatment need in the high-PED-volume subgroup following initial treatment. The mean differences in injection frequency between high- and low-PED volumes were +1.2 (

Further analysis of new-onset atrophy and fibrosis revealed macular atrophy occurred in 71 of 187 eyes (40%) included in the data set. Among the higher 25% IRF volume subgroup, patients had a 1.81-times higher risk of developing atrophy (

 = .016) compared with the lower 75% fluid volume subgroup. Fibrosis was present in 43 of the 187 eyes (23%), but there were no significant differences between the high- and low-volume subgroups after initial treatment in all fluid compartments in both the univariate and multivariate models (all 

Schmidt-Erfurth and colleagues noted that segmentation errors and generalizability are still limiting factors inherent to studies using AI-based algorithms. Given the fluid monitor’s use in real-world data sets an in clinical practice, however, they noted the tool can provide valuable insights and assist physicians in making more informed decisions.

“With the help of automated fluid quantifications using AI, we can tailor individual treatment regimens, predict the risk of disease progression, and use this information to increase patient adherence during their lifelong disease management,” investigators wrote.

Reiter GS, Mares V, Leingang O, et al. Long-term effect of fluid volumes during the maintenance phase in neovascular age-related macular degeneration in the real world: results from Fight Retinal Blindness!. Can J Ophthalmol. Published online November 18, 2023. doi:10.1016/j.jcjo.2023.10.017

Ciulla TA, Hussain RM, Pollack JS, Williams DF. Visual Acuity Outcomes and Anti-Vascular Endothelial Growth Factor Therapy Intensity in Neovascular Age-Related Macular Degeneration Patients: A Real-World Analysis of 49 485 Eyes. 

. 2020;4(1):19-30. doi:10.1016/j.oret.2019.05.017

Bogunović H, Mares V, Reiter GS, Schmidt-Erfurth U. Predicting treat-and-extend outcomes and treatment intervals in neovascular age-related macular degeneration from retinal optical coherence tomography using artificial intelligence. 

. 2022;9:958469. Published 2022 Aug 9. doi:10.3389/fmed.2022.958469

Ophthalmology registry data show increased macular fluid volume after initial treatment are associated with increased numbers of injections in nAMD treatment. 

Age-Related Macular Degeneration

age-related macular degeneration condition center page is a comprehensive resource for clinical news and insights on retina disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for patients with AMD.

Real-World Data Reveal Impact of Macular Fluid Volume on nAMD Treatment

Lana Pine is the editor of HCPLive Rheumatology. She is an experienced editor and technical writer with a demonstrated history of working in the banking and publishing industries. In her free time, she enjoys cooking, yoga, listening to podcasts, and drawing. She can be reached via email at LPine@mjhlifesciences.com.

Surveys given to patients with post-viral 

 helped to guide the development of a patient-centric digital health solution app, according to data presented at the 

American College of Rheumatology’s 2023 Convergence

 In addition to the surveys, a usability testing component was able to identify issues regarding the onboarding process. Investigators believe future research investigating the impact of onboarding on patient adoption and enhancement of patient engagement is necessary. 

Patient-reported information is a crucial tool in the management of fibromyalgia and has become increasingly popular in rheumatology in recent years. In a recent interview with 

, John Botson, MD, explained, “Patient-reported outcomes are important…What really ensures the patient stays on treatment is how the patient feels and their quality of life.”

Post-viral fibromyalgia is a condition that can manifest after a viral infection, such as COVID-19. In fact, recent research has demonstrated roughly 30% of post-COVID-19 patients satisfy the American College of Rheumatology (ACR) diagnostic criteria for fibromyalgia. These patients often experience symptoms including widespread pain, sleep impairment, chronic fatigue, anxiety, and depression.

“Digital health interventions have demonstrated efficacy by providing disease monitoring, management, and multimodal interventions to chronic pain patients,” wrote lead investigator Marc Blanchard, MSc, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, and colleagues. “However, the widespread adoption and adherence to these interventions remain an obstacle.”

Investigators used an explanatory study design to develop a patient-centered digital health management app specifically for this population of post-viral fibromyalgia patients. They aimed to accomplish this by performing usability testing and integrating the preferences of patients to enhance the usability of the app and the engagement of users to ultimately improve self-management, patient outcomes, and quality of life.

The patient preference surveys were completed by participants recruited from the post-COVID-19 patients association, “Long-COVID Schweiz.” Usability of the app was tested using a cohort of patients with post-viral fibromyalgia enrolled in the multimodal care program for chronic pain management at the University Hospital of Lausanne, in Switzerland. The survey focused on qualitative preference data regarding the functional design of the app, interactions with the app, type of monitored data, expected content, and patient-reported outcomes. Usability testing data (notes, interviews, and patient feedback) were collected by participants using a prototype.

The app included a “How are you?” section, which collected information on patient-reported outcomes and activity, a “My result” section, which monitored symptom’s activity and health conditions, and an “Act & Advice” section, which offered a personalized training program to users.

A total of 53 patients participated in the preference survey section of the study. Most (90%) preferred a standard symptoms list questionnaire instead of a chatbot to collect their patient-reported outcomes. A longitudinal symptom evaluation is available in the “My result” section of the app. When given the option, most patients preferred active training programs (63%) and information (59%) over gamified and interactive content (15%).

Most (81%) participants explained they wanted their symptoms displayed alongside a benchmark of all other patients to better understand what helped other patients experiencing similar symptoms. Similarly, the majority of patients (63%) were interested in being provided links to patient communities. With this in mind, investigators added an anonymized discussion forum to the app.

Six patients participated in the usability testing portion of the study, of which only 2 demonstrated sufficient understanding of the app’s functionalities and were able to navigate it without additional help. Investigators explained these results highlight the importance of an onboarding process.

BlanchardM, Ming AzevedoP, PrétatT, Koller C, et al. From Patient Needs to Platform Design: Using Patient Preference to Guide the Development of a Post-Viral Fibromyalgia Management App. Presented at: American College of Rheumatology Convergence 2023. San Diego, CA. November 10-15, 2023.

Pine, L. (2023b, November 24). John Botson, MD: Pegloticase Plus immunomodulator enhances gout treatment. HCP Live. https://www.hcplive.com/view/john-botson-md-pegloticase-plus-immunomodulator-enhances-gout-treatment

Common themes included preferring a standard list of symptoms, active training programs, and the desire for community.

Fibromyalgia

On the HCPLive fibromyalgia page, resources on the topics of medical news and expert insight into fibrositis can be found. Content includes articles, interviews, videos, podcasts, and breaking news on fibromyalgia, and more.

Patient Survey Leads to Better Understanding of Digital Health Preferences in Fibromyalgia 

A nationwide study encompassing individuals with 

 in the United States revealed complex barriers faced in visiting an eye care professional for 

 screening, with factors tied to social determinants of health and socioeconomic status.

The study, including nearly 12,000 participants with T2D, revealed the factors associated with eye care in the prior 12 months included a higher educational level, income, and insurance status while experiencing food and housing insecurity were associated with not receiving eye care in the same period.

“Our results highlight self-reported barriers to seeking care and the potential importance of taking steps to promote health equity, such as providing a safe space to receive care, reducing implicit bias, and improving access to care,” wrote the investigative team, led by Sophia Y. Wang, MD, MS, of the department of ophthalmology at Byers Eye Institute, Stanford University.

Screening guidelines, including those from the American Academy of Ophthalmology (AAO), have recommended patients with T2D undergo an annual screening for diabetic retinopathy starting at diagnosis.

  Prior research has shown the association between various socioeconomic variables and lower adherence to diabetic retinopathy screening, but few have elaborated on the patient perspective to understand the reason behind this association.

In this analysis, Wang and colleagues assessed the differences in demographics, overall health, and social determinants of health between patients with T2D who did and did not self-report a visit to an eye care professional for diabetic retinopathy screening.

 The All of Us Research Database includes extensive health information from ≥250,000 individuals across the US and self-reported survey data. It puts an emphasis on capturing a diverse patient population, including traditionally underrepresented groups in medicine, to better understand health disparities.

The study used the All of Us version 7 cohort, the most recent version, which included data on participants aged ≥18 years enrolled from May 2018 to July 2022. The primary endpoint was patients' self-reported visit to an eye care practitioner, including an optometrist, ophthalmologist, or eye doctor, in the past 12 months. Primary variables included information from various surveys, measuring social determinants of health, health literacy, race and ethnicity, and income.

Among 11,551 analyzed participants with T2D, 7983 (69%) participants reported having visited an eye care practitioner in the past year. Characteristics revealed the overall mean age of participants was 65 years, 6301 (54.55%) were cisgender women, and 4456 patients (39%) reported a household income of <$50,000. Survey data revealed most measures differed significantly between patients who self-reported or did not self-report a visit to an eye care professional.

Upon analysis, investigators found individuals with food insecurity or housing insecurity were less likely to visit an eye care practitioner than those who were financially stable (food insecurity: adjusted odds ratio [aOR], 0.75 [95% CI, 0.61 - 0.91; housing insecurity: aOR, 0.86 [95% CI, 0.75 - 0.98]). Those with fair mental health were additionally less likely to visit an eye care practitioner (aOR, 0.84; 95% CI, 0.56 - 0.96) compared to those with good mental health.

The analysis also revealed factors connected to a participant’s attitude toward practitioner concordance were associated with not having seen an eye care practitioner. Those who believed practitioner concordance on race or ethnicity, gender, language, or religion to be somewhat or very important were less likely to see an eye practitioner (aOR, 0.83 [95% CI, 0.74 - 0.93]; aOR, 0.85 [95% CI, 0.76 - 0.95], respectively).

A shared identity between patient and physician has been linked to a higher quality patient experience and could lead to potentially improved outcomes. Wang and colleagues noted this may be a result of a patient’s trust in their clinician, due to commonalities that can improve the ways patients and physicians relate to one another.

“Our results demonstrated the importance of practitioner concordance in relation to delaying eye care, suggesting the potential importance of enhancing workforce diversity and implementing cultural competency training to bridge the gap between patient-physician discordance,” investigators wrote.

Younessi DN, Lin JC, Janetos TM. Regulatory and Informational Gaps in the Over-the-Counter Eye Care Product Industry—Over the Counter, Under the Radar. JAMA Ophthalmol. Published online November 02, 2023. doi:10.1001/jamaophthalmol.2023.4961

Flaxel CJ, Adelman RA, Bailey ST, et al. Diabetic Retinopathy Preferred Practice Pattern® [published correction appears in Ophthalmology. 2020 Sep;127(9):1279]. 

. 2020;127(1):P66-P145. doi:10.1016/j.ophtha.2019.09.025

Factors associated with receiving eye care in past 12 months included a higher educational level and income, while food and housing insecurity were associated with not receiving eye care.

Health Equity Barriers Emerge in Access to Diabetic Retinopathy Screening

Patrick Campbell is the managing editor of HCPLive. Formerly the editorial lead of Endocrinology Network, Practical Cardiology, and Rheumatology Network, Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. He now helps to lead coverage in each of these respective areas for HCPLive. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter with the Pocono Record in Stroudsburg, PA, and Star News Group in Manasquan, NJ. He also touts experience in multimedia, having spent time as a multimedia specialist with NJ Advance Media and multimedia coordinator at the Pocono Record. Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

Raj Dhar, MD
Credit: Washington University School of Medicine

Data from a new trial suggests thyroid hormone administration in brain-dead 

, a guideline-directed practice dating back decades, offered no significant benefit relative to saline infusion in improving rate of transplantation or graft survival.

A joint effort coordinated by 15 organ-procurement organizations in the US, results of the trial, which included 838 brain-dead donors, concluded intravenous levothyroxine infusion did not result in significantly more hearts being transplanted, with investigators suggesting this approach may even place recipients at greater risk of severe hypertension and tachycardia.

“We decided to investigate whether intravenous thyroid hormone would result in more hearts transplanted. This practice has been adopted by multiple organ-procurement organizations and is used on thousands of organ donors each year, without ever having been rigorously studied,” said Raj Dhar, MD, a professor of neurology at Washington University and an attending physician in the Neurology/Neurosurgery Intensive Care Unit at Barnes-Jewish Hospital.

 “It turns out that it doesn’t have any benefit and may cause some harm. Our findings tell us we should halt this practice.”

Citing a lack of high-quality evidence backing consensus guidelines on the topic, Dhar and a team of colleagues launched the current study e the hypothesis that intravenous levothyroxine would increase the rate of hearts transplanted from hemodynamically unstable brain-dead organ donors being considered for heart donation. Their research endeavor was designed as a multicenter, parallel-group, randomized trial and conducted at 15 organ-procurement organizations in the US.

For inclusion in the trial, patients needed to have a declaration of death according to neurologic criteria, authorization for research, an age of 14 to 55 years, a weight of 45 kg or more, and hemodynamic instability, which was defined as receipt of one or more vasopressors or inotropes after fluid resuscitation. Donors meeting these criteria underwent randomization in a 1:1 ratio to levothyroxine or normal saline within 24 hours of declaration of death. Investigators pointed out levothyroxine for intravenous use was reconstituted as 500 μg in 500 ml of saline and infused at a rate of 30 ml per hour and the control group received an equivalent volume of normal saline, with protocol specifying the infusion should run for 12 hours.

The primary efficacy outcome of interest was the transplantation of the donor heart. The primary safety outcome of interest was graft survival at 30 days after transplantation, with graft survival defined as patient survival with the originally transplanted heart and without mechanical circulatory support.

In total, 838 brain-dead donors were enrolled, with 419 randomized to levothyroxine and 419 randomized to saline. Initial analysis of these cohorts indicated characteristics of the donors were similar and were demographically and geographically representative of the target population of hemodynamically unstable potential heart donors. Investigators also pointed out the median expected probability the heart would be transplanted using the Scientific Registry of Transplant Recipients risk-adjusted model was 0.63 in the levothyroxine group and 0.59 in the saline group.

Upon analysis, results indicated hearts were successfully transplanted from 54.9% of the levothyroxine group and 53.2% of the control group (adjusted risk ratio [aRR], 1.01; 95% Confidence Interval [CI], 0.97 to 1.07; 

=.57). Analysis of the primary safety outcome suggested graft survival at 30 days occurred in 97.4% of the transplanted hearts from the levothyroxine group and 95.5% of the transplanted heart from the saline group (difference, 1.9 percentage points; 95% CI, −2.3 to 6.0; 

<.001 for noninferiority at a margin of 6 percentage point).

Further analysis demonstrated there were no substantial between-group differences observed in weaning from vasopressor therapy, ejection fraction on echocardiography, or organs transplanted per donor. However, investigators called attention to significant between-group differences observed in the number of cases of severe hypertension (26 vs 5; 

=.003) observed in the lev thyroxine group relative to the saline group.

“We found good evidence that this intervention we’ve been using for 40 years doesn’t work,” Dhar added.

 “It’s vital that we explore questions like this to ensure we are doing all we can for patients who need organs — and to ensure that they receive the most benefit possible from the generous people who choose to donate organs.”

Dhar R, Marklin GF, Klinkenberg WD, et al. Intravenous Levothyroxine for Unstable Brain-Dead Heart Donors [published online ahead of print, 2023 Nov 29]. 

. 2023;10.1056/NEJMoa2305969: doi: 10.1056/NEJMoa2305969

Washington University School of Medicine.Long-standing hormone treatment for donated hearts found to be ineffective. EurekAlert! November 29, 2023. Accessed November 29, 2023. https://www.eurekalert.org/news-releases/1009430.

A trial randomizing brain-dead donor hearts to levothyroxine administration or saline has returned results challenging conventional wisdom on the topic, with data indicating thyroid hormone administration may provide no significant benefit. 

Heart Failure

The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

Cardiology

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Thyroid Hormone Administration Provides No Benefit on Transplant Rate, Graft Survival for Brain-Dead Donor Hearts

Patients with juvenile onset fibromyalgia and joint hypermobility demonstrated poorer overall functioning compared with those without joint hypermobility. 

Joint Hypermobility May Increase Risk of Injury in Juvenile Onset Fibromyalgia 

A qualitative study in Denmark explores the adherence of patients with nAMD to their treatment regimen despite various barriers, including access to care and poor health literacy.

Study Examines Patient-Reported Barriers to Care in nAMD Treatment 

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

This data may bring patients with the rare immunobullous disease closer to an eventual FDA-approved treatment.


Dermatology

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Rituximab, Omalizumab Combination Therapy Well-Tolerated for Bullous Pemphigoid Patients

Ciprofloxacin, ceftriaxone, and piperacillin/tazobactam showed the greatest associations with adverse drug reaction case reports related to CDI. 

C Difficile Infection

C. difficile condition center page, resources on the topics of medical news and expert insight into Clostridium difficile can be found. Content includes articles, interviews, videos, podcasts, and breaking news on C. diff research, treatment, and drug development.

Common Hospital-Administered Antibiotics Linked to C Diff, Adverse Drug Reactions

Data from a phase 3 trial of CT-P43 in patients with moderate to severe plaque psoriasis offers additional insight into the comparative effects of the biosimilar relative to ustekinumab. 

Biosimilars

CT-P43 Shows Equivalent Efficacy, Safety for Plaque Psoriasis vs Ustekinumab

Videos

Dr Linda Stein Gold shares a clinical pearl on taking care of patents with plaque psoriasis from her practice.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Insights

A Clinical Pearl on Plaque Psoriasis

Expert dermatologist shares recent data on systemic therapy for patients with moderate psoriasis.  

Recent Data on Moderate Psoriasis

Dr Daniel J. Clauw provides an overview of pharmacologic and nonpharmacologic therapeutic approaches for the management of fibromyalgia and comments on challenges and unmet needs for patients.

Approaching Management of Fibromyalgia and Unmet Needs in Treatment

The FDA will decide on the approval of xanomeline-trospium, a dual M1/M4 muscarinic acetylcholine receptor agonist in the central nervous system, for the treatment of schizophrenia patients by September 2024.

Psychiatry

Psychiatry condition center page is a comprehensive resource for clinical news and insights on mental illnesses. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for depression, schizophrenia, bipolar disorder, anxiety, and more.

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FDA News

FDA Accepts Xanomeline-Trospium Drug Application for Schizophrenia Treatment

Daniel J. Clauw, MD, describes the role the brain and CNS play in controlling the setting of nociplastic pain in patients with fibromyalgia and highlights increased patient sensitivity to sensory stimuli.

Rheumatology

Rheumatology condition center page is a comprehensive resource for clinical news and insights on rheumatologic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for arthritis, gout, nr-AxSpA, and more.

Latest News

Vitamin D Linked to Clinical, Endoscopic Outcomes of Vedolizumab Treatment for IBD

Real-World Data Reveal Impact of Macular Fluid Volume on nAMD Treatment

Patient Survey Leads to Better Understanding of Digital Health Preferences in Fibromyalgia

Health Equity Barriers Emerge in Access to Diabetic Retinopathy Screening

Thyroid Hormone Administration Provides No Benefit on Transplant Rate, Graft Survival for Brain-Dead Donor Hearts