A special episode focuses on the issue of insulin accessibility and affordability in the United States, with four experts in the diabetes arena weighing in on the topic.

Crisis Point: Insulin Access in the United States

. Prior to joining MJH Life Sciences in 2019, he worked as a digital reporter covering nanotechnology, life sciences, material science and more with 

. He graduated with a degree in journalism from Temple University in 2008 and began his career as a local reporter for a chain of weekly newspapers based on the Jersey shore. When not working, he enjoys going to the beach and enjoying the shore in the summer and watching North Carolina Tar Heel basketball in the winter.

A new immersive video game platform could help adolescent patients with neurological and psychiatric disorders, including 

 (ADHD), autism spectrum disorder, and traumatic brain injuries (TBI) improve executive function.

In a presentation during the American Professional Society of ADHD and Related Disorders (

) in Orlando, Jennifer Crosbie, PhD, C.Psych, Clinical Psychologists at The Hospital for Sick Children (SickKids) and an associate professor for the University of Toronto, spoke about how the video game, called Mega Team, could help address specific symptoms in patients rather than just diseases.

 following the conference, Crosbie said what is unique about the project is that patients actually helped design the video game to try to train executive functions.

“The idea behind trying to train executive functions, which we feel are an underlying core deficit that we feel leads to downstream impairment,” Crosbie said. “By training executive function, we hope to improve those skills and have that downstream impact in day-to-day functioning.”

The platform is a five-week at-home system that leverages new technologies and virtual reality.

Crosbie recently led a small pilot study testing the platform in patients with brain disorders and executive function deficits. A larger scale study is currently being planned.

Videos

Crosbie presented results from a small pilot study testing a video game platform for patients with executive function deficits during the annual APSARD meeting. 

News

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Jennifer Crosbie, PhD: A Video Game Platform for Improving Executive Function

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.

Results of a study conducted by investigators at Texas Tech University underlines the need for reform in health screenings and a more holistic approach to care for people with autism.

Results of the systematic review and meta-analysis, which included nearly 3 dozen published articles reporting cardiometabolic risk factors among people with autism spectrum disorder and matched controls, indicate people with autism had a greater relative risk of developing a slew of cardiometabolic disorders compared to their counterparts without autism, including both type 1 and type 2 diabetes, dyslipidemia, and 

“To our knowledge, this was the first comprehensive systematic review and meta-analysis exploring the autism associated risks of diabetes mellitus, hypertension, dyslipidemia, and macrovascular disease,” wrote investigators. “Based on our results, individuals with autism seem to be at a greater associated risk of developing DM by 57.3%, type 1 diabetes mellitus by 64.1%, type 2 diabetes mellitus by 146.7%, dyslipidemia by 69.4%, and atherosclerotic heart disease by 45.9%.”

Citing previous data outlining the potential for elevated cardiometabolic risk, a team of investigators led by Chanaka Kahathuduwa, MD, MPhil, PhD, of the Department of neurology at Texas Tech University, designed the current study as a systematic review and meta-analysis of observational or baseline data of intervention studies reporting prevalence of cardiometabolic risk factors among children or adults with autism and matched participants without autism. With this in mind, the investigators performed a search of the PubMed, Scopus, Web of Science, ProQuest, Emboss, and Ovid databases from inception through July 21, 2022 without restrictions on date of publication or language.

From their search, investigators identified 34 studies encompassing more than 8 million individuals for inclusion in the systematic review and meta-analysis. The overall study cohort included 276,173 participants with autism and 7,733,306 participants without autism. The cohort of participants without autism had a mean age of 31.2 (range, 3.8-72.8) years and the cohort of participants with autism had a mean age of 22.8 (range, 3.8-72.8) years. The pooled cohort was 47% were female.

The primary outcome of interest for the study was the RR of diabetes, hypertension, dyslipidemia, and atherosclerotic macrovascular disease among people with autism. Secondary outcomes of interest included the RR of type 1 and type 2 diabetes, cardiovascular disease, stroke, and peripheral artery disease. Of the 34 studies identified for inclusion, 22 reported statistics allowing for computation of relative risk (RR) of cardiometabolic risk factors and the other 12 reported laboratory measurements of interest.

Upon analysis, results indicated a diagnosis of autism was associated with greater risks of developing diabetes overall (RR, 1.57 [95% CI, 1.23-2.01]; 20 studies) as well as for type 1 diabetes (RR, 1.64 [95% CI, 1.06-2.54]; 6 studies) and type 2 diabetes (RR, 2.47 [95% CI, 1.30-4.70]; 3 studies) as individual outcomes of interest. Further analysis indicated a diagnosis of autism was associated with a greater risk of dyslipidemia (RR, 1.69. [95% CI, 1.20-2.40]; 7 studies) and cardiovascular disease (RR, 1.46 [95% CI, 1.42-1.50]; 3 studies).

However, investigators pointed out no statistically significant association of increased risk was observed for hypertension (RR, 1.22 [95% CI, 0.98-1.52]; 12 studies) and stroke (RR, 1.19 [95% CI, 0.63-2.24]; 4 studies) among people with autism. In meta-regression analyses, results indicated children with a diagnosis of autism were at a greater is of developing hypertension and diabetes than adults, but investigators called attention to a concerningly high level of between-study heterogeneity for several meta-analyses.

, Elizabeth Weir, PhD, of the Autism Research Centre in the Department of Psychiatry at the University of Cambridge, underlined the importance of the study’s findings on emphasizing the need for reform in management given the rising rates of autism spectrum disorder and the already shortened life expectancy for these patients.

“The results from this systematic review and meta-analysis require clinicians and researchers alike to radically rethink the health care provision that is currently provided to autistic people,” Weir wrote. “More support for both mental and physical health care across the life span should be offered and new research on how to improve outcomes is critical.”

Association Between Autism Spectrum Disorders and Cardiometabolic Diseases

Articles

A systematic review and meta-analysis of nearly 3 dozen published articles details the apparent increase in risk of cardiovascular disease and diabetes associated with a diagnosis of autism. 

Clinical

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Children, Adults with Autism Face Heightened Risk of Cardiometabolic Illnesses

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 

 was found to be effective for adult patients with moderate-to-severe plaque psoriasis who had inadequate responses to ustekinumab.

The investigators’ research into guselkumab was conducted in order to determine both the efficacy and safety profile of the treatment for 

The study was authored by L. Gargiulo, from the IRCCS Humanitas Research Hospital’s Dermatology Unit in Rozzano, MI, Italy.

“Our multicentric retrospective study aimed to assess the effectiveness and safety of guselkumab in 233 patients who received this drug after failing therapy with ustekinumab,” Gargiulo and colleagues wrote.

The aforementioned NAVIGATE trial previously resulted in data demonstrating guselkumab’s efficacy for patients treated previously with ustekinumab, but the new study was conducted to test for a longer-term, real-world setting.

The research team conducted a multicenter, retrospective study at 14 various hospitals in Italy, recruiting 233 participants with moderate-to-severe psoriasis and given guselkumab following a poor response to ustekinumab.

The participants were recruited between the periods of January 2020 and September 2022.

At baseline, Week 16, Week 52, and Week 104, the researchers assessed both the 233 psoriasis patients’ characteristics and Psoriasis Area and Severity Index (PASI) scores.

Additionally, the team registered the percentages of study participants who had reached 75%, 90%, and 100% PASI improvement, compared with baseline (PASI 75, PASI 90, PASI 100, respectively).

The investigators found that after 52 weeks, 89.88% of the study participants achieved PASI 75, 71.43% achieved PASI 90, and 53.83% achieved PASI 100.

A total of 90.48% of psoriasis patients included achieved absolute PASI scores of ≤ 2 by Week 52, the investigators noted.

The team reported that there were higher PASI 75, 90, and 100 rates in these patients compared to those in NAVIGATE, and those participants with involvement of difficult-to-treat regions of the body were found after 16 weeks to be much less likely to reach PASI 90 and PASI 100.

Obesity was also found to be a factor affecting patients’ results, as those who were obese were found after 52 weeks to have substantially lower PASI 75 and PASI ≤ 2 scores.

That being said, responses to guselkumab evened out for every patient regardless of body mass index (BMI) or any other identified subgroup by 104 weeks.

“Guselkumab was well tolerated, as no significant safety findings emerged after two years of therapy,” they wrote. “Larger and longer prospective studies and retrospective analyses of patient databases are needed to further assess the effectiveness and safety of guselkumab in real-life bio-experienced patients.”

Real-life effectiveness and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab

Journal of the European Academy of Dermatology and Venereology

New research, comparable with that of the NAVIGATE trial, was conducted and showed strong results for the use of guselkumab for psoriasis patients.


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.

Study Suggests Efficacy of Guselkumab in Psoriasis Patients with Inadequate Ustekinumab Response

A new study highlights the need to for better epidemiologic surveillance in order to detect specific clusters of 

 strains in high risk locations, such as neurosurgery wards.

A team, led by Xiajing Bi Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, identified the epidemiology of CDII in a neurosurgery department over the course of 24 months, with particular attention paid to the transmission of C difficile using whole-genome sequencing.

There are very few studies focusing on the transmission of C difficile, particularly in wards with low detection rates like neurosurgery departments. However, there is a greater need to identify specific clusters.

“Since the emergence of hypervirulent variants of toxigenic 

 RT027, the morbidity and mortality of CDI have increased markedly, and this has been accompanied by large healthcare-associated outbreaks,” the authors wrote. “CDI has aroused great concern worldwide due to its increasing incidence, recurrence, morbidity, and impact on healthcare spending.”

In the study, the investigators isolated C difficile strains from fecal samples of neurosurgical patients.

The team typed toxigenic strains using multilocus sequence typing, PCR ribotyping and using capillary gel electrophoresis, as well as whole-genome sequencing to characterize 

Finally, they performed comparative genomic analyses to compare the genomic differences between all ST-37 strains from other wards and examined the susceptibility to 8 antimicrobial agents using the E-test.

The results show isolates from patients in the neurosurgery department basically fell into 2 distinct lineages where s11052403 and s 10090304 were isolated from a patient on the 8th floor and a patient on the 9th floor of the neurosurgery ward.

The 2 strains were highly similar and exhibited differences of only 2 single-nucleotide polymorphisms.

All C difficile ST-37/RT017 strains isolated from neurosurgical patients were resistant to several different classes of antibiotics.

“There is an urgent need to raise awareness of 

 infection, and epidemiologic surveillance is required to detect clustering and transmission of 

 cases in China,” the authors wrote. “Strict disinfection of the environment is essential to reduce transmission of 

 and achieve effective infection control in the hospital setting.”

Retrospective Study of the Epidemiology of Clostridioides difficile Infection in the Neurosurgery Department of a Tertiary Hospital in China

The 2 strains identified were highly similar and exhibited differences of only 2 single-nucleotide polymorphisms.

C Difficile Infection

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Investigators Isolate C Difficile Strains in Neurosurgery Department

As advancing technology continues to push patient care into the future, a new emphasis has been placed on creating technologies with the ability to be customized and precise to each patient. There may be no fields where this is more evident than in diabetes technologies, where breakthroughs seem to occur on a regular basis and, earlier this month, a 

historic, first-of-its-kind clearance from the US Food and Drug Administration

 furthered this ability to customize and adapt care in an individualized manner most for each person with diabetes.

Named Tidepool Loop, the prescription-only mobile app, which was created by Tidepool, received clearance from the FDA for use with compatible devices for automated insulin dosing to help manage 

 in persons 6 years of age and older. A 501(c)3 organization founded in 2013, Tidepool Loop represents the latest addition to a suite of software tools from Tidepool that already includes Tidepool Web, Tidepool Mobile, and Tidepool Uploader. A patient-led project, the Tidepool Loop was created with the intent of allowing people with diabetes to use the app with compatible integrated continuous glucose monitors (iCGM) and alternate controller-enabled pumps to automatically increase, decrease, and suspend delivery of basal insulin based on iCGM readings and predicted glucose values. The app, which is only available for the iPhone at the time of writing and is also the first app to enable insulin delivery from a compatible Apple Watch, is also designed to recommend and deliver correction boluses when glucose values are predicted to exceed predefined thresholds.

To celebrate the historic clearance and provide real-world perspective on what it means for people with type 1 diabetes, Diana Isaacs, PharmD, an endocrine clinical pharmacist and coordinator of the CGM Program at the Cleveland Clinic, and Natalie Bellini, DNP, an endocrine nurse practitioner with R&B Medical Group, tackle the clearance of the Tidepool Loop in this special edition episode of 

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives

In the episode, hosts discuss the clearance, what is unique about the app’s customizability, and other top points for people with diabetes and members of the diabetes care team to consider with the technology moving into the future.

 are available in an audio-only format on 

Podcasts

In this episode of Diabetes Dialogue, ours hosts discuss the clearance of Tidepool Loop, what is unique about the app’s customizability and compatibility with other diabetes technologies, and other top points for people with diabetes and members of the diabetes care team to consider with the technology moving into the future.

Type 1 Diabetes

Diabetes Dialogue

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Diabetes Dialogue: FDA Clearance of Tidepool Loop

In a recent study, DLE patients responded well to topical niacinamide 2% and 4% as adjuvant therapy, with strong results and few side effects.

Dermatology

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Lupus

Topical Niacinamide Effective as Adjuvant Therapy for Discoid Lupus Erythematosus

Lana Dykes 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 LDykes@mjhlifesciences.com.

The January 2023 rheumatology month in review highlights a recent study that indicated an increased risk of hospitalization and death among patients with gout and COVID-19, the expansion of research evaluating adalimumab biosimilars, and trends in fibromyalgia. 





Rheumatoid Arthritis

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Rheumatology Month in Review: January 2023 

An FDA panel voted unanimously this week to support harmonizing an annual primary and booster dose, moving public health strategies to reflect the endemic course of COVID-19.

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Our COVID-19 Vaccine Expectations Are Finally Getting Realistic

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 lower DME resolution rate was associated with a thicker baseline CST and better baseline best-corrected visual acuity in eyes treated with aflibercept. 

Ophthalmology

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Thicker Baseline CST Linked to Longer DME Resolution in Aflibercept-Treated Eyes

A new review shows a majority of COVID-19 randomized, controlled trial preprints have been published with changes to the components of the original findings.

COVID-19 Preprint Studies Take About 6 Months to Publish

SARS-CoV-2 infections cause microbiome dysbiosis in patient and possibly an increase in opportunistic pathogens and a decrease in beneficial bacteria.

Significant Gut Microbiota Differences Found in COVID-19 Patients, Healthy Individuals

The January 2023 cardiology month in review features a trio of articles related to management of atrial fibrillation, the FDA approval of Abbott’s Navitor system, and a study spotlighting the prevalence of mental health conditions among cardiologists.

Cardiology Month in Review: January 2023

In this recent study, mental health conditions associated with alopecia areata were assessed by the study’s investigators.

Anxiety, Depressive Disorder Prevalence Greater Among Alopecia Areata Patients

A sugary drinks tax in England may have prevented over 5,000 cases of obesity a year in older girls, but had no significant association with obesity levels in year six boys or younger children. 


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Sugary Drinks Tax May Be Effective In Preventing Childhood Obesity 

The approval of the adalimumab biosimilar, adalimumab-aacf, signals the beginning of Fresenius Kabi's long-term dedication to biosimilars.


Latest News

Jennifer Crosbie, PhD: A Video Game Platform for Improving Executive Function

Children, Adults with Autism Face Heightened Risk of Cardiometabolic Illnesses

Study Suggests Efficacy of Guselkumab in Psoriasis Patients with Inadequate Ustekinumab Response

Investigators Isolate C Difficile Strains in Neurosurgery Department

Diabetes Dialogue: FDA Clearance of Tidepool Loop