To the Editor:
In his review of inflammation, atherosclerosis, and coronary artery disease, Hansson (April 21 issue)
1
focuses on T cells, macrophages, and mast cells as the cellular components of ...the immune system that play a key role in ischemic heart disease. However, he omits a possible role for neutrophils.
Several lines of evidence support the possibility that these cells are involved in this condition. Early studies showed a strong positive correlation between peripheral-blood neutrophil counts and the risk of acute myocardial infarction
2
and documented the presence of activated circulating neutrophils in acute coronary syndromes.
3
Furthermore, infiltration by neutrophils of . . .
Baricitinib and imatinib are considered therapies for coronavirus disease 2019 (COVID‐19), but their ultimate clinical impact remains to be elucidated, so our objective is to determine whether these ...kinase inhibitors provide benefit when added to standard care in hospitalized COVID‐19 patients. Phase‐2, open‐label, randomized trial with a pick‐the‐winner design conducted from September 2020 to June 2021 in a single Spanish center. Hospitalized adults with COVID‐19 pneumonia and a symptom duration ≤10 days were assigned to 3 arms: imatinib (400 mg qd, 7 days) plus standard‐care, baricitinib (4 mg qd, 7 days) plus standard‐care, or standard‐care alone. Primary outcome was time to clinical improvement (discharge alive or a reduction of 2 points in an ordinal scale of clinical status) compared on a day‐by‐day basis to identify differences ≥15% between the most and least favorable groups. Secondary outcomes included oxygenation and ventilatory support requirements, additional therapies administered, all‐cause mortality, and safety. One hundred and sixty‐five patients analyzed. Predefined criteria for selection of the most advantageous arm were met for baricitinib, but not for imatinib. However, no statistically significant differences were observed in formal analysis, but a trend toward better results in patients receiving baricitinib was found compared to standard care alone (hazard ratio HR for clinical improvement: 1.41, 95% confidence intervals CI: 0.96−2.06; HR for discontinuing oxygen: 1.46, 95% CI: 0.94−2.28). No differences were found regarding additional therapies administered or safety. Baricitinib plus standard care showed better results for hospitalized COVID‐19 patients, being the most advantageous therapeutic strategy among those proposed in this exploratory clinical trial.
Abstract Objective Emerging data have shown an increased risk of malignancy among patients diagnosed with systemic sclerosis (SSc) so identification of risk factors linking both disorders might have ...prognostic implications. The aim of this study was to assess the clinical and treatment-related risk factors for cancer in a single-center cohort of patients with SSc. Methods Demographic, clinical, capillaroscopic, immunological and treatment-related data from 432 consecutive SSc patients were retrospectively analyzed. Variables that reached significant association in the univariate analysis were entered into a logistic regression in order to identify independent risk factors for cancer. Results Malignancy was diagnosed in 53 patients (12.2%). Fifty-eigth neoplasms were identified, among which breast ( n = 15), lung ( n = 10) and hematologic ( n = 9) malignancies were the most prevalent. In 19 patients the diagnosis of both scleroderma and tumour was made in < 3 years apart. Cancer significantly decreased the probability of survival (OR = 2.61; 95%CI 1.46–4.69; p = 0.001). No association with age, sex, smoking, cutaneous subset or RNA polymerase-III antibodies was found. However, risk of cancer was directly associated with the presence of anti-PM/Scl antibodies (OR = 3.90; 95%CI 1.31–11.61; p = 0.014), and inversely related to aspirin use (OR = 0.33; 95%CI 0.12–0.90; p = 0.031), which remained as independent risk factors for cancer on multivariate analysis. Conclusions PM/Scl antibodies seem to be associated with a higher risk of cancer in scleroderma. In contrast, the use of aspirin is related to a lower risk of cancer in our series. More studies are needed to ascertain the role of anti PM/Scl antibodies and aspirin in the development of malignancy among patients with SSc.
Evolocumab in Patients with Cardiovascular Disease García de Tena, Jaime; Morales-Ortega, Alejandro; Pindao-Quesada, Gloria ...
The New England journal of medicine,
08/2017, Letnik:
377, Številka:
8
Journal Article
Recenzirano
Odprti dostop
To the Editor:
Sabatine et al. (May 4 issue)
1
report the results of the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial. The addition of ...evolocumab to standard therapy was associated with an absolute risk reduction of 2 percentage points in both the primary and secondary end points after a median duration of follow-up of 26 months. The fact that approximately 30% of the patients were receiving moderate-intensity statin therapy and the lack of clinical efficacy of evolocumab in the small group of patients receiving ezetimibe (presumably combined with a statin) arouse concern about . . .
•Imatinib has been proposed as a potential treatment for COVID-19.•BCR-Abl inhibitors might interfere with humoral immunity.•IgG synthesis after COVID-19 is not impaired by a short course of imatinib.
Sabatine et al. (May 4 issue)1 report the results of the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial. The addition of evolocumab to ...standard therapy was associated with an absolute risk reduction of 2 percentage points in both the primary and secondary end points after a median duration of follow-up of 26 months.
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