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Atogepant is the first and only, oral calcitonin gene-related peptide (CGRP) receptor antagonist approved for migraine. Dose: 60 mg dose 1 OD in chronic migraine. 30 mg and 60 mg for prevention of episodic migraine.

Clinical Inshorts by ClinicHours

Two classes of drugs may be more effective than others for the treatment of gastroparesis, though the overall quality of evidence remains low to moderate and additional data are needed, according to a new report. Oral dopamine antagonists and tachykinin-1 antagonists appear superior to placebo. Only one drug, the dopamine antagonist metoclopramide, has US Food and Drug Administration approval for the treatment of gastroparesis (Gastroparesis is a chronic disorder which means delayed stomach emptying without a blockage).

Clinical Inshorts by ClinicHours

New more aggressive targets for blood pressure and lipids are among the changes to the annual American Diabetes Association (ADA) Standards of Care in Diabetes 2023. The new definition of hypertension in people with diabetes is ≥ 130 mmHg systolic or ≥ 80 mmHg diastolic blood pressure, repeated on two measurements at different times. Among individuals with established cardiovascular disease, hypertension can be diagnosed with one measurement of ≥ 180/110 mmHg. The goal of treatment is now less than 130/80 mmHg if it can be reached safely.

Clinical Inshorts by ClinicHours

Investigators found that levels of formic acid, a metabolic product of formaldehyde found in urine, were significantly higher in individuals with Alzheimer disease including those with subjective cognitive decline, which may indicate very early stages of the disorder. Urinary formic acid and formaldehyde are likely to be new biomarkers independent of the existing AD diagnostic criteria. Researchers also compared formic acid and formaldehyde levels across different AD stages and found significantly higher levels across all stages compared with people who had no cognitive decline. Levels were also higher in patients with AD than in patients with MCI and those with cognitive impairment and no MCI, as well as in those with poorer neurologic test scores.

Source: Frontiers

Clinical Inshorts by ClinicHours

Neurofilament light chain (NfL) is a biomarker for both disease progression and treatment response in multiple sclerosis (MS), but the search continues for additional biomarkers to distinguish between disease activity and progression. Serum glial fibrillary acid protein (GFAP) could be a useful complement to NfL in MS, although it is not ready for the clinic.NfL is a structural protein of neurons, while GFAP is a structure protein of astrocytes. NfL therefore reflects neuronal damage, while GFAP is an indicator of astrogliosis and astrocytic damage. GFAP has been shown to be increased in progressive MS and has been applied in traumatic brain injury and neuromyelitis optica spectrum disorder. Serum GFAP is a promising biomarker reflecting progression in MS and it is complementary to NfL.

Inshorts by ClinicHours

The oral potassium-competitive acid blocker vonoprazan was superior to the proton pump inhibitor lansoprazole for erosive esophagitis, according to results of the phase 3 PHALCON-EE trial. The 878 patients with healing were re-randomized to receive vonoprazan 10 mg 1 OD, vonoprazan 20 mg, or lansoprazole 15 mg for 24 weeks in the maintenance phase. For maintenance of healing at week 24, vonoprazan was noninferior to lansoprazole in the primary analysis and superior on secondary analysis of healing (80.7% for vonoprazan 20 mg and 79.2% for vonoprazan 10 mg vs 72.0% for lansoprazole; P < .0001 for both comparisons). As expected, serum gastrin increased to a greater extent with vonoprazan than lansoprazole, with levels > 500 pg/mL in 16% of those taking 20 mg at the end of maintenance therapy, the authors report. After stopping vonoprazan, gastrin levels dropped by roughly 60%-65% within 4 weeks. Last May, the FDA approved two vonoprazan based therapies for the treatment of H pylori infection.

Inshorts by ClinicHours

Ibalizumab is a long-acting monoclonal antibody, was first approved by the FDA in 2018 for the treatment of adults with multidrug resistant HIV-1. It is used in combination with other antiretroviral drugs. Prior to this approval, the drug was administered intravenously as a single 2000 mg loading dose, followed by an 800 mg maintenance dose every 2 weeks by a trained medical professional. The intravenous infusion is given over 15 to 30 minutes. Now, the maintenance dose can be administered by IV push, a method where the undiluted medication is delivered intravenously by injection, in just 30 seconds. Adverse effects of ibalizumab include diarrhea, dizziness, nausea, rash, immune reconstitution inflammatory syndrome.

Inshorts by ClinicHours