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Tocilizumab cuts deaths in hospitalized COVID-19 patients

Tocilizumab, sold under the brand name Actemra, is an intravenous anti-inflammatory monoclonal antibody drug used to treat rheumatoid arthritis. It was added to the trial in April 2020 for patients with COVID-19 who required oxygen and had evidence of inflammation.

The study data were from 2,022 COVID-19 patients who were randomly allocated to receive tocilizumab by intravenous infusion and who were compared with 2,094 patients randomly allocated to usual care alone. Researchers said 82% of all patients were taking a systemic steroid such as dexamethasone.

Results showed that treatment with tocilizumab significantly reduced deaths – with 596 (29%) of the patients in the tocilizumab group dying within 28 days, compared with 694 (33%) patients in the usual care group.

Pembrolizumab ‘Preferred Choice’ in MSI-H/dMMR Metastatic CRC

Pembrolizumab significantly improved progression-free survival compared with chemotherapy among patients with microsatellite instability–high/mismatch repair–deficient (MSI-H/dMMR) metastatic colorectal cancer, according to results from the KEYNOTE-177 study.

Study Details: The KEYNOTE-177 trial included 307 patients with confirmed, untreated MSI-H/dMMR metastatic colorectal cancer who were randomly assigned to receive pembrolizumab 200 mg every 3 weeks for up to 35 cycles (n = 153) or the investigators’ choice of chemotherapy (n = 154). Chemotherapy regimens included modified FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) alone or in combination with either bevacizumab or cetuximab, or FOLFIRI (leucovorin, fluorouracil, irinotecan) alone or in combination with either bevacizumab or cetuximab. Patients in the chemotherapy group could cross over to pembrolizumab therapy after disease progression.

Source: Medscape

Ruxolitinib as second line drug in Chronic GVHD

Ruxolitinib, a JAK inhibitor first marketed for use in myelofibrosis, is already approved for acute GVHD. The US Food and Drug Administration approved that indication last year on the basis of data from two previous trials, REACH 1 and REACH 2. The trials found that ruxolitinib was superior to best available therapy for treating patients with acute GVHD.

In the current REACH 3 study, Zeiser and colleagues compared ruxolitinib with best available therapy in 329 patients with moderate-to-severe cGVHD (both steroid dependent and steroid resistant).

Source: Medscape

VEXAS Syndrome

Researchers from the National Institutes of Health (NIH) have discovered a new inflammatory disorder called Vacuoles, E1 enzyme, X-linked, Autoinflammatory and somatic Syndrome (VEXAS), which is caused by mutations in the UBA1 gene.

VEXAS causes symptoms that included blood clots in veins, recurrent fevers, pulmonary abnormalities and vacuoles (unusual cavity-like structures) in myeloid cells.

Antihypertensive drugs that reduces risk for Depression

The risk of depression is elevated in patients with cardiovascular diseases, but several specific antihypertensive therapies are associated with reduced risk, and none appear to increase the risk, according to a population-based study that evaluated 10 years of data in nearly 4 million subjects.

Agents associated with a reduced risk of depression were: two angiotensin agents, enalapril and ramipril; three calcium antagonists, amlodipine, verapamil, and verapamil combinations; and four beta-blockers, propranolol, atenolol, bisoprolol, and carvedilol.

Source: Medscape

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