A 2022 systematic review and meta-analysis identified 11 randomized controlled trials (RCTs) of 930 adults admitted to the intensive care unit (ICU) with primary neurologic injury to evaluate the efficacy of stress ulcer prophylaxis (SUP) in reducing gastrointestinal bleeding (GIB). Primary neurological conditions included traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracranial hemorrhage (ICH) as well as other conditions. The interventions compared the use of histamine-2-receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) against placebo, no prophylaxis, or each other. Enteral nutrition varied with 6 studies implementing early enteral feeding practices, 4 studies implementing fasting, and the remaining studies lacking data. [1] A pooled analysis revealed that both PPIs and H2RAs significantly reduced the occurrence of GIB compared to placebo or no prophylaxis, with risk ratios (RR) of 0.37 (95% confidence interval [CI] 0.23 to 0.59; 0<0.001) and 0.42 ...

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A 2014 prospective, single-center study conducted in Sweden evaluated the effects of repeated measurements of intraocular pressure (IOP) using Goldmann applanation tonometry (GAT) and applanation resonance tonometry (ART) in six healthy volunteers. The study also investigated the impact of two topical anesthetics, oxybuprocaine/fluorescein and tetracaine, on IOP and anterior chamber volume (ACV). Participants underwent alternating IOP measurements in both eyes for one hour after instillation of either oxybuprocaine/fluorescein in the right eye or tetracaine in the left. Consecutive series of six IOP measurements per method were performed, and ACV was photographed periodically using Pentacam in the tetracaine-treated eyes. A separate trial was conducted on the same participants to isolate the effect of the anesthetics alone, with identical drop administration but without repeated IOP measurements. [1] The study documented significant reductions in IOP during repeated applanation f...

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A 2024 pooled analysis of long-term outcomes from three clinical trials explored the durability of teprotumumab in individuals with thyroid eye disease (TED). The collective data involved 112 patients who completed seven or eight infusions of teprotumumab within the Phase 2, Phase 3 OPTIC, and OPTIC-X (see Table 1) studies. Clinical endpoints, including a reduction in Clinical Activity Score (CAS) by ≥2 points, improvements in proptosis (≥2 mm reduction), diplopia (≥1 Gorman grade), quality of life (GO-QoL), and overall response (proptosis + CAS improvement), were evaluated over an extended follow-up period. Data were assessed at multiple time points, from the study baseline to week 24 (therapy period) and beyond, with the longest follow-up extending to 99 weeks. Key findings demonstrated a sustained response in inflammatory activity and ophthalmic outcomes, with 91.2% of patients achieving CAS response and 89.5% reporting improvements in the composite European Group of Graves’ Orbi...

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A 2014 guidance statement published by the Executive Committee of the American Uveitis Society provided recommendations for the management of Behçet's disease in uveitis. Based on the available evidence, the expert panel recommends the use of anti-tumor-necrosis factor (anti-TNF) therapy, with infliximab or adalimumab, as a first- or second-line corticosteroid-sparing therapy for patients with ophthalmic manifestations of Behçet's disease. Infliximab may also be considered as a first- or second-line treatment for acute exacerbations of pre-existing Behçet's disease. The use of etanercept may be considered for Behçet's patients with uveitis who are intolerant to infliximab and adalimumab, although the quality of evidence is relatively lower. These recommendations are based on meta-analyses and comparative studies that have demonstrated the efficacy of anti-TNF agents, particularly infliximab, in managing the various manifestations of Behçet's disease. These studies have reported resp...

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Suzetrigine (also called VX-548) is a selective inhibitor of voltage-gated sodium channel NaV1.8 being studied for pain relief. The NaV1.8 receptor holds a role in transmitting nociceptive signals with selective expression in peripheral nociceptive neurons of the dorsal-root ganglia. Because the NaV1.8 receptor and the gene encoding it (SCN10A) are not found in the human brain, it is hypothesized that suzetrigine will not have central nervous system effects (including abuse and dependence potential). [1-4] In July 2022, the U.S. Food and Drug Administration (FDA) accepted a new drug application (NDA) submission for suzetrigine to treat moderate-to-severe pain with an assigned Prescription Drug User Fee Act (PDUFA) date of January 30, 2025. This comes after submitting two phase 3 results (Table 1) of suzetrigine compared to hydrocodone/acetaminophen and placebo following abdominoplasty and bunionectomy procedures. [3-5] Additional preliminary results were revealed in December 2...

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