Clinical
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Inavolisib Tablets (Itovebi)
The U.S. Food and Drug Administration (FDA) has approved inavolisib, a phosphatidylinositol 3-kinase (PI3K) inhibitor, for the treatment of advanced hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer with a PIK3CA mutation. Inavolisib was granted a priority review and Breakthrough Therapy Designation.
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Long-Term Proton Pump Inhibitor Use and the Risk of Colorectal Cancer
A large retrospective cohort study demonstrated that long-term use of proton pump inhibitors is associated with an increased risk of developing colorectal adenocarcinoma.
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Diagnostic Criteria for Paraneoplastic Neurologic Syndromes
This study evaluates the effectiveness of the updated 2021 Paraneoplastic Neurologic Syndromes (PNS)-CARE score in diagnosing PNS, highlighting significant improvements in sensitivity and specificity compared to the 2004 criteria, while also addressing limitations related to study design, diagnostic criteria comparison, and the need for further research in diverse patient populations.
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Epilepsy and Cardiovascular Events
This large prospective cohort study found that older adults with a lifetime history of epilepsy were more likely to experience cardiovascular events (CVEs), and that enzyme-inducing antiseizure medications (EIASMs) may account for a significant portion of this risk. The findings suggest a potential causal link between epilepsy treated with EIASMs and CVE, highlighting the need for careful medication selection in epilepsy management.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), there were no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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Neurologic Toxicity with Immune Checkpoint Inhibitors
In a nationwide, multicenter, retrospective study of patients with neurologic immune-related adverse events related to immune checkpoint inhibitors, more than half of patients developed a chronic condition associated with a higher rate of severe neurologic disability and mortality.
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Migraine Trigger or Prodromal Symptom: Which Came First — the Chocolate or the Craving?
Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.
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Left Atrial vs. Left Ventricular Parameters for Intervention Decisions
A one-institution study of serial echocardiograms in patients with moderate to severe or severe aortic regurgitation demonstrated that changes in left atrial size and strain changed over time in a similar fashion regardless of sex and age, and were of incremental prognostic value compared to left ventricular size and function.
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Screening Relatives of Hypertrophic Cardiomyopathy Patients
A retrospective cohort study of the first-degree relatives of patients with hypertrophic cardiomyopathy (HCM) seen in screening clinics in Denmark has shown that the diagnostic yield of the first visit is 26% and subsequent visits add 4%. The best predictor of the development of HCM in relatives of families with negative genetic findings was maximal left ventricular wall thickness of ≥ 10 mm.
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Benefits of Early, Aggressive Cholesterol-Lowering After Myocardial Infarction
A large national registry study of myocardial infarction patients has shown that achieving target levels of non-high-density lipoprotein cholesterol by one month and maintaining them for at least one year reduces subsequent major adverse cardiac events and argues for aggressive early cholesterol management rather than the usual stepwise approach.