Advances in Therapy

This study investigated the effect of a herbal anticellulite pill on visible cellulite in the thighs. Sixty female volunteers took a herbal anticellulite pill or a herbal anticellulite pill plus supplements of conjugated linoleic acid for 60 days. The combination treatment had a beneficial effect in as many as 75% of the women. The appearance of the skin improved significantly, and thigh circumference was reduced by an average of 0.88 inch. Further investigation in a larger, longer placebo-controlled trial is warranted.

Nghiên cứu CORE nhằm cung cấp cái nhìn chi tiết về việc sử dụng dung dịch immunoglobulin dưới da 20% (Ig20Gly) trong điều trị cho bệnh nhân mắc các bệnh thiếu hụt miễn dịch nguyên phát (PID) tại Đức và Thụy Sĩ. Các bệnh nhân mắc PID đã nhận được liều ổn định của bất kỳ loại immunoglobulin dưới da nào trong ít nhất 3 tháng trước khi tham gia nghiên cứu này đủ điều kiện tham gia nghiên cứu đa trung tâm (n = 5), giai đoạn 4, không can thiệp, và đồng thời theo dõi theo chiều dọc. Ngoài các đặc điểm nhân khẩu học và lâm sàng ban đầu, dữ liệu về việc sử dụng và độ an toàn của Ig20Gly, cũng như các kết quả tự báo cáo của bệnh nhân (Chỉ số Chất lượng Cuộc sống/Bảng hỏi sự Hài lòng về Điều trị cho Thuốc) đã được thu thập tại thời điểm bắt đầu, 6 và 12 tháng. Phân tích thống kê được thực hiện để mô tả. Tổng cộng có 36 bệnh nhân cung cấp dữ liệu tại thời điểm bắt đầu [69.4% nữ; tuổi trung bình: 41.6 năm (7–78 năm)]. Tổng cộng 23 và 26 bệnh nhân tham dự các cuộc hẹn 6 và 12 tháng, tương ứng; 16 bệnh nhân đã tham dự cả ba cuộc hẹn. Một bệnh nhân đã rút lại sự đồng ý trước theo dõi 6 tháng. Tốc độ truyền dịch tối đa trung vị của Ig20Gly tại thời điểm bắt đầu, 6 tháng và 12 tháng là 26.7, 24.5 và 40.0 mL/h, tương ứng (10–60 mL/h). Các tham số truyền dịch và liều lượng vẫn nhất quán giữa các thời điểm: bệnh nhân sử dụng trung vị hai vị trí truyền dịch, chủ yếu là bụng, và tất cả bệnh nhân đều sử dụng máy bơm truyền dịch; tất cả trừ một bệnh nhân đều thực hiện truyền tại nhà và phần lớn tự tiêm Ig20Gly (80.8–83.3%) với khoảng cách một tuần (69.2–73.9%). Trong quá trình theo dõi, 10 sự kiện bất lợi đã được báo cáo: không sự kiện nào được đánh giá là nghiêm trọng, trong khi 2 sự kiện được coi là có thể liên quan đến Ig20Gly. Tổng điểm kết quả tự báo cáo của bệnh nhân vẫn ở mức cao trong suốt nghiên cứu. Nghiên cứu CORE cung cấp bằng chứng thực tế về tính linh hoạt, khả năng thực hiện, độ an toàn và khả năng dung nạp của các lần truyền Ig20Gly, chủ yếu là hàng tuần, trong 1 năm ở bệnh nhân mắc PID. Đăng ký Nghiên cứu Lâm sàng Đức, DRKS00014562. Được đăng ký vào ngày 9 tháng 4 năm 2018.

Rheumatoid arthritis (RA) is a chronic and refractory autoimmune disease characterized by synovial inflammation with unknown aetiology. Immune system dysfunction mediated by CD4+ T lymphocytes, which is regulated by the cytokine osteopontin (OPN), plays an important role in the pathogenesis of RA. In this study, the levels of peripheral CD4+ T subsets and serum OPN in patients with active RA were measured and analysed to determine the possible pathogenesis of RA and to provide potential therapeutic targets. Serum OPN levels in both patients with active RA and patients with refractory RA were higher than those in healthy controls (HCs). Compared with HCs, the absolute numbers of Th2 cells increased in patients with active RA, while the absolute counts of Th1 and Treg cells decreased. There was no significant difference in CD4+ T subset levels between new-onset and refractory patients. As the condition persisted or deteriorated, a gradual increase in the levels of OPN and gradual declines in the absolute counts of Th1 and Treg cells were observed in patients with active RA. The fewest Th1 and Treg cells and the highest OPN levels were observed in patients with high disease activity. The serum OPN level was only significantly negatively correlated with the absolute counts of Treg cells in the CD4+ T lymphocyte subsets. Fewer Treg cells with the increase in disease activity may be related to the increased OPN concentration, which may provide new ideas and directions for the targeted immunoregulatory treatment of RA.

The coronavirus disease 2019 (COVID-19) pandemic created challenges related to disease management of patients with ulcerative colitis (UC). The UC Narrative COVID-19 survey was conducted from August to December 2021 among adults with UC from the United States, Canada, Japan, France, and Finland. Patients were questioned on disease management, health care access and experience, and preferences for interactions with their doctor. Data were analyzed descriptively. In total, 584 patients qualified for and completed the survey. Compared with 2019, 25% experienced more flares during the pandemic (from early 2020). Most patients (88%) taking prescription medication were very/somewhat satisfied with their current treatment plan; 53% were hesitant to make changes during the pandemic. Factors that patients agreed helped control UC symptoms during the pandemic included fewer social outings (37%), working from home (29%), and less busy schedules (28%). Greater anxiety/stress (43%) and hesitancy to visit a hospital/office (34%) made the control of UC symptoms more difficult. Compared with 2019, more patients relied on certain alternative support systems during the pandemic. Patients who used in-person and virtual appointments were equally very satisfied/satisfied with the quality of care (both 81%). In-person appointments were preferred by 68% of patients when meeting a new doctor, 55% when experiencing a flare, and 52% for regular check-ups; 41% preferred virtual appointments for UC prescription refills. During the pandemic, most patients were satisfied with their current UC treatment plan and access to care; more patients relied on certain alternative UC management support systems, and many were impacted by anxiety/stress. The coronavirus disease 2019 (COVID-19) pandemic created challenges for patients with ulcerative colitis. These challenges included managing symptoms, lifestyle changes, and access to health care. We asked patients with ulcerative colitis to answer questions about their experience during the pandemic to try to understand how the pandemic was affecting them. A total of 584 patients from the United States, Canada, Japan, France, and Finland took part. Patients were asked questions online. We asked them about their disease activity during the COVID-19 pandemic compared with before the pandemic and how their disease was managed, their access to health care, and their experience during the pandemic. We also asked them about their satisfaction with the types of appointments they had during the pandemic (for example, in-person or virtual meetings), and their interactions and preference for interactions with their doctors. We found that most patients were satisfied with their current treatment plan, their access to health care, and the quality of the care they received. However, many patients experienced greater stress or anxiety, and there was a negative impact on their emotional well-being. During the pandemic, more patients relied on alternative support systems such as online patient portals or virtual appointments, but patients preferred in-person appointments with their doctors in most cases except for refilling prescriptions. This information may help doctors understand the impact of the COVID-19 pandemic on patients with ulcerative colitis, and may help doctors and patients develop treatment plans that include both in-person and virtual appointments.

Pharmacotherapy for overactive bladder (OAB) is generally associated with low rates of persistence and adherence. This study was conducted to explore the patient journey in a UK primary care setting (experiences, perceptions, attitudes, and levels of engagement and expectations) and identify self-reported reasons for patient non-adherence and/or non-persistence to medications for OAB. This was a qualitative, non-interventional study involving one-to-one semi-structured, face-to-face or phone interviews with individuals aged 40–80 years, diagnosed with OAB, and currently taking, or having taken, either antimuscarinic or β3-adrenoceptor agonist medications within the last 12 months. Thematic analyses of interview transcripts identified themes surrounding the participants’ experiences with OAB. A total of 20 interviews were conducted (face-to-face, n = 13; telephone, n = 7). Interviews from five men and 13 women (mean age 70 years) were included in the final analysis. The most common OAB symptoms reported included urgency, frequency, incontinence and nocturia. Several key themes of factors influencing persistence and/or adherence to prescribed OAB medication were identified: patients’ attitude and condition adaptation behaviour; support with treatment; unmet efficacy/tolerability expectations; drug/condition hierarchy. Non-adherence and/or non-persistence to OAB medication was largely intentional, with patients balancing side effects against perceived clinical benefits. Perceived lack of efficacy was the primary reason for discontinuing treatment. Other factors cited included side effects of medication (either experienced or a fear of future effects), a general aversion to long-term medication taking, drug/condition hierarchy relative to other comorbidities, and limited healthcare professional (HCP) support/engagement. Patients expressed condition adaptation behaviours to help self-manage their condition. Persistence and adherence to OAB medication may be suboptimal. HCPs might be able to improve persistence and adherence by fostering realistic treatment expectations and scheduling regular medication reviews. These measures may help optimise patient care and support more adherent behaviours, thus minimising the impact of undertreated OAB on patient quality of life. Innovate UK and Astellas Pharma Europe Ltd (APEL).

Topical oral sprays are frequently used to prevent and manage oropharyngeal inflammation and lesions. This study investigated the histopathologic changes noted in the oral mucosa of mice after topical application of 3 widely prescribed antibacterial products. The 25 animals were divided into 5 groups and treated for 10 days with 2 sprays daily, as follows: group 1—chlorhexidine gluconate 0.12% + benzydamine hydrochloride 0.15%; group 2—benzydamine 0.27 mg/0.18 mL x 30 mL; group 3—chlorhexidine 0.2%; group 4—fusafungine 1%; and group 5 (cohort)—physiologic serum. On day 10 after drug administration, biopsy specimens were taken from the oropharyngeal mucosa of the tongue, the cheek mucosa, and the tongue base; these were examined under a light microscope and were classified as normal or pathologic. All topical oral sprays produced some degree of histopathologic change, such as hyperplasia, fibrosis, low-grade dysplasia, congestion, or edema. The local irritant effects of topical oral sprays should be considered when treatment is selected for patients with oropharyngeal disorder.