Margams Pharma Pvt.Ltd

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19/08/2020

Pharmacy:

Esketamine nasal spray a new kid on the block for treatment-resistant depression
Esketamine nasal spray effectively and rapidly improves depressive symptoms in patients with treatment-resistant depression, making it the first antidepressant to be approved by the US FDA in a new drug class.

Linagliptin, glimepiride equally safe for the heart in CAROLINA
Cardiovascular (CV) outcomes were similar between the dipeptidyl peptidase 4 (DPP-4) inhibitor linagliptin and the sulfonylurea glimepiride in the CAROLINA* study of patients with early type 2 diabetes (T2D) and increased CV risk.

Dose reduction has little impact on regorafenib tolerability, efficacy not compromised
Reducing the dose of regorafenib did little to affect the overall tolerability of the drug in patients with metastatic colore**al cancer (mCRC), according to the phase II REARRANGE* trial presented at ESMO GI 2019.

D2d drops the bomb: Vitamin D no better than placebo at preventing diabetes
Supplementation with vitamin D among vitamin D-sufficient adults who are at high risk of developing diabetes does not reduce the risk of developing the disease vs placebo, according to the randomized, placebo-controlled D2d* trial.

Prophylactic antibiotics could reduce infection risk after operative vaginal delivery
Women who receive a single dose of amoxicillin and clavulanic acid within 6 hours of operative vaginal delivery could significantly reduce their postpartum infection risk, according to the UK-based ANODE* trial.

Add-on bevacizumab improves efficacy of trifluridine/tipiracil in mCRC
Adding bevacizumab to trifluridine/tipiracil (FTD/TPI) significantly improves progression-free survival (PFS) and overall survival (OS) compared with FTD/TPI in patients with chemorefractory metastatic colore**al cancer (mCRC), according to a study presented at ESMO GI 2019.

19/08/2020

Oncology:

Olaparib delays progression in BRCA-mutated metastatic pancreatic cancer
Patients with metastatic pancreatic cancer who carry a germline BRCA1/2 mutation may have their risk of disease progression almost halved with olaparib maintenance therapy following first-line treatment with platinum-based chemotherapy, according to results of the phase III POLO trial reported at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.

MONALEESA-7 highlights survival benefit of ribociclib in premenopausal women with HR+ HER2- breast cancer
The addition of the CDK* 4/6 inhibitor ribociclib to endocrine therapy significantly extended overall survival (OS) in premenopausal women with HR+ HER2- advanced breast cancer, as evidenced in the phase III MONALEESA-7** trial.

TITAN seals a win for apalutamide + ADT in mCSPC
Adding apalutamide to androgen-deprivation therapy (ADT) significantly extends radiographic progression-free survival (rPFS) and overall survival (OS) in patients with metastatic castration-sensitive prostate cancer (mCSPC) compared with ADT alone, the TITAN* study shows.

Taxane-based TPEx shows promise for head, neck cancer
The taxane-based TPEx regimen demonstrated encouraging overall survival (OS) benefit for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) compared with the fluorouracil (5FU)-based EXTREME regimen, according to the results of the TPExtreme* trial presented at ASCO 2019.

Uveal melanoma develops earlier in Asians
Uveal melanoma (UM) presents at a younger age for Chinese and Asian-Indian patients than it does for Caucasians, according to a new Singapore study.

Statins protect against dementia in diabetic prostate cancer patients on ADT
Statins appear to exert neuroprotective effects in diabetic prostate cancer patients receiving androgen deprivation therapy (ADT), with a recent study showing that the drug confers benefit for the risk of dementia. The benefit is greater with higher statin adherence and intensity.

06/05/2020

Gastroenterology:

Biosimilar CT-P13 noninferior to infliximab for Crohn's Disease

The latest phase III randomized trial showed that infliximab biosimilar CT-P13 was noninferior to its reference product in patients with active Crohn’s disease (CD), providing the first high-level evidence on the equivalence of efficacy between the two for a non-rheumatological i

Nintedanib slows lung function decline in systemic sclerosis-related ILD

Treatment with the tyrosine kinase inhibitor (TKI) nintedanib reduces pulmonary function decline in patients with systemic sclerosis–associated interstitial lung disease (SSc-ILD), according to the phase III SENSCIS* trial which is touted as the largest randomized controlled trial in SSc-ILD thus far.

Encouraging efficacy with glecaprevir-pibrentasvir combo in HCV

Treatment with the direct-acting antiviral (DAA) combination of glecaprevir and pibrentasvir led to encouraging sustained virological response (SVR) among individuals with hepatitis C virus (HCV) infection, results of two real-world studies presented at the International Liver Congress™ (ILC 2019) showed.

PPI reduces bleeding from gastroduodenal lesions during antiplatelet/anticoagulant treatment

Co-therapy with proton pump inhibitors (PPIs) in patients receiving low-dose anticoagulation and/or aspirin for stable cardiovascular disease confers no benefit for upper gastrointestinal events but may reduce bleeding due to gastroduodenal lesions, a study has shown.

On-demand vonoprazan as good as PPI maintenance for nonerosive reflux

Use of vonoprazan as an on-demand therapy for nonerosive reflux disease appears to be equally effective as a proton pump inhibitor (PPI) maintenance treatment, a study has found.

Add-on sublingual nitrate improves diclofenac for preventing post-ECRP pancreatitis

Prophylaxis with re**al diclofenac together with sublingual nitrate reduces the incidence of postendoscopic retrograde cholangiopancreatography (post-ECRP) pancreatitis more than with diclofenac alone, a recent trial has found.

23/04/2020

Psychiatry:

Virtual reality useful for pain reduction, cognitive rehab and medical training
Virtual reality (VR) can be used to reduce pain during wound care for burn patients, facilitate cognitive rehabilitation for patients with neurological or psychiatric disorders, and transform medical training for healthcare staff, according to data presented at the 2019 Hong Kong Hospital Authority Convention.

Statin use associated with dementia risk reduction after concussion in older adults
Concussion is associated with a substantial long-term risk of dementia in older adults, but the risk can be reduced modestly with the use of statins, a large population-based double cohort study has shown.

Psychosocial disposition may affect pain after breast surgery
Having a negative affect and high temporal summation of pain appears to increase the risk of significant pain and continued opioid use after breast surgery, reports a new study.

Perinatal maternal depressive symptoms linked to child brain development
A consistent association exists between perinatal maternal depressive symptoms and child brain development assessed 10 years later, suggests a recent study.

19/08/2019

Cardiology:

NOACs gain upper hand in 2019 AF Update
The 2019 *AHA/ACC/HRS Focused Update of the Atrial fibrillation (AF) Guideline gives weight to non-vitamin K oral anticoagulants (NOACs) over the old and tested warfarin for AF patients eligible for oral anticoagulation but without moderate-to- severe mitral stenosis or a mechanical heart valve.

Statins for the elderly: Where do we stand now?
Statins reduce major vascular events regardless of age, including in people aged >75 years, reveals a meta-analysis of 28 randomized trials in the Cholesterol Treatment Trialists’ (CTT) Collaboration.

Glucose control within 12 hours of stroke onset: How low can you go?
The perception that the more aggressive glucose control is the better the patient will be doesn’t hold true in the multicentre SHINE* trial. Intensive glucose control at a target of 80–130 mg/dL with intravenous (IV) insulin did not improve outcomes in patients with ischaemic stroke. Instead, it carried an increased risk of severe hypoglycaemia.

Intensive BP-lowering may not reduce recurrent stroke risk
Among patients with a history of stroke, an intensive blood pressure-lowering regimen did not reduce the risk of recurrent stroke compared with a standard blood pressure-lowering regimen, according to results of the RESPECT* trial presented at ISC 2019.

OSA patients with excessive sleepiness at highest risk of CVD
Adults who have obstructive sleep apnoea (OSA) with excessively sleepy subtype are at a higher risk of cardiovascular diseases (CVD) compared with those without excessive daytime sleepiness, a study show

Breast cancer survivors have increasing stroke risk with survivorship
Breast cancer survivors saw increasing risk of stroke along with growing duration of survivorship, particularly during the post-menopausal period, according to a study presented at ISC 2019.

CLINICAL SUMMARIES
• Mediterranean diet a global weapon against stroke
• Artificially sweetened beverages pose increased risks of heart disease, stroke

19/08/2019

Pharmacy:

Sacituzumab govitecan shows promise in advanced bladder cancer
Sacituzumab govitecan, a novel investigational antibody-drug conjugate, showed clinical activity in patients with metastatic urothelial carcinoma (mUC) who had progressed following standard therapy, including treatment with checkpoint inhibitors, according to an early study presented at GUCS 2019.

Adding darolutamide to ADT improves outcomes in nmCRPC
Men with nonmetastatic castration-resistant prostate cancer (nmCRPC) more than halved their risk of dying or developing distant metastasis when treated with darolutamide in addition to androgen deprivation therapy (ADT), according to findings of the phase III ARAMIS* trial.

Adjuvant durvalumab prolongs RFS in oesophageal adenocarcinoma
Adjuvant treatment with durvalumab, a PD-L1 inhibitor, following trimodality therapy may improve relapse-free survival (RFS) in patients with locally advanced oesophageal adenocarcinoma (LA-EAC) or gastroesophageal junction (GEJ) adenocarcinoma who did not achieve pCR* after neoadjuvant chemoradiation, according to a small study presented at the ASCO Gastrointestinal Cancers Symposium 2019 (ASCO GI 2019).

Capecitabine + oxaliplatin yields high response rate in re**al cancer
Neoadjuvant chemoradiotherapy (CRT) comprising capecitabine and oxaliplatin shows better efficacy over other preoperative CRT regimens in terms of clinical response for locally advanced re**al cancer (LARC), according to a network meta-analysis.

New topical agents on the horizon for eczema treatment
Two novel investigational topical agents show potential in improving symptoms of atopic dermatitis, according to early phase trials presented at the Inflammatory Skin Disease Summit (ISDS) in Vienna, Austria.

Mirabegron a promising treatment option for OAB symptoms in men
Use of mirabegron in the treatment of men with overactive bladder (OAB) appears to effectively alleviate urgency and storage symptoms, but not reduce the frequency of micturition episodes, according to data from the MIRACLE study.

31/07/2019

Multidisciplinary:

NOACs gain upper hand in 2019 AF Update
The 2019 *AHA/ACC/HRS Focused Update of the Atrial fibrillation (AF) Guideline gives weight to non-vitamin K oral anticoagulants (NOACs) over the old and tested warfarin for AF patients eligible for oral anticoagulation but without moderate-to- severe mitral stenosis or a mechanical heart valve.

Stroke dovetails with spikes in opioid misuse, infective endocarditis
Hospitalization rates for stroke increased by 20 percent each year between 2008 and 2015, according to a large US study, and these incidents were apparently tied to spikes in opioid misuse and cases of drug-related infective endocarditis.

No overall benefit with aspirin for primary prevention in latest study
Using aspirin for primary prevention of cardiovascular (CV) disease was associated with a reduced risk of CV events but an increased risk of major bleeding, a new meta-analysis of 13 large randomized trials shows.

Treating vitamin D deficiency may help prevent COPD attacks
Vitamin D supplements can help reduce the rate of moderate-to-severe COPD* exacerbations in patients with inadequate vitamin D levels (

31/07/2019

Pharmacy:

Telmisartan, amlodipine, rosuvastatin: Triple threat against hypertension, dyslipidaemia
The three-drug combination of telmisartan, amlodipine and rosuvastatin yields significant reductions in blood pressure and low-density lipoprotein cholesterol levels in patients with hypertension and dyslipidaemia while having a good safety profile and tolerability, according to data from the J-TAROS* trial.

Paroxetine outdoes fluoxetine, escitalopram for premature ej*******on
The selective serotonin reuptake inhibitor paroxetine fared better than fluoxetine and escitalopram in managing premature ej*******on (PE), demonstrating improved intravaginal ejaculatory latency time (IELT), according to a meta-analysis. Moreover, combining paroxetine with tadalafil or behavioural therapy was better than paroxetine alone in improving IELT.

Baricitinib a safe alternative to DMARDs for RA
The selective Janus kinase (JAK) inhibitor baricitinib shows an acceptable safety profile up to 5.5 years of long-term exposure in patients with moderate-to-severe active rheumatoid arthritis (RA), according to an integrated safety analysis.

JAK3 inhibitors zoom in as potential cure for spot baldness
Treatment with two investigational, oral JAK inhibitors may be beneficial in individuals with moderate‐to‐severe alopecia areata (spot baldness), an autoimmune disease that can cause a lot of anxiety, according to an ongoing phase II study.

Reduced renal events with empagliflozin in Asian patients with T2D
Asian patients with type 2 diabetes (T2D) and existing cardiovascular disease (CVD) who received empagliflozin in the EMPA-REG OUTCOME* trial had a reduced risk of adverse renal events, a finding consistent with that of the overall trial population.

No overall benefit with aspirin for primary prevention in latest study
Using aspirin for primary prevention of cardiovascular (CV) disease was associated with a reduced risk of CV events but an increased risk of major bleeding, a new meta-analysis of 13 large randomized trials shows.

08/04/2019

Cardiology:

Transfemoral TAVR trumps SAVR for early major stroke risk
The risk of major stroke at 30 days was higher after surgical aortic valve replacement (SAVR) than after transfemoral-transcatheter AVR (TF-TAVR) in patients with similar risk profile, according to data from the PARTNER* trials.

Broken heart syndrome: Darker prognosis looms, black holes remain
Darker long-term prognosis looms large for broken heart syndrome, further dimming hope for clinicians managing what they earlier thought was a transient benign condition that is caused by extreme emotional and physical stress — not by underlying heart disease.

130/80 home BP equivalent to clinic BP for stage 1 hypertension
Analyses of data from two large, independent US cohorts show that a home blood pressure (BP) threshold of 130/80 mm Hg corresponds to the same value in clinic BP for stage 1 hypertension diagnosis (based on the 2017 ACC/AHA* guidelines), thus lending support to the use of home BP cutoff of 130/80 mm Hg for diagnosis of hypertension.

Regular flu shots may be life-saving for patients with heart failure
Getting vaccinated against influenza can improve survival of patients with heart failure (HF), with earlier and more frequent vaccination being associated with a greater protection against deaths from cardiovascular (CV) events or any cause, a large Danish nationwide cohort study shows.

Menopause a 'critical window' for CVD prevention via lifestyle changes
A healthy lifestyle during the menopausal transition, as typified by abstinence from smoking, regular exercise, and a healthy diet, is associated with less development of subclinical atherosclerosis, according to data from the prospective SWAN* cohort.

Is catheter ablation preferable to drug therapy in concomitant AF and HF?
Patients with coexisting atrial fibrillation (AF) and heart failure (HF) have a reduced risk of all-cause mortality and heart failure-related hospitalizations after undergoing AF catheter ablation compared with drug therapy, according a meta-analysis of six trials.

CLINICAL SUMMARIES
• Bariatric surgery reduces burden of resistant hypertension in obese patients
• MitraClip provides long-term improvements in patients with inoperable mitral regurgitation

08/04/2019

Respirology:

Benralizumab: Safety persists in severe, uncontrolled asthma
The interleukin (IL)-5 receptor α antibody benralizumab continues to show a safety profile similar to that observed in the preceding primary trials along with sustained efficacy through 2 years of treatment in patients with severe, uncontrolled asthma, according to the BORA* extension trial.

Regular flu shots may be life-saving for patients with heart failure
Getting vaccinated against influenza can improve survival of patients with heart failure (HF), with earlier and more frequent vaccination being associated with a greater protection against deaths from cardiovascular (CV) events or any cause, a large Danish nationwide cohort study shows.

Exhalation delivery system with fluticasone effective in chronic rhinosinusitis with nasal polyps
An exhalation delivery system with fluticasone (EDS-FLU) effectively reduces important symptoms in chronic rhinosinusitis patients with nasal polyps (NP), according to a recent study.

Higher afatinib starting dose, better PFS in NSCLC patients with brain metastases
Patients with advanced non-small-cell lung cancer (NSCLC) and brain metastases demonstrated better progression-free survival (PFS) when initiating the oral EGFR* TKI** afatinib at a higher rather than a lower dose, according to a retrospective study from Singapore.

Dupilumab improves concurrent asthma, sinonasal outcomes in AD
Treatment with the human monoclonal antibody dupilumab led to improved asthma and sinonasal outcomes occurring concurrently with atopic dermatitis (AD), according to the results of a pooled analysis of four phase 3 trials* presented at ISDS 2018.

CLINICAL SUMMARIES
• Persistent airway inflammation common in asthmatics despite medication use
• Higher circulating hsCRP concentration tied to risk of lung cancer
• LAMA can be safely added to ICS-LABA combination for treating COPD.

02/04/2019

Multidisciplinary:

JAK3 inhibitors zoom in as potential cure for spot baldness
Treatment with two investigational, oral JAK inhibitors may be beneficial in individuals with moderate‐to‐severe alopecia areata (spot baldness), an autoimmune disease that can cause a lot of anxiety, according to an ongoing phase II study.

Long-term incense exposure may affect renal health
Frequent, long-term exposure to incense may be associated with an elevated risk for end-stage renal disease (ESRD), according to findings from the Singapore Chinese Health Study (SCHS).

What’s salt got to do with atopic dermatitis?
Patients with atopic dermatitis (AD) have elevated levels of sodium chloride or salt in their skin compared with those with nonlesional atopic and healthy skin, according to a new study finding which experts described as “provocative.”

Do probiotics have a role in ulcerative colitis?
While probiotics may help induce remission in patients with ulcerative colitis (UC), its role in remission maintenance is less certain, suggests two studies presented at AIBD 2018.

Staying fit can ward off heart disease, even in low-risk people
Increasing cardiorespiratory fitness (CRF) is associated with decreasing risk of coronary heart disease (CHD), even in an apparently healthy, low-risk population with no prior history of cardiovascular (CV) disease (CVD), according to the HUNT*3 Study.

Too much or too little sleep may up risk of death, CVD
Sleeping too much or too little may expose us to an increased risk of deaths and major cardiovascular (CV) events, with 6–8 hours a day appearing to be the optimal sleep duration, according to the PURE* study

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