tbuckley/cabot-search huggingface dataset:
Fixed Triple Therapy in Chronic Obstructive Pulmonary Disease and Survival. Living Better, Longer, or Both?
Authors: Jørgen Vestbo
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Fixed Triple Therapy in Chronic Obstructive Pulmonary Disease and SurvivalLiving Better, Longer, or Both?Does regular pharmacological treatment including inhaled corticosteroids (ICS) reduce mortality in patients with chronic obstructive pulmonary disease (COPD)?Few questions have attracted more attention in COPD, and the number of commentaries, editorials, and reviews on this topic by far exceeds the limited number of original papers addressing the topic.However, here is one more.In this issue of the Journal, Lipson and colleagues (pp.1508-1516) report findings from a post hoc analysis of the IMPACT (Informing the Pathway of COPD Treatment) trial (1).The trial was enriched for exacerbators, and the primary outcome was the annual rate of on-treatment moderate and severe exacerbations comparing a fixed combination of fluticasone furoate (FF), umeclidinium (UMEC), and vilanterol (VI) with fixed combinations of UMEC/VI and FF/VI.Mortality was listed among "other efficacy outcomes" (2), and the article presents an expanded analysis of mortality compared with the one reported in their primary report (3).By obtaining information on vital status at end of the trial for an additional 574 patients, the authors had information on vital status for 10,313 of the 10,355 patients included in the trial.The authors compared mortality in patients randomized to FF/UMEC/VI with those randomized to either a fixed combination of FF/VI or a fixed combination of UMEC/VI.After 1 year, there were significantly fewer deaths in the triple-combination group (FF/UMEC/VI) than in the UMEC/VI group (absolute risk reduction [ARR], 0.83%; relative risk reduction [RRR], 28%; P = 0.042) but not when comparing the FF/VI group with the UMEC/VI group (ARR, 0.55%; RRR, 18%; P = 0.190).When analyses were restricted to on-treatment mortality, both these group analyses were statistically significant.The authors convincingly showed that missing outcome data on the 0.4% of the patient population were very unlikely to have had an impact on the reported estimates.Only a few previous trials of an ICS-containing treatment have had mortality as a primary outcome.The TORCH (Toward a Revolution in COPD Health) study (4) found a 2.6% ARR and a 17.5% RRR in deaths when comparing the combination of salmeterol and fluticasone propionate with placebo.However, the P value was adjusted from 0.041 to 0.052 to take a late interim analysis into account, and the study has since been referred to as "negative."The SUMMIT (Study to Understand Mortality and Morbidity) (5) compared a combination of vilanterol and fluticasone furoate with placebo in patients with moderate COPD
Health Care Utilization, Care Satisfaction, and Health Status for Medicare Advantage and Traditional Medicare Beneficiaries With and Without Alzheimer Disease and Related Dementias
Authors: Sungchul Park, Lindsay White, Paul Fishman, Eric B. Larson, Norma B. Coe
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Compared with traditional Medicare (TM) fee-for-service plans, Medicare Advantage (MA) plans may provide more-efficient care for beneficiaries with Alzheimer disease and related dementias (ADRD) without compromising care quality. <h3>Objective</h3> To determine differences in health care utilization, care satisfaction, and health status for MA and TM beneficiaries with and without ADRD. <h3>Design, Setting, and Participants</h3> A cohort study was conducted of MA and TM beneficiaries with and without ADRD from all publicly available years of the Medicare Current Beneficiary Survey between 2010 and 2016. To address advantageous selection into MA plans, county-level MA enrollment rate was used as an instrument. Data were analyzed between July 2019 and December 2019. <h3>Exposures</h3> Enrollment in MA. <h3>Main Outcomes and Measures</h3> Self-reported health care utilization, care satisfaction, and health status. <h3>Results</h3> The sample included 47 100 Medicare beneficiaries (25 900 women [54.9%]; mean [SD] age, 72.2 [11.4] years). Compared with TM beneficiaries with ADRD, MA beneficiaries with ADRD had lower utilization across the board, including a mean of −22.3 medical practitioner visits (95% CI, −24.9 to −19.8 medical practitioner visits), −2.3 outpatient hospital visits (95% CI, −3.6 to −1.1 outpatient hospital visits), −0.2 inpatient hospital admissions (95% CI, −0.3 to −0.1 inpatient hospital admissions), and −0.1 long-term care facility stays (95% CI, −0.2 to −0.1 long-term care facility stays). A similar trend was observed among beneficiaries without ADRD, but the difference was greater between MA and TM beneficiaries with ADRD than between MA and TM beneficiaries without ADRD (mean, −15.0 medical practitioner visits [95% CI, −18.7 to −11.3 medical practitioner visits], −1.7 outpatient hospital visits [95% CI, −3.0 to −0.3 outpatient hospital visits], and −0.1 inpatient hospital admissions [95% CI, −1.0 to 0.0 inpatient hospital admissions]). Overall, no or negligible differences were detected in care satisfaction and health status between MA and TM beneficiaries with and without ADRD. <h3>Conclusions and Relevance</h3> Compared with TM beneficiaries, MA beneficiaries had lower health care utilization without compromising care satisfaction and health status. This difference was more pronounced among beneficiaries with ADRD. These findings suggest that MA plans may be delivering health care more efficiently than TM, especially for beneficiaries with ADRD.
Risk/Benefit Tradeoff of Antithrombotic Therapy in Patients With Atrial Fibrillation Early and Late After an Acute Coronary Syndrome or Percutaneous Coronary Intervention
Authors: John H. Alexander, Daniel Wojdyla, Amit N. Vora, Laine Thomas, Christopher B. Granger, Shaun G. Goodman, Ronald Aronson, Stephan Windecker, Roxana Mehran, Renato D. Lopes
Journal: Circulation (2020)

In AUGUSTUS (Open-Label, 2×2 Factorial, Randomized, Controlled Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Percutaneous Coronary Intervention), patients with atrial fibrillation and a recent acute coronary syndrome and those undergoing percutaneous coronary intervention had less bleeding with apixaban than vitamin K antagonist (VKA) and with placebo than aspirin. However, the number of ischemic events was numerically higher with placebo. The aim of this analysis is to assess the tradeoff of risk (bleeding) and benefit (ischemic events) over time with apixaban versus VKA and aspirin versus placebo.In AUGUSTUS, 4614 patients with atrial fibrillation and recent acute coronary syndrome or percutaneous coronary intervention on a P2Y12 inhibitor were randomized to blinded aspirin or placebo and to open-label apixaban or VKA for 6 months. In a post hoc analysis, we compared the risk of 3 composite bleeding outcomes and 3 composite ischemic outcomes from randomization through 30 days and from 30 days to 6 months with apixaban and VKA and with aspirin and placebo.Compared with VKA, apixaban had either a lower or a similar risk of bleeding and ischemic outcomes from randomization to 30 days and from 30 days to 6 months. From randomization to 30 days, aspirin caused more severe bleeding (absolute risk difference, 0.97% [95% CI, 0.23-1.70]) and fewer severe ischemic events (absolute risk difference, -0.91% [95% CI, -1.74 to -0.08]) than placebo. From 30 days to 6 months, the risk of severe bleeding was higher with aspirin than placebo (absolute risk difference, 1.25% [95% CI, 0.23-2.27]), whereas the risk of severe ischemic events was similar (absolute risk difference, -0.17% [95% CI, -1.33 to 0.98]).In patients with atrial fibrillation and recent acute coronary syndrome or percutaneous coronary intervention receiving a P2Y12 inhibitor, apixaban is preferred over VKA. Use of aspirin immediately and for up to 30 days results in an equal tradeoff between an increase in severe bleeding and a reduction in severe ischemic events. After 30 days, aspirin continues to increase bleeding without significantly reducing ischemic events. These results inform shared, patient-centric decision making on the ideal duration of the use of aspirin after an acute coronary syndrome or percutaneous coronary intervention in patients with atrial fibrillation receiving oral anticoagulation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02415400.
Evidence Strength of Pharmaceutical Industry-Funded Clinical Trials in Metastatic NSCLC: A Comparison With Other Sources of Funding
Authors: Barbara de Souza Gutierres, Pedro N. Aguiar, Barbara B. Dourado, Alanda L. Alves, Silvio Matsas, Anderson R. Simões, Auro del Giglio
Journal: Journal of Thoracic Oncology (2020)
Prevalence of comorbidities and risk factors in spondyloarthritis: results of a cross-sectional study
Authors: Yupeng Lai, Yanpeng Zhang, Shaozhen Mo, Jinsheng Ma, Tongxin Ni, Zhihao Lei, Jun Xia, Chiduo Xu
Journal: Annals of the Rheumatic Diseases (2020)

Spondyloarthritis (SpA) includes axial and peripheral SpA, according to the Assessment of SpondyloArthritis international Society classification criteria.1 2 An increasing number of research has focused on the comorbidities and risk factors in SpA. The first and latest international cross-sectional ASAS-COMOSPA study, published in the Annals of the Rheumatic Diseases , has proposed some comorbidities such as cardiovascular diseases, osteoporosis, cancers, infections and gastrointestinal diseases. This research has also proposed the risk factors for cardiovascular diseases, cancers and osteoporosis.3 Other studies have also focused on the cardiovascular diseases among patients with SpA.4–6 However, as for heart comorbidities, valvular heart disease was not mentioned in the ASAS-COMOSPA study, while it has been reported to be associated with SpA in a number of recent studies, based both on epidemiology and pathology.7–9 As for risk factors for cardiovascular diseases, hyperuricaemia was not included as well, while uric acid has also been proven to be related to cardiovascular disease in the recent years.10–13 Since there are still some comorbidities and risk factors to be evaluated, we proposed a research to include valvular heart disease as a comorbidity of SpA and hyperuricaemia as a risk factor of cardiovascular disease among patients with SpA.

From 2016 to 2018, we conducted a cross-sectional study of 202 SpA diagnosed by rheumatologists in the Chinese Shenzhen Second People’s Hospital. We extracted data from the hospital’s information systems by searching medical files at the Department of Rheumatology and Immunology, the Department of Ophthalmology, and the Department of Gastroenterology. All the medical files were examined to see if the diagnosis of axial or peripheral SpA could be confirmed.

Once the diagnosis of axial and peripheral SpA was confirmed, the following categories of data were collected: demographics and disease characteristics, extra-articular manifestations, comorbidities, risk factors for comorbidities, and …
AB0427 OCCURRENCE OF NEUROPSYCHIATRIC MANIFESTATIONS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM THE SWISS LUPUS COHORT AND META-ANALYSIS OF THE PERTINENT LITERATURE
Authors: A. L. Meier, U. Steiner, L. M. Bachmann
Journal: Annals of the Rheumatic Diseases (2020)

Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, often presenting with neuropsychiatric manifestations. Reports on the frequency and patterns of these manifestations vary substantially and remain incompletely understood. Objectives: We examined neuropsychiatric manifestations in the prospective nationwide cohort of Swiss SLE (SSCS) patients and conducted a systematic literature review to contextualise our findings. Methods: We reviewed all patients included in the SSCS from 2007-2019 and classified severe neuropsychiatric manifestations. Searches were performed in relevant electronic databases from 1.1999-1.2020 and by checking reference lists of the pertinent literature. Authors of important papers were contacted to obtain further (unpublished) studies. We included prospective or cross-sectional studies focussing on neuropsychiatric manifestations in SLE, defined according the ACR criteria of 1999. Study selection and data extraction was made in duplicate. We secured salient study characteristics, composition of cohorts, the definitions and the frequencies of neuropsychiatric manifestations. We assessed heterogeneity across reports and investigated sources of variation using meta-regression models. Results: The frequencies of severe manifestations found in the SSLE were 7.1% (49/688) for cerebrovascular events, 5.3% (37/688) for seizures and 6.5% (45/688) for psychosis. The time-to-event analysis showed a linear relationship between duration of SLE and cumulative incidence of severe neuropsychiatric manifestations. Searches identified 530 studies and authors’ contact yielded another unpublished report. We included 28 studies. The mean rates of the most commonly reported severe neuropsychiatric manifestations ranged in the magnitude of 50 percent points. Study characteristics and composition of cohorts could not explain heterogeneity of reported manifestation rates. Conclusion: The spectrum of neuropsychiatric manifestations in SLE is widely dispersed. The diagnostic work-up and the reporting of manifestations varied substantially across studies which may explain inconsistencies to some extent. We call for concerted efforts and a broad consensus regarding stringent definitions of neuropsychiatric SLE manifestations that allow targeted detection, particularly with view to timely intervention and patient outcomes. Disclosure of Interests: None declared
Active and Effective Measures for the Care of Patients With Cancer During the COVID-19 Spread in China
Authors: Zhijie Wang, Jie Wang, Jie He
Journal: JAMA Oncology (2020)

Active and Effective Measures for the Care of Patients With Cancer During the COVID-19 Spread in ChinaRecently, an outbreak of the highly infectious novel coronavirus disease 2019 (COVID-19) has swept Wuhan, China, with 80 303 confirmed diagnosed cases in China as of March 3, 2020. 1 Considering its high risk of person-toperson transmission, hospitals, especially in China, are the typical congregating places that will bear the brunt of this infectious disease.To reduce or avoid cross infection of COVID-19, many hospitals have started taking actions to limit the number of outpatient visits and inpatient admissions.For example, only emergency surgeries can be guaranteed, while most others are postponed.Maintenance chemotherapy and/or immunotherapy treatments for patients with advanced cancer are often suspended.However, forced delays or interruptions of routine treatment might increase the risk of disease deterioration, especially for patients with cancer.In China, approximately 4.3 million cases of cancer are diagnosed each year. 2 During the epidemic of COVID-19, the treatment of patients with cancer, which is often considered as nonemergent, is inevitably affected across China, especially in Wuhan.As a result of powerful prevention and control measures, the spread of COVID-19 has been gradually controlled.However, cases have been diagnosed in a number ofcountriesoutsideofChina,especiallyinSouthKoreaand Iran, leading to a global outbreak.As of March 3, 2020, newly diagnosed cases and deaths owing to COVID-19 had occurred in nearly 70 countries or regions, including South Korea,Iran,Italy,Japan,Germany,Singapore,Spain,andthe US,withatotalof11 953confirmedcases. 3 Theinsidiousonset (which can manifest without any obvious clinical symptoms, such as fever, in the early phase) and long incubation period (up to 24 days 4 ) indicate the strong transmissibility of COVID-19.The World Health Organization has declared COVID-19tobea"publichealthemergencyofinternational concern." 5 Therefore,itmayhaveaworldwideinfluenceon the diagnosis and treatment of patients with cancer.Patientswithcancerareusuallycharacterizedbyolder ages, multiple complicated diseases, and lower immunity, meaning a higher probability of severe illness and increased mortality compared with the healthy population once infected with COVID-19. 6To alleviate the difficulties of patients with cancer in seeking medical aid and simultaneously avoid COVID-19-related nosocomial cross infection between patients and medical staff, several mandatory measures are being carried out in the National Cancer Center/Cancer Hospital, Chinese Academy of Sciences during this period.First,multipleon-sitetemperaturetestsareperformed at the entrances of the hospital, the outpatient clinic, and
Convalescent Plasma to Treat COVID-19
Authors: John D. Roback, Jeannette Guarner
Journal: JAMA (2020)

Chenguang Shen, PhD; Zhaoqin Wang, PhD; Fang Zhao, PhD; Yang Yang, MD; Jinxiu Li, MD; Jing Yuan, MD; Fuxiang Wang, MD; Delin Li, PhD; Minghui Yang, PhD; Li Xing, MM; Jinli Wei, MM; Haixia Xiao, PhD; Yan Yang, MM; Jiuxin Qu, MD; Ling Qing, MM; Li Chen, MD; Zhixiang Xu, MM; Ling Peng, MM; Yanjie Li, MM; Haixia Zheng, MM; Feng Chen, MM; Kun Huang, MM; Yujing Jiang, MM; Dongjing Liu, MD; Zheng Zhang, MD; Yingxia Liu, MD; Lei Liu, MD
Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association
Authors: Dhanunjaya R. Lakkireddy, Mina K. Chung, Rakesh Gopinathannair, Kristen K. Patton, Ty J. Gluckman, Mohit Turagam, Jim Cheung, Parin Patel, Juan Sotomonte, Rachel Lampert, Janet K. Han, Bharath Rajagopalan, Lee Eckhardt, Jose Joglar, Kristin Sandau, Brian Olshansky, Elaine Wan, Peter A. Noseworthy, Miguel Leal, Elizabeth Kaufman, Alejandra Gutierrez, Joseph E. Marine, Paul J. Wang, Andrea M. Russo
Journal: Circulation (2020)

Coronavirus disease 2019 (COVID-19) is a global pandemic that is wreaking havoc on the health and economy of much of human civilization. Electrophysiologists have been impacted personally and professionally by this global catastrophe. In this joint article from representatives of the Heart Rhythm Society, the American College of Cardiology, and the American Heart Association, we identify the potential risks of exposure to patients, allied healthcare staff, industry representatives, and hospital administrators. We also describe the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities. We provide guidance for managing invasive and noninvasive electrophysiology procedures, clinic visits, and cardiac device interrogations. In addition, we discuss resource conservation and the role of telemedicine in remote patient care along with management strategies for affected patients.
Abstract 14727: Rating Discrepancies in Application of Domestic and International Appropriateness Use Criteria; A Report From KICS-Japanese Multicenter PCI Registry
Authors: Taku Inohara, Shun Kohsaka, Hiroaki Miyata, Ikuko Ueda, Yuichiro Maekawa, Akio Kawamura, Keiichi Fukuda
Journal: Circulation (2013)

Background: Appropriateness measures for percutaneous coronary intervention (PCI) using Appropriate Use Criteria (AUC) has been in widespread use to assess quality as it relates to patient selectio...
Abstract P4-08-03: Tumor suppressors p53 and ARF control ADAR1-driven tumorigenicity in triple negative breast cancer
Authors: Che-Pei Kung, Catherine E Kuzmicki, Emily A Bross, Sua Ryu, Eric Freeman, Thwisha Sabloak, Emily R Bramel, Leonard B Maggi, Jason D Weber
Journal: Cancer Research (2020)

Abstract Research Overview and Objective Triple-negative breast cancer (TNBC) accounts for one-fifth of the breast cancer patient population. The heterogeneous nature of TNBC and lack of options for targeted therapy make its treatment a constant challenge. The co-deficiency of tumor suppressors p53 and ARF is a significant genetic signature enriched in TNBC, but it is not yet clear how TNBC is regulated by this genetic alteration. Methods To answer this question, we established p53/ARF-defective murine embryonic fibroblast (MEF) to study the molecular and phenotypic consequences in vitro. Moreover, transgenic mice were generated to investigate the effect of p53/ARF deficiency on mammary tumor development in vivo. Results Increased transformation capability was observed in p53/ARF-defective cells, and formation of aggressive mammary tumors was also seen in p53−/−ARF−/− mice. RNA-editing enzyme ADAR1 was identified as a potential mediator for the elevated oncogenic potential. Interestingly, we found that the overexpression of ADAR1 is also prevalent in human TNBC cell lines and patient specimen. Using short hairpin RNA (shRNA) to reduce ADAR1 expression abrogated the oncogenic potential of human TNBC cell lines, while non-TNBC cells are less susceptible. Different levels of RNA editing of known ADAR1 targets were detected in shRNA-treated human TNBC cell lines, suggesting that ADAR1-mediated RNA editing contributes to TNBC pathogenesis. Implication/Discussion These results indicate critical roles played by the tumor suppressors p53 and ARF in the pathogenesis of TNBC, partially through affecting ADAR1-mediated RNA editing. Further understanding of this pathway could shed light on potential vulnerabilities of TNBC and inform the development of personalized therapies based on patients’ genetic signiatures. Citation Format: Che-Pei Kung, Catherine E Kuzmicki, Emily A Bross, Sua Ryu, Eric Freeman, Thwisha Sabloak, Emily R Bramel, Leonard B Maggi Jr, Jason D Weber. Tumor suppressors p53 and ARF control ADAR1-driven tumorigenicity in triple negative breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-08-03.
The natural history of progressive fibrosing interstitial lung diseases
Authors: Kevin K. Brown, Fernando J. Martinez, Simon L.F. Walsh, Victor J. Thannickal, Antje Prasse, Rozsa Schlenker-Herceg, Rainer-Georg Goeldner, Emmanuelle Clerisme-Beaty, Kay Tetzlaff, Vincent Cottin, Athol U. Wells
Journal: European Respiratory Journal (2020)

We used data from the INBUILD and INPULSIS trials to investigate the natural history of progressive fibrosing interstitial lung diseases (ILDs). Subjects in the two INPULSIS trials had a clinical diagnosis of idiopathic pulmonary fibrosis (IPF) while subjects in the INBUILD trial had a progressive fibrosing ILD other than IPF and met protocol-defined criteria for ILD progression despite management. Using data from the placebo groups, we compared the rate of decline in forced vital capacity (FVC) (mL·year −1 ) and mortality over 52 weeks in the INBUILD trial with pooled data from the INPULSIS trials. The adjusted mean annual rate of decline in FVC in the INBUILD trial (n=331) was similar to that observed in the INPULSIS trials (n=423) (−192.9 mL·year −1 and −221.0 mL·year −1 , respectively; nominal p-value=0.19). The proportion of subjects who had a relative decline in FVC &gt;10% predicted at Week 52 was 48.9% in the INBUILD trial and 48.7% in the INPULSIS trials, and the proportion who died over 52 weeks was 5.1% in the INBUILD trial and 7.8% in the INPULSIS trials. A relative decline in FVC &gt;10% predicted was associated with an increased risk of death in the INBUILD trial (hazard ratio 3.64) and the INPULSIS trials (hazard ratio 3.95). These findings indicate that patients with fibrosing ILDs other than IPF, who are progressing despite management, have a subsequent clinical course similar to patients with untreated IPF, with a high risk of further ILD progression and early mortality.