Obicetrapib excels as lipid lowering agent in Phase 3 trials

Obicetrapib, a highly selective oral CETP inhibitor, has shown significant promise in a Phase III trial by dramatically reducing LDL cholesterol levels in high-risk individuals who had an inadequate response to existing lipid-lowering therapies, all without noticeable side effects. These findings support its potential as an effective treatment for patients already on maximal lipid-lowering therapy. Additionally, a cardiovascular outcomes trial is currently underway to evaluate its long-term impact in adults with a history of atherosclerotic cardiovascular disease and persistently high LDL cholesterol.

Obicetrapib is a highly selective cholesteryl ester transfer protein inhibitor that reduces low-density lipoprotein (LDL) cholesterol levels. The efficacy and safety of obicetrapib have not been fully characterized among patients at high risk for cardiovascular events.

They conducted a multinational, randomized, placebo-controlled trial involving patients with heterozygous familial hypercholesterolemia or a history of atherosclerotic cardiovascular disease who were receiving maximum tolerated doses of lipid-lowering therapy. Patients with an LDL cholesterol level of 100 mg per deciliter or higher or a non–high-density lipoprotein (HDL) cholesterol level of 130 mg per deciliter or higher, as well as those with an LDL cholesterol level of 55 to 100 mg per deciliter or a non-HDL cholesterol level of 85 to 130 mg per deciliter and at least one additional cardiovascular risk factor, were eligible for inclusion.

The patients were randomly assigned in a 2:1 ratio to receive either 10 mg of obicetrapib once daily or matching placebo for 365 days. The primary end point was the percent change in the LDL cholesterol level from baseline to day 84. Results: A total of 2530 patients underwent randomization; 1686 patients were assigned to receive obicetrapib and 844 to receive placebo. The mean age of the patients was 65 years, 34% were women, and the mean baseline LDL cholesterol level was 98 mg per deciliter.

The least-squares mean percent change from baseline to day 84 in the LDL cholesterol level was −29.9% (95% confidence interval [CI], −32.1 to −27.8) in the obicetrapib group, as compared with 2.7% (95% CI, −0.4 to 5.8) in the placebo group, for a between-group difference of −32.6 percentage points (95% CI, −35.8 to −29.5; P<0.001). The incidence of adverse events appeared to be similar in the two groups. Among patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia who were receiving maximum tolerated doses of lipid-lowering therapy and were at high risk for cardiovascular events, obicetrapib reduced LDL cholesterol levels by 29.9%.

Reference:

Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk

Authors: Stephen J. Nicholls, M.B., B.S., Ph.D., Adam J. Nelson, M.B., B.S., Ph.D., Marc Ditmarsch, M.D., John J.P. Kastelein, M.D., Ph.D., Christie M. Ballantyne, M.D., Kausik K. Ray, M.D., Ann Marie Navar, M.D., et al. DOI: 10.1056/NEJMoa2415820. The New England Journal of Medicine.

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Role of Genetics in Maturity-Onset Diabetes of the Young and Personalized Diabetes Care , explores review

Korea: Maturity-Onset Diabetes of the Young (MODY) is a lesser-known but clinically significant form of diabetes that accounts for 1%–2% of all diabetes cases, a recent review has suggested. Despite its low prevalence, MODY’s genetic nature and early onset make it a vital diagnosis for clinicians, especially given its implications for individualized treatment.

The review carried out by Sung-Hoon Kim, Division of Endocrinology & Metabolism, Department of Medicine, Cheil General Hospital & Women’s Healthcare Center, Dankook University College of Medicine, Seoul, Korea, provides an overview of recent updates on MODY in the literature with a focus on studies conducted in Korea.

MODY is a monogenic condition passed down in an autosomal dominant pattern, primarily caused by defects in pancreatic β-cell function. Patients often develop symptoms during adolescence or early adulthood. However, MODY is frequently misdiagnosed as either type 1 or type 2 diabetes, leading to unnecessary or inappropriate treatments.

To date, researchers have identified 13 MODY subtypes, each linked to mutations in specific genes such as HNF1A, GCK, HNF4A, and HNF1B. These mutations result in varying clinical presentations—from mild fasting hyperglycemia in GCK-MODY, which often requires no treatment, to progressive β-cell failure in HNF1A-MODY, which responds well to sulfonylureas instead of insulin.

The review, published in the Diabetes & Metabolism Journal, highlights the variability of MODY gene prevalence across populations. In Europe, HNF1A and GCK mutations dominate, whereas Asian populations, including Korean and Japanese groups, show lower detection rates of known MODY genes. This suggests the presence of undiscovered MODY-causing genes in these regions, pointing to the need for further genetic research and broader testing panels.

Genetic diagnosis not only enables personalized treatment but also allows predictive testing for asymptomatic family members. With advancements in next-generation sequencing, detecting known and novel MODY mutations has become more feasible and cost-effective.

Importantly, the review emphasizes the role of MODY as a model for precision medicine in diabetes care. A timely and accurate diagnosis can help clinicians choose targeted therapies and avoid unnecessary insulin use, particularly in patients with subtypes like HNF1A- or HNF4A-MODY. Moreover, identifying MODY has prognostic value and can guide management during pregnancy and long-term follow-up.

However, the lack of awareness and diagnostic challenges mean many MODY cases remain undetected. The authors call for the establishment of national MODY registries and structured diagnostic approaches to improve early identification and treatment outcomes.

“MODY, a monogenic form of diabetes accounting for 1–2% of cases, holds key insights into diabetes pathogenesis. Its clinical variability stems from genetic heterogeneity and advances in molecular genetics now allow for tailored treatments by subtype—showcasing personalized medicine,” the authors concluded.

“Early and accurate diagnosis benefits both patients and families by guiding therapy and prognosis. However, most MODY cases remain undiagnosed due to diagnostic challenges. A nationwide registry and systematic strategies are crucial for improving detection and management.

Reference:

Kim SH. Maturity-Onset Diabetes of the Young: What Do Clinicians Need to Know?. Diabetes Metab J. 2015;39(6):468-477.

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Weight-loss drugs cut alcohol intake by almost two-thirds, research in Ireland suggests

Individuals who take liraglutide or semaglutide for weight loss reduce their alcohol consumption by almost two-thirds in four months, new research being presented at this year’s European Congress on Obesity (ECO 2025) has found.

Alcohol use disorder is a relapsing condition that accounts for 2.6 million deaths a year – 4.7% of all deaths globally.

Treatments such as cognitive behavioural therapy (CBT), therapies that aim to strengthen motivation to stop or reduce drinking and medication can be very successful in the short-term, however, 70% of patients relapse within the first year.

Glucagon-like peptide-1 (GLP-1) analogues, drugs developed to treat obesity, have reduced alcohol intake in animal studies, but reports are only starting to emerge about their effect on alcohol intake in humans.

To find out more, Professor Carel le Roux, of University College Dublin, and colleagues in Ireland and Saudi Arabia prospectively collected data on the alcohol intake of patients who were being treated for obesity at a clinic in Dublin.

The real-world study involved 262 adults with a BMI ≥27 kg/m² (79% female, average age 46 years, average weight 98kg/15 stone 6lb) who were prescribed the GLP-1 analogues liraglutide or semaglutide for weight loss.

The patients were categorised into non-drinkers (n=31, 11.8%) rare drinkers (<10 units/week, n=52 19.8%) and regular drinkers (>10 units/week, n=179, 68.4%) based on their self-reported alcohol intake before they started taking the weight-loss drugs.

188 of the 262 patients were followed-up for an average 4 of months. None of them had increased their alcohol intake.

Average alcohol intake decreased from 11.3 units/week to 4.3 units/week after 4 months of treatment with the GLP-1 analogues – a reduction of almost two-thirds.

Among the regular drinkers, intake decreased from 23.2 units/week to 7.8 units/week. This reduction of 68% is comparable to that achieved by nalmefene, a drug used to treat alcohol use disorder in Europe, notes Professor le Roux.

He adds: “The exact mechanism of how GLP-1 analogues reduce alcohol intake is still being investigated but it is thought to involve curbing cravings for alcohol that arise in subcortical areas of the brain that are not under conscious control. Thus, patients report the effects are ‘effortless’.”

The study’s limitations include the relatively small number of patients, the use of self-reported alcohol intake and the absence of a control group. Its strengths include the use of data collected prospectively in a real-world setting.

Professor Le Roux concludes: “GLP-1 analogues have been shown treat obesity and reduce the risk of multiple obesity-related complications. Now, the beneficial effects beyond obesity, such as on alcohol intake, are being actively studied, with some promising results.”

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Combination of significant weight gain and late motherhood greatly increases woman’s risk of breast cancer, finds UK study

Women who experience significant weight gain after the age of 20 and either have their first child after the age of 30 or don’t have children are almost three times more likely to develop breast cancer than those who give birth earlier and whose weight remains relatively stable, new research from the UK being presented at this year’s European Congress on Obesity (ECO 2025) has found.

Previous research has shown that weight gain in adulthood increases the risk of developing breast cancer after the menopause.

Other research has found that an early first pregnancy may cut the risk of breast cancer. For example, a review of 21 studies on reproductive risk factors for breast cancer reported that each additional year of age of first full-term pregnancy adds 5% to the risk of premenopausal breast cancer and 3% to the risk of postmenopausal breast cancer.1

However, the combined effect of these two factors and whether weight gain has less effect on breast cancer risk if a woman has an early first pregnancy, has yet to be established.

Breast cancer is one of the most common cancers worldwide, with 2.3 million diagnoses in women in 2022 and 670,000 deaths.2 In the UK, where it is the most common cancer, there are almost 57,000 cases and 11,500 deaths a year.3

“In England, the proportion of the women with obesity or overweight has increased from 49% in 1993 to 59% in 20214, and the proportion of women giving birth later in life has been steadily increasing over the past 50 years5”, says lead researcher Lee Malcomson, of the University of Manchester, Manchester, UK.

“Meanwhile, diagnoses of breast cancer in women are at their highest ever rate.6 More information about how age of motherhood and weight gain affect the risk of breast cancer, would allow us to better work out who is most at risk of the disease and target lifestyle advice accordingly.”

For the study, Mr Malcomson and colleagues analysed data on 48,417 women (median age 57 years, median BMI 26.3 kg/m²) who took part in PROCAS7, a large UK study of women attending breast screening.

The women were categorised based on whether they had their first pregnancy early (before the age of 30 years), late (aged 30 years or older) or were nulliparous (had not given birth) and weight gain in adulthood. Weight gain was calculated by asking participants to recall their weight at the age of 20 and subtracting it from their current weight. The women were followed up for a median of 6.4 years, during which 1,702 were diagnosed with breast cancer.

Analysis of the results found that women with an early first pregnancy had greater weight gain during adulthood than those with a late first pregnancy, with 0.21kg of additional weight gain for each year earlier the pregnancy occurred.

It also confirmed the literature that an early first pregnancy protects against post-menopausal breast cancer and that adult weight gain is associated with an increased risk of the disease.

However, the study found no evidence that having a first pregnancy at an early age reduces the increased breast cancer risk caused by weight gain.

It did show that women who had a greater than 30% increase in weight during adulthood and either had their first child after age 30, or did not have children, were nearly three times more likely (2.73 times) to develop breast cancer compared with women who had an early first pregnancy and less than a 5% increase in adult weight.

Mr Malcomson concludes: “Our study is the first to establish how weight gain and age of first birth interact to affect a woman’s risk of breast cancer.

“It is vital that GPs are aware that the combination of gaining a significant amount of weight and having late first birth – or, indeed, not having children – greatly increases a woman’s risk of the disease.”

The combination of significant weight gain and late motherhood greatly increases a woman’s risk of breast cancer, UK study finds European Congress on Obesity (ECO2025)

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Compared with placebo, Extended caffeine treatment did not shorten hospitalization in preterm babies with apnea: JAMA

Compared with placebo, Extended caffeine treatment did not shorten hospitalization in preterm babies  with apnea suggests a new study published in the JAMA.

Hospitalization of moderately preterm infants may be prolonged while waiting for apnea of prematurity to resolve after discontinuing caffeine. A study was done to evaluate whether extending caffeine treatment reduces the duration of hospitalization. From February 2019 to December 2022, this randomized clinical trial in 29 US hospitals enrolled infants born at 29 to 33 weeks’ gestation who at 33 to 35 weeks’ postmenstrual age were receiving caffeine treatment with plans to discontinue it plus receiving full feeds (≥120 mL/kg/d). Follow-up was completed on March 20, 2023. The primary outcome was days to discharge after randomization. Secondary outcomes included days to physiological maturity (apnea free for 5 consecutive days, receiving full oral feeds, and out of the incubator for at least 48 hours), postmenstrual age at discharge, all-cause hospital readmissions, all-cause sick and emergency department visits, safety outcomes, and death. Results A total of 827 infants (median gestational age, 31 weeks; 414 female [51%]) were randomized (416, caffeine; 411, placebo) out of the 878 planned before reaching the prespecified futility threshold. Days of hospitalization after randomization did not differ between groups (18.0 days [IQR, 10 to 30 days] for caffeine vs 16.5 [IQR, 10 to 27 days] for placebo; adjusted median difference, 0 days [95% CI, −1.7 to 1.7 days]), nor did days to physiological maturity differ (14.0 vs 15.0 days, adjusted median difference, −1 day [95% CI, −2.4 to 0.4 days]). Infants receiving caffeine were apnea free sooner (6.0 vs 10.0 days; adjusted median difference, −2.7 days [95% CI, −3.4 to −2.0 days ]) but had similar days to full oral feeding (7.5 vs 6.0 days, adjusted median difference, 0 days [95% CI, −0.1 to 0.1]). Rates of readmissions and sick visits did not differ between groups. There was no statistically significant difference in adverse events between the 2 groups. In moderately preterm infants, continuation of caffeine treatment compared with placebo did not shorten hospitalization.

Reference:

Carlo WA, Eichenwald EC, Carper BA, et al. Extended Caffeine for Apnea in Moderately Preterm Infants: The MoCHA Randomized Clinical Trial. JAMA. Published online April 28, 2025. doi:10.1001/jama.2025.5791

Keywords:

Compared, placebo, Extended, caffeine, treatment, shorten, hospitalization, preterm babies, JAMA, Carlo WA, Eichenwald EC, Carper BA

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D-Dimer Levels and NIHSS Scores Predict Poor Outcomes in Elderly Stroke Patients: Study

Researchers have found in a new study that elevated D-dimer levels and higher NIHSS scores were found to strongly predict poor prognosis in elderly patients with cerebral infarction. Patients with worse outcomes had significantly higher D-dimer levels, which correlated positively with NIHSS scores. D-dimer showed 72% sensitivity and 74% specificity. Additional key risk factors included advanced age, atrial fibrillation, and a history of transient ischemic attacks. This study evaluates the relationship between D-dimer levels and NIHSS scores with prognosis in elderly patients with cerebral infarction.

Methods: This study was a retrospective study that included 112 elderly patients with cerebral infarction admitted to our hospital from January 2022 to December 2023. The modified Rankin Scale (mRS) was used to assess the prognosis at six-month follow-up, and patients were divided into two groups: good prognosis (mRS 0– 2) and poor prognosis (mRS 3– 6). Detailed data collection and statistical analysis were conducted, including descriptive statistics of baseline data, correlation analysis between D-dimer and NIHSS scores, and multivariate logistic regression analysis to identify independent risk factors for poor prognosis. Results: Patients in the poor prognosis group had significantly higher age, BMI, proportions of smoking history, alcohol consumption history, transient ischemic attack (TIA) history, atrial fibrillation history, admission NIHSS scores, and D-dimer levels compared to the good prognosis group (P< 0.05). In addition, there were significant differences in D-dimer levels among patients with mild (NIHSS 1– 4), moderate (NIHSS 5– 14), and severe (NIHSS≥ 15) strokes (P< 0.001), and D-dimer levels were significantly positively correlated with NIHSS scores (r=0.58, P< 0.001). Multivariate logistic regression analysis showed that D-dimer levels, admission NIHSS scores, age, atrial fibrillation, and TIA history were independent predictors of poor prognosis (P< 0.05). ROC curve analysis showed that the AUC of D-dimer in predicting poor prognosis was 0.76 (95% CI: 0.67– 0.85), with a sensitivity of 72% and specificity of 74%. D-dimer and NIHSS showed a significant positive correlation (r=0.58, P< 0.001), with an AUC of 0.76 for predicting poor prognosis. Independent risk factors included age, atrial fibrillation, and a history of TIA. These findings support the use of D-dimer as a critical biomarker in risk stratification for elderly stroke patients.

Reference:

Zheng Z. D-Dimer Levels and NIHSS as Prognostic Predictors in Elderly Patients with Cerebral Infarction. Clin Interv Aging. 2025;20:505-511

https://doi.org/10.2147/CIA.S502994

Keywords:

D-Dimer Levels, NIHSS, Scores, Predict, Poor, Outcomes, Elderly, Stroke, Patients, Study , elderly cerebral infarction, D-dimer, NIHSS score, prognosis assessment, risk factors

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Study evaluates Innovative Approach to Pain Management in Cardiac Implant Procedures

Recent study aimed to compare the effectiveness of combined PECS 1 block and intercostal nerve block with local infiltration as an analgesic technique during Cardiac Implantable Electronic Device (CIED) implantations. Seventy patients were initially enrolled in the study, with 63 patients scheduled for pacemaker implantations being included. The patient demographics were comparable between the two groups. Pain assessments using the Numeric Rating Scale (NRS) showed significantly higher scores in the local infiltration group during the initial steps of the procedure. However, there were no significant differences in pain scores at 1, 2, 4, 8, and 24 hours post-procedure between the two groups.

Block Approach and Pain Reduction

The study observed that the combined block approach led to a substantial reduction in pain scores and opioid usage during the intraoperative period, along with decreased non-steroidal anti-inflammatory drug (NSAID) requirements in the postoperative period. The PECS 1 block and intercostal nerve block effectively reduced pain levels, with the combined nerve block resulting in lower pain scores during major steps of the procedure. The first demand for analgesia was significantly delayed in patients who received the combined nerve block compared to the local infiltration group.

Combined Block Benefits

Patients who received the combined block required less fentanyl during the procedure and had lower post-procedure paracetamol requirements. The duration of hospital stay and post-procedure pain scores were comparable between both groups. The study highlighted the significance of the PECS 1 block and intercostal nerve block in reducing pain during CIED implantations, emphasizing its potential as an alternative analgesic technique.

Study Methodology

The study method involved randomizing patients into two groups, with Group A receiving local infiltration and Group B receiving the combined PECS 1 block and intercostal nerve block under ultrasound guidance. During the procedure, additional analgesia was provided if NRS scores exceeded 3, and intravenous fentanyl boluses were administered as needed. Pain scores were assessed post-procedure, and IV paracetamol was given if NRS exceeded 3.

Statistical Analysis

Statistical analysis revealed a significant decrease in pain scores at the initial steps with the combined nerve block, a prolonged time for the first analgesia demand, and reduced opioid and paracetamol requirements in the combined block group. The study concluded that the combined PECS 1 and intercostal nerve block provided better analgesia during CIED implantations compared to traditional local infiltration, making it a promising analgesic option for these procedures.

Conclusion

In conclusion, the study demonstrated that the combination of PECS 1 and intercostal nerve block offers improved intraoperative analgesia and lowers the analgesic requirements in patients undergoing CIED implantations. Further research is recommended to validate the efficacy of these newer blocks and explore their potential for enhancing patient comfort and outcomes in similar procedures in the future.

Key Points

– The study compared the efficacy of combined PECS 1 block and intercostal nerve block with local infiltration for analgesia during Cardiac Implantable Electronic Device (CIED) implantations.

– Patients who received the combined block approach had significantly lower pain scores and reduced opioid usage during the procedure compared to those who received local infiltration.

– The combined nerve block approach resulted in delayed demand for analgesia, reduced NSAID requirements postoperatively, and lower pain scores during major procedural steps. – Patients receiving the combined block needed less fentanyl during the procedure and had lower post-procedure paracetamol requirements.

– Statistical analysis showed that the combined PECS 1 and intercostal nerve block led to decreased pain scores, delayed analgesia demand, and reduced opioid and paracetamol requirements compared to local infiltration.

– The study suggests that the combination of PECS 1 and intercostal nerve block provides better analgesia during CIED implantations, highlighting its potential as an alternative analgesic technique for enhancing patient comfort and outcomes.

Reference –

Muhilan Senthilkumar et al. (2025). Comparison Of Combined Pectoralis Plane Block And Intercostal Nerve Block With Local Infiltration Analgesia In Patients Undergoing Cardiac Implantable Electronic Device Implantation – A Randomized Controlled Trial.. *Annals Of Cardiac Anaesthesia*, 28 2, 170-175 . https://doi.org/10.4103/aca.aca_164_24.

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Patient-Centered Telehealth may enhance Maternal Healthcare by building strong nurse-patient relationships: Study

Underserved populations in the United States, particularly those facing social and economic challenges, are at higher risk for poor maternal health outcomes. Maternal health complications and mortality rates have been on the rise, disproportionately affecting low-income and racial minority women. Limited access to timely and high-quality prenatal and postnatal care has been identified as a significant contributor to the higher morbidity and mortality risk faced by these populations. To address these disparities and increase access to care, many states in the U.S. have expanded their Medicaid programs. Despite the expanded coverage, barriers like a shortage of providers, transportation issues, long wait times, and poor patient-provider relationships continue to impede women’s access to quality prenatal care.

Telehealth Program as a Solution

Telehealth programs have emerged as a promising solution to improve maternal health outcomes and reduce barriers to care. The Pregnancy and Postpartum Support Program (PPSP), launched by OSF HealthCare in collaboration with federally qualified health centers, provides telehealth services to pregnant women, including adolescents, with 24/7 virtual access to registered nurses (RNs) and advanced practice registered nurses (APRNs). This app-based program aims to enhance access to care, timely assessment, and referrals to necessary resources for pregnant and postpartum women.

Perspectives on Telehealth Relationships

Recently published study focused on exploring the perspectives of patients and nurses involved in the PPSP regarding the relationships established through telehealth. Through qualitative interviews with 23 women enrolled in the program and five nurses supporting its implementation, the study uncovered key themes related to nurse-patient relationships. Patients valued the timely responses from nurses, feeling supported and at ease knowing they could reach out anytime. They appreciated the comfort of texting nurses and considered them as approachable and non-judgmental sources of support. Nurses also highlighted the benefits of digital communication in enhancing relationships, allowing for more frequent interactions and personalized care.

Importance of Nurse-Patient Communications

The study emphasized the importance of effective communication, emotional support, and patient-centered care in nurturing positive nurse-patient relationships in telehealth programs. Patients appreciated the 24-hour access to nursing staff, action-oriented care, and the ability to communicate via text messaging, which allowed them to control the frequency of interactions with program staff. The development of therapeutic relationships was essential in providing patients with emotional support, personalized care, and a sense of trust and comfort throughout their pregnancy and postpartum journey.

Impact of Telehealth Programs

The findings suggest that telehealth programs, when designed to prioritize patient preferences and foster therapeutic nurse-patient relationships, can significantly improve access to quality maternal healthcare. By emphasizing programmatic aspects that support virtual relationships, such as 24/7 access, personalized care, and effective communication, telehealth initiatives like the PPSP can effectively address barriers to care and enhance patient outcomes. Further research is recommended to explore the long-term impact of telehealth programs on maternal health and the sustainability of positive nurse-patient relationships in digital care settings.

Key Points

– Underserved populations in the U.S. facing social and economic challenges are at higher risk for poor maternal health outcomes, with maternal health complications and mortality rates disproportionately affecting low-income and racial minority women.

– Limited access to timely and high-quality prenatal and postnatal care is a significant contributor to the higher morbidity and mortality risk faced by vulnerable populations. – Telehealth programs, such as the Pregnancy and Postpartum Support Program (PPSP), have emerged as a promising solution to improve maternal health outcomes and reduce barriers to care by providing virtual access to registered nurses and advanced practice registered nurses.

– Qualitative interviews with patients and nurses involved in the PPSP highlighted key themes related to nurse-patient relationships, emphasizing the importance of timely responses, emotional support, and personalized care.

– Effective communication, emotional support, and patient-centered care are crucial for nurturing positive nurse-patient relationships in telehealth programs, allowing patients to feel supported, in control of interactions, and comfortable throughout their pregnancy and postpartum journey.

– Telehealth programs, when prioritizing patient preferences and fostering therapeutic nurse-patient relationships through 24/7 access, personalized care, and effective communication, can significantly improve access to quality maternal healthcare and enhance patient outcomes. Further research is recommended to explore the long-term impact of telehealth programs on maternal health.

Reference –

Matthew D. Dalstrom et al. (2025). Examining Digital Care Relationships Of Medicaid Participants In The Pre/Postnatal Care Period: A Qualitative Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07587-z.

 

The findings indicate that telehealth programs, when tailored to respect patient preferences and build , can greatly enhance access to quality maternal healthcare.

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Laparoscopic Supracervical has Lower Postoperative Risks in Uterine Fibroid Surgery vs Total Hysterectomy: Study

Researchers have found in a new study that Laparoscopic supracervical hysterectomy was linked to a lower risk of short-term postoperative complications compared to total laparoscopic hysterectomy in patients with uterine fibroids, supporting its consideration during shared decision-making for minimally invasive surgery.

Uterine fibroids are the most common indication for benign hysterectomy in the United States, but data regarding the association between hysterectomy type and outcomes for this indication are lacking.This study aimed to describe the rate and odds of short-term (30 days) postoperative complications between patients who underwent minimally invasive total laparoscopic hysterectomy and those who underwent laparoscopic supracervical hysterectomy for uterine fibroids. This was a cohort study of prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2020. The characteristics of women who underwent total laparoscopic hysterectomy and those who underwent laparoscopic supracervical hysterectomy for uterine fibroids were identified. In addition, the risk factors associated with the occurrence of 30-day postoperative complications, defined according to the Clavien-Dindo classification, were identified. Multivariate regression analysis, including age, body mass index, race, comorbidities, American Society of Anesthesiologists classification, uterine weight, and concomitant procedures, was performed to identify the adjusted odds of postoperative complications. The co-primary outcomes were (1) the risk of a composite of any postoperative complications and (2) the risk of major postoperative complications according to surgical type.Results: Overall, 44,413 patients underwent minimally invasive total laparoscopic hysterectomy, and 6383 patients underwent laparoscopic supracervical hysterectomy. The operative time was shorter in the total laparoscopic hysterectomy group than in the laparoscopic supracervical hysterectomy group (143.0 vs 150.6 minutes, respectively; P < .001). In addition, the proportion of uterine weight of >250 g was lower in the total laparoscopic hysterectomy group than in the laparoscopic supracervical hysterectomy group (39.4% vs 45.1%, respectively; P < .001). The rates of any and major complications were higher in the total laparoscopic hysterectomy group than in the laparoscopic supracervical hysterectomy group (any complications: 6.6% vs 5.3%, respectively; P < .001; major complications: 2.7% vs 1.6%, respectively; P < .001), whereas the rates of minor complications were comparable in both groups (4.4% vs 4.1%, respectively; P = .309). In multivariate regression analysis, laparoscopic supracervical hysterectomy was independently associated with a lower risk of any (adjusted odds ratio, 0.79; 95% confidence interval, 0.70–0.88) and major (adjusted odds ratio, 0.55; 95% confidence interval, 0.44–0.69) complications than total laparoscopic hysterectomy. Laparoscopic supracervical hysterectomy was associated with a lower risk of short-term postoperative complications in patients with uterine fibroids than total laparoscopic hysterectomy. Our findings can aid in shared decision-making before minimally invasive hysterectomy for uterine fibroids.

Reference:

Raanan Meyer, Kacey M. Hamilton, Rebecca J. Schneyer, Gabriel Levin, Mireille D. Truong, Kelly N. Wright, Matthew T. Siedhoff. Short-term outcomes of minimally invasive total vs supracervical hysterectomy for uterine fibroids: a National Surgical Quality Improvement Program study. American Journal of Obstetrics and Gynecology, Volume 232, Issue 4, 2025, Pages 377.e1-377.e10, ISSN 0002-9378, https://doi.org/10.1016/j.ajog.2024.10.006. (https://www.sciencedirect.com/science/article/pii/S0002937824010548)

Keywords:

Laparoscopic, Supracervical, Lower, Postoperative, Risks, Uterine, Fibroid, Surgery, Total Hysterectomy, Study , American Journal of Obstetrics and Gynecology, Raanan Meyer, Kacey M. Hamilton, Rebecca J. Schneyer, Gabriel Levin, Mireille D. Truong, Kelly N. Wright, Matthew T. Siedhoff

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Delgocitinib Cream Outperforms Alitretinoin for Treatment of Severe Chronic Hand Eczema: Lancet

Spain: In the phase III DELTA FORCE trial, delgocitinib cream demonstrated superior efficacy and a more favorable safety profile than oral alitretinoin for patients with severe chronic hand eczema. Fewer adverse events were reported in the delgocitinib group (49%) versus the alitretinoin group (76%), highlighting it as a promising alternative in a field with limited treatment options.

The findings were published online in The Lancet on April 16, 2025.

Chronic hand eczema is a long-standing, persistent, and variable inflammatory skin condition that affects the hands and wrists, often causing significant disruption to daily life and overall well-being. The researchers note that topical corticosteroids may provide limited relief in severe cases, making systemic therapy necessary. Oral alitretinoin is one of the few approved systemic options for treatment-resistant cases; however, concerns regarding its side effects and long-term safety have highlighted the need for safer and more effective alternatives.

Against the above background, Prof Ana Maria Giménez-Arnau, Department of Dermatology, Hospital Del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain, and colleagues conducted the head-to-head, phase 3 DELTA FORCE trial to evaluate the efficacy and safety of topical delgocitinib cream in comparison to oral alitretinoin, which is currently the only approved systemic treatment for severe chronic hand eczema.

The randomized, assessor-masked trial was carried out across 102 centers in ten countries, including the UK, Germany, and Canada. Adults aged 18 and above with severe chronic hand eczema were randomly assigned to receive either delgocitinib cream (20 mg/g, twice daily) or alitretinoin capsules (30 mg, once daily) for up to 24 weeks.

The main goal was to measure the change in the Hand Eczema Severity Index (HECSI) score from the start of the trial to week 12. Efficacy was analyzed in patients with baseline data, and safety was evaluated in all who received the treatment.

The following were the key findings:

  • A total of 513 patients (65% female, 35% male) were enrolled between June 15, 2022, and Dec 5, 2023, and randomly assigned to receive either delgocitinib cream (n=254) or alitretinoin (n=259).
  • Ten patients were excluded after randomization due to not meeting eligibility criteria, resulting in 250 patients in the delgocitinib group and 253 in the alitretinoin group for analysis.
  • One patient from the delgocitinib group and three from the alitretinoin group were excluded from the primary analysis due to missing baseline HECSI data.
  • Delgocitinib cream showed a significantly greater reduction in HECSI score at week 12 (–67.6) compared to alitretinoin (–51.5), with a between-group difference of –16.1.
  • Fewer adverse events were reported in the delgocitinib group (49%) than in the alitretinoin group (76%).
  • Headache occurred in 4% of patients using delgocitinib versus 32% with alitretinoin.
  • Nasopharyngitis was reported in 12% of the delgocitinib group and 14% of the alitretinoin group.
  • Nausea was rare with delgocitinib (<1%) compared to 6% with alitretinoin.

“The findings demonstrated that delgocitinib cream provided better effectiveness and a more favorable safety profile than oral alitretinoin over 24 weeks,” the authors noted, concluding that “these results highlight the potential of delgocitinib cream as a promising treatment option for patients with severe chronic hand eczema.”

Reference:

Giménez-Arnau AM, Pinter A, Sondermann W, Reguiai Z, Woolf R, Lynde C, Legat FJ, Costanzo A, Silvestre JF, Mellerup N, Østerdal ML, Plohberger U, Ryttig L, Bauer A; trial investigators. Efficacy and safety of topical delgocitinib cream versus oral alitretinoin capsules in adults with severe chronic hand eczema (DELTA FORCE): a 24-week, randomised, head-to-head, phase 3 trial. Lancet. 2025 Apr 16:S0140-6736(25)00001-7. doi: 10.1016/S0140-6736(25)00001-7. Epub ahead of print. PMID: 40252681.

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