Thiruvananthapuram Medical College achieves milestone in advanced stroke care

Thiruvananthapuram: The Neurology Department of the Government Medical College (GMC) Thiruvananthapuram has achieved a significant milestone in the field of advanced stroke treatment through its neurointervention facilities.

“Neuro-intervention services at the Medical College began in June 2023. Under the current government, the first Neuro Cath Lab in the country within the neurology department was established here,” Health Minister Veena George said, news agency UNI reported.

Since then, the deployment has successfully performed 320 diagnostic cerebral angiograms and 55 therapeutic neuro-intervention procedures — a total of 375 neuro-interventions. This includes several complex procedures that are rarely performed in India.

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Congratulating the entire neurology team for bringing numerous patients back to life through these advanced treatments, she said the team has successfully treated extremely rare and complex conditions like aneurysms.

Procedures such as angioplasty on extremely thin blood vessels within the brain were performed with great success. This has placed Thiruvananthapuram Medical College among the very few institutions in India capable of handling such complex procedures.

The hospital has also successfully performed embolisation procedures for rare conditions like dural arteriovenous fistula (dural AV fistula), carotid-cavernous fistula, and arteriovenous malformations (AVMs).

These advanced treatments, which typically cost several lakhs of rupees, are provided either free of charge or at a very low cost under government health schemes. Even patients aged up to 90 have successfully undergone mechanical thrombectomy at the hospital.

A stroke (also called a cerebrovascular accident) occurs when the blood vessels supplying the brain are blocked (thrombosis) or ruptured (hemorrhage).

Stroke treatment is highly time-sensitive – patients must reach the hospital within 4.5 hours of the first symptoms for the treatment to be effective. Symptoms of stroke include sudden facial drooping, weakness in the arms or legs, and slurred speech. Anyone exhibiting these signs should be rushed to a hospital without delay.

To provide comprehensive stroke care, Thiruvananthapuram Medical College has established an advanced stroke centre equipped with facilities such as a CT angiogram, a stroke cath lab, and a dedicated stroke ICU.

A Stroke Helpline is also available for assistance. In case of any suspicion of stroke, immediately call the Stroke Centre’s helpline at 9946332963 for guidance and emergency support. A fully equipped medical team is available 24/7 at the centre to ensure timely and life-saving treatment, reports UNI.

Also Read:Kerala: Health Minister Veena George to inaugurate first ever project on collection, disposal of expired medicines

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Once-Monthly MariTide Shows Promising Weight Loss in Obesity and Type 2 Diabetes: Phase 2 Trial

USA: A once-monthly injectable therapy, maridebart cafraglutide (MariTide), demonstrated significant weight loss in individuals with obesity-with and without type 2 diabetes-according to a new phase 2 clinical trial published in The New England Journal of Medicine. The trial, led by Dr. Ania M. Jastreboff from Yale School of Medicine and her colleagues, explored the efficacy and safety of this novel dual-action peptide–antibody conjugate over 52 weeks.

MariTide is designed to combine the effects of glucagon-like peptide-1 (GLP-1) receptor activation with glucose-dependent insulinotropic polypeptide (GIP) receptor antagonism. This unique mechanism targets key metabolic pathways involved in appetite regulation, insulin sensitivity, and weight management.

The study enrolled a total of 592 adults, divided into two cohorts: individuals with obesity (465 participants) and those with both obesity and type 2 diabetes (127 participants). Participants were randomized to receive various dosing regimens of maridebart cafraglutide or a placebo injection over a year. Doses ranged from 140 mg to 420 mg, administered every four or eight weeks, with some groups undergoing dose escalation to evaluate tolerability.

The study revealed the following findings:

  • In the obesity-only cohort, participants lost an average of 12.3% to 16.2% of their baseline body weight over 52 weeks, depending on the dosing regimen, compared to just 2.5% in the placebo group.
  • The greatest weight reduction was observed in participants receiving 420 mg of maridebart cafraglutide every four weeks.
  • Among individuals with both obesity and type 2 diabetes, average weight loss ranged from 8.4% to 12.3% at week 52, while the placebo group showed only a 1.7% weight reduction.
  • Participants with obesity and diabetes also experienced significant improvements in blood sugar control, with HbA1c levels dropping by 1.2 to 1.6 percentage points, in contrast to a 0.1-point reduction in the placebo group.
  • Gastrointestinal adverse events such as nausea and diarrhea were frequently reported but occurred less often and with lower intensity among those who received dose-escalation or lower starting doses.
  • The trial did not report any new or unexpected safety concerns, reinforcing the overall tolerability of the treatment.

The authors wrote, “Overall, the trial findings suggest that maridebart cafraglutide, administered once a month, has the potential to become an effective therapeutic option for weight management in adults with or without type 2 diabetes. The substantial and sustained weight reduction, along with improvements in blood sugar levels, marks a promising advance in the treatment landscape for obesity.”

“Further research, including larger phase 3 trials, will be essential to confirm long-term safety and effectiveness before regulatory approval,” they concluded.

Reference:

Jastreboff AM, Ryan DH, Bays HE, et al. Once-monthly maridebart cafraglutide for the treatment of obesity — a phase 2 trial. N Engl J Med. 2025;Epub ahead of print.

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Flavan-3-ols Significantly Improve Blood Pressure and Vascular Health: Study

A new study published in the European Journal of Preventive Cardiology has found that foods rich in flavan-3-ols have the potential to decrease blood pressure and enhance vascular function drastically, particularly among those with high or hypertensive levels. A recent meta-analysis affirms the cardiovascular effect of flavan-3-ols, substances present in cocoa, tea, apples, and other fruits. The study was published in Vasiliki L. and colleagues.

Flavan-3-ols have been known for their antioxidant and anti-inflammatory actions for decades. Despite that, their therapeutic application in cardiovascular prevention was limited. This systematic review sought to evaluate systematically their effect on blood pressure and endothelial function based on data collected over almost eight decades.

The authors performed a PROSPERO-registered systematic review and meta-analysis (CRD42023454691). They screened and examined 109 publications of 145 RCTs published between 1946 and March 2024. All the studies had estimated the impacts of flavan-3-ol-dense interventions like epicatechin, epigallocatechin-gallate (EGCG), cocoa products, green and black tea, grape extract, and apples.

Participants had an average daily intake of 586 mg of flavan-3-ols (95% confidence interval: 510–662 mg). Both office and 24-hour ambulatory blood pressure (BP) as well as flow-mediated dilation (FMD) were specifically measured in the study to determine endothelial function.

Key Findings

Reduction in Blood Pressure:

• Office BP was lowered by a mean of 2.8 mmHg systolic and 2.0 mmHg diastolic for all participants.

• Twenty-four-hour ambulatory BP fell by 3.7 mmHg systolic and 2.6 mmHg diastolic.

Greater Effects in Hypertension:

Participants with elevated or hypertensive BP at baseline experienced greater decreases:

• Office BP: −5.9 mmHg systolic and −2.7 mmHg diastolic

• 24-hour ambulatory BP: −6.8 mmHg systolic and −5.1 mmHg diastolic

Endothelial Function Improved:

• Flow-mediated dilation (FMD) improved by 2.0% after acute and 1.7% after repeated intake of flavan-3-ol-rich foods, regardless of changes in BP.

Safety Profile:

• A dverse events reported were trivial and infrequent, occurring in only 0.4% of participants.

Foods rich in flavan-3-ol reduce high blood pressure significantly and improve vascular function, justifying their inclusion in cardiovascular preventive therapy. Due to their good safety profile and availability, the compounds present a promising and convenient method for the control of vascular well-being.

Reference:

Vasiliki Lagou, Arno Greyling, Mario G Ferruzzi, Simon S Skene, Joy Dubost, Ayse Demirkan, Inga Prokopenko, Julie Shlisky, Ana Rodriguez-Mateos, Christian Heiss, Impact of flavan-3-ols on blood pressure and endothelial function in diverse populations: a systematic review and meta-analysis of randomized controlled trials, European Journal of Preventive Cardiology, 2025;, zwaf173,https://doi.org/10.1093/eurjpc/zwaf173

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Weight Stability or Sustained Weight Loss May Help Prevent Heart and Metabolic Diseases: Study

Researchers have discovered that people who continue to lose and regain weight, a process referred to as weight cycling, are at significantly greater risk of acquiring a number of significant cardiometabolic illnesses, even if their baseline body mass index (BMI) is already elevated. The research highlights that weight cycling, in contrast to weight stability or maintained weight reduction, is more linked with negative health consequences like type 2 diabetes, heart failure, and liver disease. The study was conducted by Alison Z and colleagues published in the Journal of Clinical Endocrinology and Metabolism.

This is the first large-scale study to directly compare how various long-term weight trajectories, weight stability, weight gain, weight loss, and weight cycling, impact the risk of prevalent cardiometabolic disease in adults with comparably high baseline BMIs. The study, underpinned by de-identified health records across more than two decades, underlines the importance of clinical strategies that aim not only to achieve weight loss but to maintain weight over time.

The authors carried out a retrospective cohort study based on electronic health record data from Vanderbilt University Medical Center for adult patients between 1997 and 2020. Adults with elevated baseline BMI were included in the analysis and their longitudinal weight trajectories over time were followed. They were grouped into four categories according to their weight trajectory: weight stable, weight gainers, weight losers, and weight cyclers.

In order to determine disease risk, the researchers employed multivariate Cox proportional hazards regression models in a landmark study design. They investigated associations between weight trajectory and incidence of ten prevalent cardiometabolic diseases, controlling for confounding factors like age, sex, and comorbidities.

Key Findings

Weight cycling was found to be significantly linked to elevated risk of multiple cardiometabolic diseases versus weight stability:

• Heart Failure: Individuals with weight cycling were 54% more likely to develop heart failure (HR 1.54; 95% CI: 1.31–1.82). Weight gain (HR 1.29; 95% CI: 1.08–1.55) and weight loss (HR 1.32; 95% CI: 1.10–1.58) were also associated with higher risk of heart failure, though less so than with weight cycling.

• Obstructive Sleep Apnea: Weight cycler risk increased by 28% (HR 1.28; 95% CI: 1.15–1.42).

• Type 2 Diabetes Mellitus (T2DM): Weight cyclers had an increased risk of 23% (HR 1.23; 95% CI: 1.10–1.38).

• Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD): There was a 28% increased risk in weight cyclers (HR 1.28; 95% CI: 1.08–1.51).

The findings underscore the significance of enhancing long-term weight maintenance or permanent weight loss as primary preventive strategies against cardiometabolic disease. For people who have obesity, prevention of repeated weight change may be as important as how much weight they lose.

Reference:

Swartz AZ, Wood K, Farber-Eger E, Petty A, Silver HJ. Weight Trajectory Impacts Risk for Ten Distinct Cardiometabolic Diseases. J Clin Endocrinol Metab. 2025 Jun 11:dgaf348. doi: 10.1210/clinem/dgaf348. Epub ahead of print. PMID: 40498904

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Surgery plus speech therapy linked to improved language after stroke, reveals research

Combining neck surgery with intensive speech therapy is associated with greater improvements in a person’s ability to communicate after a stroke than intensive speech therapy alone, finds a clinical trial published by The BMJ today.

The results show improvements immediately after surgery without any long-term severe adverse events or lasting discomfort, as well as reported improvements in quality of life and post-stoke depression over six months.

Stroke is the most common cause of aphasia (problems with communication, including speaking, understanding others, reading and writing). More than 60% of patients are affected up to one year, referred to as chronic post-stroke aphasia.

Intensive speech and language therapy (iSLT) is a standard treatment for chronic post-stroke aphasia, but it’s not clear if combining a type of neck surgery called C7 neurotomy (NC7) and iSLT might be more effective.

To find out, researchers in China identified 50 patients aged 40 to 65 years with aphasia and muscle stiffness (spasticity) in their right arm for more than a year after a single stroke affecting the left side of the brain, which is responsible for language.

The participants, who all spoke fluent Chinese before their stroke, were randomly assigned to receive either surgery plus 3 weeks iSLT (intervention group) or 3 weeks iSLT alone (control group).

The main measure of interest was the change in Boston Naming Test (BNT) score (ability to name drawings of everyday objects) at day 3, one, and six months into the trial. Others included changes in aphasia severity and patient reported quality of daily life and depression.

The results show that the intervention group demonstrated statistically significant improvements across all measured outcomes compared with controls.

At 1 month, the average increase in BNT score was 11.16 points in the intervention group, and 2.72 points in the control group (difference: 8.51 points). This increase in language function remained stable at 6 months (difference: 8.26 points).

Aphasia severity also improved more in the intervention group than the control group (difference at one month 7.06 points) and patient-reported activity of daily life and post-stroke depression significantly improved compared with controls.

No surgery or procedure related severe adverse events were reported at 6 months.

The authors acknowledge that participants were relatively young, mostly male, and all native Chinese speakers, which limits the generalisability of their findings, and say an extended follow-up study is needed to verify patients’ performance over a longer time period.

However, they conclude that NC7 plus 3 weeks intensive SLT “is a superior treatment for chronic post-stroke aphasia compared with intensive speech and language therapy alone” and “can benefit patients in quality of daily life and post-stroke depression.”

This trial is an interesting step forward, says Supattana Chatromyen at the Neurological Institute of Thailand, in a linked editorial.

Some caution is, however, warranted, she says, but if further evidence supports these findings, they seem to offer a glimmer of hope for people with chronic stroke who meet the appropriate criteria.

“Although intensive SLT remains the cornerstone of aphasia treatment, C7 neurotomy could become a potential adjunctive option for carefully selected individuals in the future,” she writes. “This research should spark further scientific research and a critical re-evaluation of rehabilitation paradigms and policies for chronic stroke care, fostering a more optimistic and proactive approach to long term recovery.”

Reference:

Feng J, Hu R, Lyu M, Ma X, Li T, Meng Y et al. Right C7 neurotomy at the intervertebral foramen plus intensive speech and language therapy versus intensive speech and language therapy alone for chronic post-stroke aphasia: multicentre, randomised controlled trial BMJ 2025; 389 :e083605 doi:10.1136/bmj-2024-083605

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Focusing on weight loss alone for obesity may do more harm than good, suggests study

Focusing solely on achieving weight loss for people with a high body mass index (BMI) may do more harm than good, argue experts in The BMJ today.

Dr Juan Franco and colleagues say, on average, people with high weight will not be able to sustain a clinically relevant weight loss with lifestyle interventions, while the potential harms of weight loss interventions, including the reinforcement of weight stigma, are still unclear.

They stress that a healthy lifestyle has important benefits, but that weight alone might not give an adequate picture of someone’s health, and say doctors should provide high quality, evidence based care reflecting individual preferences and needs, regardless of weight.

Lifestyle interventions that focus on restricting an individual’s energy intake and increasing their physical activity levels have for many decades been the mainstay recommendation to reduce weight in people with obesity, explain the authors.

However, rigorous evidence has indicated that these lifestyle interventions are largely ineffective in providing sustained long term weight loss and reducing cardiovascular events (eg, heart attacks and strokes) or death.

Even though a healthy lifestyle provides important benefits, acknowledging that weight alone might not give an adequate picture of someone’s health, and recognising the limitations of lifestyle interventions for weight loss, could pave the way for more effective and patient centred care, they say.

Focusing on weight loss might also contribute to societal weight bias – negative attitudes, assumptions, and judgments about people based on their weight – which may not only have adverse effects on mental health but may also be associated with disordered eating, the adoption of unhealthy habits, and weight gain, they add.

They point out that recent clinical guidelines reflect the growing recognition that weight is an inadequate measure of health, and alternative approaches, such as Health at Every Size (HAES), acknowledge that good health can be achieved regardless of weight loss and have shown promising results in improving eating behaviours.

While these approaches should be evaluated in large clinical trials, doctors can learn from them to provide better and more compassionate care for patients with larger bodies, they suggest.

“Doctors should be prepared to inform individuals seeking weight loss about the potential benefits and harms of interventions and minimise the risk of developing eating disorders and long term impacts on metabolism,” they write. “Such a patient centred approach is likely to provide better care by aligning with patient preferences and circumstances while also reducing weight bias.”

They conclude: “Doctors’ advice about healthy eating and physical activity is still relevant as it may result in better health. The main goal is to offer good care irrespective of weight, which means not caring less but rather discussing benefits, harms, and what is important to the patient.”

Reference:

Franco J V A, Grundtvig Gram E , Meyer L, Grandi D, Cruzat B, Christiansen L B et al. Beyond body mass index: rethinking doctors’ advice for weight loss BMJ 2025; 389 :e084654 doi:10.1136/bmj-2025-084654.

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Early Puberty Linked to Long-Term Risk of Psychiatric Disorders, Study Finds

Germany: A new cohort study published in JAMA Network Open reveals that children diagnosed with idiopathic central precocious puberty (CPP) may be significantly more vulnerable to developing a range of psychiatric disorders, with mental health challenges potentially persisting for several years following the initial diagnosis.

Led by Dr. Lars Dinkelbach from the Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Germany, the study evaluated data from more than 6.5 million individuals insured under the German statutory health system between 2010 and 2023. The research aimed to investigate the long-term psychiatric implications of CPP, a condition where puberty begins unusually early without an identifiable cause.

Using a population-based, retrospective cohort design, the researchers analyzed the health records of 1,094 patients with idiopathic CPP and compared them to 5,448 matched controls. Participants were matched based on sex, birth year interval, obesity status, and insurance period to ensure accurate comparisons. Nearly all CPP cases (91.3%) were female, and around 23% had obesity.

The study revealed the following findings:

  • 24.7% of children with CPP were diagnosed with at least one psychiatric disorder, compared to 16.9% of controls.
  • The risk of depression was higher in CPP patients (7.5%) than in controls (4.6%), with an adjusted risk ratio (aRR) of 1.73.
  • Anxiety disorders were more common in CPP patients, with an aRR of 1.45.
  • Oppositional defiant and conduct disorders (ODD/CD) showed an elevated risk in CPP patients, with an aRR of 1.76.
  • The risk of attention-deficit/hyperactivity disorder (ADHD) was also increased, with an aRR of 1.53.
  • ODD/CD symptoms were observed to begin even before the diagnosis of CPP.
  • Higher rates of depression and ADHD persisted for at least eight years after the initial CPP diagnosis, indicating long-term mental health impacts.

According to the authors, the study is the first to provide robust, large-scale evidence linking CPP with an increased risk of psychiatric disorders. It also sheds light on the timing of symptom onset, emphasizing the importance of early and sustained mental health monitoring in these children.

Notably, the study identified an increased risk of psychiatric issues not only in girls who predominantly present with CPP but also in boys. This group is often underrepresented in research on puberty.

The authors recommend that healthcare providers, parents, and caregivers remain vigilant for signs of emotional or behavioral challenges in children with CPP, even long after the initial endocrine diagnosis. Early psychiatric evaluation and intervention could play a crucial role in improving long-term outcomes.

The authors concluded, “Further research is warranted to explore the biological and psychosocial mechanisms that may underlie this association, to inform targeted interventions to support the mental well-being of affected children.”

Reference:

Dinkelbach L, Grasemann C, Kiewert C, Leikeim L, Schmidt B, Hirtz R. Central Precocious Puberty and Psychiatric Disorders. JAMA Netw Open. 2025;8(6):e2516679. doi:10.1001/jamanetworkopen.2025.16679

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Sodium Bicarbonate Toothpaste Reduces Localized Gingivitis More Effectively Than Conventional Fluoride Toothpaste: Study

Researchers have found in a new study that twice-daily brushing with a sodium bicarbonate toothpaste significantly improved oral health and reduced localized gingivitis over 12 weeks, as measured by BI, MGI, and TPI indices, compared to a conventional fluoride toothpaste.

A study was done to determine the effect on gingival inflammation of toothbrushing with sodium bicarbonate toothpaste for 12 weeks compared to brushing with a conventional fluoride toothpaste. An ethically-approved, single-centre, controlled, examiner-blind, randomized, two-treatment arm, parallel study in consenting healthy ≥18yr participants with ≥20 teeth diagnosed with localised gingivitis. Approximately 200 eligible participants brushed for 2weeks with a fluoride acclimatization toothpaste before randomization to brushing 2/daily with a sodium bicarbonate (test) or fluoride (control) toothpaste. No pre-prophylaxis was conducted prior to study start. Modified gingival index (MGI), bleeding index (BI) and Turesky plaque index (TPI), were measured at baseline, 3, 6 and 12weeks. Participants completed a diary for compliance monitoring. Results: 190 participants were randomised, 188 completed the study. The test group demonstrated a statistically significant reduction in number of bleeding sites from baseline to 12-weeks (p=0.0032), 6-weeks (p=0.0031) and 3-weeks (p=0.0091), and compared to control group from baseline to 12-weeks (p=0.0013). The test group showed significantly (all p<0.0001) decreased mean MGI score from baseline to 3-weeks, 6-weeks, and 12-weeks compared to control group; significantly decreased mean overall TPI score from baseline to 3-weeks (p=0.0012), 6-weeks (p=0.0058), and 12-weeks (p<0.0001) compared to control; and significantly reduced mean interproximal TPI scores compared to control group from baseline to 3-weeks (p=0.0022), 6-weeks (p=0.0099) and 12-weeks (p<0.0001). Twice daily toothbrushing with a sodium bicarbonate toothpaste significantly improved oral health reducing localised gingivitis compared to brushing with a conventional fluoride toothpaste, measured by BI, MGI and TPI over 12 weeks. Localised, gingivitis can be resolved or prevented with excellent home-use oral hygiene measures, but this is rarely achieved with mechanical brushing alone. Twice daily toothbrushing with sodium bicarbonate toothpaste demonstrated added value in reducing localised gingivitis and improving oral health compared to brushing with a conventional fluoride toothpaste.

Reference:

Nicola X. West, Jianhong Qiu, Alexander J. Pollard, Maria Davies, Gary Smith, Paola Gomez-Pereira, Joon Seong. A randomised, controlled, trial investigating the effect of tooth brushing with a sodium bicarbonate toothpaste for 12 weeks compared to a conventional fluoride toothpaste on gingivitis, Journal of Dentistry, 2025, 105886, ISSN 0300-5712,

https://doi.org/10.1016/j.jdent.2025.105886.

(https://www.sciencedirect.com/science/article/pii/S0300571225003306)

Keywords:

Sodium, Bicarbonate, Toothpaste, Reduces, Localized, Gingivitis, More, Effectively, Conventional, Fluoride, Toothpaste, Study, Nicola X. West, Jianhong Qiu, Alexander J. Pollard, Maria Davies, Gary Smith, Paola Gomez-Pereira, Joon Seong, Journal of Dentistry

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Enpatoran Shows Efficacy in Reducing Disease Activity in CLE and SLE Patients with Active Lupus Rash in new study

Enpatoran, a TLR7/8 inhibitor, demonstrated clinically meaningful improvements in disease activity among patients with cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE) presenting with active lupus rash in Phase2 study. While the CLE cohort met its primary endpoint, the SLE cohort did not achieve the same outcome.

The findings are from Cohort A of the Phase 2 WILLOW study. Results will be presented at the 16th International Congress on Systemic Lupus Erythematosus (LUPUS 2025), taking place May 21-24 in Toronto.

WILLOW is a global, multicenter, randomized, placebo-controlled Phase 2 study evaluating three doses of enpatoran taken twice daily (25 mg, 50 mg and 100 mg) versus placebo plus standard of care (SoC) over 24 weeks. The study features a unique design across two lupus cohorts, including both patients with active SLE and CLE. Cohort A focused on patients with CLE or SLE with active lupus rash and evaluated organ-specific disease activity using the Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity (CLASI-A) score, a well-defined endpoint in CLE studies that measures different aspects of mucocutaneous manifestations. Cohort B was designed to evaluate the effect of enpatoran on systemic disease activity of SLE patients with the BICLA response endpoint.

Cohort A met its primary endpoint, demonstrating a dose-response relationship and showing a clinically meaningful improvement in CLASI-A scores at Week 16 (p = 0.0002). Additionally, at Week 24 up to 91.3% of patients receiving enpatoran achieved a CLASI-50 response (≥50% improvement from baseline), and up to 60.9% achieved a CLASI-70 response (≥70% improvement), compared with 38.5% and 11.5%, respectively, in the placebo group. In this cohort, enpatoran was well-tolerated, and exhibited a manageable safety profile consistent with previous studies, with no new safety signals identified.

“Lupus can make navigating everyday life difficult. The skin manifestation, known as lupus rash, often comes with persistent itching, which can lead to scarring and hair loss. This can significantly impact the physical, emotional and social well-being of those living with lupus, underscoring the urgent need for effective treatments,” said Jan Klatt, Head of Development Unit Neurology & Immunology for the Healthcare business of Merck KGaA, Darmstadt, Germany. “We are encouraged by the WILLOW results, where we observed clinically meaningful efficacy with a favorable safety profile in people living with lupus rash. Based on these results, discussions with health authorities on a global Phase 3 program with enpatoran are underway.”

In addition, and confirming the biological activity, treatment with enpatoran in Cohort A also led to a rapid reduction in interferon gene signature scores beginning at Week 2, which was maintained to Week 24, confirming the involvement of the TLR7/8 pathway in interferon activation in CLE. Overall, evidence from the WILLOW study supports the continued development of enpatoran as a treatment for autoimmune diseases like lupus.

On Cohort B of the WILLOW study, promising efficacy results were observed in prespecified subpopulations, even though the primary endpoint of dose response was not met. The full readout from this cohort will be presented at the European Alliance of Associations for Rheumatology Congress (EULAR 2025).

Principal investigator Prof. Eric Morand of Monash University and Monash Health, said, “These new findings offer promising evidence that, with enpatoran, we may be able to advance outcomes, which remain suboptimal for most patients. The data from the WILLOW study further our understanding of TLR7/8 inhibition in SLE and CLE, which is a novel mechanism of action that may offer new hope for patients.”

Toll-like receptors (TLR)7 and TLR8 play a relevant role in lupus pathogenesis and are associated with severe manifestations of the disease. By inhibiting these key disease drivers, enpatoran’s unique proposed mechanism of action aims to enhance therapeutic efficacy while preserving the body’s immune response, potentially overcoming limitations of existing lupus therapies.

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Breast Cancer Survivors may have Lower Alzheimer’s Risk, Linked to Radiation Therapy: JAMA

A recent Korean study published in the Journal of American Medical Association found that breast cancer survivors had a slightly lower risk of developing Alzheimer’s dementia (AD) when compared to cancer-free individuals. The reduced risk was notably associated with radiation therapy, while other treatments showed no significant effect. However, the protective effect was strongest at 6 months post-treatment and diminished over time.

This research evaluated data from over 70,000 breast cancer patients who underwent surgery between 2010 and 2016. These individuals were matched 1:3 with cancer-free controls and followed for a median of 7.3 years. The analysis was completed in the first half of 2024 using data from the Korean National Health Insurance Service.

Over the study period, 1,229 cases of AD were diagnosed among breast cancer survivors, equating to an incidence rate of 2.45 cases per 1,000 person-years. After adjusting for socioeconomic status and comorbidities, this study found that breast cancer survivors had a modestly reduced risk of AD when compared to the control group, with a subdistribution hazard ratio (SHR) of 0.92 (95% CI, 0.86–0.98).

The reduced risk was particularly noticeable among survivors aged 65 years and older (SHR, 0.92; 95% CI, 0.85–0.99). However, a landmark analysis revealed that the lower risk of AD was no longer statistically significant after 5 years of survival, suggesting that the early survivorship period may uniquely influence cognitive outcomes.

Radiation therapy was linked to a notably lower risk of developing AD, with an adjusted hazard ratio (HR) of 0.77 (95% CI, 0.68–0.87). Meanwhile, anthracycline-based chemotherapy, often associated with cognitive complaints, did not significantly increase the risk of AD in this cohort. The findings showed that younger survivors had an overall lower incidence of AD when compared to older groups, and those who received radiation therapy experienced the lowest observed rates of AD.

Overall, this study contributes to the nuanced understanding of “chemo brain” and cognitive aging in cancer survivors. While treatment-related cognitive impairment remains a valid concern, this research suggests that some treatments may offer neuroprotective benefits, possibly through mechanisms related to inflammation, immune modulation, or vascular changes.

Reference:

Jeong, S.-M., Jung, W., Cho, H., Choi, H. L., Jeon, K. H., Nam, K.-W., Lee, Y.-G., Kim, B., Han, K., & Shin, D. W. (2025). Alzheimer disease in breast cancer survivors. JAMA Network Open, 8(6), e2516468. https://doi.org/10.1001/jamanetworkopen.2025.16468

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