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Upadacitinib in the treatment of Rheumatoid Arthritis and Other Medical Updates

Written by Mary Pooja
  1. Upadacitinib in the treatment of Rheumatoid Arthritis

    Upadacitinib is an oral, reversible Janus kinase (JAK) inhibitor with selectivity for JAK1 over JAK2, JAK3, and tyrosine kinase 21 that has been approved for the treatment of rheumatoid arthritis. Studies have shown remission with the use of upadacitinib in approximately 30% of patients regardless of previous treatment, including those who had not previously received methotrexate or who had had treatment failure with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) or biologic DMARDs. In this 24-week, phase 3, double-blind, controlled trial, The efficacy and safety of upadacitinib and abatacept is studied.

    Link: https://www.nejm.org/doi/full/10.1056/NEJMoa2008250?query=featured_home

  2. Vitamin D for COVID-19 (VIVID) trial: A pragmatic cluster-randomized design

    To determine the effect of vitamin D supplementation on disease progression and post-exposure prophylaxis for COVID-19 infection. We hypothesize that high-dose vitamin D3 supplementation will reduce risk of hospitalization/death among those with recently diagnosed COVID-19 infection and will reduce risk of COVID-19 infection among their close household contacts. The rationale and design of a planned pragmatic, cluster-randomized, double-blinded trial (N = 2700 in total nationwide), with 1500 newly diagnosed individuals with COVID-19 infection, together with up to one close household contact each (~1200 contacts), randomized to either vitamin D3 (loading dose, then 3200 IU/day) or placebo in a 1:1 ratio and a household cluster design. The study duration is 4 weeks. The primary outcome for newly diagnosed individuals is the occurrence of hospitalization and/or mortality. Key secondary outcomes include symptom severity scores among cases and changes in the infection (seroconversion) status for their close household contacts. Changes in vitamin D 25(OH)D levels will be assessed and their relation to study outcomes will be explored.

    Link: https://www.contemporaryclinicaltrials.com/article/S1551-7144(20)30254-8/pdf

  3. Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study

    Obesity shortens life expectancy. Bariatric surgery is known to reduce the long-term relative risk of death, but its effect on life expectancy is unclear. This study used the Gompertz proportional hazards regression model to compare mortality and life expectancy among patients treated with either bariatric surgery (surgery group) or usual obesity care (control group) in the prospective, controlled Swedish Obese Subjects (SOS) study and participants in the SOS reference study (reference cohort), a random sample from the general population.

    Link: https://www.nejm.org/doi/full/10.1056/NEJMoa2002449?query=featured_home

  4. COVID-19 and first trimester spontaneous abortion: a case-control study of 225 pregnant patients

    The disease caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) was named Coronavirus Disease 19 (COVID-19) and classified as a global public health emergency. The evidence related to the impact of COVID-19 on pregnancy are limited to the second and the third trimester of pregnancy, while data on the first trimester are scant. Many viral infections can be harmful to the fetus during the first trimester of pregnancy, and whether SARS-CoV-2 is one of them is still unknown. With this study we evaluated SARS-CoV-2 infection as a risk factor for early pregnancy loss in first trimester of pregnancy. Furthermore, COVID-19 course in the first trimester was assessed.

    Link: https://pubmed.ncbi.nlm.nih.gov/33039396/

About the author

Mary Pooja