Roxadustat is more beneficial than rHuEPO in facilitating the regression of left ventricular hypertrophy in haemodialysis patients

A recent study found that roxadustat is more beneficial than recombinant human erythropoietin (rHuEPO) in reducing left ventricular hypertrophy (LVH) in haemodialysis (HD) patients. This study’s results were published in the Journal of Internal Medicine. 
In this prospective, multi-centre, randomized trial, 114 participants were enrolled and randomized to either the roxadustat group or the rHuEPO group in a 1:1 ratio. The dosage of both treatment regimens was adjusted to achieve a haemoglobin level of 10.0-12.0 g per dL for the patients. The primary endpoint of the study was to evaluate the change in left ventricular mass index (LVMI, g/m2) measured through echocardiography from the beginning to the end of the 12-month period.
The median duration of dialysis was 33 months and the roxadustat group showed a decrease in LVMI from 116.18 ± 27.84 to 110.70 ± 25.74 g/m2. On the other hand, the rHuEPO group experienced an increase in LVMI from 109.35 ± 23.41 to 114.99 ± 28.46 g/m2. Notably, there was a significant difference in the change of LVMI between the two groups [-5.48 (-11.60 to 0.65) versus 5.65 (0.74 to 10.55)]. The roxadustat group exhibited superior changes in left ventricular mass, 6-minute walk test and the end-diastolic volume. 
Thus, it can be concluded that in HD patients, roxadustat proves to be more advantageous than rHuEPO in regression of LVH.
 

The causal associations between metabolites and allergic diseases

Recent research demonstrated that imbalances in multiple circulating and urinary metabolites could be associated with the development and progression of allergic diseases. These findings are important for devising targeted strategies for both the prevention and treatment of allergic conditions. The results of this study were documented in the journal Respiratory Research. 
A two-sample Mendelian Randomization (MR) analysis was undertaken to examine possible causal associations between circulating and urinary metabolites and allergic diseases. The exposures were obtained from a genome-wide association study (GWAS) that included four hundred and eighty-six circulating metabolites, as well as a GWAS that targeted fifty-five urinary metabolites. Outcome data related to allergic diseases, including atopic dermatitis (AD), asthma, and allergic rhinitis (AR) were sourced from the FinnGen biobank in Europe (Cohort 1) and the Biobank Japan in Asia (Cohort 2). The MR findings from both cohorts were integrated through a meta-analysis.
The analysis utilizing MR identified a total of six urinary metabolites and fifty circulating metabolites in Cohort 1, alongside two urinary metabolites and fifty-four circulating metabolites in Cohort 2, which may have a causal relationship with allergic diseases. A subsequent meta-analysis of the MR findings highlighted 1-arachidonoylglycerophosphoinositol (odds ratio 2.178; 95% confidence interval 1.388-3.419; P value = 7.15E-04) and stearoylcarnitine (odds ratio 8.654; 95% confidence interval 4.399-17.025; P value = 4.06E-10) as the most significant causal circulating metabolites associated with allergic rhinitis (AR) and asthma, respectively. Additionally, tyrosine (odds ratio 0.601; 95% confidence interval: 0.380-0.952; P value = 0.030), histidine (odds ratio 0.734; 95% confidence interval: 0.594-0.907; P value = 0.004) and alanine (odds ratio 0.280; 95% confidence interval: 0.125-0.628; P = 0.002) were identified as urinary metabolites that provide the most substantial protective effects against atopic dermatitis (AD), asthma, and AR, respectively.
Thus, it can be concluded that imbalances in multiple circulating and urinary metabolites may be associated with the onset and advancement of allergic conditions. The implications of these results are important for creating targeted interventions for both the prevention and treatment of allergic conditions.
 

Effectiveness of two different remineralising toothpastes in children with drug-controlled asthma and allergic rhinitis

In a recent study, it was found that two types of remineralising toothpastes show promising results in reducing dental sensitivity and periodontal indices and may be suitable for children with asthma and allergic rhinitis to use at home. This study’s findings were published in the European Journal of Paediatric Dentistry.

For this study, a total of 40 patients between the ages of 6-14 years, who had enamel demineralisations, were included. Several indices were collected such as, Schiff air index (SAI), bleeding on probing (BoP), plaque index (PI), susceptibility index (SI), Basic Erosive Wear Examination (BEWE) for soft and hard tissues pathologies, salivary pH, and decayed missing filled teeth (DMFT). Following mechanical debridement with piezoelectric instrumentation and glycine powder, patients were evenly divided into two groups: group 1 used a zinc hydroxyapatite toothpaste, whereas group 2 used a calcium sodium phosphosilicate toothpaste. Both groups were instructed to use the toothpaste twice a day. The study was conducted over the following time frames: baseline (T0), after one month (T1), after three months (T2), and after six months (T3).

Significant intragroup differences from the beginning to the end of the study were observed for the variables PI, BOP, and SAI (p < 0.05). Upon analysing SI, group 1 exhibited significant intragroup variances when comparing each time frame with T3 (p < 0.05).

It can be concluded that the two remineralising toothpastes significantly reduce dental sensitivity and periodontal indices, suggesting that they may be suitable for children with asthma and allergic rhinitis to use at home.

The efficacy of daprodustat in treating anemia in dialysis patients

Recent research indicates that dialysis-dependent patients with anemia exhibited a substantial increase in serum hemoglobin and total iron binding capacity (TIBC), along with a decrease in serum ferritin, following the administration of daprodustat, in a manner that depended on the dosage. This study’s findings were published in The Pan African Medical Journal.

A systemic search of the databases PubMed, Scopus, Web of Science, and Cochrane was conducted. Seven distinct trials were ultimately selected for systematic review, with six of them involving a total of 759 patients included in the network meta-analysis (NMA).

The administration of daprodustat 25-30 mg resulted in the largest change in serum hemoglobin (MD=1.86, 95% confidence interval = [1.20; 2.52]), ferritin (MD= -180.84, 95% confidence interval = [-264.47; -97.20]), and total iron binding capacity (TIBC) (MD=11.03, 95% confidence interval = [3.15; 18.92]) from initial values.

It can be concluded that the administration of daprodustat resulted in a marked elevation in serum hemoglobin and total iron binding capacity (TIBC), and a reduction in serum ferritin among dialysis-dependent individuals with anemia, in a manner that depended on the dosage.

The combination of omalizumab and allergen immunotherapy compared to immunotherapy alone for the treatment of allergic diseases

The combination of omalizumab and allergen immunotherapy (AIT) can effectively enhance the overall efficacy and safety of AIT by increasing the target maintenance dose (TMD) and the sustained unresponsiveness (SU), while also lowering the risk of severe systemic adverse effects. The findings of the study have been published in the International Forum of Allergy & Rhinology.

The Cochrane Library, MEDLINE/PubMed, Scopus, and Embase databases were thoroughly examined to identify randomized controlled trials that investigated the effects of omalizumab combined with allergen immunotherapy in comparison to allergen immunotherapy by itself. To estimate the outcomes, a random-effects model was established with a 95% confidence interval.

Eleven eligible randomized controlled trials, involving a total of nine hundred and one patients, were included in the meta-analysis. The results of the pooled analysis indicated that the combination of omalizumab and AIT significantly improved the count of patients achieving the TMD and SU to allergens, with odds ratios (OR) of 2.43 (95% confidence interval: 1.33-4.44; p value = 0.004; I2 = 35%) for TMD and odds ratio of 6.77 (95% confidence interval: 2.10-21.80; p value = 0.001; I2 = 36%) for SU. In addition, patients receiving the combination therapy reported a significantly lower incidence of severe systemic adverse events compared to those treated with AIT alone, with an odds ratio of 0.32 (95% confidence interval: 0.18-0.59; p value = 0.0003; I2 = 0%). Additionally, improvements in daily rescue medication scores (mean difference [MD] = -0.14), symptom severity score (MD = -0.26), and the incidence of epinephrine use in AIT (odds ratio = 0.20) were considerably more apparent than those in allergen immunotherapy by itself.

The above study showed that the use of omalizumab alongside allergen immunotherapy can substantially boost the efficacy and safety of AIT. This combination allows for an increase in the TMD and SU, while also decreasing the chances of experiencing severe systemic adverse effects.