Clinical
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Tolebrutinib May Slow Disability Progression in Patients with SPMS
A recent prospective study showed that tolebrutinib slows disability progression in patients with nonrelapsing secondary progressive multiple sclerosis (SPMS). There were some safety concerns, especially hepatotoxicity. A lack of demonstrated effect on some functional outcomes warrants careful consideration and continuing study.
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CSF α-Synuclein Seed Amplification Assays in Parkinsonian Syndromes
This large longitudinal study, which looked at cerebrospinal fluid α-synuclein seed amplification assays (SAAs) from three large cohorts, demonstrated efficacy in distinguishing between Parkinson’s disease and progressive supranuclear palsy, as well as predicting cognitive decline based on kinematic analysis of the SAA samples.
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Long-Term Peripheral Nerve Function Changes in People with Well-Controlled Type 2 Diabetes
The authors conducted a prospective observational study comparing the effect of early diagnosed, well-controlled type 2 diabetes on peripheral nerve function. Overall, they found similar rates of decline in nerve function in people with well-controlled diabetes compared to age- and sex-matched individuals with normal glucose tolerance. Given the similar decline in nerve function, the authors concluded that the course of diabetic sensorimotor neuropathy is influenced primarily by nerve function at the time of diagnosis and age-related physiological decline.
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Endocrine Causes of Secondary Hypertension
Primary care providers should maintain a high index of suspicion for endocrine-related secondary hypertension, particularly in patients with resistant hypertension or atypical presentations. Conditions such as pheochromocytoma, primary hyperaldosteronism, and Cushing syndrome are common, yet frequently underdiagnosed causes that, if missed, can lead to rapid end-organ damage. This article emphasizes the need for early recognition and diagnostic vigilance, and equips clinicians with guidance to improve diagnostic accuracy and enhance patient outcomes through targeted treatment.
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Does an Elevated Troponin Level Post-Exercise Indicate Occult Coronary Atherosclerosis?
In middle-aged competitive recreational athletes, increases in cardiac troponin levels with exercise competitions were not infrequent. In a subgroup, coronary artery calcium by computed tomography was found in almost two-thirds, but the prevalence and magnitude of calcium was not associated with the exercise troponin response.
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Does Lipoprotein(a) Improve the Risk Calculation of the PREVENT Equation?
A pooled cohort from the Multi-Ethnic Study of Atherosclerosis and the United Kingdom Biobank study has shown that, overall, the American Heart Association PREVENT risk scores performed well at predicting atherosclerotic cardiovascular disease risk even in those with high lipoprotein(a) levels, but considering lipoprotein(a) in those with low PREVENT scores may help make therapeutic decisions in these individuals.
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Benefits of Nudging in Severe Aortic Stenosis
A single health system study of electronic provider notifications when severe aortic stenosis was discovered on echocardiography showed that referrals for aortic valve replacement significantly increased, especially in women and those > 80 years of age.
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Balloon Angioplasty for Chronic Thromboembolic Pulmonary Hypertension
A multinational, prospective registry of balloon pulmonary angioplasty has shown that significant improvement in patients with chronic thromboembolic pulmonary hypertension can be accomplished with few complications and no periprocedural mortality.
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Complications with the First Transcatheter Tricuspid Valve: Real-World Analysis
This review of complications seen in real-world practice with the Evoque transcatheter tricuspid valve highlights the need for careful patient selection and operator training with this technology.
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Gepotidacin Tablets (Blujepa)
The U.S. Food and Drug Administration has approved gepotidacin, a first-in-class antibacterial medication for the treatment of uncomplicated urinary tract infections. It is the first new class of oral antibiotics approved in nearly 30 years.