Mepolizumab versus benralizumab for eosinophilic granulomatosis with polyangiitis (EGPA): A European real-life retrospective comparative studyMattioli, Urban, Padoan
et alJ Autoimmun (2025) 153, 103398
Abstract: Following the results of the MANDARA trial, this real-life study aimed at comparing the effectiveness and safety profile of mepolizumab versus benralizumab in a European EGPA cohort.We conducted a retrospective observational comparative study including EGPA patients, who received mepolizumab or benralizumab at the asthma dose. Patients were matched 1:1 by sex, age, BVAS and oral corticosteroid (OCS) dosage at the treatment initiation (T0). Complete response (CR) and partial response (PR), disease activity, OCS, pulmonary parameters, eosinophil count, relapses, and safety outcomes were also compared at 3, 6 and 12 months.Patients treated with mepolizumab or benralizumab (n = 88 each) were matched: 57 % were females, median age was 54 years (IQR 45-60), median OCS dose 10 (7.5-12.5) and 10 (7-13) mg/day, median BVAS 4 (2-7) and 3 (2-8), respectively. 45.4 % of patients in the mepolizumab group and 51.1 % in the benralizumab group achieved CR or PR at T3, with CR steadily increasing during follow-up for both treatments. At T12, a higher CR rate was found in the benralizumab group (48.1 % vs 32.4 %, p = 0.005). No differences in BVAS, OCS, and respiratory parameters were observed between groups at the different timepoints. Throughout the follow-up, both treatments reduced eosinophil count, although a deeper reduction was found in the benralizumab group at all timepoints (p < 0.0001). Safety profile was comparable between patient groups.Mepolizumab and benralizumab showed comparable overall effectiveness and safety in EGPA. However, benralizumab achieved a higher CR rate at T12, and a deeper peripheral eosinophil reduction.Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Real-world clinical practice and outcomes in Peruvian patients with advanced EGFR T790M mutation positive NSCLC: A multicenter analysisGalvez-Nino, Roque, Ruiz
et alCancer Treat Res Commun (2025) 43, 100906
Abstract: Despite osimertinib being the standard therapy for advanced EGFR T790M mutation positive NSCLC, in many Latin American countries, access to molecular testing and targeted therapies is limited, directly impacting patient outcomes. This study describes the real-world management and outcomes of Peruvian patients with advanced EGFR-mutated NSCLC who develop the T790M mutation.We conducted a multicenter retrospective study including patients from nine Peruvian institutions, both public and private, who progressed to first-line EGFR TKI and developed T790M mutation, detected between January 2018 and December 2023. We evaluated demographic, clinico-pathological features and treatment data, including diagnostic pathway, treatment patterns, and survival outcomes.Seventy-eight patients were included; T790M was detected by liquid biopsy in 52.6 % of cases. Median time from progression to T790M detection was 59.5 days (7-244). Osimertinib was administered to 62.8 % of patients after detection, with a median initiation time of 42 days (1-104). Median overall survival (OS) from first-line treatment was 46.6 months for patients who received osimertinib, 23.9 months for those receiving other therapies, and 16.1 months for those without treatment (p = 0.001). Among osimertinib-treated patients, the objective response rate (ORR) was 59.2 %, with a median progression-free survival (PFS) of 15.8 months. Median OS from osimertinib initiation was 16.3 months, significantly longer than for patients receiving other treatments after T790M detection (9.7 months; p = 0.002).This study confirms the real-world effectiveness of osimertinib in Peruvian patients with advanced EGFR T790M positive NSCLC and highlights the importance of timely detection and access to targeted therapies.Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.
The effects of feminization hormone therapy on the brain of transgender women: A hypothesisZubiaurre-Elorza, Uribe, Marcos
et alJ Neuroendocrinol (2025)
Abstract: Gender-affirming hormone therapy (GAHT) is a medical treatment used to help transgender individuals align their physical appearance with their gender identity. GAHT in transgender women (TW) has been found to lead to a reduction in brain tissue with an expansion of the ventricles. We discuss an animal model studying the effects of GAHT that suggests dehydration of brain tissue and an alteration in the relative concentration of brain metabolites. We hypothesize that estradiol, acting on astrocytes, alters cerebral blood flow, water metabolism, and metabolite concentration and argue that these changes could explain the higher risk of stroke observed in GAHT-treated TW compared to untreated cisgender men. Future studies should clarify the mechanisms underlying the brain tissue changes induced by GAHT.© 2025 British Society for Neuroendocrinology.
Pseudothrombocytopenia and other conditions associated with spuriously low platelet countsCattaneo
Haematologica (2025)
Abstract: Accurate measurements of the platelet count are necessary to diagnose thrombocytosis or thrombocytopenia correctly, gauge the severity of the clinical risk and identify the most appropriate therapeutic intervention. Despite increased diagnostic accuracy with the electronic counters, it is still unsatisfactory in rare situations. Conditions causing spurious thrombocytopenia include the following. 1) Pre-analytical errors, such as difficult venipunctures, over-/under-filling of blood collection tubes, insufficient mixing of blood with the anticoagulant (EDTA), which may cause fibrin formation; 2) EDTA-induced, temperature- and time-dependent, antibody-mediated in vitro platelet agglutination, with consequent reduction in the number of single platelets in the sample; the condition, referred to as Pseudothrombocytopenia, is benign and does not need follow-up or medical interventions; the use of alternative in vitro anticoagulants does not prevent agglutinates formation in all samples; accurate platelet counts could be obtained by testing EDTAsamples immediately after blood collection. 3) EDTA-induced in vitro platelet adherence to leukocytes (Platelet Satellitism), caused by bridging IgG antibodies binding to GPIIb-IIIa on platelets and the Fc receptor-III on leukocytes; occasionally, leukocytes may phagocytose platelets and/or form platelets/leukocytes clumps. 4) Presence of large/giant platelets (commonly from patients with congenital or acquired thrombocytopenia) that are not recognized as such by electronic counters, which distinguish platelets from other cells based on their smaller size. 5) Blood from patients with type 2B von Willebrand Disease, which may display large/giant platelets and platelet agglutinates. All the above conditions are easily identifiable by microscopic examination of anticoagulated peripheral blood smears, which is an indispensable diagnostic procedure in hematology.
膜杰作
Star Staining
