4- Thursday Pharmacotherapy News – 22th April

1 – Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma

• Lenvatinib in combination with pembrolizumab or everolimus has activity against advanced renal cell carcinoma.
• The efficacy of these regimens as compared with that of sunitinib is unclear.
• A total of 1069 patients were randomly assigned to receive lenvatinib plus pembrolizumab (355 patients), lenvatinib plus everolimus (357), or sunitinib (357).
• Lenvatinib plus pembrolizumab was associated with significantly longer progression-free survival and overall survival than sunitinib.

Source: NEJM

2 – Antibody Responses in Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine

• The efficacy of two injections of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike messenger RNA (mRNA) vaccines (BNT162b2 [Pfizer] and mRNA-1273 [Moderna]) in preventing symptomatic SARS-CoV-2 infection in persons without previous coronavirus disease 2019 (Covid-19) has been shown to be high.
• This study illustrates what the response would be to the first vaccine dose in persons with previous Covid-19.

Source: NEJM

3 – Adjuvant Nivolumab in Resected Esophageal or Gastroesophageal Junction Cancer

• No adjuvant treatment has been established for patients who remain at high risk for recurrence after neoadjuvant chemoradiotherapy and surgery for esophageal or gastroesophageal junction cancer.
• Among patients with resected esophageal or gastroesophageal junction cancer who had received neoadjuvant chemoradiotherapy, disease-free survival was significantly longer among those who received nivolumab adjuvant therapy than among those who received placebo.

Source: NEJM

4- Trial of Upadacitinib and Adalimumab for Psoriatic Arthritis

• The Janus kinase inhibitor upadacitinib is a potential treatment for psoriatic arthritis.
• The efficacy and safety of upadacitinib as compared with adalimumab, a tumor necrosis factor α inhibitor, in patients who have an inadequate response to nonbiologic disease-modifying antirheumatic drugs are unclear.
• The percentage of patients with psoriatic arthritis who had an ACR20 response at week 12 was significantly higher with 15-mg or 30-mg upadacitinib than with placebo.
• The 30-mg dose but not the 15-mg dose was superior to adalimumab. Adverse events were more frequent with upadacitinib than with placebo.

Source: NEJM

5 – Lumasiran, an RNAi Therapeutic for Primary Hyperoxaluria Type 1

• Primary hyperoxaluria type 1 (PH1) is a rare genetic disease caused by hepatic overproduction of oxalate that leads to kidney stones, nephrocalcinosis, kidney failure, and systemic oxalosis.
• Lumasiran, an investigational RNA interference (RNAi) therapeutic agent, reduces hepatic oxalate production by targeting glycolate oxidase.
• Lumasiran reduced urinary oxalate excretion, the cause of progressive kidney failure in PH1. The majority of patients who received lumasiran had normal or near-normal levels after 6 months of treatment.

Source: NEJM

6 – Glucose-Lowering Drugs to Reduce Cardiovascular Risk in Type 2 Diabetes

• In patients with type 2 diabetes and established cardiovascular disease (or in those with a high risk of cardiovascular disease) in whom glycemic goals are not achieved with metformin, agents from the GLP-1 receptor agonist or SGLT2 inhibitor classes with demonstrated cardiovascular benefit constitute the recommended treatment.

Source: NEJM

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