4- Thursday Pharmacotherapy News – 25th November

1 – Intravenous Metoprolol Versus Diltiazem for Rate Control in Atrial Fibrillation

• Currently, it remains unclear whether β-blockers or nondihydropyridine calcium channel blockers are preferred for the acute management of atrial fibrillation (AF).
• The objective of this study was to compare the efficacy and safety of intravenous (IV) metoprolol and diltiazem for rate control.
• There was no difference in the achievement of rate control between IV metoprolol and diltiazem.
• This is the largest study to date comparing the two classes of agents for acute rate control in AF.
• No patient-specific factors were identified that would influence the preferential use of one medication over the other.

Source: SAGE Journals

2 – Valproic Acid After Neurosurgery Induces Elevated Risk of Liver Injury: A Prospective Nested Case-Control Study

• Valproic acid (VPA) has been widely used to prevent epileptic seizures after neurosurgery in China. We have found that the incidence of liver injury (LI) in patients using VPA after neurosurgery is higher than that in other patients.
• The objective of this study was to investigate the risk factors of LI in patients using VPA after neurosurgery.
• Length of treatment, VPA trough concentration, and Glasgow score were associated with LI in patients after neurosurgery.
• A gene test may be necessary for people who are prescribed VPA for a long time.

Source: SAGE Journals

3 – Risankizumab in Severe Asthma — A Phase 2a, Placebo-Controlled Trial

• Interleukin-23 has been implicated in airway inflammation that is mediated by type 2 and type 17 cytokines.
• Whether targeting interleukin-23 in the treatment of asthma improves disease control and reduces airway inflammation is unclear.
• Risankizumab treatment was not beneficial in severe asthma.
• The time to the first asthma worsening was shorter and the annualized rate of asthma worsening was higher with risankizumab than with placebo.

Source: NEJM

4- Efficacy and Safety of Itepekimab in Patients with Moderate-to-Severe Asthma

• Monoclonal antibodies targeting IgE, interleukin-4 and -13, and interleukin-5 are effective in treating severe type 2 asthma, but new targets are needed.
• Itepekimab is a new monoclonal antibody against the upstream alarmin interleukin-33.
• The efficacy and safety of itepekimab as monotherapy, as well as in combination with dupilumab, in patients with asthma are unclear.
• Interleukin-33 blockade with itepekimab led to a lower incidence of events indicating a loss of asthma control than placebo and improved lung function in patients with moderate-to-severe asthma.

Source: NEJM

5 – Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

• The incidence of coronavirus disease 2019 (Covid-19) among adolescents between 12 and 17 years of age was approximately 900 per 100,000 population from April 1 through June 11, 2021.
• The safety, immunogenicity, and efficacy of the mRNA-1273 vaccine in adolescents are unknown.
• The mRNA-1273 vaccine had an acceptable safety profile in adolescents.
• The immune response was similar to that in young adults, and the vaccine was efficacious in preventing Covid-19.

Source: NEJM

6 – Evaluation of the BNT162b2 Covid-19 Vaccine in Children 5 to 11 Years of Age

• Safe, effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in children younger than 12 years of age.
• A phase 1, dose-finding study and an ongoing phase 2–3 randomized trial are being conducted to investigate the safety, immunogenicity, and efficacy of two doses of the BNT162b2 vaccine administered 21 days apart in children 6 months to 11 years of age.
• They present results for 5-to-11-year-old children.
• A Covid-19 vaccination regimen consisting of two 10-μg doses of BNT162b2 administered 21 days apart was found to be safe, immunogenic, and efficacious in children 5 to 11 years of age.

Source: NEJM

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