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Internal Medicine

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  • Iptacopan Capsules (Fabhalta)

    The U.S. Food and Drug Administration has approved the first oral drug to treat paroxysmal nocturnal hemoglobinuria (PNH). Iptacopan is a first-in-class oral selective inhibitor of complement factor B (C3 pathway). It is distributed by Novartis Pharmaceutical Corporation as Fabhalta.

  • Metformin Use Is Associated with Decreased Diabetes-Associated Dementia

    In two recent cohort studies, metformin use was found to decrease the risk of developing dementia in older adults with type 2 diabetes mellitus.

  • Risk Factors for Atrial Fibrillation

    A United Kingdom Biobank study of new onset atrial fibrillation (AF) has shown strong associations with hypertension and obesity at all ages and acute illnesses/surgery in older individuals. Genetics was less important, but in those at low genetic risk, obesity and hypertension were strong predictors of AF.

  • Do Patients with Heart Failure Feel Better on Dapagliflozin?

    An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.

  • H. pylori Infection – A Potential Modifiable Risk Factor of Alzheimer’s Dementia

    A large nested case-control cohort study of subjects aged 50 years and older found that clinically apparent Helicobacter pylori infection is associated with a moderately increased risk of developing Alzheimer’s disease.

  • Vonoprazan Fumarate Tablets (Voquezna)

    The U.S. Food and Drug Administration has approved vonoprazan for the treatment of all grades of erosive esophagitis. Vonoprazan is a potassium-competitive acid blocker that originally was approved in 2022 for use in combination with amoxicillin or with amoxicillin and clarithromycin for the treatment of Helicobactor pylori infection.

  • Treatable Causes of Rapidly Progressive Dementias

    Many cases of rapidly progressive dementia are caused by prion diseases and have no effective treatments. But, with the greater awareness of the presentation for autoimmune encephalitis, these disorders make up an increasing percentage of presenting cases and can be aggressively and successfully treated. The STAM3P score helps to identify potentially treatable cases of this disorder.

  • Apixaban Dose in Atrial Fibrillation Patients with Chronic Kidney Disease

    A large nationwide health systems database study comparing 5 mg apixaban vs. 2.5 mg twice daily in patients with stage 4/5 chronic kidney disease not on dialysis shows that the 5 mg dose increases the risk of bleeding compared to 2.5 mg without any improvement in the risk of stroke, systemic emboli, or death.

  • Slow-Wave Sleep and Risk of Dementia

    In this long-term observational study of sleep efficiency in the Framingham Heart Study population, researchers found a strong correlation between a decline in duration of slow-wave sleep during aging and the risk of incident dementia from all causes. However, a direct cause-and-effect relationship cannot be determined from this observational study.

  • Peak SARS-CoV-2 Viral Loads Delayed

    In an effort to characterize the hypothetical utility of rapid COVID-19 antigen kits, the authors of this study examined cycle threshold values in symptomatic adults infected with SARS-CoV-2 relative to the onset of symptoms.