Randomized Trials
RCT | Immediate vs. delayed sequential bilateral cataract surgery: non-inferior in safety, higher cost-effectiveness
6 Jun, 2023 | 14:41h | UTCSafety, effectiveness, and cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (BICAT-NL study): a multicentre, non-inferiority, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
News Release: Cataract surgery: two-sided treatment better than one-by-one approach – Maastricht University
RCT | Tirzepatide outperforms insulin glargine in HbA1c reduction and weight loss in type 2 diabetes
6 Jun, 2023 | 14:39h | UTC
Commentary on Twitter
The SURPASS-AP-Combo trial shows that addition of #tirzepatide as 2L or 3L therapy is non-inferior & superior to insulin glargine for glycemic outcomes at 40 weeks in an Asia-Pacific (mostly Chinese) population w/ type 2 #diabetes. https://t.co/RDh2WSJ1wZ pic.twitter.com/nm6pPpVdxH
— Nature Medicine (@NatureMedicine) June 2, 2023
RCT | Perioperative pembrolizumab improves pathological outcomes, event-free survival in early-stage NSCLC
6 Jun, 2023 | 14:36h | UTCPerioperative Pembrolizumab for Early-Stage Non–Small-Cell Lung Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Presented at #ASCO23: In the KEYNOTE-671 trial, pts with resectable lung cancer were assigned to neoadjuvant pembrolizumab or placebo plus chemotherapy followed by adjuvant pembrolizumab or placebo. Two-year event-free survival was 62.4% with pembrolizumab & 40.6% with placebo.
— NEJM (@NEJM) June 3, 2023
RCT | Befotertinib tops Icotinib in NSCLC progression-free survival, but increases serious adverse events
6 Jun, 2023 | 14:13h | UTCBefotertinib (D-0316) versus icotinib as first-line therapy for patients with EGFR-mutated locally advanced or metastatic non-small-cell lung cancer: a multicentre, open-label, randomised phase 3 study – The Lancet Respiratory Medicine (link to abstract – $ for full-text)
RCT | Noninferiority shown between DOACs and LMWH for recurrent VTE prevention in cancer patients
5 Jun, 2023 | 13:50h | UTCSummary: This unblinded, pragmatic, noninferiority randomized clinical trial aimed to assess the efficacy of direct oral anticoagulants (DOACs) against low-molecular-weight heparin (LMWH) in preventing recurrent venous thromboembolism (VTE) in patients with cancer. The study included 671 patients from 67 oncology centers, with a new clinical or radiological diagnosis of VTE.
Participants were randomly assigned to receive either a DOAC or LMWH for 6 months, and treating physicians selected and prescribed the drugs based on considerations like availability and drug-drug interactions. The primary outcome was the rate of recurrent VTE at 6 months. Findings revealed that the DOAC group had a recurrent VTE rate of 6.1% as compared to 8.8% in the LMWH group, showing noninferiority. Both groups had statistically similar rates of major bleeding and severe adverse events.
This pragmatic study included patients with advanced cancer and brain metastases, impaired performance status, and reduced liver or kidney function, making it more representative of routine oncology practice. Moreover, patient adherence to DOAC treatment was significantly higher than to LMWH. Nevertheless, the study had limitations, including the lack of blinding and underrepresentation of certain racial and ethnic groups.
In conclusion, this trial suggests that DOACs were noninferior to LMWH for preventing recurrent VTE in patients with cancer over a 6-month follow-up period, supporting the use of DOACs in this population for VTE prevention. Further research is needed to confirm these results and investigate long-term outcomes.
Article: Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual abstract
Commentary on Twitter
Among adults with cancer and VTE, direct oral anticoagulants were noninferior to low-molecular-weight heparin for preventing recurrent VTE over 6-month follow-up. #ASCO23 https://t.co/DP5RvlSYxe pic.twitter.com/rBJ99plopK
— JAMA (@JAMA_current) June 2, 2023
RCT | Osimertinib improves overall survival in resected EGFR-mutated NSCLC, but validity of control group questioned on social media
5 Jun, 2023 | 13:46h | UTCOverall Survival with Osimertinib in Resected EGFR-Mutated NSCLC – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter by Dr. Vinay Prasad (recommended – click to see the video)
Here is the REAL @Plenary_Session on #ADAURA #ASCO23 #ASCO2023
38.5% of people who had recurrence got OSI (very low!)
That just isn't good enough
Brain staging is suboptimal= occult met disease
Would you let your mother be on the control arm and not get OSI on progression? pic.twitter.com/CU3jtrvFOj— Vinay Prasad MD MPH (@VPrasadMDMPH) June 5, 2023
Clinical Trial Update | Olaparib plus bevacizumab first-line maintenance in ovarian cancer
5 Jun, 2023 | 13:07h | UTCOriginal Study: Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian Cancer – New England Journal of Medicine
RCT | Dupilumab improves lung function and reduces exacerbations in COPD patients with elevated eosinophils
1 Jun, 2023 | 12:20h | UTCDupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Dupilumab Improves Outcomes for COPD, Type 2 Inflammation in Randomized Trial – HCP Live
Commentary on Twitter
Presented at #ATS2023: In the BOREAS trial, dupilumab resulted in a lower annualized rate of exacerbations than placebo among patients with COPD and an elevated blood eosinophil count. Full trial results: https://t.co/9IWZr3YqsN
— NEJM (@NEJM) May 21, 2023
Phase 2b RCT | Danuglipron, an oral GLP-1R agonist, reduces body weight and improves glycemic control in type 2 diabetes
1 Jun, 2023 | 12:17h | UTC
RCT | JAK inhibitor Upadacitinib shows superiority over placebo for moderate-to-severe Crohn’s disease
1 Jun, 2023 | 12:08h | UTCUpadacitinib Induction and Maintenance Therapy for Crohn’s Disease – New England Journal of Medicine (link to abstract – $ for full-text)
RCT | Adapted mindfulness training shows efficacy in reducing elevated office blood pressure
1 Jun, 2023 | 12:03h | UTC
Cluster RCT | Point-of-care CRP testing cuts antibiotic prescriptions in respiratory illnesses in primary care
1 Jun, 2023 | 11:58h | UTCCommentary: Use of CRP testing reduced antibiotics for respiratory infections, trial finds – CIDRAP
RCT | Prophylactic platelet transfusion reduces CVC-related bleeding in patients with platelets 10-50 K/mm³
31 May, 2023 | 14:20h | UTCPlatelet Transfusion before CVC Placement in Patients with Thrombocytopenia – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Withholding of prophylactic platelet transfusion before CVC placement in pts with a platelet count of 10,000 to 50,000 per cubic millimeter did not meet the predefined margin for noninferiority & resulted in more CVC-related bleeding events than prophylactic platelet transfusion.
— NEJM (@NEJM) May 27, 2023
RCT | Early initiation of DOACs not statistically superior to later use in atrial fibrillation-related stroke
31 May, 2023 | 14:17h | UTCEarly versus Later Anticoagulation for Stroke with Atrial Fibrillation – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
ELAN: Early DOACs Safe, May Help After Ischemic Stroke in AF Patients – TCTMD
Commentary on Twitter
Late breaking at #ESOC2023: In the ELAN trial, the estimated incidence of stroke, systemic embolism, hemorrhage, or death was 2.8 percentage points lower to 0.5 percentage points higher with early than with later use of direct oral anticoagulants. Full results:
— NEJM (@NEJM) May 24, 2023
RCT | Ketamine non-Inferiority to ECT for nonpsychotic resistant depression
31 May, 2023 | 14:15h | UTCKetamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Study Finds Ketamine is at Least as Effective as ECT for Treating Major Depression – Mass General Brigham
RCT | Sulbactam-durlobactam non-inferior to colistin in reducing 28-day mortality from carbapenem-resistant ABC
30 May, 2023 | 12:08h | UTCEfficacy and safety of sulbactam–durlobactam versus colistin for the treatment of patients with serious infections caused by Acinetobacter baumannii–calcoaceticus complex: a multicentre, randomised, active-controlled, phase 3, non-inferiority clinical trial (ATTACK) – The Lancet Infectious Diseases (link to abstract – $ for full-text)
News Release: Novel antibiotic succeeds in trial against hospital-acquired pneumonia – Rutgers University
RCT | NmCV-5 pentavalent meningococcal vaccine shows non-inferiority to quadrivalent MenACWY-D in Mali and Gambia
30 May, 2023 | 11:46h | UTC
Commentary on Twitter
Original Article: Meningococcal ACWYX Conjugate Vaccine in 2-to-29-Year-Olds in Mali and Gambia https://t.co/RScQOr5IWS#InfectiousDisease pic.twitter.com/jA6d92QlK2
— NEJM (@NEJM) May 26, 2023
RCT | Preliminary evidence for right median nerve stimulation in awakening from acute traumatic coma
30 May, 2023 | 11:36h | UTC
Commentary on Twitter
? Unlocking consciousness: important data on @yourICM but results should be replicated ideally by multicentric trial w blind intervention + including detailed data on WLSM as long-term outcome by validated metric.
?️ https://t.co/nvLl9A84oDRefers to
?️ https://t.co/VifPF3wTvI pic.twitter.com/0Sqpu56Mov— Intensive Care Medicine (@yourICM) May 22, 2023
RCT | Group support and skill-based learning reduce opioid use in chronic pain, but leads to no effect on pain perception
29 May, 2023 | 11:14h | UTCReducing Opioid Use for Chronic Pain With a Group-Based Intervention: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
News Release: New treatment helps people stop addictive opioid painkillers used for chronic pain – University of Warwick
RCT | Communication-priming intervention boosts goals-of-care discussions for seriously ill patients
29 May, 2023 | 11:12h | UTCIntervention to Promote Communication About Goals of Care for Hospitalized Patients With Serious Illness: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Conversations on Goals of Care With Hospitalized, Seriously Ill Patients – JAMA (free for a limited period)
See also: Visual Abstract
Commentary: Some Surrogate Endpoints Are Fine – By Dr John Mandrola
Phase 2 RCT | Peresolimab outperforms placebo in patients with moderate-to-severe rheumatoid arthritis
24 May, 2023 | 13:07h | UTCA Phase 2 Trial of Peresolimab for Adults with Rheumatoid Arthritis – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Peresolimab Demonstrates Efficacy in Treating Patients With Rheumatoid Arthritis – HCP Live
Commentary on Twitter
Peresolimab showed efficacy in a phase 2a trial in patients with rheumatoid arthritis. These results provide evidence that stimulation of the PD-1 receptor has potential efficacy in the treatment of rheumatoid arthritis. https://t.co/2MkxLBrKTf
— NEJM (@NEJM) May 20, 2023
Cluster RCT | Single-dose rifapentine reduces 4-year leprosy incidence in household contacts
23 May, 2023 | 13:09h | UTCSingle-Dose Rifapentine in Household Contacts of Patients with Leprosy – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary:
Tuberculosis drug shows protective effect against leprosy – CIDRAP
RCT | Effectiveness of genotype-specific tricyclic antidepressant dosing in patients with major depressive disorder
23 May, 2023 | 12:52h | UTC
Commentary on Twitter
Genotype-guided tricyclic antidepressant dosing may help patients with depression reach faster therapeutic plasma concentrations, with potentially fewer adverse effects. https://t.co/06cIaQjmwV pic.twitter.com/ZBdXZLeWc3
— JAMA Network Open (@JAMANetworkOpen) May 8, 2023
RCT | No significant differences among three exercise strategies for knee osteoarthritis
23 May, 2023 | 12:38h | UTC
RCT | Remote pulmonary artery monitoring may improve QoL, reduce hospitalizations in symptomatic (NYHA III) heart failure
22 May, 2023 | 13:47h | UTCRemote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial – The Lancet (link to abstract – $ for full-text)
News Release: Remote monitoring reduces heart failure hospitalisations and improves quality of life – European Society of Cardiology
Commentary: CardioMEMS Beats Standard Care in First European RCT: MONITOR-HF – TCTMD
Commentary on Twitter
Remote monitoring reduces #HeartFailure hospitalisations and improves quality of life ?#HeartFailure2023 #HF #HFA_ESC #MONIT0R_HF pic.twitter.com/Rvg1y45tCQ
— European Society of Cardiology (@escardio) May 20, 2023