Kyung Hee University

TUESDAY, Sept. 17, 2024 -- A new prognostic model can predict and stratify hepatocellular carcinoma (HCC) risk in noncirrhotic adult patients with chronic hepatitis B (CHB), according to a study published online Sept. 17 in the Annals of Internal Medicine . Gi-Ae Kim, M.D., Ph.D., from Kyung Hee University Hospital in Seoul, South Korea, and colleagues developed and externally validated a prognostic model for HCC risk in noncirrhotic adult patients with CHB, without notable alanine aminotransferase (ALT) elevation. The model was developed in 6,949 patients with CHB from a Korean hospital-based cohort, and was validated externally among 7,429 patients with CHB combined from the Taiwanese cohort and seven cohorts from Korea and Hong Kong. The researchers found that the derivation and validation cohorts identified 435 and 467 incident HCC cases over 10 and 12 years, respectively. One of the strongest predictors of HCC development was baseline hepatitis B virus DNA level, which demonstrated a nonlinear parabolic association in both cohorts, with the highest risk seen for moderate viral loads. Age, sex, platelet count, ALT levels, and positive hepatitis B e antigen result were additional predictors included in the new model. Satisfactory discrimination and calibration were exhibited by the model, with c-statistics of 0.844 and 0.813 in the derivation and validation cohorts, respectively, with multiple imputation. Greater positive net benefit was yielded in the model compared with other strategies in the 0 to 18 percent threshold. "This model has the potential to inform optimal medical management strategies for patients with CHB who do not meet the current criteria for antiviral treatment," the authors write.

WEDNESDAY, Sept. 4, 2024 -- First-generation antihistamines are associated with a higher seizure risk in young children, according to a study published online Aug. 28 in JAMA Network Open . Ju Hee Kim, M.D., from the Kyung Hee University Medical Center in Seoul, South Korea, and colleagues evaluated associations between prescriptions of first-generation antihistamines and seizures in children. The analysis included data from the National Health Insurance Service database in Korea for children born in 2002 through 2005, who visited the emergency department for seizure events through 2019. The researchers identified 11,729 children who had a seizure event and were prescribed antihistamines during the hazard period (one to 15 days before seizure; 1,476 children) or the control period (31 to 45 days before seizure [1,239 children] or 61 to 75 days before seizure [1,278 children]), but not both. Most seizure events occurred in children aged 6 to 24 months (31.0 percent) and 25 months to 6 years (45.5 percent). First-generation antihistamine prescription was associated with an increased seizure event risk during the hazard period (adjusted odds ratio [aOR], 1.22). This risk was even higher in children aged 6 to 24 months who were prescribed first-generation antihistamines (aOR, 1.49) versus children aged 25 months to 6 years (aOR, 1.11). "These findings emphasize the need for careful and judicious prescription of first-generation antihistamines in young children and underline the need for further research to elucidate associations between antihistamine prescriptions and seizure risk," the authors write. Abstract/Full Text Editorial Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

MONDAY, July 15, 2024 -- Some diabetes drugs appear to lower the risk that people with type 2 diabetes will develop dementia or Alzheimer’s disease, a new evidence review says. The risk of dementia and Alzheimer’s is significantly lower in patients treated with metformin or a class of meds called "sodium glucose co-transporter-2 (SGLT-2) inhibitors", compared with other diabetes drugs, researchers report. Type 2 diabetes affects about 530 million people around the world, and there’s at least a 50% increased risk of cognitive impairment and dementia in these people, researchers said in background notes. “Our study contributes to the existing evidence by suggesting potential additional benefits of SGLT-2 inhibitors in mitigating dementia risk, thereby providing significant clinical implications for diabetes management,” lead researcher Yeo Jin Choi at Kyung Hee University in Seoul, South Korea, said in a news release. “Elderly patients aged 75 years or older may particularly benefit from these findings, since they often face greater cognitive health concerns,” Choi added. For their review, researchers analyzed data from 16 prior studies involving more than 1.5 million patients. The studies looked at six diabetic drug classes: DPP4 inhibitors, metformin, SGLT-2 inhibitors, sulfonylureas, alpha-glucosidase inhibitors and thiazolidinediones. The lowest risk of dementia and Alzheimer’s was found in patients taking metformin, results show. But SGLT-2 inhibitors were also associated with a lower risk of cognitive decline as well, and also provided heart health benefits, researchers said. These drugs include Farxiga (dapagliflozin) and Jardiance (empagliflozin). What's more, results show that SGLT-2 inhibitors performed better than all other drugs, including metformin, in reducing dementia risk in patients 75 and older. “We were quite surprised by the study results, particularly the potential cognitive benefits of SGLT-2 inhibitors over metformin and DPP-4 inhibitors in patients aged 75 years or older,” Choi said. “This finding is particularly notable given that SGLT-2 inhibitors are currently used for heart failure management as well.” Metformin works by decreasing the amount of glucose produced by the liver and by making muscle tissue more sensitive to insulin, the American Diabetes Association says. SGLT-2 inhibitors increase the amount of glucose that is excreted in urine, lowering blood sugar levels, the ADA says. The new study appears in the American Journal of Preventive Medicine . Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.