Author: Kit Yarn

With the emergence and increasing popularity of glucagon-like peptide 1 (GLP-1) agonists for the treatment of obesity in recent years, it might be worth investigating if these agents are able to reduce the cardiovascular risks associated with overweight and obesity, especially since they have been shown to reduce risk of major adverse cardiovascular events in patients with type 2 diabetes who are at high cardiovascular risk.

Summary: The recent MULTISTARS AMI trial reveals significant findings, indicating that immediate multivessel PCI is non-inferior to staged procedures for patients with STEMI and multivessel coronary artery disease. This approach potentially alters the course of treatment by reducing serious cardiac events, thereby influencing guidelines on the optimal timing for such interventions.

Treatment-resistant depression affects 10-30% of patients with major depressive disorder (MDD). These patients have trialled two or more pharmacologic treatments that have been given adequate duration for a response, at an adequate dose. This is associated with increased hospitalization, higher mortality and suicide rates.  Esketamine nasal spray (Spravato), the newest agent to be approved by both the United States Food Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of treatment-resistant depression, has fulfilled a long-standing need for additional agents to treat this serious condition. In its phase 3 trials, Esketamine nasal spray combined with an oral antidepressant…

The use of glucagon-like peptide-1 receptor agonists (GLP-1 RA) have increased significantly in recent years due to its marked efficacy in body weight reduction in clinical trials and most recently, due to claims by celebrities and social media personalities that they have lost weight after using Ozempic (Semaglutide). While there were earlier concerns on supply shortage due to high demand of on-label and off-label use, there has been reports of a new adverse event signal that has drawn scrutiny from health authorities in the United States (US), European union (EU) and in Asia about its possible link to suicidal episodes. 

Iron deficiency is present in 50% of the patients with heart failure and it is associated with worse symptoms and outcomes [1]. There have been a few studies analysing the benefit of intravenous (IV) ferric carboxymaltose in heart failure with iron deficiency. In the AFFIRM-AHF [2] trial, administration of IV ferric carboxymaltose reduced the risk of cardiovascular death and total hospitalisations for heart failure in patients hospitalized for acute heart failure.

In the past few years, there has been an expansion of indications for SGLT-2 inhibitors. Initially used as add-on therapy in the treatment of type 2 diabetes, the current evidence supports its use as first line treatment for diabetes in patients with high risk of atherosclerotic cardiovascular disease (ASCVD), use as adjunct therapy heart failure with reduced ejection fraction (HFrEF) and for chronic kidney disease (CKD) [1].  There is already evidence for Canagliflozin and Dapagliflozin use in CKD, based on the results from CREDENCE trial and DAPA-CKD trial specifically. However, the results of these trials were insufficient to support the…

Dupilumab (Dupixent) by Sanofi has initially been marketed for the treatment of uncontrolled moderate-to-severe Atopic Dermatitis. Its indications have since expanded to include moderate-to-severe eosinophilic asthma, chronic rhinosinusitis with nasal polyps and more. It is a fully human monoclonal antibody that blocks the receptor components for interleukin-4 and interleukin-13, which are involved in the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) [1].  The World Health Organisation (WHO) estimates that by 2060, more than 5.4 million deaths per year will be attributed to COPD and related conditions. Many patients still experience symptoms and exacerbations despite being on guideline recommended triple inhaler…

Cardiogenic shock is the leading cause of death amongst patients hospitalized with acute myocardial infarction. Immediate revascularization of the culprit lesion is the only treatment available but mortality still remains high. The use of extracorporeal life support (ECLS), which enables full circulatory and respiratory support, have increased with the aim to achieve haemodynamic stabilization in patients with severe or rapidly deteriorating infarct-related cardiogenic shock. 

Combination of Ipilimumab and Nivolumab is one of the first line treatment recommended in patients with advanced renal-cell carcinoma with intermediate or poor prognostic risk according to International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) categories[1]. However, in the CheckMate 214 trial [2], which studied nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma, 20% of the patients on nivolumab and ipilimumab had progressive disease.  In an exploratory analysis in the CheckMate 9ER trial [3], which studied the combination of cabozantinib, a multi- tyrosine kinase inhibitor, in combination with nivolumab compared to sunitinib in previously untreated advanced renal cell carcinoma, a…

The American College of Cardiology had just released an expert consensus on the management of heart failure with preserved ejection fraction (HFpEF) earlier in April. This document is the first to address the management of individuals with HFpEF specifically.  The treatment of HFpEF used to be limited to managing comorbidities. However, with advances in the pathophysiology of HFpEF, increasing evidence in pharmacological agents in HFpEF and improved methods of diagnosis this document seeks to address key clinical questions such as testing and diagnosing patients with suspected HFpEF, management of comorbidities and initiation of GDMTs.  This article aims to highlight key…