Medical Bulletin 14/November/2022

Like elite firefighters headed into the wilderness to combat an uncontrolled blaze, probiotic bacteria do a better job quelling gut inflammation when they're equipped with the best gear.

A new study by researchers at the University of Wisconsin-Madison demonstrates just how much promise some well-equipped gut-friendly bacteria hold for improving treatments of inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis.

Led by Quanyin Hu, a biomedical engineer and professor in the UW-Madison School of Pharmacy, the research builds on technology the team had previously designed. That prior technology encases beneficial bacteria within a very thin protective shell to help them survive an onslaught of stomach acids and competing microbes long enough to establish and multiply in the guts of mice.

Reference:

Quanyin Hu et al,Mucoadhesive probiotic backpacks with ROS nano-scavengers enhance the bacteriotherapy for inflammatory bowel diseases, Science Advances, DOI 10.1126/sciadv.abp8798

Anifrolumab and deucravacitinib combo shows promise in patients with lupus

Type I interferon (IFN) is a powerful immune activator that is present at high levels in the majority of patients with lupus, an autoimmune disease. In Arthritis & Rheumatology, researchers report positive results from the first placebo-controlled long-term trial of anifrolumab-a human monoclonal antibody that targets the type I IFN receptor-in patients with lupus.

In the long-term extension trial of two earlier phase 3 trials, patients continued anifrolumab 300 mg, switched from anifrolumab 150 mg to 300 mg, or were re-randomized from placebo to either anifrolumab 300 mg or continued placebo, administered every 4 weeks, with all patients also receiving standard therapy. Anifrolumab was administered as an intravenous infusion.

Reference:

"A Randomized, Placebo-controlled Phase 3 Extension Trial of the Long-term Safety & Tolerability of Anifrolumab in Active Systemic Lupus Erythematosus." Kenneth C. Kalunian, Richard Furie, Eric F. Morand, Ian N. Bruce, Susan Manzi, Yoshiya Tanaka, Kevin Winthrop, Ihor Hupka, Lijin (Jinny) Zhang, Shanti Werther, Gabriel Abreu, Micki Hultquist, Raj Tummala, Catharina Lindholm,and Hussein Al-Mossawi. Arthritis & Rheumatology; Published Online: November 12, 2022 (DOI: 10.1002/art.42392).

"Deucravacitinib, a Tyrosine Kinase 2 Inhibitor, in Systemic Lupus Erythematosus: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Trial." Eric Morand, Marilyn Pike, Joan T. Merrill, Ronald van Vollenhoven, Victoria P. Werth, Coburn Hobar, Nikolay Delev, Vaishali Shah, Brian Sharkey, Thomas Wegman, Ian Catlett, Subhashis Banerjee, Shalabh Singhal. Arthritis & Rheumatology; Published Online: November 12, 2022 (DOI: 10.1002/art.42391).

In patients with knee osteoarthritis, nerve-blocking anesthetics around the knee relieve pain

Results from a recent clinical trial published by Wiley in Arthritis & Rheumatology demonstrate that patients with knee osteoarthritis experience short term pain relief from genicular nerve blocks-or locally injected anesthetics that block nerves around the knee joint.

In the trial, 59 patients were randomized to receive a nerve block or a placebo injection. At baseline and weeks 2, 4, 8 and 12, participants recorded their pain on a scale of 0 to 10.

Reference:

"Genicular nerve block for pain management in patients with knee osteoarthritis: A randomised placebo-controlled trial." Ernst M. Shanahan, Lucinda Robinson, Suellen Lyne, Richard Woodman, Fin Cai, Kokum Dissanayake, Kate Paddick, Giovanna Cheung, and Frank Voyvodic. Arthritis & Rheumatology; Published Online: November 12, 2022 (DOI: 10.1002/art.42384).

Long-term physical and mental health outcomes after COVID-19 occur in all ages

Studies have established that some people infected with COVID-19 suffer long-term health problems following the acute phase of the disease. However, evidence on post-acute (post-COVID-19) syndrome is still limited, especially for children and adolescents.

Following COVID-19 infection, there is significant new onset morbidity in children, adolescents and adults across 13 distinct diagnosis and symptom complexes, according to a new study publishing November 10th in the open access journal PLOS Medicine by Martin Roessler of Technische Universität Dresden, Germany, and colleagues.

Reference:

Roessler M, Tesch F, Batram M, Jacob J, Loser F, Weidinger O, et al. (2022) Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med 19(11): e1004122. https://doi.org/10.1371/journal.pmed.1004122