Orphan or Rare Diseases

Model-Informed Approach Supporting Drug Development and Regulatory Evaluation for Rare Diseases

Sat, 2022-12-03 06:00

J Clin Pharmacol. 2022 Dec;62 Suppl 2:S27-S37. doi: 10.1002/jcph.2143.

NO ABSTRACT

PMID:36461744 | DOI:10.1002/jcph.2143

Categories: Literature Watch

Bayesian Complex Innovative Trial Designs (CIDs) and Their Use in Drug Development for Rare Disease

Sat, 2022-12-03 06:00

J Clin Pharmacol. 2022 Dec;62 Suppl 2:S56-S71. doi: 10.1002/jcph.2132.

NO ABSTRACT

PMID:36461743 | DOI:10.1002/jcph.2132

Categories: Literature Watch

Think Rare, Think Inside and Out: Simple Question-Based Approach to Complex Rare Disease Drug Development

Sat, 2022-12-03 06:00

J Clin Pharmacol. 2022 Dec;62 Suppl 2:S6-S11. doi: 10.1002/jcph.2173.

NO ABSTRACT

PMID:36461741 | DOI:10.1002/jcph.2173

Categories: Literature Watch

Bridging the Gap With Clinical Pharmacology in Innovative Rare Disease Treatment Modalities: Targeting DNA to RNA to Protein

Sat, 2022-12-03 06:00

J Clin Pharmacol. 2022 Dec;62 Suppl 2:S95-S109. doi: 10.1002/jcph.2172.

NO ABSTRACT

PMID:36461740 | DOI:10.1002/jcph.2172

Categories: Literature Watch

Regulatory Framework for Drug Development in Rare Diseases

Sat, 2022-12-03 06:00

J Clin Pharmacol. 2022 Dec;62 Suppl 2:S15-S26. doi: 10.1002/jcph.2171.

NO ABSTRACT

PMID:36461739 | DOI:10.1002/jcph.2171

Categories: Literature Watch

Superior mesenteric artery syndrome and disseminated tuberculosis: "Double troubleˮ

Fri, 2022-12-02 06:00

Indian J Tuberc. 2022 Oct;69(4):702-705. doi: 10.1016/j.ijtb.2021.08.019. Epub 2021 Aug 19.

NO ABSTRACT

PMID:36460412 | DOI:10.1016/j.ijtb.2021.08.019

Categories: Literature Watch

Gall bladder tuberculosis: Review of literature

Fri, 2022-12-02 06:00

Indian J Tuberc. 2022 Oct;69(4):421-426. doi: 10.1016/j.ijtb.2021.08.028. Epub 2021 Aug 27.

NO ABSTRACT

PMID:36460370 | DOI:10.1016/j.ijtb.2021.08.028

Categories: Literature Watch

Omental venous malformation: a rare cause of spontaneous haemoperitoneum

Fri, 2022-12-02 06:00

BMJ Case Rep. 2022 Dec 2;15(12):e250695. doi: 10.1136/bcr-2022-250695.

NO ABSTRACT

PMID:36460311 | DOI:10.1136/bcr-2022-250695

Categories: Literature Watch

Genetic Predisposition to Male Breast Cancer: A Case Series

Thu, 2022-12-01 06:00

Anticancer Res. 2022 Dec;42(12):5795-5801. doi: 10.21873/anticanres.16086.

NO ABSTRACT

PMID:36456130 | DOI:10.21873/anticanres.16086

Categories: Literature Watch

Risk factors for cerebral complications in patients with pulmonary arteriovenous malformations: A multicenter retrospective cohort study

Thu, 2022-12-01 06:00

PLoS One. 2022 Dec 1;17(12):e0278610. doi: 10.1371/journal.pone.0278610. eCollection 2022.

NO ABSTRACT

PMID:36454973 | DOI:10.1371/journal.pone.0278610

Categories: Literature Watch

Therapeutics in Metabolic Diseases

Thu, 2022-12-01 06:00

Adv Exp Med Biol. 2023;1396:255-273. doi: 10.1007/978-981-19-5642-3_17.

NO ABSTRACT

PMID:36454472 | DOI:10.1007/978-981-19-5642-3_17

Categories: Literature Watch

Commentary: Dysthyroid optic neuropathy: A lurking danger in thyroid eye disease

Thu, 2022-12-01 06:00

Indian J Ophthalmol. 2022 Dec;70(12):4428-4429. doi: 10.4103/ijo.IJO_2126_22.

NO ABSTRACT

PMID:36453359 | DOI:10.4103/ijo.IJO_2126_22

Categories: Literature Watch

Commentary: Dysthyroid optic neuropathy

Thu, 2022-12-01 06:00

Indian J Ophthalmol. 2022 Dec;70(12):4426-4428. doi: 10.4103/ijo.IJO_2202_22.

NO ABSTRACT

PMID:36453358 | DOI:10.4103/ijo.IJO_2202_22

Categories: Literature Watch

Challenges in diagnostic testing of nephritic factors

Thu, 2022-12-01 06:00

Front Immunol. 2022 Nov 14;13:1036136. doi: 10.3389/fimmu.2022.1036136. eCollection 2022.

ABSTRACT

Nephritic factors (NeFs) are autoantibodies promoting the activity of the central enzymes of the complement cascade, an important first line of defense of our innate immune system. NeFs stabilize the complement convertase complexes and prevent their natural and regulator-mediated decay. They are mostly associated with rare complement-mediated kidney disorders, in particular with C3 glomerulopathy and related diseases. Although these autoantibodies were already described more than 50 years ago, measuring NeFs for diagnostic purposes remains difficult, and this also complicates our understanding of their clinical associations. In this review, we address the multifactorial challenges of NeF diagnostics. We describe the diseases NeFs are associated with, the heterogenic mechanisms of action of different NeF types, the different methods available in laboratories used for their detection, and efforts for standardization. Finally, we discuss the importance of proper NeF diagnostics for understanding the clinical impact of these autoantibodies in disease pathophysiology and for considering future complement-directed therapy.

PMID:36451820 | PMC:PMC9702996 | DOI:10.3389/fimmu.2022.1036136

Categories: Literature Watch

Brittle bone disease (osteogenesis imperfecta): a rare condition

Thu, 2022-12-01 06:00

Pan Afr Med J. 2022 Sep 7;43:11. doi: 10.11604/pamj.2022.43.11.35300. eCollection 2022.

NO ABSTRACT

PMID:36451730 | PMC:PMC9674524 | DOI:10.11604/pamj.2022.43.11.35300

Categories: Literature Watch

Arterial insufficiencies: Central retinal artery occlusion

Tue, 2022-11-29 06:00

Undersea Hyperb Med. 2022 Fourth Quarter;49(4):533-547. doi: 10.22462/07.08.2022.12.

ABSTRACT

Central retinal artery occlusion (CRAO) is a relatively rare emergent condition of the eye resulting in sudden painless vision loss. This vision loss is usually dramatic and permanent, and the prognosis for visual recovery is poor. A wide variety of treatment modalities have been tried over the last 100 years with little to no success, with the exception of hyperbaric oxygen therapy. The optimum number of treatments will vary depending on the severity and duration of the patient's symptoms and the degree of response to treatment. The majority of patients will stabilize within a few days after symptom onset. Utilization review is recommended for patients treated for more than three days after clinical plateau.

PMID:36446298 | DOI:10.22462/07.08.2022.12

Categories: Literature Watch

Treatment of adrenocortical carcinoma: oncological and endocrine outcomes

Tue, 2022-11-29 06:00

Curr Opin Urol. 2023 Jan 1;33(1):50-58. doi: 10.1097/MOU.0000000000001045. Epub 2022 Oct 21.

ABSTRACT

PURPOSE OF REVIEW: Adrenocortical carcinoma (ACC) is a rare, aggressive disease with a paucity of data and great variability between published studies regarding its treatment. This review provides information on current clinical management and oncological and endocrine outcomes.

RECENT FINDINGS: Complete surgical resection is the only potentially curative treatment for adrenocortical carcinoma (ACC). Adjuvant mitotane treatment is recommended in patients with favourable/intermediate prognosis. As part of the endocrine follow-up, steroid hormones and thyroid hormones may be decreased or increased and may need to be substituted or suppressed. Recurrences are common. If the disease-free interval is more than 12 months, surgery is a treatment if complete resection is feasible. In advanced/metastatic ACC patients, the prognosis is poor. Mitotane monotherapy is only appropriate for patients with low tumour burden and indolent disease. Patients with unfavourable prognosis should be treated with aggressive cytotoxic therapy. Patients requiring third-line treatment should be considered for clinical trials. Immunotherapy and targeted therapy are currently being investigated, but have so far yielded only unsatisfactory results.

SUMMARY: There is scarce evidence for the treatment of ACC, which often complicates clinical decision-making. Patients who progress on EDP-M should be treated in clinical trials.

PMID:36444650 | DOI:10.1097/MOU.0000000000001045

Categories: Literature Watch

Association of migration status with quality of life among rural and urban adults with rare diseases: A cross-sectional study from China

Mon, 2022-11-28 06:00

Front Public Health. 2022 Nov 10;10:1030828. doi: 10.3389/fpubh.2022.1030828. eCollection 2022.

ABSTRACT

BACKGROUND: A considerable proportion of rare disease patients decide to migrate to access a definitive diagnosis or appropriate care, which could affect their quality of life in a long term.

OBJECTIVE: To compare quality of life (QoL) between migrants and residents and explore the possible mechanism of how migration influence the QoL among rural and urban adults with rare diseases, respectively.

METHODS: A cross-sectional study at national level was conducted in a study sample of 1,150 adult patients in China. Migration was defined as being away from one's original place of residence for at least 12 months. Patients who remained in their place of residence in the past 12 months ("resident") were treated as a comparison group for "migrants". Original area of residence (rural vs. urban) for both residents and migrants was used for comparison. The brief version of the World Health Organization Quality of Life instrument was used to measure QoL. Multiple linear regression analyses were adopted to assess the direct association between migration status and QoL after controlling for the confounders that affect QoL. The indirect associations between migration status and QoL, mediated by potential mediators including number of family members living together, individual income, catastrophic health expenditure, and social support, were estimated using the mediation model.

RESULTS: Among the group of rural participants, migration was directly associated with physical QoL (β = 5.07, 95% CI 2.01-8.13) and environmental QoL (3.95, 1.37-6.53), indirectly associated with physical QoL (0.58, 0.05-1.28) and social QoL (0.50, 0.01-1.16) via individual income, and also indirectly associated with environmental QoL (-0.47, -1.12 to -0.50) via tangible support. On the other hand, neither direct nor indirect associations of migration with four domain scores of QoL were significant among the group of urban participants.

CONCLUSION: Among rural adults with rare diseases, migration was found to have positive direct effect on physical and environmental QoL, positive indirect effect on physical and social QoL through increased individual income, and negative indirect effect on environmental QoL via reduced tangible support. By contrast, neither direct nor indirect associations of migration with QoL were significant among the group of urban participants.

PMID:36438276 | PMC:PMC9686420 | DOI:10.3389/fpubh.2022.1030828

Categories: Literature Watch

The evolving landscape of pulmonary arterial hypertension clinical trials

Sun, 2022-11-27 06:00

Lancet. 2022 Nov 26;400(10366):1884-1898. doi: 10.1016/S0140-6736(22)01601-4.

ABSTRACT

Although it is a rare disease, the number of available therapeutic options for treating pulmonary arterial hypertension has increased since the late 1990s, with multiple drugs developed that are shown to be effective in phase 3 randomised controlled trials. Despite considerable advancements in pulmonary arterial hypertension treatment, prognosis remains poor. Existing therapies target pulmonary endothelial dysfunction with vasodilation and anti-proliferative effects. Novel therapies that target proliferative vascular remodelling and affect important outcomes are urgently needed. There is need for additional innovations in clinical trial design so that all emerging candidate therapies can be rigorously studied. Pulmonary arterial hypertension trial design has shifted from short-term submaximal exercise capacity as a primary endpoint, to larger clinical event-driven trial outcomes. Event-driven pulmonary arterial hypertension trials could face feasibility and efficiency issues in the future because increasing sample sizes and longer follow-up durations are needed, which would be problematic in such a rare disease. Enrichment strategies, innovative and alternative trial designs, and novel trial endpoints are potential solutions that could improve the efficiency of future pulmonary arterial hypertension trials while maintaining robustness and clinically meaningful evidence.

PMID:36436527 | DOI:10.1016/S0140-6736(22)01601-4

Categories: Literature Watch

The clinical impact of donor against recipient HLA one way mismatch on the occurrence of graft versus host disease in liver transplantation

Sat, 2022-11-26 06:00

Sci Rep. 2022 Nov 25;12(1):20337. doi: 10.1038/s41598-022-24778-2.

ABSTRACT

Graft versus host disease (GVHD) after liver transplantation (LT) is a rare, fatal disease. This study aimed to evaluate the risk factors of GVHD after LT including the human leukocyte antigen (HLA) donor-recipient relationship after LT. LT recipients, who underwent HLA typing together with donors, were included in the study. The donor against recipient (D → R) one-way mismatch of HLA loci was evaluated. HLA relationships, along with basic characteristics, were analyzed as variable factors of GVHD, graft survival, and patient survival. A total of 994 living donor LT (LDLT) and 393 deceased donor LT (DDLT) patients were included. Nine patients had suffered GVHD, four LDLT with D → R one-way at three loci, one LDLT without D → R one-way at three loci, and four DDLT without D → R one-way at three loci. Four (57.1%) of seven LDLT patients, with D → R one-way mismatch at three loci, developed GVHD. D → R one-way mismatch at three loci was related to high GVHD incidence (HR 787, p < 0.001, multivariate). D → R one-way mismatch at three loci was related to graft failure and patient death (HR 9.90, p = 0.020 and HR 12.8, p < 0.001, respectively, multivariate). Only one GVHD without D → R one-way mismatch at three loci, survived despite receiving multiple modalities including tumor necrosis factor-alpha inhibitors. D → R one-way mismatch at three loci was significantly related to GVHD incidence after LT.

PMID:36434131 | DOI:10.1038/s41598-022-24778-2

Categories: Literature Watch

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