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Semaglutide & PAD: 54% Risk Reduction in Diabetics

by DrMichaelLee
written by DrMichaelLee

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Semaglutide (Ozempic) Shows Promise in Improving Walking Distance for Type 2 Diabetes Patients with PAD

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Chicago, IL – New findings from a subanalysis of the STRIDE trial, presented at the American Diabetes Association (ADA) 2025 conference, indicate that semaglutide 1.0 mg (Ozempic) provides significant benefits for individuals with type 2 diabetes and peripheral artery disease (PAD). The research demonstrates significant improvements in walking distance, regardless of HbA1c levels or other diabetes treatments [1].

Semaglutide’s Impact on Peripheral Artery Disease

The STRIDE trial, a double-blind, randomized, placebo-controlled study, investigated the effects of semaglutide on walking distance in patients with type 2 diabetes and PAD. The study, which began in 2020, involved 792 patients across 20 countries who were randomly assigned to receive either semaglutide or a placebo for 52 weeks [2].

Did You Know? Peripheral artery disease affects over 200 million people worldwide, and those with diabetes are at a higher risk.

The primary endpoint of the trial focused on the ratio from baseline in maximum walking distance at 52 weeks. Results showed a significant advantage for semaglutide, with an estimated treatment ratio (ETR) of 1.13 (95% CI, 1.06-1.21; *P* = .0004). Secondary outcomes further supported these findings, including greater betterment in walking distance, significantly higher quality-of-life scores, and improved pain-free walking distance [3].

Key Findings Presented at ADA 2025

professor Subodh Verma, MD, PhD, a cardiovascular surgeon at the University of Toronto and senior author of the STRIDE trial, presented a subanalysis at ADA 2025, highlighting that semaglutide was associated with significantly improved walking outcomes, enhanced quality of life, and a 54% reduction in the risk of disease progression.The median ratio to baseline in maximum walking distance was 1.21 in the semaglutide group compared to 1.08 in the placebo group at week 52 [4].

Pro Tip: Regular monitoring of foot health is crucial for individuals with diabetes and PAD to prevent complications.

Efficacy data indicated that the positive effects of semaglutide were independent of baseline glycemic control, duration of diabetes, or intensity of diabetes treatment.The effects were also consistent across different BMI categories and irrespective of background SGLT2 inhibitor use.

Safety and Tolerability

Additional safety data from the STRIDE trial demonstrated that semaglutide was well-tolerated, with no treatment-related deaths and a safety profile consistent with prior data.This reinforces semaglutide as a safe and effective treatment option for this patient population

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Health

Psoriasis Linked to Increased Metabolic Syndrome Risk, Mediated by Disease Activity

by DrMichaelLee
written by DrMichaelLee

Psoriasis Patients Face Elevated Metabolic Syndrome Risk

Individuals with psoriasis are at a heightened risk of developing metabolic syndrome, according to recent research. This finding underscores the need for vigilant monitoring and proactive health management within this patient population.

Psoriasis as a MetS Risk Factor

A new study reveals that psoriasis significantly increases the likelihood of metabolic syndrome (MetS). The study further suggests that the severity of the psoriasis directly impacts the risk of MetS. The greater the inflammatory burden, the higher the metabolic disorder risk, as noted by the research.

“Early recognition of MetS in psoriasis patients is critical for mitigating long-term health risks and improving clinical outcomes,”

—Xiaoyan Zhang, China-Japan Friendship Hospital

According to the Centers for Disease Control and Prevention, roughly 37% of U.S. adults have metabolic syndrome, highlighting the broad public health relevance of this research (CDC, 2024).

Study Methodology

Researchers conducted a thorough analysis of studies on psoriasis and MetS. The investigation considered articles from databases like CNKI, PubMed, and Web of Science. The search encompassed publications up to February 2025, aiming to find all relevant studies.

The inclusion criteria for the analysis consisted of observational designs, such as cross-sectional and prospective studies. Studies needed to feature a psoriasis case group and a control group. Furthermore, the diagnosis had to be clinically or pathologically confirmed.

Key Findings

The meta-analysis included 14 articles involving 9,641 patients with psoriasis. The collective prevalence of clinically significant metabolic dysregulation among the psoriasis cases reached 26.49%. When compared to control groups, psoriasis patients showed higher odds ratios for MetS.

In patients with severe psoriasis, a higher risk of developing MetS was identified. The study revealed a positive linear trend between PASI scores and MetS incidence. This indicated a link between disease severity and the chances of developing MetS.

Call to Action

The investigators concluded that clinicians should pay closer attention to the metabolic health of psoriasis patients. Regular monitoring, alongside early intervention measures, is vital to prevent the onset of MetS. They emphasized the importance of interdisciplinary collaborations to improve patient care.

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Health

Biologic Decision-Making in Asthma and COPD: Prioritizing Earlier, Precise Intervention

by DrMichaelLee
written by DrMichaelLee

New Respiratory Treatments Reshape Asthma and COPD Care

Advances in respiratory medicine are transforming asthma and chronic obstructive pulmonary disease (COPD) management, moving away from generalized treatments to personalized approaches. These changes are expanding treatment options and redefining long-term disease control for individuals once considered hard to treat.

Biologics Revolutionize Asthma Management

Biologic therapies have been central to this shift in asthma care. New drugs like dupilumab (Dupixent), benralizumab (Fasenra), and tezepelumab (Tezspire) have set new standards for effective intervention. The approval of tezepelumab in 2021, the first biologic for severe asthma not limited by eosinophil count, broadened treatment options. This progress is also strengthening collaboration between allergists and pulmonologists.

Joseph Khaabbaza, MD

COPD management is starting to see similar innovation, with the 2024 FDA approval of dupilumab for eosinophilic COPD marking a significant step. As the lines between asthma and COPD continue to blur, clinicians need to reevaluate traditional treatment pathways.

Expert Insights on Emerging Therapies

A recent clinical forum brought together pulmonologists and allergists to discuss the updates in respiratory care, led by pulmonologist Joseph Khabbaza, MD, of Cleveland Clinic. Panelists discussed the central role of biologics in modern asthma management, particularly for those with type 2 inflammation. The use of biomarkers like eosinophils and FeNO has also grown substantially.

“I’ve been more aggressive with, if my patient needs steroids more than twice in 6 months or so, I’m pulling the trigger faster and faster, even without long-acting muscarinic antagonist (LAMA), just because I first-hand know the major long-term side effects of steroids 10 years, 15 years down the road,”

—Forum Participant

Another shift is that pulmonologists are managing biologics more often, and initiating them earlier to reduce steroid use and prevent long-term problems, despite payer criteria. The global prevalence of COPD is estimated to be around 10% of adults aged 40 years and over, highlighting the scale of the issue (World Health Organization, 2024).

Future Directions in Respiratory Care

COPD management is beginning to adopt similar principles, recognizing that some patients with type 2 inflammation may benefit from biologics. Panelists emphasized the need for longer-acting biologics, better phenotyping, and broader eligibility definitions, especially for COPD patients.

“Asthma and COPD have evolved over the last few years and with a lot of thinking about eosinophils and type 2 inflammation, and we now have more pathways and more treatments than ever before to try to help these patients. And we want to minimize prednisone, and minimize exacerbation. I think those are- If we can do those two things in asthma and COPD patients, that’ll be good for everyone in the system,” Khabbaza concluded.

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Health

Masked Taper & CBT-I: Reducing Reliance on Sleep Meds | Expert Advice

by DrMichaelLee
written by DrMichaelLee

Masked Tapering Boosts Benzodiazepine Discontinuation for Insomnia Patients: SLEEP 2025

SEATTLE, WA – A novel approach to benzodiazepine deprescribing, combining masked tapering with augmented cognitive behavioral therapy for insomnia (CBT-I), shows promising results in helping older adults discontinue long-term use of these medications. The findings, presented at SLEEP 2025, highlight the potential of this method to improve sleep quality and reduce reliance on benzodiazepines (BZRA) among individuals with insomnia.

The Masked Tapering Approach

researchers,led by Dr. Constance Fung from the David Geffen School of Medicine at UCLA,developed a Masked Taper plus cognitive behavioral therapy-augmented program (MTcap) to minimize placebo effects and boost discontinuation. The study involved 188 adults aged 55 and older (average age 69.2 years, 34.6% female) who had been using alprazolam, lorazepam, temazepam, or zolpidem for at least two nights per week for a minimum of three months. Participants used a BZRA an average of 5.9 days a week.

Did You Know? Benzodiazepines are associated with a 36% increased risk of dementia in older adults, according to a 2012 study in JAMA Internal medicine.

Study Results: MTcap vs. Standard Tapering

The multi-site trial compared eight weeks of MTcap with standard, gradual tapering. Six months after treatment, the MTcap group showed a significantly higher BZRA discontinuation rate (73.4%) compared to the standard tapering group (58.6%). Both groups experienced improvements in insomnia severity, as measured by the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index.

Specifically, baseline epworth Sleepiness Scale scores increased from 6.32 and 6.21 at baseline for MTcap and standard taper,respectively,to 3.98 and 3.92 at 1 week and 4.54 and 3.91at 6 months. Pittsburgh Sleep Quality index scores also showed improvements from baseline to week 1 and month 6 in both arms.

Comparison of MTcap and Standard tapering Results
Outcome MTcap Standard Tapering
BZRA discontinuation (6 months) 73.4% 58.6%
Average Age of Participants 69.2 years 69.2 years

Challenging Thoughts About Medication

A key element of the masked tapering program involved a diary where participants recorded their perceived nightly dosage compared to their baseline dose. This approach encouraged patients to question the actual effectiveness of their medication.

Pro Tip: Gradual tapering, combined with behavioral therapies, is recommended by the American Academy of Family Physicians for safe benzodiazepine discontinuation.

Dr. Fung emphasized the importance of patients asking themselves, “Is this pill really doing something for me?” The goal is for patients to recognize that they may not be sleeping well and may not necessarily need a sleeping pill after completing the MTcap program.

Future Research Directions

Further analyses are planned to gain a better understanding of the factors contributing to the sustained discontinuation rates observed in the study. researchers aim to identify the specific mechanisms through which masked tapering and augmented CBT-I promote long-term success.

What strategies have you found most effective in managing insomnia without medication? How can healthcare providers better support patients in safely discontinuing benzodiazepines?

Benzodiazepines and Insomnia: An Evergreen Perspective

Benzodiazepines are a class of psychoactive drugs primarily used to treat anxiety, insomnia, and seizures. While effective for short-term relief, long-term use can lead to dependence, tolerance, and a range of adverse effects, particularly in older adults.Insomnia, characterized by difficulty falling or staying asleep, affects millions worldwide and can significantly impact quality of life. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a non-pharmacological treatment that addresses the underlying causes of insomnia through behavioral and cognitive techniques. Studies have shown that CBT-I is as effective as medication in the short term and more effective in the long term, without the risks associated with drug dependence and side effects. The increasing awareness of the risks associated with long-term benzodiazepine use has led to a growing emphasis on deprescribing strategies and alternative treatments like CBT-I.

Frequently Asked Questions About Benzodiazepine Discontinuation

What are the risks of long-term benzodiazepine use?
Long-term use can lead to dependence, tolerance, cognitive impairment, increased risk of falls, and paradoxical effects like increased anxiety or insomnia.
What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?
CBT-I is a structured program that helps individuals identify and change thoughts and behaviors that contribute to insomnia. it includes techniques like sleep restriction, stimulus control, and relaxation training.
How does masked tapering work?
Masked tapering involves gradually reducing the dosage of a medication without the patient’s knowledge of the specific tapering schedule,minimizing potential placebo effects and psychological dependence.
Is it safe to stop benzodiazepines abruptly?
Abruptly stopping benzodiazepines can lead to withdrawal symptoms, including anxiety, insomnia, seizures, and rebound symptoms. Gradual tapering under medical supervision is recommended.
where can I find more facts about CBT-I?
You can find more information about CBT-I from healthcare providers,sleep specialists,and organizations like the National Sleep Foundation.

Disclaimer: This article provides general information and should not be considered medical advice. Consult with a healthcare professional for personalized guidance on benzodiazepine discontinuation and insomnia treatment.

share this article to spread awareness about safe benzodiazepine deprescribing strategies. What are your thoughts on the masked tapering approach? Leave a comment below!

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Health

Coats’ Disease Treatment & Outcomes: Expert Interview with Dr. David Abramson

by Ethan Caldwell
written by Ethan Caldwell

Coats’ Disease: Genetic insights Refine Treatment

New York – July 9, 2024 – The 2025 NYSOS meeting provided new insights into Coats’ disease, a rare disorder affecting the retina. ophthalmologist David H. Abramson, MD, illuminated the latest findings, detailing the genetic underpinnings of the disease, its treatment, and highlighting advances in surgical approaches. Identifying a genetic link is key and could change everything.

Coats’ Disease: Unraveling Genetic Mysteries and Refining Treatment Approaches

New insights into Coats’ disease, a rare disorder affecting retinal blood vessels, were presented at the 2025 New York State Ophthalmological Society (NYSOS) Annual Meeting.David H. abramson, MD, an ophthalmologist at Memorial Sloan Kettering Cancer Center, shared findings from a pediatric surgery and highlighted emerging genetic links that could revolutionize diagnosis and treatment.

The Challenge of Coats’ Disease

Coats’ disease is characterized by abnormal,leaky blood vessels in the retina,leading to fluid buildup and potential vision loss. Historically, the condition is defined by telangiectatic, exudative retinal vessels with peripheral capillary dropout. Advanced stages can result in severe complications.

  • Subretinal exudation
  • Retinal detachment
  • Neovascular glaucoma
  • loss of the eye

Early-stage cases,were the disease is localized to about 90 degrees of the retina,often respond well to laser photocoagulation. However, more extensive cases present a notable therapeutic challenge.

Did you know? Coats’ disease is frequently enough unilateral, affecting only one eye. However, advanced imaging techniques reveal that bilateral involvement may be more common than previously thought.

Anti-VEGF and Telomere Biology: A potential Connection

While anti-VEGF (vascular endothelial growth factor) agents have proven successful in treating other retinal conditions, their effectiveness in Coats’ disease has been limited and unpredictable. Dr. Abramson’s case involved a combination therapy of laser and anti-VEGF, resulting in a positive outcome.this success prompted him to explore a possible link between treatment response and underlying telomere biology disorders.

“I’ve had a suspicion – but I don’t really have anything more than a suspicion – that it’s the patients who have the telomere biology disorders causing Coats’ who are the ones that actually do respond to anti-VEGF agents.”

David H. abramson, MD, Memorial Sloan Kettering Cancer Center

Telomeres are protective caps on the ends of chromosomes, and their dysfunction has been linked to various diseases. Further research is needed to confirm this potential connection.

Surgical Management and It’s Limitations

Surgery for total retinal detachment in Coats’ disease is technically straightforward, but its effectiveness is often hampered by the thick, viscous nature of chronic subretinal exudate. Dr. Abramson described the exudate as being like honey. The high failure rate has led manny experienced pediatric retinal surgeons to favor conservative management in such cases.

Steroid use has shown some promise, but consistent positive outcomes remain elusive. Moreover, existing treatments can lead to scarring that impairs vision.

“Success here is not steadfast as getting good vision. Success is keeping the eye and, of course, identifying what [the disease] is.”

David H. Abramson, MD, Memorial Sloan Kettering Cancer Center

Pro Tip: Early diagnosis and intervention are crucial in managing Coats’ disease. Regular eye exams for children can definitely help detect the condition in its early stages, improving the chances of successful treatment.

Genetic Insights: Beyond a Unilateral Condition

Dr. Abramson’s genetic findings are enriching the understanding of Coats’ disease. while traditionally considered a unilateral condition, widefield fluorescein angiography reveals bilateral involvement in many cases. Genetic studies have identified mutations in genes like LTBP2, even though many cases remain genetically unexplained.

These findings support a broader systemic context, which dr. Abramson categorized as Coats’ plus. This involves multi-organ involvement, including cardiac, hepatic, pulmonary, dermatologic, neurocognitive, and hematologic systems, with associated risks of malignancy and bone marrow failure.

The Future of Coats’ Disease Management

Currently, no gene-targeted therapies exist for Coats’ disease. However, recognizing the systemic associations allows for earlier multidisciplinary interventions and more complete patient care. Dr. Abramson emphasized the importance of moving beyond outdated clinical paradigms and integrating modern imaging techniques and genetic diagnostics to improve outcomes and guide long-term management strategies.

Frequently Asked questions (FAQ)

What is Coats’ disease?
Coats’ disease is a rare eye disorder involving abnormal blood vessels in the retina.
What are the symptoms of coats’ disease?
Symptoms can include vision loss, strabismus (crossed eyes), and leukocoria (white pupil).
How is Coats’ disease treated?
Treatment options include laser photocoagulation, cryotherapy, and, in certain specific cases, surgery. Anti-VEGF injections may also be used.
Is Coats’ disease genetic?
While some cases have been linked to genetic mutations, many remain genetically unexplained.
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Business

Tirzepatide Offers Potential Alternative to Daily Hormone Shots for Rare Genetic Fat Disorder

by Ethan Caldwell
written by Ethan Caldwell

A groundbreaking study suggests that a once-weekly ⁤injection of tirzepatide could ⁣revolutionize‍ treatment for patients with congenital generalized lipodystrophy (CGL), ‌a rare genetic disorder​ characterized by the near-complete absence of fat tissue ⁢from birth. This innovative approach may replace​ the ‍current standard-of-care, which involves daily injections ‍of metreleptin, a synthetic form of the hormone ⁣leptin. the findings, led by Christopher Buettner, ⁢MD, PhD, chief of endocrinology,⁤ metabolism, ⁣and‍ nutrition at Rutgers Robert ​wood Johnson Medical School, offer hope for improved quality of‌ life and reduced treatment burden for patients with this debilitating condition.

The Challenges of Current Treatment ⁣

CGL, an autosomal recessive ⁣disorder, affects only a few thousand‍ people worldwide.patients with CGL face severe metabolic⁢ complications, including insulin resistance, diabetes, and hepatic steatosis, due to the absence of adipose tissue and subsequent leptin⁤ deficiency. the current treatment, metreleptin, is FDA-approved but⁤ comes with importent challenges. ⁣Daily injections can be painful,especially for patients with minimal fat tissue,and the high‌ cost of the therapy adds ⁤to the burden. ‌

“Leptin is an vital hormone, made only by fat tissue, that is an critically important regulator of metabolism, so leptin therapy made intuitive sense in ​patients with CGL,” explained Buettner. “The hormone GLP1,which is mimicked by tirzepatide,is not made in adipose tissue,and while tirzepatide is an insulin sensitizer,we did not expect‌ it woudl ⁤have such ⁣potency in patients ‍with CGL.”

Tirzepatide: A Promising Option

Tirzepatide, a dual GLP-1/GIP agonist, is already‍ FDA-approved for type 2 diabetes and chronic weight management. Its ​ability to improve‌ insulin resistance made it a compelling candidate for ⁤CGL​ treatment. The study focused on two patients with CGL type ⁤1, a variant prevalent among individuals of african descent.One patient, a 23-year-old Black man with a BMI of 23, had⁣ previously struggled with the pain of daily injections and discontinued treatment. ‌After switching to tirzepatide‌ monotherapy,‍ he received escalating doses over four weeks.

while lower doses (2.5 mg,‍ 5 mg, and 7.5⁢ mg) did not substantially‍ reduce glucose​ levels,they improved insulin sensitivity,as‍ evidenced by ​decreasing C-peptide levels. The study ‍highlights​ the potential of tirzepatide to not only⁣ manage metabolic complications but also‌ reduce the pain and cost associated with​ current⁤ treatments. ‌

Key Findings at a ​Glance

| ​ Aspect ⁢ ⁤ | Details ‍ ⁤​ ‌ ⁤ ​ ⁣ |
|—————————|—————————————————————————–|
| Current Treatment ‍ | ‌Daily metreleptin injections, costly and painful for⁣ patients with CGL.|
| Proposed ‌Treatment | Once-weekly tirzepatide injections,improving insulin sensitivity. |
| Study Participants | Two patients with CGL type 1, ⁣one a ‌23-year-old Black man. ​ ​ ‍ ‍ ⁢ ​ |
| Outcomes ⁤ ‌ | Improved insulin sensitivity, reduced treatment burden. |

A Brighter Future for ⁣CGL ​Patients

“These patients are severely ill and ​face markedly reduced life expectancy ‍due to profound insulin resistance,” ‌Buettner emphasized. the introduction of ‌ tirzepatide as a⁤ once-weekly therapy could significantly enhance⁤ patient adherence ​and ⁣outcomes, offering a ⁤more affordable and less painful alternative​ to metreleptin.As research continues, the potential of ⁣ tirzepatide ⁢to transform the lives ‌of⁣ those with congenital generalized lipodystrophy becomes increasingly clear.⁤ For ​more insights into this⁣ groundbreaking study, explore the‍ full ‍findings⁤

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