nach oben

Drugs & Aging

Erschienen in:

01.01.2007 | Review Article

Management of Gout in Older Adults

Barriers to Optimal Control

verfasst von: Karl T. Hoskison, Dr Robert L. Wortmann

Erschienen in: Drugs & Aging | Ausgabe 1/2007

Einloggen, um Zugang zu erhalten

Abstract

Gout, a common inflammatory arthritis, can be diagnosed with absolute certainty. Gout results from the body’s reaction to urate crystals deposited in tissues, and this pathophysiology is well understood. If used appropriately, available therapies can be entirely effective in not only treating the symptoms of gout, but also in eliminating the excess urate from the body, thereby eradicating the disease. Because of these facts, management of patients with gout should be successful. However, management of gout is particularly challenging in the elderly, even though the principles of management are the same for all age groups. The purpose of this article is to review these principles and discuss them as they pertain to the elderly.

The classic gout attack is acute in onset, extremely painful and associated with marked swelling, warmth, erythema and tenderness of a single joint. However, the diagnosis of gout may be challenging in the elderly because atypical presentations are more common in this group.

Treatment of acute gout involves the use of NSAIDs, colchicine, corticoste-roids or corticotropin (adrenocorticotropic hormone). Unfortunately, co-morbid conditions such as chronic kidney disease, peptic ulcer disease and congestive heart failure may make the use of these agents dangerous or contraindicated. Thus, it is important to try to treat an acute flare of gout at the earliest sign, because the sooner treatment is initiated, the faster the inflammation will resolve.

Urate-lowering agents include allopurinol and uricosuric agents. These also must be used judiciously in the elderly. However, if used at the lowest dose that maintains the serum urate level below 5.0–6.0 mg/dL, the excess urate in the body will be eliminated, acute flares will no longer occur and tophi will resolve.

Gout is often seen in association with hypertension, excessive alcohol consumption, obesity and hypertriglyceridaemia. These conditions and the medications used to treat them may contribute to the hyperuricaemia. Treating these conditions and using medications that do not promote hyperuricaemia will aid in the management of gout.

Despite the challenges that often complicate the management of gout in the elderly, an understanding of the pathophysiology of the disease and both the indications and limitations of the medications used should allow successful treatment.

Saag KG, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout [abstract]. Arthritis Res Ther 2006; 8Suppl. 1: S2PubMedCrossRef

Mikuls TR, Farrar JT, Bilker WB, et al. Suboptimal physician adherence to quality indicators for the management of gout and asymptomatic hyperuricemia: results from the UK General Practice Research Database (GPRD). Rheumatology 2005; 44: 1038–42PubMedCrossRef

Wallace KL, Riedel AA, Joseph-Ridge N, et al. Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population. J Rheumatol 2004; 31: 1582–7PubMed

Guyer B, Freedman MA, Strobino DM, et al. Annual summary of vital statistics: trends in health of Americans during the 20th century. Pediatrics 2000; 106: 1307–17PubMedCrossRef

Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults 1992–2000. JAMA 2002; 288: 1723–17PubMedCrossRef

Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment and control of hypertension in the United States, 1988–2000. JAMA 2003; 290: 199–206PubMedCrossRef

Rathmann W, Funkhouser E, Dyer AR, et al. Relations of hyperuricemia with various components of insulin resistance syndrome in young black and white adults: the CARDIA study. Ann Epidemiol 1998; 8: 250–61PubMedCrossRef

Choi H, Adkinson K, Karlson E, et al. Obesity, weight change, hypertension, diuretic use, and risk of gout in men. Arch Intern Med 2005; 165: 742–8PubMedCrossRef

Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA 2003; 289: 2560–72PubMedCrossRef

10.

Caspi D, Lubart E, Graff E, et al. The effect of mini-dose aspirin on renal function and uric acid handling in elderly patients. Arthritis Rheum 2000; 43: 103–8PubMedCrossRef

11.

Ene-Stroescu D, Gorbien MJ. Gouty arthritis: a primer of late-onset gout. Geriatrics 2005 (Jul); 60: 24–31PubMed

12.

Schlesinger N, Schumacher HR Jr. Gout: can management be improved? Curr Opin Rheumatol 2001; 13: 240–4PubMedCrossRef

13.

Schlesinger N, Baker DG, Schumacher HR Jr. How well have diagnostic tests and therapies for gout been evaluated? Curr Opin Rheumatol 1999; 11: 441–5PubMedCrossRef

14.

Mikuls TR, MacLean CH, Olivieri J, et al. Quality of care indicators for gout management. Arthritis Rheum 2004; 50(3): 937–43PubMedCrossRef

15.

Schumacher HR Jr, Edwards NL, Perez-Ruiz F, et al. Outcome measures for acute and chronic gout. J Rheumatol 2005; 32: 2452–5PubMed

16.

Zhang W, Doherty M, Pascual E, et al. EULAR evidenced based report recommendations for gout. Part 1: diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006 Oct; 65(10): 1310–11. Epub 2006 May 17

17.

Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendation for gout. Part II: management report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Ann Rheum Dis 2006 Oct; 65(10): 1312–24. Epub 2006 May 17PubMedCrossRef

18.

Park YB, Park YS, Lee WK, et al. Clinical manifestations of Korean female gouty patients. Clin Rheumatol 2000; 19: 142–6PubMedCrossRef

19.

Townshend D, Vasu P. Gouty tenosynovitis — more common than we think? N Z Med J 2004; 117: 1188

20.

Kini S, Mittal G, Balakrishna C, et al. An unusual systemic presentation of gout. J Assoc Physicians India 2000; 48: 354–5PubMed

21.

Symons MCR. Self-treatment of gout. Med Hypothesis 2001; 57: 241–2CrossRef

22.

Hunter DJ, York M, Chaisson CE, et al. Recent diuretic use and the risk of recurrent gout attacks: the online case-crossover gout study. J Rheumatol 2006; 33: 1341–5PubMed

23.

Wortmann RL. Treatment of acute gouty arthritis: one physician’s approach and where this management stands relative to developments in the field. Curr Rheumatol Rep 2004; 6: 235–9PubMedCrossRef

24.

Schumacher HR Jr, Boice JA, Daikh DI, et al. Randomized double blind trial of etoricoxib and indomethacin in treatment of gouty arthritis. BMJ 2002; 324: 1488–92PubMedCrossRef

25.

Dieppe PA. Investigation and management of gout in the young and the elderly. Ann Rheum Dis 1991; 50: 263–6PubMedCrossRef

26.

Fendrick AM, Garabedian-Ruffalo SM. A clinician’s guide to the selection of NSAID therapy. Pharm Ther 2002; 27: 579–82

27.

Lange U, Schumann C, Schmidt KL. Current aspects of colchicine therapy: classical indications and new therapeutic uses. Eur J Med Res 2001; 6: 150–60PubMed

28.

Molad Y. Update on colchicine and its mechanism of action. Curr Rheumatol Rep 2002; 4: 252–6PubMedCrossRef

29.

Wallace SL, Singer JZ. Review: systemic toxicity associated with the intravenous administration of colchicine — guidelines for use. J Rheumatol 1988; 15: 495–9PubMed

30.

Evans TI, Wheeler MT, Small RE, et al. A comprehensive investigation of inpatient colchicine use shows more education is needed. J Rheumatol 1996; 23: 143–9PubMed

31.

Ahern MJ, Reid C, Gordon TP, et al. Does colchicine work? The results of the first controlled study in acute gout. Aust N Z J Med 1987; 17: 301–4PubMedCrossRef

32.

Kim KY, Schumacher H, Hunsche E, et al. A literature review of the epidemiology and treatment of acute gout. Clin Ther 2003; 25: 1593–617PubMedCrossRef

33.

Iacobuzio-Donahue CA, Lee EL, Abraham SC, et al. Colchicine toxicity: distinct morphologic findings in gastrointestinal biopsies. Am J Surg Path 2001; 25: 1067–70PubMedCrossRef

34.

Chattopadhyay I, Shetty HMG, Routledge PA, et al. Colchicine induced rhabdomyolysis. Postgrad Med J 2001; 77: 191–4PubMedCrossRef

35.

Simkin P, Gardner GC. Colchicine use in cyclosporine treated transplant recipients: how little is too much? J Rheumatol 2000; 27: 1334–7PubMed

36.

Pirzada NA, Medell M, Ali II. Colchicine induced neuromy-opathy in a patient with normal renal function. J Clin Rheumatol 2001; 7: 374–6PubMedCrossRef

37.

Alloway JA, Moriarty MJ, Hoogland YT, et al. Comparison of triamcinolone acetonide with indomethacin in the treatment of acute gouty arthritis. J Rheumatol 1993; 20: 111–3PubMed

38.

Terkeltaub RA. Gout. N Engl J Med 2003; 349: 1647–55PubMedCrossRef

39.

Groff GD, Franck WA, Raddatz DA. Systemic steroid therapy for acute gout: a clinical trial and review of the literature. Semin Arthritis Rheum 1990; 19: 329–36PubMedCrossRef

40.

Clive DM. Renal transplant-associated hyperuricemia and gout. J Am Soc Nephrol 2000; 11: 974–9PubMed

41.

Siegel LB, Alloway JA, Nashel DJ. Comparison of adrenocorticotropic hormone and triamcinolone acetonide in the treatment of acute gouty arthritis. J Rheumatol 1994; 21: 1325–7PubMed

42.

Wyngaarden JB, Kelley WN. Gout and hyperuricemia. New York (NY): Grane & Stratton, 1976

43.

Fernandez C, Naguera R, Gonzalez JA, et al. Treatment of acute attacks of gout with a small dose of intraarticular triamcinolone acetonide. J Rheumatol 1999; 26: 2285–6PubMed

44.

Rull M, Claybome G, Sieck M, et al. Intraarticular corticoste-roid preparations: different characteristics and their effect during inflammation induced by monosodium urate crystals in the rat subcutaneous air pouch. Rheumatology 2003; 42: 1093–100PubMedCrossRef

45.

Axelrod D, Preston S. Comparison of parenteral adrenocorticotropic hormone with oral indomethacin in the treatment of acute gout. Arthritis Rheum 1988; 33: 803–5CrossRef

46.

Ritter J, Kerr LD, Valeriano-Marcet J, et al. ACTH revisited: effective treatment for acute crystal induced synovitis in patients with multiple medical problems. J Rheumatol 1994; 21: 696–9PubMed

47.

Getting SJ, Christian HC, Flower RJ, et al. Activation of melanocortin type 3 receptor as a molecular mechanism for adreno-corticotropic hormone efficacy in gouty arthritis. Arthritis Rheum 2002; 46: 2765–75PubMedCrossRef

48.

Gutman AB. Gout. In: Beeson PB, McDermott W, editors. Textbook of medicine. 12th ed. Philadelphia (PA): WB Saunders, 1958: 595

49.

Nakayama DA, Barthelemy C, Carrera G, et al. Tophaceous gout: a clinical and radiographie assessment. Arthritis Rheum 1984; 27: 468–73PubMedCrossRef

50.

McCarthy GM, Barthelemy CR, Veum JA, et al. Influence of antihyperuricemic therapy on the clinical and radiographie progression of gout. Arthritis Rheum 1991; 34: 489–95CrossRef

51.

Bull PW, Scott JT. Intermittent control of hyperuricemia in the treatment of gout. J Rheumatol 1989; 16: 1246–8PubMed

52.

Van Lieshout-Zuidema MF, Breedveld FC. Withdrawal of long-term antihyperuricemic therapy in tophaceous gout. J Rheumatol 1993; 20: 1383–5PubMed

53.

Pascual E, Battle-Gualda E, Martinez A, et al. Urate crystals in asymptomatic metatarsophalangeal joints. Ann Intern Med 1999; 131: 756–9PubMed

54.

Li-Yu J, Claybume G, Sieck M, et al. Treatment of chronic gout: can we determine when urate stores are depleted enough to prevent attacks of gout? J Rheumatol 2001; 28: 577–80PubMed

55.

Shoji A, Yamanaka H, Kamatani N. A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Arthritis Rheum 2004; 51: 321–5PubMedCrossRef

56.

Palella TD, Kelley WN. An approach to hyperuricemia and gout. Geriatrics 1984; 39: 89–102PubMed

57.

Ferraz MB, O’Brien B. A cost effectiveness analysis of urate lowering drugs in nontophaceous recurrent gouty arthritis. J Rheumatol 1995; 22: 908–14PubMed

58.

Becker MA, Schumacher HR Jr, Wortmann RL, et al. Febuxostat, a novel non purine selective inhibitor of xanthine oxidase. Arthritis Rheum 2005; 52: 916–23PubMedCrossRef

59.

Becker MA, Schumacher HR Jr, Wortmann RL, et al. Febuxostat versus allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005; 353: 2450–61PubMedCrossRef

60.

Wallace S, Singer J, Duncan G, et al. Renal function predicts colchicine toxicity: guidelines for the prophylactic use of colchicine in gout. J Rheumatol 1991; 18: 264–9PubMed

61.

Yu TF, Gutman AB. Efficacy of colchicine prophylaxis: prevention of recurrent gouty arthritis over a mean period of five years in 208 gouty subjects. Ann Intern Med 1961; 55: 179–86PubMed

62.

Perez-Ruiz F, Calabozo M, Pijoan JI, et al. Effect of urate-lowering therapy on the velocity of size reduction of tophic in chronic gout. Arthritis Rheum 2002; 47: 356–60PubMedCrossRef

63.

Harris M, Bryant LR, Danaher P, et al. Effect of low dose daily aspirin on serum urate levels and urinary excretion in patients receiving probenecid for gouty arthritis. J Rheumatol 2000; 27: 2873–6PubMed

64.

Perez-Ruiz F, Alonso-Ruiz A, Calabozo M, et al. Efficacy of allopurinol and benzbromarone for the control of hyperuricemia: a pathogenic approach to the treatment of primary chronic gout. Ann Rheum Dis 1998; 57: 545–9PubMedCrossRef

65.

Perez-Ruiz F, Calabozo C, Herrero-Betes A, et al. Improvement in renal function in patients with chronic gout after proper control of hyperuricemia and gouty bouts. Nephron 2002; 86: 287–92CrossRef

66.

Perez-Ruiz F, Gomez-Ullate P, Amenabar JJ, et al. Long-term efficacy of hyperuricemia treatment in renal transplant patients. Nephrol Dial Transplant 2003; 18(3): 603–6PubMedCrossRef

67.

Wortman RL. Gout and hyperuricemia. Curr Opin Rheumatol 2002; 14: 281–6CrossRef

68.

Schumacher HR, Becker MA, Wortmann RL, et al. Febuxostat versus allopurinol and placebo in subjects with hyperuricemia and gout [abstract]. Arthritis Rheum 2005; 52 Suppl.: S680

69.

Perez-Ruiz F, Hernando I, Villar I, et al. Correction of allopurinol dosing should be based on clearance of Creatinine, but not plasma Creatinine levels: another insight to allopurinol-related toxicity. J Clin Rheumatol 2005 Jun; 11(3): 129–33PubMedCrossRef

70.

Hande KR, Noone RM, Stone WI. Severe allopurinol toxicity: description and guidelines for presentation in patients with renal insufficiency. Am J Med 1984; 76: 47–53PubMedCrossRef

71.

Dalbeth N, Kumar S, Stamp L, et al. Dose adjustment of allopurinol to Creatinine clearance does not provide adequate control of hyperuricemia in patients with gout. J Rheumatol 2006; 33: 1646–50PubMed

72.

Singer JZ, Wallace SL. The allopurinol hypersensitivity syndrome: unnecessary morbidity and mortality. Arthritis Rheum 1986; 29: 82–7PubMedCrossRef

73.

Fam AG, Dunne SM, Iazzitta J, et al. Efficacy and safety of desensitization to allopurinol following cutaneous reactions. Arthritis Rheum 2001; 44: 231–8PubMedCrossRef

74.

Fam AG. Difficult gout and new approaches for control of hyperuricemia in the allopurinol-allergic patient. Curr Rheumatol Rep 2001; 3: 29–35PubMedCrossRef

75.

Raman G, Sharman V, Lee H. Azathioprine and allopurinol: a potentially dangerous combination. J Intern Med 1990; 228: 69–71CrossRef

76.

Becker MA, Schumacher HR Jr, Wortmann RL, et al. Febuxostal: a novel non-purine selective inhibitor of xanthine oxidase in allopurinol intolerant patients [abstract]. Arthritis Rheum 2004; 50: 9 Suppl.: S336

77.

Bomalaski JS, Holtsberg FW, Ensor CM, et al. Uricase formulated with polyene glycol (uricase-PEG 20): biochemical rational and preclinical studies. J Rheumatol 2002; 29: 1942–9PubMed

78.

Ganson NJ, Kelley SJ, Scarlett E, et al. Control of hyperuricemia in subjects with refractory gout, and induction of antibody against polyethylene glycol (PEG), in a phase I trial of subcutaneous PEGylated urate oxidase [abstract]. Arthritis Res Ther 2005; 8: R12CrossRef

79.

Choi H, Atkinson KK, Karlson E, et al. Alcohol intake and risk of incident gout in men: a prospective study. Lancet 2004; 363: 1277–81PubMedCrossRef

80.

Ghany M, Hoofnagle JH. Approach to the patient with liver disease. In: Braunwald E, Fauci AS, Kasper DL, et al., editors. Harrison’s principles of internal medicine. 16th ed. New York (NY): McGraw Hill, 2005: 1808–12

81.

Moore AA, Giuli L, Gould R, et al. Alcohol use, comorbidity, and mortality. J Am Geriate Soc 2006; 54: 757–62CrossRef

82.

Maesaka JK, Fishbane S. Regulation of renal urate excretion: a critical review. Am J Kidney Dis 1998; 32: 917–25PubMedCrossRef

83.

Dessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis 2000; 59: 539–48PubMedCrossRef

84.

Choi HK, Liu S. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2005; 52(1): 283–9PubMedCrossRef

85.

Fam AG. Gout, diet and the insulin resistance syndrome. J Rheumatol 2002; 29: 1350–6PubMed

86.

Yamamoto T, Moriwaki Y, Takahashi S, et al. Effect of fenofibrate on plasma concentration and urinary excretion of purine bases and oxypurinol. J Rheumatol 2001; 28: 2294–7PubMed

87.

Tenenbaum A, Fisman EZ, Boyko V, et al. Attenuation of progression of insulin resistance in patients with coronary artery disease by bezafibrate. Arch Intern Med 2006; 166: 737–41PubMedCrossRef

88.

ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitors or calcium channel blockers vs. diuretics. JAMA 2002; 288: 2981–97CrossRef

89.

Minghelli G, Seydoux C, Goy JJ, et al. Uricosuric effect of the angiotensin II receptor antagonist losarían in heart transplant recipients. Transplantation 1998; 66: 268–71PubMedCrossRef

90.

Wurzner G, Gerster JC, Chiolero A, et al. Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricemia and gout. J Hypertens 2001; 19: 1855–60PubMedCrossRef

91.

Stamp L, Sharpies K, Gow P, et al. The optimal use of allopurinol: an audit of allopurinol use in South Auckland. Aust N Z J Med 2000; 30: 567–72PubMedCrossRef

92.

Mikuls TR, Curtis JR, Allison JJ, et al. Medication errors with the use of allopurinol and colchicine: a retrospective study of a national anonymous internet-accessible error reporting system. J Rheumatol 2006; 33: 562–6PubMed

93.

Liang MH, Fries JF. Asymptomatic hyperuricemia: the case for conservative management. Ann Intern Med 1978; 88: 666–70PubMed

94.

Wortmann RL. The treatment of gout: the use of an analogy. Am J Med 1998; 105: 513–6PubMedCrossRef

95.

Wannamethee SG, Sharper AG, Whincup PH. Serum urate and the risk of major coronary heart disease events. Heart 1997; 78: 147–53PubMed

96.

Niskanen LK, Laaksonen DE, Nyyssonen K, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 2004; 164: 1546–51PubMedCrossRef

97.

Baker JF, Krishnan E, Chen L, et al. Serum uric acid and cardiovascular disease: recent developments, and where do they leave us? Am J Med 2005; 118: 816–26PubMedCrossRef

98.

Freedman DS, Williamson DF, Gunter EW, et al. Relation of serum uric acid to mortality and ischemie heart disease: the NHANES I Epidemiologic Follow-Up Study. Am J Epidemiol 1995; 141: 637–44PubMed

99.

Culleton BF, Larson MG, Kannel WB, et al. Serum uric acid and risks for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 1999; 131: 7–13PubMed

100.

Krishnan E, Baker JF, Furst DE, et al. Gout and the risk of acute myocardial infarction. Arthritis Rheum 2006; 54: 2688–96PubMedCrossRef

101.

Feig DI, Nakagawa T, Karumanchi SA, et al. Hypothesis: uric acid, nephron number, and the pathogenesis of essential hypertension. Kidney Int 2004; 66: 281–7PubMedCrossRef

102.

Chen J, Muntner P, Hamm LL, et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140(3): 167–74PubMed

103.

Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350(23): 2362–74PubMedCrossRef

104.

Katzmarzyk PT, Church TS, Blair SN. Cardiorespiratory fitness attenuates the effects of the metabolic syndrome on all-cause and cardiovascular disease mortality in men. Arch Intern Med 2004; 164(10): 1092–7PubMedCrossRef

Titel: Management of Gout in Older Adults
Barriers to Optimal Control
verfasst von: Karl T. Hoskison
Dr Robert L. Wortmann
Publikationsdatum: 01.01.2007
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 1/2007
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.2165/00002512-200724010-00002

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

NSCLC: Progressionsfreies Überleben unter Osimertinib fast versiebenfacht

06.06.2024 ASCO 2024 Kongressbericht

Erste Ergebnisse der Phase-III-Studie LAURA etablieren Osimertinib als neuen Therapiestandard für Menschen mit nicht-resezierbarem, EGFR-mutiertem, nicht-kleinzelligem Lungenkarzinom im Stadium III, die nach definitiver Radiochemotherapie progressionsfrei sind. Auf der ASCO-Tagung wurden diese beeindruckenden Ergebnisse besprochen.

Hodgkin Lymphom: BrECADD-Regime übertrifft die Erwartungen

05.06.2024 ASCO 2024 Kongressbericht

Das Kombinationsregime BrECADD mit Brentuximab vedotin ermöglichte in der Studie HD21 beim fortgeschrittenen klassischen Hodgkin-Lymphom eine unerwartet hohe progressionsfreie Überlebensrate von 94,3% nach vier Jahren. Gleichzeitig war das Regime besser tolerabel als der bisherige Standard eBEACOPP.

Antikörper-Drug-Konjugat verdoppelt PFS bei Multiplem Myelom

05.06.2024 ASCO 2024 Nachrichten

Zwei Phase-3-Studien deuten auf erhebliche Vorteile des Antikörper-Wirkstoff-Konjugats Belantamab-Mafodotin bei vorbehandelten Personen mit Multiplem Myelom: Im Vergleich mit einer Standard-Tripeltherapie wurde das progressionsfreie Überleben teilweise mehr als verdoppelt.

Neuer TKI gegen CML: Höhere Wirksamkeit, seltener Nebenwirkungen

05.06.2024 Chronische myeloische Leukämie Nachrichten

Der Tyrosinkinasehemmer (TKI) Asciminib ist älteren Vertretern dieser Gruppe bei CML offenbar überlegen: Personen mit frisch diagnostizierter CML entwickelten damit in einer Phase-3-Studie häufiger eine gute molekulare Response, aber seltener ernste Nebenwirkungen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2007

Elderly Medical Patients Treated with Prophylactic Dosages of Enoxaparin

Gerontology Forum

Effects of Statins on Cognitive Function in Patients with Alzheimer’s Disease in Galantamine Clinical Trials

Post-Herpetic Neuralgia in Older Adults