461. Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria.
作者: Régis Peffault de Latour.;Alexander Röth.;Austin G Kulasekararaj.;Bing Han.;Phillip Scheinberg.;Jaroslaw P Maciejewski.;Yasutaka Ueda.;Carlos M de Castro.;Eros Di Bona.;Rong Fu.;Li Zhang.;Morag Griffin.;Saskia M C Langemeijer.;Jens Panse.;Hubert Schrezenmeier.;Wilma Barcellini.;Vitor A Q Mauad.;Philippe Schafhausen.;Suzanne Tavitian.;Eloise Beggiato.;Lee Ping Chew.;Anna Gaya.;Wei-Han Huang.;Jun Ho Jang.;Toshio Kitawaki.;Abdullah Kutlar.;Rosario Notaro.;Vinod Pullarkat.;Jörg Schubert.;Louis Terriou.;Michihiro Uchiyama.;Lily Wong Lee Lee.;Eng-Soo Yap.;Flore Sicre de Fontbrune.;Luana Marano.;Ferras Alashkar.;Shreyans Gandhi.;Roochi Trikha.;Chen Yang.;Hui Liu.;Richard J Kelly.;Britta Höchsmann.;Cécile Kerloeguen.;Partha Banerjee.;Rafael Levitch.;Rakesh Kumar.;Zhixin Wang.;Christine Thorburn.;Samopriyo Maitra.;Shujie Li.;Aurelie Verles.;Marion Dahlke.;Antonio M Risitano.
来源: N Engl J Med. 2024年390卷11期994-1008页
Persistent hemolytic anemia and a lack of oral treatments are challenges for patients with paroxysmal nocturnal hemoglobinuria who have received anti-C5 therapy or have not received complement inhibitors. Iptacopan, a first-in-class oral factor B inhibitor, has been shown to improve hemoglobin levels in these patients.
462. Next-Generation Multitarget Stool DNA Test for Colorectal Cancer Screening.
作者: Thomas F Imperiale.;Kyle Porter.;Julia Zella.;Zubin D Gagrat.;Marilyn C Olson.;Sandi Statz.;Jorge Garces.;Philip T Lavin.;Humberto Aguilar.;Don Brinberg.;Charles Berkelhammer.;John B Kisiel.;Paul J Limburg.; .
来源: N Engl J Med. 2024年390卷11期984-993页
A next-generation multitarget stool DNA test, including assessments of DNA molecular markers and hemoglobin level, was developed to improve the performance of colorectal cancer screening, primarily with regard to specificity.
463. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening.
作者: Daniel C Chung.;Darrell M Gray.;Harminder Singh.;Rachel B Issaka.;Victoria M Raymond.;Craig Eagle.;Sylvia Hu.;Darya I Chudova.;AmirAli Talasaz.;Joel K Greenson.;Frank A Sinicrope.;Samir Gupta.;William M Grady.
来源: N Engl J Med. 2024年390卷11期973-983页
Colorectal cancer is the third most diagnosed cancer in adults in the United States. Early detection could prevent more than 90% of colorectal cancer-related deaths, yet more than one third of the screening-eligible population is not up to date with screening despite multiple available tests. A blood-based test has the potential to improve screening adherence, detect colorectal cancer earlier, and reduce colorectal cancer-related mortality.
464. Intraventricular CARv3-TEAM-E T Cells in Recurrent Glioblastoma.
作者: Bryan D Choi.;Elizabeth R Gerstner.;Matthew J Frigault.;Mark B Leick.;Christopher W Mount.;Leonora Balaj.;Sarah Nikiforow.;Bob S Carter.;William T Curry.;Kathleen Gallagher.;Marcela V Maus.
来源: N Engl J Med. 2024年390卷14期1290-1298页
In this first-in-human, investigator-initiated, open-label study, three participants with recurrent glioblastoma were treated with CARv3-TEAM-E T cells, which are chimeric antigen receptor (CAR) T cells engineered to target the epidermal growth factor receptor (EGFR) variant III tumor-specific antigen, as well as the wild-type EGFR protein, through secretion of a T-cell-engaging antibody molecule (TEAM). Treatment with CARv3-TEAM-E T cells did not result in adverse events greater than grade 3 or dose-limiting toxic effects. Radiographic tumor regression was dramatic and rapid, occurring within days after receipt of a single intraventricular infusion, but the responses were transient in two of the three participants. (Funded by Gateway for Cancer Research and others; INCIPIENT ClinicalTrials.gov number, NCT05660369.).
465. Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.
作者: Raffaele Marfella.;Francesco Prattichizzo.;Celestino Sardu.;Gianluca Fulgenzi.;Laura Graciotti.;Tatiana Spadoni.;Nunzia D'Onofrio.;Lucia Scisciola.;Rosalba La Grotta.;Chiara Frigé.;Valeria Pellegrini.;Maurizio Municinò.;Mario Siniscalchi.;Fabio Spinetti.;Gennaro Vigliotti.;Carmine Vecchione.;Albino Carrizzo.;Giulio Accarino.;Antonio Squillante.;Giuseppe Spaziano.;Davida Mirra.;Renata Esposito.;Simona Altieri.;Giovanni Falco.;Angelo Fenti.;Simona Galoppo.;Silvana Canzano.;Ferdinando C Sasso.;Giulia Matacchione.;Fabiola Olivieri.;Franca Ferraraccio.;Iacopo Panarese.;Pasquale Paolisso.;Emanuele Barbato.;Carmine Lubritto.;Maria L Balestrieri.;Ciro Mauro.;Augusto E Caballero.;Sanjay Rajagopalan.;Antonio Ceriello.;Bruno D'Agostino.;Pasquale Iovino.;Giuseppe Paolisso.
来源: N Engl J Med. 2024年390卷10期900-910页
Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking.
466. Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancer.
作者: Thomas Powles.;Begoña P Valderrama.;Shilpa Gupta.;Jens Bedke.;Eiji Kikuchi.;Jean Hoffman-Censits.;Gopa Iyer.;Christof Vulsteke.;Se Hoon Park.;Sang Joon Shin.;Daniel Castellano.;Giuseppe Fornarini.;Jian-Ri Li.;Mahmut Gümüş.;Nataliya Mar.;Yohann Loriot.;Aude Fléchon.;Ignacio Duran.;Alexandra Drakaki.;Sujata Narayanan.;Xuesong Yu.;Seema Gorla.;Blanca Homet Moreno.;Michiel S van der Heijden.; .
来源: N Engl J Med. 2024年390卷10期875-888页
No treatment has surpassed platinum-based chemotherapy in improving overall survival in patients with previously untreated locally advanced or metastatic urothelial carcinoma.
467. Simple versus Radical Hysterectomy in Women with Low-Risk Cervical Cancer.
作者: Marie Plante.;Janice S Kwon.;Sarah Ferguson.;Vanessa Samouëlian.;Gwenael Ferron.;Amandine Maulard.;Cor de Kroon.;Willemien Van Driel.;John Tidy.;Karin Williamson.;Sven Mahner.;Stefan Kommoss.;Frederic Goffin.;Karl Tamussino.;Brynhildur Eyjólfsdóttir.;Jae-Weon Kim.;Noreen Gleeson.;Lori Brotto.;Dongsheng Tu.;Lois E Shepherd.; .; .
来源: N Engl J Med. 2024年390卷9期819-829页
Retrospective data suggest that the incidence of parametrial infiltration is low in patients with early-stage low-risk cervical cancer, which raises questions regarding the need for radical hysterectomy in these patients. However, data from large, randomized trials comparing outcomes of radical and simple hysterectomy are lacking.
468. Cognition and Memory after Covid-19 in a Large Community Sample.
作者: Adam Hampshire.;Adriana Azor.;Christina Atchison.;William Trender.;Peter J Hellyer.;Valentina Giunchiglia.;Masud Husain.;Graham S Cooke.;Emily Cooper.;Adam Lound.;Christl A Donnelly.;Marc Chadeau-Hyam.;Helen Ward.;Paul Elliott.
来源: N Engl J Med. 2024年390卷9期806-818页
Cognitive symptoms after coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are well-recognized. Whether objectively measurable cognitive deficits exist and how long they persist are unclear.
469. Omalizumab for the Treatment of Multiple Food Allergies.
作者: Robert A Wood.;Alkis Togias.;Scott H Sicherer.;Wayne G Shreffler.;Edwin H Kim.;Stacie M Jones.;Donald Y M Leung.;Brian P Vickery.;J Andrew Bird.;Jonathan M Spergel.;Ahmar Iqbal.;Julie Olsson.;Monica Ligueros-Saylan.;Alkaz Uddin.;Agustin Calatroni.;Charmaine Marquis Huckabee.;Nicole H Rogers.;Nancy Yovetich.;Jennifer Dantzer.;Kim Mudd.;Julie Wang.;Marion Groetch.;David Pyle.;Corinne A Keet.;Michael Kulis.;Sayantani B Sindher.;Andrew Long.;Amy M Scurlock.;Bruce J Lanser.;Tricia Lee.;Christopher Parrish.;Terri Brown-Whitehorn.;Amanda K Rudman Spergel.;Maria Veri.;Sanaz Daneshfar Hamrah.;Erica Brittain.;Julian Poyser.;Lisa M Wheatley.;R Sharon Chinthrajah.
来源: N Engl J Med. 2024年390卷10期889-899页
Food allergies are common and are associated with substantial morbidity; the only approved treatment is oral immunotherapy for peanut allergy.
470. Benralizumab versus Mepolizumab for Eosinophilic Granulomatosis with Polyangiitis.
作者: Michael E Wechsler.;Parameswaran Nair.;Benjamin Terrier.;Bastian Walz.;Arnaud Bourdin.;David R W Jayne.;David J Jackson.;Florence Roufosse.;Lena Börjesson Sjö.;Ying Fan.;Maria Jison.;Christopher McCrae.;Sofia Necander.;Anat Shavit.;Claire Walton.;Peter A Merkel.; .
来源: N Engl J Med. 2024年390卷10期911-921页
Eosinophilic granulomatosis with polyangiitis (EGPA) is a vasculitis characterized by eosinophilic inflammation. Benralizumab, a monoclonal antibody against the interleukin-5α receptor expressed on eosinophils, may be an option for treating EGPA.
471. Rusfertide, a Hepcidin Mimetic, for Control of Erythrocytosis in Polycythemia Vera.
作者: Marina Kremyanskaya.;Andrew T Kuykendall.;Naveen Pemmaraju.;Ellen K Ritchie.;Jason Gotlib.;Aaron Gerds.;Jeanne Palmer.;Kristen Pettit.;Uttam K Nath.;Abdulraheem Yacoub.;Arturo Molina.;Samuel R Saks.;Nishit B Modi.;Frank H Valone.;Sarita Khanna.;Suneel Gupta.;Srdan Verstovsek.;Yelena Z Ginzburg.;Ronald Hoffman.; .
来源: N Engl J Med. 2024年390卷8期723-735页
Polycythemia vera is a chronic myeloproliferative neoplasm characterized by erythrocytosis. Rusfertide, an injectable peptide mimetic of the master iron regulatory hormone hepcidin, restricts the availability of iron for erythropoiesis. The safety and efficacy of rusfertide in patients with phlebotomy-dependent polycythemia vera are unknown.
472. Biomarker Changes during 20 Years Preceding Alzheimer's Disease.
作者: Jianping Jia.;Yuye Ning.;Meilin Chen.;Shuheng Wang.;Hao Yang.;Fangyu Li.;Jiayi Ding.;Yan Li.;Bote Zhao.;Jihui Lyu.;Shanshan Yang.;Xin Yan.;Yue Wang.;Wei Qin.;Qi Wang.;Ying Li.;Jintao Zhang.;Furu Liang.;Zhengluan Liao.;Shan Wang.
来源: N Engl J Med. 2024年390卷8期712-722页
Biomarker changes that occur in the period between normal cognition and the diagnosis of sporadic Alzheimer's disease have not been extensively investigated in longitudinal studies.
473. CD19 CAR T-Cell Therapy in Autoimmune Disease - A Case Series with Follow-up.
作者: Fabian Müller.;Jule Taubmann.;Laura Bucci.;Artur Wilhelm.;Christina Bergmann.;Simon Völkl.;Michael Aigner.;Tobias Rothe.;Ioanna Minopoulou.;Carlo Tur.;Johannes Knitza.;Soraya Kharboutli.;Sascha Kretschmann.;Ingrid Vasova.;Silvia Spoerl.;Hannah Reimann.;Luis Munoz.;Roman G Gerlach.;Simon Schäfer.;Ricardo Grieshaber-Bouyer.;Anne-Sophie Korganow.;Dominique Farge-Bancel.;Dimitrios Mougiakakos.;Aline Bozec.;Thomas Winkler.;Gerhard Krönke.;Andreas Mackensen.;Georg Schett.
来源: N Engl J Med. 2024年390卷8期687-700页
Treatment for autoimmune diseases such as systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, and systemic sclerosis often involves long-term immune suppression. Resetting aberrant autoimmunity in these diseases through deep depletion of B cells is a potential strategy for achieving sustained drug-free remission.
474. A Phase 3 Trial of Seladelpar in Primary Biliary Cholangitis.
作者: Gideon M Hirschfield.;Christopher L Bowlus.;Marlyn J Mayo.;Andreas E Kremer.;John M Vierling.;Kris V Kowdley.;Cynthia Levy.;Alejandra Villamil.;Alma L Ladrón de Guevara Cetina.;Ewa Janczewska.;Ehud Zigmond.;Sook-Hyang Jeong.;Yusuf Yilmaz.;Yiannis Kallis.;Christophe Corpechot.;Peter Buggisch.;Pietro Invernizzi.;Maria Carlota Londoño Hurtado.;Sandrin Bergheanu.;Ke Yang.;Yun-Jung Choi.;Daria B Crittenden.;Charles A McWherter.; .
来源: N Engl J Med. 2024年390卷9期783-794页
Effective treatments for patients with primary biliary cholangitis are limited. Seladelpar, a peroxisome proliferator-activated receptor delta agonist, has potential benefits.
475. Treatment-Resistant Depression in Older Adults.
A 67-year-old woman with a history of obesity, chronic low back pain, and recurrent episodes of major depression presents with mild depressive symptoms of more than 2 years’ duration, with worsening symptoms over the past 4 months. She was receiving sertraline at a stable dose of 100 mg per day until 3 months ago, when she initially presented for her worsening depressive symptoms. At that time, sertraline was tapered off, and treatment with extra-long extended-release bupropion (bupropion XL) was started at a dose of 150 mg daily and was increased to 300 mg daily 3 weeks later. Despite having taken the higher dose of bupropion XL for more than 2 months, the patient continues to have low mood, loss of interest in usual pleasurable activities, trouble falling asleep, wakefulness several times during the night, diminished energy, poor appetite, difficulty concentrating, and intrusive thoughts of being “better off dead,” but she does not have active suicidal thinking. Her nine-question Patient Health Questionnaire (PHQ-9) score is 17 (on a scale of 0 to 27, with higher scores indicating greater severity of depressive symptoms). How would you evaluate and treat this patient?
476. High-Dose ERT, Rituximab, and Early HSCT in an Infant with Wolman's Disease.
作者: Siawosh K Eskandari.;Elisabeth G M Revenich.;Dirk J Pot.;Foekje de Boer.;Marc Bierings.;Francjan J van Spronsen.;Peter M van Hasselt.;Caroline A Lindemans.;Charlotte M A Lubout.
来源: N Engl J Med. 2024年390卷7期623-629页
Wolman's disease, a severe form of lysosomal acid lipase deficiency, leads to pathologic lipid accumulation in the liver and gut that, without treatment, is fatal in infancy. Although continued enzyme-replacement therapy (ERT) in combination with dietary fat restriction prolongs life, its therapeutic effect may wane over time. Allogeneic hematopoietic stem-cell transplantation (HSCT) offers a more definitive solution but carries a high risk of death. Here we describe an infant with Wolman's disease who received high-dose ERT, together with dietary fat restriction and rituximab-based B-cell depletion, as a bridge to early HSCT. At 32 months, the infant was independent of ERT and disease-free, with 100% donor chimerism in the peripheral blood.
477. Cefepime-Taniborbactam in Complicated Urinary Tract Infection.
作者: Florian M Wagenlehner.;Leanne B Gasink.;Paul C McGovern.;Greg Moeck.;Patrick McLeroth.;MaryBeth Dorr.;Aaron Dane.;Tim Henkel.; .
来源: N Engl J Med. 2024年390卷7期611-622页
Carbapenem-resistant Enterobacterales species and multidrug-resistant Pseudomonas aeruginosa are global health threats. Cefepime-taniborbactam is an investigational β-lactam and β-lactamase inhibitor combination with activity against Enterobacterales species and P. aeruginosa expressing serine and metallo-β-lactamases.
478. Electronic Nicotine-Delivery Systems for Smoking Cessation.
作者: Reto Auer.;Anna Schoeni.;Jean-Paul Humair.;Isabelle Jacot-Sadowski.;Ivan Berlin.;Mirah J Stuber.;Moa Lina Haller.;Rodrigo Casagrande Tango.;Anja Frei.;Alexandra Strassmann.;Philip Bruggmann.;Florent Baty.;Martin Brutsche.;Kali Tal.;Stéphanie Baggio.;Julian Jakob.;Nicolas Sambiagio.;Nancy B Hopf.;Martin Feller.;Nicolas Rodondi.;Aurélie Berthet.
来源: N Engl J Med. 2024年390卷7期601-610页
Electronic nicotine-delivery systems - also called e-cigarettes - are used by some tobacco smokers to assist with quitting. Evidence regarding the efficacy and safety of these systems is needed.
479. Inhibition of CD40L with Frexalimab in Multiple Sclerosis.
作者: Patrick Vermersch.;Cristina Granziera.;Yang Mao-Draayer.;Gary Cutter.;Oleksandr Kalbus.;Ivan Staikov.;Michal Dufek.;Stephane Saubadu.;Raphael Bejuit.;Philippe Truffinet.;Biljana Djukic.;Erik Wallstroem.;Gavin Giovannoni.; .
来源: N Engl J Med. 2024年390卷7期589-600页
The CD40-CD40L costimulatory pathway regulates adaptive and innate immune responses and has been implicated in the pathogenesis of multiple sclerosis. Frexalimab is a second-generation anti-CD40L monoclonal antibody being evaluated for the treatment of multiple sclerosis.
480. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection.
作者: Gregory W Albers.;Mouhammad Jumaa.;Barbara Purdon.;Syed F Zaidi.;Christopher Streib.;Ashfaq Shuaib.;Navdeep Sangha.;Minjee Kim.;Michael T Froehler.;Neil E Schwartz.;Wayne M Clark.;Charles E Kircher.;Ming Yang.;Lori Massaro.;Xiao-Yu Lu.;Gregory A Rippon.;Joseph P Broderick.;Ken Butcher.;Maarten G Lansberg.;David S Liebeskind.;Amre Nouh.;Lee H Schwamm.;Bruce C V Campbell.; .
来源: N Engl J Med. 2024年390卷8期701-711页
Thrombolytic agents, including tenecteplase, are generally used within 4.5 hours after the onset of stroke symptoms. Information on whether tenecteplase confers benefit beyond 4.5 hours is limited.
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