Risultati per: Terapia antibiotica: breve durata vs. lunga durata

I risultati del progetto Iss “Veterani in Sella”

I risultati del progetto Iss “Veterani in Sella”

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

To the Editor A recent trial to assess whether aspirin would provide benefits for preventing invasive cancer events among survivors of breast cancer had a primary outcome of invasive disease–free survival and a key secondary outcome of overall survival. For the primary end point, the hazard ratio for aspirin vs placebo was 1.27 (95% CI, 0.99-1.63; P = .06). For overall survival, the hazard ratio was 1.19 (95% CI, 0.82-1.72; P = .36), numerically favoring placebo. All analyses were conducted with the intention-to-treat principle.

To the Editor A recent study that investigated the effects of aspirin on breast cancer recurrence in high-risk patients with nonmetastatic disease concluded that daily aspirin therapy did not reduce breast cancer recurrence or improve survival. We have some comments about this study.

To the Editor The Alliance A011502 trial was stopped early for futility at a median duration of just over 1.5 years and a follow-up of less than 3 years. The mechanisms of action and optimal dose associated with aspirin’s cancer-preventive effect remain an area of active research. Trials such as Add-Aspirin and CaPP3 (ISRCTN16261285) are comparing different doses of aspirin in both the adjuvant setting and among individuals with Lynch syndrome. However, prior data make clear that aspirin’s beneficial effect on cancer incidence and mortality does not emerge until at least 5 to 10 years of follow-up and likely persists for at least 10 years after cessation of use. These unique features of aspirin’s preventive effects are particularly relevant for malignancies with a low risk of early events and deaths, such as hormone receptor–positive breast cancer, in which the annual hazards of recurrence are low but remain stable during a prolonged period, up to 20 years. The eligibility criteria of this trial were revised according to this rationale. Almost 90% of the participants in the Alliance A011502 trial were women with hormone receptor–positive breast cancer. Therefore, the number of events accrued at the early-stoppage decision likely represented only a fraction of events that would be expected in the long term. In this context, we suggest that the futility therefore should not have been based on typical statistical criteria but rather should have also considered the unique pharmacology of aspirin and the natural history of breast cancer, for which longer follow-up, as originally planned, would have been more informative.

This cohort study of patients with type 2 diabetes compares the rates of hyperkalemia and renin-angiotensin system (RAS) inhibitor persistence in those who used glucagon-like peptide 1 receptor agonists (GLP-1RAs) or dipeptidyl peptidase 4 inhibitors (DPP-4is).

This randomized clinical trial compares the outcomes of hypofractionation vs conventional fractionation postmastectomy radiation therapy regimens in patients undergoing implant-based breast reconstruction.

This randomized clinical trial compares the effectiveness and safety of a novel low-dose triple-pill protocol, compared with a standard-care protocol, for blood pressure lowering among Black African adults in Nigeria.