The AJMC® clinical page includes all the published content across AJMC.com, The American Journal of Managed Care® and Evidence-Based Oncology™ on a variety of specialties, including dermatology, cardiology, oncology, and rheumatology.
May 17th 2025
Novel therapies for multiple myeloma (MM), including chimeric antigen receptor T-cell and bispecific antibodies, extend lives but raise concerns about treatment costs and adherence, and they haven't replaced stem cell transplantation, Harsh Parmar, MD, of Hackensack University Medical Center, explains.
Gaps in Patient Care for IgA Nephropathy
April 21st 2025Panelists discuss how significant gaps in immunoglobulin A (IgA) nephropathy patient care persist, including delayed diagnosis, limited access to nephrology expertise, inadequate disease monitoring, and insufficient psychosocial support throughout the disease journey.
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Current Treatments for IgA Nephropathy and the 4-Hit Cascade
April 21st 2025Panelists discuss how current immunoglobulin A (IgA) nephropathy treatments primarily target downstream inflammatory pathways of the 4-hit cascade, with emerging therapies now beginning to address specific upstream mechanisms including abnormal IgA1 production, autoantibody formation, and immune complex deposition.
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Overview of Treatment Landscape for IgA Nephropathy: Standard of Care and KDIGO Guidelines
April 21st 2025Panelists discuss how immunoglobulin A (IgA) nephropathy treatment has evolved to include supportive care with optimized blood pressure control and renin-angiotensin system blockade as first-line therapy, with increasingly targeted immunomodulatory approaches for higher-risk patients showing persistent proteinuria.
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Ruxolitinib Cream and Atopic Dermatitis at AAD 2025
April 21st 2025A panelist discusses how real-world data presented at the 2025 American Academy of Dermatology Annual Meeting (AAD 2025) demonstrates that initiating ruxolitinib cream therapy for atopic dermatitis (AD) significantly reduced patients’ reliance on other topical treatments, oral corticosteroids, and biologics in both biologic-experienced (n = 125) and biologic-naive (n = 431) populations, suggesting this Janus kinase (JAK) inhibitor may serve as an effective steroid-sparing agent with potential for long-term disease management across different patient subgroups.
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Clinical Impact of IgA Nephropathy and Quality of Life
April 21st 2025Panelists discuss how immunoglobulin A (IgA) nephropathy significantly impacts patients’ quality of life through chronic symptoms, treatment burden, psychological effects, and the looming threat of progressive kidney function decline.
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Criteria for Discontinuing Treatment With an Amyloid-Targeting Therapy
April 18th 2025Panelists discuss how treatment continuation decisions for amyloid-targeting therapies involve comprehensive assessment of multiple factors including cognitive and functional changes measured through standardized tools, occurrence and severity of adverse events, treatment adherence capabilities, impact on patient/caregiver quality of life, disease progression rate, emerging safety signals, and ongoing dialogue about evolving treatment goals and expectations.
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Important Updates in the Management of Uncomplicated UTIs
Panelists discuss how American Urological Association (AUA) guidelines for recurrent uncomplicated urinary tract infections (UTIs) in women recommend culture-confirmed diagnosis, prophylactic antibiotics, nonantibiotic prevention, self-initiated treatment, and behavioral modifications while noting pivmecillinam’s recent FDA approval. Pivmecillinam features a penicillin-binding protein 2 inhibition mechanism with 85% to 95% efficacy against gram-negative uropathogens, including extended-spectrum β-lactamase producers; minimal intestinal flora disruption; low resistance rates; and primarily mild gastrointestinal adverse effects.
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Economic Burden Associated With Uncomplicated UTIs
Panelists discuss how treatment failure in uncomplicated urinary tract infections (UTIs) creates substantial economic burden through direct costs of additional health care visits, repeated diagnostic tests, and rescue medications alongside indirect costs from productivity losses, with implications including progression to complicated infections such as pyelonephritis, increased emergency department use, antimicrobial resistance development threatening broader public health, psychological impacts on patients, and strain on health care resources that could be mitigated through more effective initial treatment strategies.
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Panelists discuss how effective communication about amyloid-targeting therapies requires transparent discussions of modest cognitive benefits alongside potential risks, particularly events related to amyloid-related imaging abnormalities (ARIA), while addressing practical considerations including treatment burden, infusion center logistics, monitoring requirements, costs, insurance coverage, and caregiver involvement to help patients and families make fully informed decisions aligned with their values and circumstances.
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Racial Differences in CA-125 Levels Tied to Ovarian Cancer Treatment Delays
April 17th 2025Black and American Indian women with ovarian cancer were less likely to have elevated cancer antigen 125 (CA-125) levels at diagnosis, resulting in delayed chemotherapy initiation and highlighting the need for more inclusive guidelines.
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Elevated Inflammatory Marker Levels Associated With Increased Overactive Bladder Risk
April 15th 2025Systemic immune inflammation index, neutrophil-to-lymphocyte ratio, and systemic inflammation response index levels may offer a noninvasive method to identify individuals at increased risk of developing overactive bladder.
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Lebrikizumab Shows Promise in Long-Term Atopic Dermatitis Control: Raj Chovatiya, MD, PhD
April 15th 2025Raj Chovatiya, MD, PhD, MSCI, highlights the long-term effectiveness of lebrikizumab across diverse patients, including those with prior biologic use, positioning it as a potential first-line treatment for moderate to severe atopic dermatitis.
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SGLT2 Inhibitors Show Renal Benefits in HF and CKD as Prescribers Target Uptake Gaps
April 15th 2025Abstracts featured at the National Kidney Foundation Spring Clinical Meeting highlighted the renoprotective benefits of SGLT2 inhibitors in heart failure and diabetic kidney disease while emphasizing the need for strategies to increase their uptake in primary care.
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Significant Disease Burden and Management Issues in Chronic Spontaneous Urticaria
April 15th 2025Patients with chronic spontaneous urticaria experienced a long delay in diagnosis, a substantial impact on their quality of life, and often received inadequate treatment, highlighting the need for better management and understanding of the condition.
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Challenges in Timely Identification of IgA Nephropathy
April 14th 2025Panelists discuss how diagnostic challenges in immunoglobulin A (IgA) nephropathy lead to delayed identification, missed treatment windows, and increased risk of irreversible kidney damage due to the requirement for invasive biopsy, nonspecific symptoms, and variable disease presentation.
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Adherence in Psoriasis Care: Barriers, Solutions, and the Road Ahead
April 14th 2025A panelist discusses how real-world evidence from a large cohort study (n = 31521) presented at AAD 2025 reveals notable differences in treatment patterns, discontinuation rates, persistence, and adherence among psoriasis patients treated with different biologics including tildrakizumab, risankizumab, guselkumab, and ustekinumab, with implications for clinical decision-making based on early versus late disease onset and prior biologic exposure.
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Signs and Symptoms of IgA Nephropathy
April 14th 2025Panelists discuss how patients with immunoglobulin A (IgA) nephropathy typically present with microscopic or gross hematuria, often during upper respiratory infections, along with variable proteinuria and sometimes hypertension or decreased kidney function.
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Panelists discuss how hesitancy in prescribing amyloid-targeting therapies stems from multiple factors including concerns about ARIA adverse effects, modest clinical efficacy data, high treatment costs and limited insurance coverage, logistical challenges of regular infusions and monitoring, infrastructure requirements for specialized imaging, uncertainty about long-term benefits, and the need for careful patient selection within appropriate disease stages.
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Recurrence Rates in Uncomplicated UTIs
Panelists discuss how significant gaps in current uncomplicated urinary tract infection (UTI) therapies include insufficient nonantibiotic preventive strategies, limited options for multidrug-resistant pathogens, inadequate personalized treatment approaches, minimal focus on biofilm disruption, lack of rapid point-of-care diagnostics to guide targeted therapy, poor understanding of the urinary microbiome’s role in infection susceptibility, and insufficient research into immunomodulatory interventions that could address the underlying mechanisms of recurrence and resistance development.
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Patient Selection for Amyloid-Targeting Therapies: Key Characteristics and Considerations
April 11th 2025Panelists discuss how ideal candidates for amyloid-targeting therapy typically present with biomarker-confirmed early-stage Alzheimer disease, demonstrate positive amyloid PET scans or CSF biomarkers, exhibit mild cognitive impairment or mild dementia, lack contraindications such as significant cerebrovascular disease or anticoagulant use, have adequate support systems for monitoring and managing potential adverse effects, and would benefit from comprehensive pretreatment evaluations including brain MRI and APOE genotyping.
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Patient Factors Influencing Antibiotic Selection in Uncomplicated UTIs
Panelists discuss how fluoroquinolones are generally reserved for uncomplicated urinary tract infections (UTIs) only when first-line options are contraindicated or pathogen resistance is confirmed, with treatment duration ranging from single-dose fosfomycin to 3 to 5 days for most antibiotics and 7 to 10 days for nitrofurantoin, noting shorter regimens typically achieve 85% to 95% adherence rates compared with 60% to 75% for longer courses, significantly affecting treatment success, particularly when patient factors such as adverse effects, dosing complexity, and lifestyle disruptions are considered.
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