Drug-Survival Profiling of Second-Line Biologic Therapy in Rheumatoid Arthritis: Choice of Another TNFi or a Biologic of Different Mode of Action?

OBJECTIVES: Aiming to assess the best choice of second-line therapy between second-line TNF-inhibitor (TNFi) and biologics of different mode of action (BDMA-rituximab/tocilizumab/abatacept) in rheumatoid arthritis (RA) by assessing their drug-survival spanning more that 10years, after discontinuation of the first-line TNFi. METHODS: This retrospective-observational drug-survival study was performed across 2-different hospitals in UK by conventional-statistics and machine-learning approach. RESULTS: From a total of 435-patients, 213 [(48.9%); TNFi-n=122 (57.3%), BDMA-n=91(42.7%)] discontinued their second-line biologic [median-drug-survival: TNFi-27months (95%CI 22-32months) vs BDMA-37months (95%CI 32-52months)]. As second-line, BDMA was likely to reduce the risk of treatment-discontinuation [Hazard-ratio/HR-0.63 (95%CI 0.48-0.83)] compared to TNFi, but only in seropositive-patients [HR-0.52 (95%CI 0.38-0.73)], not in seronegative-RA. Uncovered by the survival-tree and adjusted by propensity-score, drug-survival benefit of BDMA over TNFi was not observed if the seropositive-patients were previously exposed to monoclonal-TNFi (HR-0.77, 95% CI 0.49-1.22) versus soluble TNFi (etanercept or its biosimilar) or if first-line TNFi was terminated within 23.9months of initiation (HR-0.97, 95%CI 0.56-1.68). CONCLUSION: BDMA, as second-line biologic, is more likely to be sustained in seropositive-patients particularly if they were previously not exposed monoclonal TNFi. Drug-survival benefit of BDMA was not observed in seronegative-patients or if the first-line TNFi was stopped within 2 years

Natural product-based nanoformulations for cancer therapy: Opportunities and challenges.

Application of natural product-based nanoformulations for the treatment of different human diseases, such as cancer, is an emerging field. The conventional cancer therapeutic modalities, including surgery, chemotherapy, immunotherapy, radiotherapy has limited achievements. A larger number of drawbacks are associated with these therapies, including damage to proliferating healthy tissues, structural deformities, systemic toxicity, long-term side effects, resistance to the drug by tumor cells, and psychological problems. The advent of nanotechnology in cancer therapeutics is recent; however, it has progressed and transformed the field of cancer treatment at a rapid rate. Nanotherapeutics have promisingly overcome the limitations of conventional drug delivery system, i.e., low aqueous solubility, low bioavailability, multidrug resistance, and non-specificity. Specifically, natural product-based nanoformulations are being intentionally studied in different model systems. Where it is found that these nanoformulations has more proximity and reduced side effects. The nanoparticles can specifically target tumor cells, enhancing the specificity and efficacy of cancer therapeutic modalities which in turn improves patient response and survival. The integration of phytotherapy and nanotechnology in the clinical setting may improve pharmacological response and better clinical outcome of patients

Abstracts of AICTE Sponsored International Conference on Post-COVID Symptoms and Complications in Health

This book presents the selected abstracts of the International Conference on Post-COVID Symptoms and Complications in Health, hosted from the 28th to 29th of April 2022 in virtual mode by the LR Institute of Pharmacy, Solan (H.P.)-173223 in Collaboration with AICTE, New Delhi. This conference focuses on the implications of long-term symptoms on public health, ways to mitigate these complications, improve understanding of the disease process in COVID-19 patients, use of computational methods and artificial intelligence in predicting complications, and the role of various drug delivery systems in combating the complications. Conference Title:  International Conference on Post-COVID Symptoms and Complications in HealthConference Sponsor: AICTE, New Delhi.Conference Date: 28-29 April 2022Conference Location: OnlineConference Organizer: LR Institute of Pharmacy, Solan (H.P.)-173223

Abstracts of AICTE Sponsored International Conference on Post-COVID Symptoms and Complications in Health

This book presents the selected abstracts of the International Conference on Post-COVID Symptoms and Complications in Health, hosted from the 28th to 29th of April 2022 in virtual mode by the LR Institute of Pharmacy, Solan (H.P.)-173223 in Collaboration with AICTE, New Delhi. This conference focuses on the implications of long-term symptoms on public health, ways to mitigate these complications, improve understanding of the disease process in COVID-19 patients, use of computational methods and artificial intelligence in predicting complications, and the role of various drug delivery systems in combating the complications. Conference Title:  International Conference on Post-COVID Symptoms and Complications in HealthConference Sponsor: AICTE, New Delhi.Conference Date: 28-29 April 2022Conference Location: OnlineConference Organizer: LR Institute of Pharmacy, Solan (H.P.)-173223