Anifrolumab in Systemic Lupus Erythematosus (SLE): A Critical Appraisal of Clinical Trials and its Prospects for Elevating Patients' Quality of Life

Systemic Lupus Erythematosus (SLE) presents a complex autoimmune challenge characterized by chronic inflammation and multi-organ involvement. This paper offers a comprehensive analysis of anifrolumab, a promising monoclonal antibody that targets type I interferon signaling, as a potential treatment for SLE. It also compares with existing therapies, namely belimumab and rituximab. Anifrolumab received FDA approval in 2021 based on evidence from clinical trials, such as MUSE and TULIP-2, demonstrating its effectiveness in reducing disease activity, glucocorticoid usage, and flares among SLE patients. However, concerns regarding its safety profile, particularly herpes zoster infections and immunosuppression, should be addressed. Comparative analysis of belimumab and rituximab reveals their distinct mechanisms of action and levels of clinical evidence. Belimumab, focusing on B-cell activity, has a longer history of reducing disease activity and flares. Rituximab, while promising, lacks direct comparative data. Challenges related to the long-term safety and efficacy of anifrolumab emphasize the need for personalized treatment strategies, patient selection, and real-world data integration. The paper discusses the importance of tailoring therapies based on biomarker profiles and clinical characteristics, involving patients in shared decision-making, and monitoring treatment responses over time. The paper highlights ongoing research and clinical trials exploring new therapeutic approaches for SLE, offering hope for improved outcomes. It underscores that anifrolumab, while promising, should be considered within the context of individual patient needs, with further studies necessary to refine treatment choices for SLE patients

Glucagon-like peptide 1 agonists: a ray of hope for the treatment of polycystic ovarian syndrome

Dear editor, The Glucagon-like-peptide receptor- 1, agonists belong to a class of drugs that have been used to treat type 2 diabetes. Liraglutide and Semaglutide are drugs of this class, commonly sold under the brand names Saxenda and Wegovy respectively. These drugs have also been approved by the FDA for weight loss in diabetic and non-diabetic obese people.1 The mechanism of action of GLP-1 agonists involve stimulating insulin secretion and delaying gastric emptying. Moreover, GLP-1 receptors are found on adipose tissue, where they promote the conversion of stored fat into energy. They also target the appetite center in the hypothalamus which increases satiety and reduces food intake to cause weight loss. A large number of females who struggle with obesity, concomitantly suffer from Polycystic Ovarian syndrome (PCOS) also which is a multifactorial endocrine disorder in women of reproductive age, affecting 4-20% women around the world.2 One of the major manifestations of this syndrome is weight gain and difficulty in losing it. In contemporary medicine, the treatment of PCOS is limited to lifestyle intervention and symptomatic management. Thus, the patients of PCOS are often told by their doctors to simply lose weight. Physicians around the world agree that weight loss is crucial for women with PCOS who are obese to attain better metabolic, reproductive, and cardiovascular outcomes, because if not treated, obesity worsens the presentation of PCOS. But it is noteworthy that the ongoing hormonal imbalances, increased appetite and insulin resistance in this syndrome, all work against the body’s natural mechanism to lose weight and make it extremely difficult for the patient. This creates a dire need for external interventions regarding weight management in PCOS. Where conventional methods like dietary modifications and exercise alone do not provide substantial results, GLP-1 agonists can be a breakthrough for the management of PCOS since recent research and clinical data also provides evidence of correlation between obesity, GLP-1 kinetic alterations, and pathophysiology of PCOS.3 Hence the use of GLP-1 agonists can be a viable option for treatment of PCOS as multiple clinical trials have shown significant weight reduction, decrease in testosterone levels, improvement in insulin sensitivity and menstrual cycles.4 As the prevalence of PCOS continues to rise in Pakistan, the major presenting complaints include; weight gain, facial hair, acne and menstrual irregularities in teenage girls and infertility in married females. ---Continu

Single parenthood and depression: A thorough review of current understanding.

Publication status: PublishedBACKGROUND: Single parenthood is becoming increasingly common in today's society for various reasons such as divorce, the death of a spouse, or the choice of parenthood. Regrettably, there seems to be no significant concern among world leaders regarding depression arising from single parenting. AIM: This article aimed to explore the prevalence of depression in single parents, the factors contributing to it, and its effects on their physical and emotional well-being. Additionally, it aims to investigate the long-lasting effects of depression in single parents, effective therapeutic approaches to tackle these issues and offer proactive suggestions for relevant global stakeholders. METHODOLOGY: A selection of studies was identified through electronic databases such as PubMed, Embase, and PsycINFO databases. The search strategy encompassed terms related to single parenthood, depression, mental health, prevalence, risk factors, and treatment modalities. Included studies comprised of peer-reviewed research articles, systematic reviews, meta-analyses, and observational studies published in English. RESULT: Today, there is a growing prevalence of single parenthood due to a range of factors, including divorce, the loss of a partner, and intentional decisions regarding single parenthood. However, this transition comes with challenges, including the risk of developing depression. Depression is a serious mental health condition affecting many individuals worldwide. Raising a child alone increases the likelihood of developing depression for the parent due to the increased burden and responsibilities. Such parents tend to have low self-esteem, suicide/suicide attempts, and so forth and children born by those parents are vulnerable to depression, physical abuse, infections, etc. CONCLUSION: Future research should focus on identifying effective interventions for treating depression among single parents and improving the availability of mental health facilities for this vulnerable population, especially in places with a high prevalence of depression. Mental health physicians in collaboration with obstetricians and gynecologists across the globe should offer counseling and mediation services during pre-conception care visits for both single and partnered parents