Author Interviews, Heart Disease, NEJM / 06.10.2025
NEJM: AQUATIC Study Evaluates Risks/Benefits of Aspirin With On Oral Anticoagulation In Chronic Coronary Syndrome
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation
MedicalResearch.com Interview with: [caption id="attachment_70865" align="alignleft" width="200"]
Prof. Lemesle[/caption]
Gilles Lemesle, M.D., Ph.D
Lille University Hospital, Lille, France
Guillaume Cayla, M.D., Ph.D
Université de Montpellier, France
Martine Gilard, M.D., Ph.D
Hospital Cavale Blanche, Brest, France
MedicalResearch.com: What is the background for this study?
Response: Patients with chronic coronary syndrome (CCS) and receiving long-term oral anticoagulation (OAC), mainly but not solely for atrial fibrillation, are at high risk of both atherothrombotic events on one side and bleeding events on the other side.
Therefore, the optimal antithrombotic management for these patients with CCS requiring OAC after stenting is critical, especially in those patients at high residual atherothrombotic risk.
Previous studies reported that in this specific context, the addition of antiplatelet therapy on top of OAC increases bleeding without a clear benefit on ischemic outcomes. Nevertheless, these studies presented several limitations, which restricted the applicability of their results in clinical pratice. They were indeed all open-labelled, included patients without stenting and/or at low atherothrombotic risk, and focused on Asian patients who have different atherothrombotic and bleeding risks as compared to Europeans.
Thus, the rationale of the AQUATIC trial comes from the need to better identify the optimal antithrombotic regimen in high-risk patients with CCS and previous stenting, who receive long-term OAC, in order to optimize the atherothrombotic/bleeding risks in this population. The AQUATIC trial analyzed the efficacy and safety of adding aspirin to OAC, a combination that is still commonly used for this high-risk population in clinical daily practice.
Dr. Bradshaw[/caption]
Catriona Bradshaw MMBS(Hons), PhD, FAChSHM, FAHMS
Professor (Research), Head of Research Translation and Mentorship
and of The Genital Microbiota and Mycoplasma Group Melbourne
School of Translational Medicine, Monash University and Alfred Hospital
Principal Research Fellow at the Burnet Institute
MedicalResearch.com: What is the background for this study?
Response: One in three women globally have bacterial vaginosis (BV), a condition that causes a malodourous discharge, and associated with serious gynaecologic and obstetric sequelae (including miscarriage and preterm birth) and increases the risk sexually transmitted infections (STIs) and HIV. Women with symptoms are treated with broad-spectrum antibiotics, however, over 50% of women experience BV recurrence within 3-6 months. The recurrence rate is even higher at 60-80% among women with an ongoing regular partner. Current practice is to simply retreat women experiencing BV recurrence with the same antibiotics, which leaves them (and clinicians) frustrated and distressed.
We and others have accumulated a body of evidence to show that BV has the profile of an STI. BV-associated bacteria are detected in men in the distal urethra and on penile-skin, and couples share these organisms. However, to date, has not been recommended for BV as it is for other STIs. This is largely because men do not usually have any symptoms, and past partner-treatment trials in the 1980s and 1990s, which only used oral antibiotics for men, failed to prevent BV recurrence, which was taken as conclusive evidence against sexual transmission. Reviews of these trials have since identified their limitations.
Given the evidence of male carriage of BV-associated bacteria at two genital sites, we hypothesised that both sites needed to be targeted with antimicrobial therapy to prevent re-infection post-treatment. The aim of our study was to assess if male partner-treatment concurrently with female treatment using a combination of oral and topical antibiotics for the first time, would decrease BV recurrence over 12 weeks compared to the current standard practice of treating women only.
Dr. Thomas Robert[/caption]
MedicalResearch.com Interview with:
Thomas Robert, MD, AIX
Associate Professor of Nephrology
APHM (Assistance Publique - Hopitaux de Marseille)
Marseille, Provence-Alpes-Côte d'Azur, France
[caption id="attachment_61498" align="alignleft" width="132"]
Dr. Letavernier[/caption]
Prof. Emmanuel Letavernier, MD PhD
Nephrologist at Tenon Hospital
Paris, France
MedicalResearch.com: What is the background for this study?
Response: Our work was prompted by emerging concerns surrounding the potential nephrotoxic effects of hair-straightening products containing glyoxylic acid. This inquiry was instigated by a patient who experienced three repeated acute episodes of kidney injury in June 2020, April 2021, and July 2022, each occurring shortly after a hair-straightening procedure. Notably, these episodes resolved with hydration.
Upon examining the composition of the hair product used by the patient, which contained glyoxylic acid, and considering the patient's report of painful ulcer scalp during application and subsequent scalp scarring, we suspected a potential link between exposure to glyoxylic acid and kidney injury. Consulting with my colleague, Professor Emmanuel Letavenier, a specialist in crystalline nephropathy at Paris, confirmed this suspicion.
In summer 2023, cases series have been reported by an Israeli team (
Dr. Dubinsky[/caption]
Marla C. Dubinsky, MD
Professor of Pediatrics and Medicine
Icahn School of Medicine at Mount Sinai
Co- director, Susan and Leonard Feinstein IBD Clinical Center
Mount Sinai Health System
MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of UC?
Response: Lucent 1 and Lucent 2 were the induction and maintenance registration trials studying the efficacy and safety of mirikizumab in patients 18 years and older with moderate to severely active ulcerative colitis. Mirikizumab is a monoclonal antibody targeting the p19 subunit of IL23. Lucent-3 is the open label extension arm for those meeting inclusion criteria after completing Lucent 2. This study evaluated the long term efficacy and safety of mirikizumab in patients with ulcerative colitis who completed a total of 104 weeks of active mirikizumab treatment.
Ulcerative colitis is a chronic incurable inflammatory condition of colon. Common symptoms include diarrhea, blood in the stool, abdominal cramping and bowel urgency. Bowel urgency is one of the most burdensome symptoms that a patient with you could experience.
Prof. Hiddo Lambers Heerspink, PhD PHARMD
Department of Clinical Pharmacy and Pharmacology
University Medical Center Groningen
Groningen
Dr. Kim[/caption]
Brian S Kim, MD, MTR
Sol and Clara Kest Professor
Vice Chair of Research | Site Chair, Mount Sinai West and Morningside
Director, Mark Lebwohl Center for Neuroinflammation and Sensation
The Kimberly and Eric J. Waldman Department of Dermatology
Precision Immunology Institute | Friedman Brain Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: We generated preliminary data in mice that difelikefalin suppresses itch robustly with very little to no effect on inflammation in a model of atopic dermatitis. This led us to hypothesize that the primary mode of action of difelikefalin must be by direct modulation of sensory neurons to suppress itch and thus would be best suited for a neuropathic itch condition. These are conditions in which itch occurs relatively independently of skin inflammation as in atopic dermatitis due to hyperactive nerves.
Dr. García Cenoz[/caption]
Manuel García Cenoz MD, PhD
Dr. Han[/caption]
Meilan K Han MD, MS
Henry Sewall Professor of Medicine
Professor of Internal Medicine and Section Head
Division of Pulmonary and Critical Care Medicine, Medical School
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the NIH sponsored SPIROMICS study we demonstrated that symptomatic, tobacco exposed individuals have frequent exacerbations. Many of these individuals are treated with the same inhaled medications that have shown benefit in COPD, but we don’t have any evidence basis for this practice.
Dr. Bailey[/caption]
Michael Bailey Ph.D.
Senior Principal Engineer, Applied Physics Laboratory
Associate Professor. Mechanical Engineering
Adjunct Associate Professor Urology
MedicalResearch.com: What is the background for this study?
Response: Small (< 6 mm) kidney stones are common and often are asymptomatic. Do you do surgery or wait for them to cause a problem? Or specifically here if you are getting surgery already for other stones that are causing a problem do you take the time and possibly extra risk of cleaning out the small stone in the kidney or in the other kidney?
Dr. LeBoff[/caption]
Meryl S. LeBoff, MD
Dr. Manson[/caption]
JoAnn E. Manson, MD, DrPH
Professor, Epidemiology, Harvard T.H. Chan School Of Public Health
Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School
Chief, Preventive Medicine, Brigham And Women's Hospital
Co-Director, Womens Health, Brigham And Women's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting.
Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population.
To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US.