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4542. Malnutrition in older adults.
Malnutrition is a highly prevalent condition in older adults, and poses a substantial burden on health, social, and aged-care systems. Older adults are vulnerable to malnutrition due to age-related physiological decline, reduced access to nutritious food, and comorbidity. Clinical guidelines recommend routine screening for malnutrition in all older adults, together with nutritional assessment and individually tailored nutritional support for older adults with a positive screening test. Nutritional support includes offering individualised nutritional advice and counselling; oral nutritional supplements; fortified foods; and enteral or parenteral nutrition as required. However, in clinical practice, the incorporation of nutritional guidelines is inadequate and low-value care is commonplace. This Review discusses the current evidence on identification and treatment of malnutrition in older adults, identifies gaps between evidence and practice in clinical care, and offers practical strategies to translate evidence-based knowledge into improved nutritional care. We also provide an overview of the prevalence, causes, and risk factors of malnutrition in older adults across health-care settings.
4549. Safety, tolerability, and immunogenicity of the chimpanzee adenovirus type 3-vectored Marburg virus (cAd3-Marburg) vaccine in healthy adults in the USA: a first-in-human, phase 1, open-label, dose-escalation trial.
作者: Melinda J Hamer.;Katherine V Houser.;Amelia R Hofstetter.;Ana M Ortega-Villa.;Christine Lee.;Anne Preston.;Brooke Augustine.;Charla Andrews.;Galina V Yamshchikov.;Somia Hickman.;Steven Schech.;Jack N Hutter.;Paul T Scott.;Paige E Waterman.;Mihret F Amare.;Victoria Kioko.;Casey Storme.;Kayvon Modjarrad.;Melanie D McCauley.;Merlin L Robb.;Martin R Gaudinski.;Ingelise J Gordon.;LaSonji A Holman.;Alicia T Widge.;Larisa Strom.;Myra Happe.;Josephine H Cox.;Sandra Vazquez.;Daphne A Stanley.;Tamar Murray.;Caitlyn N M Dulan.;Ruth Hunegnaw.;Sandeep R Narpala.;Phillip A Swanson.;Manjula Basappa.;Jagada Thillainathan.;Marcelino Padilla.;Britta Flach.;Sarah O'Connell.;Olga Trofymenko.;Patricia Morgan.;Emily E Coates.;Jason G Gall.;Adrian B McDermott.;Richard A Koup.;John R Mascola.;Aurélie Ploquin.;Nancy J Sullivan.;Julie A Ake.;Julie E Ledgerwood.; .
来源: Lancet. 2023年401卷10373期294-302页
WHO has identified Marburg virus as an emerging virus requiring urgent vaccine research and development, particularly due to its recent emergence in Ghana. We report results from a first-in-human clinical trial evaluating a replication-deficient recombinant chimpanzee adenovirus type 3 (cAd3)-vectored vaccine encoding a wild-type Marburg virus Angola glycoprotein (cAd3-Marburg) in healthy adults.
4550. Momelotinib versus danazol in symptomatic patients with anaemia and myelofibrosis (MOMENTUM): results from an international, double-blind, randomised, controlled, phase 3 study.
作者: Srdan Verstovsek.;Aaron T Gerds.;Alessandro M Vannucchi.;Haifa Kathrin Al-Ali.;David Lavie.;Andrew T Kuykendall.;Sebastian Grosicki.;Alessandra Iurlo.;Yeow Tee Goh.;Mihaela C Lazaroiu.;Miklos Egyed.;Maria Laura Fox.;Donal McLornan.;Andrew Perkins.;Sung-Soo Yoon.;Vikas Gupta.;Jean-Jacques Kiladjian.;Nikki Granacher.;Sung-Eun Lee.;Luminita Ocroteala.;Francesco Passamonti.;Claire N Harrison.;Barbara J Klencke.;Sunhee Ro.;Rafe Donahue.;Jun Kawashima.;Ruben Mesa.; .
来源: Lancet. 2023年401卷10373期269-280页
Janus kinase (JAK) inhibitors approved for myelofibrosis provide spleen and symptom improvements but do not meaningfully improve anaemia. Momelotinib, a first-in-class inhibitor of activin A receptor type 1 as well as JAK1 and JAK2, has shown symptom, spleen, and anaemia benefits in myelofibrosis. We aimed to confirm the differentiated clinical benefits of momelotinib versus the active comparator danazol in JAK-inhibitor-exposed, symptomatic patients with anaemia and intermediate-risk or high-risk myelofibrosis.
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