Myeloperoxidase Inhibition in Heart Failure With Preserved or Mildly Reduced Ejection Fraction: SATELLITE Trial Results.

BACKGROUND: Inflammation is a key driver of heart failure with preserved left ventricular ejection fraction. AZD4831 inhibits extracellular myeloperoxidase, decreases inflammation, and improves microvascular function in preclinical disease models. METHODS AND RESULTS: In this double-blind phase 2a study (Safety and Tolerability Study of AZD4831 in Patients With Heart Failure [SATELLITE]; NCT03756285), patients with symptomatic heart failure, left ventricular ejection fraction of ≥40%, and elevated B-type natriuretic peptides were randomized 2:1 to once-daily oral AZD4831 5 mg or placebo for 90 days. We aimed to assess target engagement (primary end point: myeloperoxidase specific activity) and safety of AZD4831. Owing to coronavirus disease 2019, the study was terminated early after randomizing 41 patients (median age 74.0 years, 53.7% male). Myeloperoxidase activity was decreased by more than 50% from baseline to day 30 and day 90 in the AZD4831 group, with a placebo-adjusted decreased of 75% (95% confidence interval, 48, 88, nominal P < .001). No improvements were noted in secondary or exploratory end points, apart from a trend in Kansas City Cardiomyopathy Questionnaire overall summary score. No deaths or treatment-related serious adverse events occurred. AZD4831 treatment-related adverse events were generalized maculopapular rash, pruritus, and diarrhea (all n = 1). CONCLUSIONS: AZD4831 inhibited myeloperoxidase and was well tolerated in patients with heart failure and left ventricular ejection fraction of 40% or greater. Efficacy findings were exploratory owing to early termination, but warrant further clinical investigation of AZD4831. LAY SUMMARY: Few treatments are available for patients with the forms of heart failure known as heart failure with preserved or mildly reduced ejection fraction. Current treatments do not target inflammation, which may play an important role in this condition. We tested a new drug called AZD4831 (mitiperstat), which decreases inflammation by inhibiting the enzyme myeloperoxidase. Among the 41 patients in our clinical trial, AZD4831 had a good safety profile and inhibited myeloperoxidase by the expected amount. Results mean we can conduct further trials to see whether AZD4831 decreases the symptoms of heart failure and improves patients' ability to participate in physical exercise.

Innovative Strategies and Efforts of Clinical Pharmacy Services During and After COVID-19 Epidemic: Experience from Shanghai Children's Hospital.

Coronavirus disease 2019 (COVID-19), the result of infection by the SARS-CoV-2 virus, has caused a global pandemic. To respond to this outbreak rapidly and properly, clinical pharmacists in Shanghai Children's Hospital carried out innovative measures based on previous artificial intelligence experiences, such as using service robots for contactless drug delivery between Fever Clinic and Pharmacy Storage, providing telemedicine counseling on specific platforms and offering multimedia health education. With good control of the pandemic in Shanghai, these contactless services have been retained and expanded at the patients' request. The aim of this article is to share our strategies and efforts with peers who are fighting against COVID-19 in other countries and regions.

Understanding consumer's adoption of financial robo-advisors at the outbreak of the COVID-19 crisis in Malaysia

Abstract The COVID-19 crisis that resulted in diminished close contact interaction and increased financial volatility could influence consumer's perception toward online automated financial robo-advisor, in order to manage their financial planning. Based on the data collected (i.e., between February [9 reported cases] and March [36 reported cases] 2020) within the developed urban cities in Malaysia just before the nationwide lockdown, the present study examines the antecedents of financial robo-advisor's adoption during the COVID-19 crisis. A variance based analysis shows that consumers with higher financial knowledge and having a greater tendency to rely on robo-advisor tend to adopt financial robo-advisor in times of crisis. In line with the unified theory of acceptance and use of technology model, performance expectancy, social influence, and trust in robo-advisor, in particular during the pandemic, drive consumer's intention to subscribe online financial robo-advisor. The findings imply how consumers, robo-advisory service providers, and regulators could respond to unprecedented crisis such as novel corona virus-19.