ABSTRACT
Objectives: Interception therapy requires an individual to take a treatment today to prevent a future medical event. Patients must trade off treatment burdens incurred today against future benefits. We examined the preferences of high-risk lung cancer (LC) individuals for potential interception therapies that reduce the risk of developing lung cancer. Method(s): An online discrete-choice experiment (DCE) was developed for hypothetical LC interception treatments with four attributes: reduction in risk of LC over 3 years, injection site reaction severity, nonfatal serious infection risk, and death from serious infection risk. Respondents chose between two alternative treatments or a no-treatment option. The DCE was analyzed using random-parameters logit, and maximum acceptable risk for an LC risk reduction was calculated. Logit analysis explored characteristics of respondents who always selected no treatment. Result(s): The sample included 803 adults aged 50-80 years with at least a 20 pack-year smoking history. Respondents had an average willingness to accept interception therapy (alternative-specific constant=1.30, 95% CI: 0.91-1.69). Respondents viewed larger reductions in the risk of LC as most important. Respondents were willing to accept increases in risk of nonfatal serious infection up to 15% for a 15% improvement in relative LC risk reduction and increases in risk of death from serious infection up to 1.5% for a 23% improvement in relative LC risk reduction. However, 16% of respondents selected 'no treatment' for all DCE questions. Older respondents, current smokers who have never tried to quit, and those who did not get regular skin exams for cancer and/or COVID-19 vaccine were more likely to opt out of interception therapy. Conclusion(s): Generally, individuals at high risk of LC are willing to consider interception therapy. Study results can support benefit-risk assessments for future systemic LC interception treatments, and the results may have implications for other therapeutic areas.Copyright © 2023
ABSTRACT
The Covid-19 pandemic represents an unsolved problem which has caused numerous fatalities. At the present time, there is no vaccination available or curative therapy. However, recent reports suggest that SARS-CoV2 acts upon its functional receptor ACE2 inducing a variety of deleterious effects such as inflammation, endothelial dysfunction, microangiopathy, myocarditis, thrombosis and myocardial infarction. The details of the SARS-CoV2-ACE2 interaction are poorly understood and most of the hypothesis related to this are based on the extrapolation of previous research focusing on ACE2 as a receptor for SARS-CoV. Considering the similarities between SARS-CoV2 and SARS-CoV we have conducted a physiopathological analysis focusing on the key pathogenic role of ACE2 as a functional receptor for SARS-CoV2. In this context, we have identified several potential therapeutic targets which should be further evaluated in patients with Covid-19. It is likely that an efficient therapy for Covid-19 will be revealed by research investigating the binding of viral spike S protein to ACE2, and the immunological response determined by SARS-CoV2-ACE2 interaction, including the anti-viral role of plasmacytoid dendritic cells and anti-inflammatory reprogramming of macrophages. © Eugen B Petcu, Christopher Andry, Eric J Burks, Stephen Hamlet, Emiel AM Janssen, Kjell H Kjellevold, Antonio de Las Morenas, Nancy S Miller, Rodica I Miroiu, Iulian Nusem, Aurel Popa-Wagner.