(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
Oct 2 (Reuters) – Today we highlight a potentially unexpected benefit of appendectomy and some underreported side effects of wildly popular GLP-1 drugs used for weight loss and diabetes. We also cover promising results of an experimental therapy being tested for the crippling muscle disorder that hit singer Celine Dion.
REMOVING INFLAMED APPENDIX MAY LOWER COLORECTAL CANCER RISK
Patients who had surgery for an inflamed appendix had a significantly lower risk of developing colorectal cancer than those treated with antibiotics, according to an analysis of more than 30,000 cases.
Surgery was once the standard of care for acute appendicitis. Management of the condition “has changed significantly over the last decade, and antibiotic therapy is now an accepted option,” study leader Dr. Valentine Nfonsam of Morehouse School of Medicine in Atlanta explained in a statement.
Previous comparisons of the two approaches have focused on short-term outcomes.
In the study, Nfonsam and colleagues reviewed data on 15,774 patients diagnosed with acute appendicitis who underwent appendectomy and another 15,295 who were treated with antibiotics alone.
In the ensuing years, colorectal cancer was diagnosed in 0.7% of the appendectomy group and in 1.7% of the antibiotics group, according to results reported at the American College of Surgeons Clinical Congress in Washington.
After accounting for individual risk factors, appendectomy was associated with a 58% lower relative risk of a subsequent colorectal cancer diagnosis.
The appendix was once thought to be useless, but emerging research suggests that is not true, Nfonsam said.
Instead, it may play a role in the intestinal immune system and the gut microbiome, the community of microorganisms living in the digestive tract.
Whether persistent inflammation or changes in the gut microbiome contribute to development of cancer is biologically plausible, but the study wasn’t designed to answer that question, Nfonsam said.
“These results should not be interpreted to mean that everyone with appendicitis needs an appendectomy to prevent cancer,” he said.
“Antibiotic management remains an important option. But when we discuss non-operative management, we should also think beyond the immediate episode of appendicitis and consider potential long-term oncologic risk and appropriate monitoring.”
NAIL DETACHMENT MORE COMMON WITH GLP-1 USE
Nail detachment was more common among patients using GLP-1 drugs for weight loss or diabetes than non-users in a study presented on Thursday at the European Academy of Dermatology and Venereology Congress in Vienna.
Dr. Charles Taïeb of Necker University Hospital in Paris and colleagues surveyed 575 first-time GLP-1 drug users and 1,329 people who had never taken the drugs. All of them had diabetes or obesity, or both.
Overall, 39% of the GLP-1 users reported nail detachment in which the nail separates from the soft tissue underneath. That compared with 9% of non-users.
The increased risk with GLP-1 drugs persisted regardless of how much weight people lost during treatment, the researchers found.
A separate study involving the same participants found hair loss beginning after treatment initiation was more than twice as common among users (26% vs 12%), while loss of hair volume or density affected 42% of those taking GLP-1 drugs compared with 19% of non-users.
Most patients with hair loss also had scalp symptoms such as itching, redness or scaling.
“This suggests that what is happening on the scalp may go beyond the classical shedding seen after rapid weight loss and involve an inflammatory component,” Dr. Bruno Halioua, a Paris dermatologist who led the hair loss study, said in a statement.
Halioua suggested clinicians should be looking for the condition “which may be treatable.”
Neither study proves GLP-1 treatment caused the changes.
But taken together, the findings suggest that factors beyond weight loss alone may contribute to the hair, scalp and nail changes observed among GLP-1 users, Halioua said.
CAR T TREATMENT YIELDS LASTING BENEFIT IN CRIPPLING MUSCLE DISEASES
An experimental therapy from Kyverna Therapeutics has yielded significant benefits for patients with crippling autoimmune disorders that affect the nerves and muscles, researchers say.
The treatment, a CAR T-cell therapy known as mivocabtagene autoleucel, or miv-cel, significantly improved walking ability and other goals of the late-stage trial in patients with stiff- person syndrome, with the benefits persisting one year after the treatment, Kyverna said.
Stiff-person Syndrome causes muscle rigidity and increased sensitivity to sound, touch and emotional stimuli that can trigger muscle spasms.
The company expects to present detailed data from the trial at the joint ACTRIMS-ECTRIMS meeting later this month in Toronto.
In 2022, singer Celine Dion announced that she suffers from the disease.
CAR T-cell therapies involve removal of a patient’s immune system T cells, modifying and multiplying them in the lab to prime them to attack or address a specific disease or condition before reinfusing them into the patient. The first approved CAR T therapies were designed to treat blood cancers.
The new trial results “are compelling, particularly given the severe burden of stiff-person syndrome and the absence of approved therapies,” study leader Dr. Amanda Piquet, director and Celine Dion Foundation Endowed Chair in Autoimmune Neurology at the University of Colorado Anschutz School of Medicine, said in a statement.
“The sustained improvements observed in mobility, stiffness and other disease-specific measures, together with a well-tolerated profile, underscore its potential to deliver significant, long-lasting benefit to patients with Stiff-Person Syndrome,” she said of the miv-cel results.
In a separate follow-up study of a mid-stage trial in patients with generalized myasthenia gravis, miv-cel significantly improved symptoms and ability to accomplish activities of daily living, the researchers reported at the recent American Association of Neuromuscular & Electrodiagnostic Medicine Annual Meeting in Orlando.
Myasthenia gravis causes fluctuating losses of strength in skeletal muscles.
A late-stage trial of miv-cel in patients with myasthenia gravis is underway, with enrollment expected to be completed in mid-2027, the researchers said.
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(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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