Multidisciplinary | Special Reports

Healthy ageing: Early management of chronic inflammation & peripheral neuropathy in primary care

Dr. Fei Chan, Dr. Chi-Nam Lee, 20231124080000

Ageing is characterized by systemic chronic inflammation, which is accompanied by age-related conditions (eg, type 2 diabetes mellitus [T2DM] and osteoarthritis [OA]) and complications (eg, peripheral neuropathy [PN]). This article summarizes insights from an industry-sponsored symposium on healthy ageing coordinated by the Hong Kong College of Family Physicians, which focused on the role of primary care physicians in management of chronic inflammatory conditions, and in early diagnosis and treatment of PN.

Optimizing care of adults with SMA in the new era of disease-modifying therapies

Prof. Maggie Walter, Dr. Shirley Pang, 20231124080000

Spinal muscular atrophy (SMA) is a genetic disorder characterized by progressive muscle weakness and atrophy, leading to impaired motor function. Until recently, management of SMA was primarily supportive, but new treatments have improved disease prognosis. At an industry-sponsored symposium organized by the Hong Kong Neurological Society, Professor Maggie Walter of the Ludwig Maximilians University of Munich, Munich, Germany, discussed the importance of early detection of SMA and timely administration of disease-modifying therapies, such as the oral drug risdiplam (Evyrsdi^®), to prevent rapid and irreversible loss of motor function in adult patients. Dr Shirley Pang of the Division of Neurology, Queen Mary Hospital, Hong Kong, shared local experience with the use of risdiplam in adults with SMA.

SGLT2 inhibitor treatment in an elderly patient with CKD and significant proteinuria despite well-controlled T2DM

Dr. Kai-Ching Hau, 20231123000000

An 80-year-old woman with 1 year’s history of significant proteinuria presented in January 2022 with bilateral ankle swelling. Due to reduced walking ability and exercise tolerance, she became almost homebound and unable to go to the market, which she used to do every day.

T&E with anti-VEGF agent optimizes visual outcomes in patients with nAMD

Dr. Nicholas Fung, 20231123000000

A 79-year-old male patient was diagnosed with neovascular age-related macular degeneration (nAMD) of the polypoidal choroidal vasculopathy (PCV) subtype and subretinal fluid (SRF) in the left eye in November 2018 via indocyanine green angiography (IGA), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Baseline visual acuity (VA) in the left eye was 0.2. His right eye had been blind for several years, with no light perception due to chronic untreated retinal detachment.

HCV pangenotypic DAA therapy in a patient with concomitant antipsychotic treatment

Dr. Ting-Ting Chan, 20231027000000

A 43-year-old male former intravenous drug user presented with incidental findings of elevated alanine transaminase (ALT) levels in December 2021. The patient had depression and drug-induced psychosis associated with previous heroin, ketamine and methamphetamine use. He was on quetiapine 300 mg daily for his psychotic symptoms, pantoprazole 40 mg daily as needed for occasional acid reflux, and simvastatin 10 mg daily for hyperlipidaemia. He did not have hepatitis B virus (HBV) or human immunodeficiency virus (HIV) coinfection.

Cardiorenal benefits of empagliflozin in elderly patients with T2DM, HF or CKD

Prof. Silvio Inzucchi, Prof. Michael Böhm, 20231018034454

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiorenal benefits in patients with type 2 diabetes mellitus (T2DM) and those with heart failure (HF) or chronic kidney disease (CKD) with or without diabetes. However, misconceptions may lead to inertia in treatment initiation in elderly patients. At a Boehringer Ingelheim–sponsored symposium organized by the Hong Kong Geriatrics Society, Professor Silvio Inzucchi of Yale School of Medicine, New Haven, Connecticut, US, and Professor Michael Böhm of Saarland University, Saarbrücken, Saarland, Germany, presented pivotal trial and real-world data demonstrating empagliflozin’s cardiorenal benefits and safety in elderly patients with these closely interrelated cardio-renalmetabolic (CRM) conditions.

WCD 2023: Updates on abrocitinib’s efficacy in moderate-to-severe atopic dermatitis

Dr. Claire Clibborn, Dr. Erman Güler, Prof. Andrew Alexis, 20231018033527

Janus kinase (JAK) inhibition has emerged as a novel approach in systemic treatment of moderate-to-severe atopic dermatitis (AD). This article summarizes results of select phase III studies of the JAK1 Atopic Dermatitis Efficacy and Safety (JADE) global development programme investigating the safety and efficacy of abrocitinib, a selective JAK1 inhibitor, in patients with moderate-to-severe AD, which were presented at the 25th World Congress of Dermatology (WCD) held in Singapore.

Emerging role of intestinal ultrasound in IBD management

Prof. Christian Maaser, 20231018032020

Intestinal ultrasound (IUS) is increasingly acknowledged as a valid point-of-care tool that objectively assesses inflammatory bowel disease (IBD) activity. At the International Digestive Disease Forum (IDDF) 2023, Professor Christian Maaser of the Municipal Hospital of Lüneburg, Lüneburg, Germany, discussed the emerging role of IUS in IBD management. He also shared practical tips in using IUS, including how and when to use it as well as what to look for while performing IUS.

HRQoL benefits and safety considerations with ART in people living with HIV

Mr. Nikos Dedes, Mr. Jeff Taylor, Ms. Bernadette Sharp, Dr. Iskandar Azwa, Dr. Dathan Byonanebye, Dr. Kristine Torjesen, 20231018030754

Cabotegravir (CAB) plus rilpivirine (RPV) is a long-acting (LA) injectable antiretroviral therapy (ART) recommended for people living with HIV (PLHIV) who have achieved viral suppression with oral medications. The health-related quality of life (HRQoL) impact of injectable CAB + RPV (Vocabria^®/ Rekambys^®, GlaxoSmithKline) and safety considerations of ART were discussed by experts in public health and patient advocates in an industry-sponsored satellite symposium during the 12^th International AIDS Society Conference on HIV Science (IAS 2023) held in Brisbane, Australia.

DKD expert meeting highlights: Prevention and management of hyperkalaemia in patients on RASIs

Prof. Juliana Chan, Prof. Sydney Tang, Prof. Elaine Chow, Prof. Kathryn Tan, Dr. Tai-Pang Ip, Dr. Vincent Yeung, Dr. John Chan, Dr. Chung-Ping Ho, Dr. Chun-Yu Yung, 20231018025405

Hyperkalaemia or concerns regarding potential hyperkalaemia may contribute to dose reduction or discontinuation of reninangiotensin system inhibitors (RASIs). At a recent diabetic kidney disease (DKD) expert meeting chaired by Professor Juliana Chan of the Department of Medicine and Therapeutics, the Chinese University of Hong Kong (CUHK), and Professor Sydney Tang of the Department of Medicine, the University of Hong Kong (HKU), a panel of clinical pharmacologists, endocrinologists and nephrologists shared insights into personalized potassium management and provided practical guidance on RASI optimization.