Oral Azacitidine Benefits Some Older Adults With AML

In continuation of my update on azacitidine 

For older patients with acute myeloid leukemia (AML) who are in remission after chemotherapy, those receiving maintenance therapy with the oral formulation of azacitidine (CC-486) versus placebo had longer overall and relapse-free survival, according to a study published in the Dec. 24 issue of the New England Journal of Medicine.

Andrew H. Wei, M.B., B.S., Ph.D., from Monash University in Melbourne, Australia, and colleagues conducted a phase 3 randomized trial of CC-486 as maintenance therapy for patients with AML in first remission after intensive chemotherapy. A total of 472 patients aged 55 years and older who were in complete remission and were not candidates for hematopoietic stem cell transplantation were randomly assigned to receive either CC-486 or placebo once daily for 14 days per 28-day cycle (238 and 234 patients, respectively).

The researchers observed significantly longer median overall survival from the time of randomization with CC-486 versus placebo (24.7 versus 14.8 months). The corresponding median relapse-free survival was also significantly longer (10.2 versus 4.8 months). In most subgroups defined according to baseline characteristics, similar benefits of CC-486 were seen with respect to overall and relapse-free survival. During CC-486 treatment, overall health-related quality of life was preserved.

"Despite demonstrable survival advantages with CC-486 maintenance therapy, the risk of eventual relapse and death from AML remains problematic," the authors write. "Whether CC-486 may benefit patients with AML when it is used in other clinical contexts requires further investigation."

The study was funded by Celgene (a wholly owned subsidiary of Bristol Myers Squibb), which manufactures azacitidine.

https://en.wikipedia.org/wiki/Azacitidine

Oral Azacitidine Benefits Some Older Adults With AML 

Coffee Consumption Does Not Affect Insulin Sensitivity

In continuation of my updates on coffee

Consumption of four cups of coffee daily does not impact insulin sensitivity, according to a study published online Dec. 31 in the American Journal of Clinical Nutrition.

Derrick Johnston Alperet, from the National University of Singapore, and colleagues conducted a 24-week trial involving 126 overweight, non-insulin-sensitive adults aged 35 to 69 years. Participants were randomly assigned to receive either four cups of instant regular coffee or four cups of a placebo beverage per day (62 and 64 in each group, respectively). The amount of glucose metabolized per kilogram of body weight per minute (Mbw) was measured as the primary outcome.

The researchers observed no significant change in insulin sensitivity with coffee consumption versus placebo (percentage mean difference in Mbw, 4.0 percent; 95 percent confidence interval [CI], −8.3 to 18.0 percent; P = 0.53). In addition, there were no between-group differences during 24 weeks of the intervention in fasting plasma glucose or biological mediators of insulin resistance such as plasma adiponectin. Compared with participants in the placebo arm, those in the coffee arm experienced a loss of fat mass (−3.7 percent; 95 percent CI, −6.3 to −1.1 percent; P = 0.006) and a reduction in urinary creatinine concentrations (−21.2 percent; 95 percent CI, −31.4 to −9.5 percent; P = 0.001).

• "Coffee consumption was associated with a modest loss in body fat mass compared with the placebo beverage, and this potential impact on adiposity warrants confirmation in additional trials," the authors write.

https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqz306/5686860?redirectedFrom=fulltext