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1. Unbiased high-dimensional flow cytometry identified NK and DC immune cell signature in Luminal A-type and triple negative breast cancer

Author

Lukas Heger, Gordon F. Heidkamp, Lukas Amon, Falk Nimmerjahn, Tobias Bäuerle, Andreas Maier, Ramona Erber, Arndt Hartmann, Carolin C. Hack, Matthias Ruebner, Hanna Huebner, Peter Fasching, Matthias W. Beckmann, and Diana Dudziak

Subjects
Breast cancer, immune cell signature, NK cells, PD-1, tumor microenvironment, Immunologic diseases. Allergy, RC581-607, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

ABSTRACTBreast cancer is the most common malignancy in women worldwide and a highly heterogeneous disease. Four different subtypes are described that differ in the expression of hormone receptors as well as the growth factor receptor HER2. Treatment modalities and survival rate depend on the subtype of breast cancer. However, it is still not clear which patients benefit from immunotherapeutic approaches such as checkpoint blockade. Thus, we aimed to decipher the immune cell signature of the different breast cancer subtypes based on high-dimensional flow cytometry followed by unbiased approaches. Here, we show that the frequency of NK cells is reduced in Luminal A and B as well as triple negative breast cancer and that the phenotype of residual NK cells is changed toward regulatory CD11b−CD16− NK cells. Further, we found higher frequencies of PD-1+ CD4+ and CD8+ T cells in triple negative breast cancer. Moreover, while Luminal A-type breast cancer was enriched for CD14+ cDC2 (named type 3 DC (DC3)), CD14− cDC2 (named DC2) were more frequent in triple negative breast cancer. In contrast, HER2-enriched breast cancer did not show major alterations in the composition of the immune cell compartment in the tumor microenvironment. These findings suggest that patients with Luminal A- and B-type as well as triple negative breast cancer might benefit from immunotherapeutic approaches targeting NK cells.

Published
2024
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2. Improved Glycemic Control during a One-Week Adventure Camp in Adolescents with Type 1 Diabetes—The DIACAMP Study

Author

Antonia-Therese Kietaibl, Faisal Aziz, Eva Wurm, Celine Tomka, Elke Fröhlich-Reiterer, Othmar Moser, Thomas R. Pieber, Peter Fasching, Julia K. Mader, Harald Sourij, and Felix Aberer

Subjects
diabetes mellitus type 1, continuous glucose monitoring, diabetes camp, Biotechnology, TP248.13-248.65
Abstract

Adolescence remains a crucial age associated with diabetes distress in individuals living with type 1 diabetes (T1D). The Austrian organization “Diabär” regularly hosts a one-week adventure camp for adolescents (12–18 years) living with T1D. The camp focuses on “fun activities” without a structured educational protocol in order to minimize diabetes distress and increase diabetes management skills. In contrast to educational camps, training is kept to a minimum. However, attendees analyze the glycemic data of the previous day with their medical supervisor once daily during the camp. All subjects used a standardized real-time continuous glucose monitoring (CGM) system (DexcomG7) throughout the whole study. Glycemic metrics were prospectively analyzed during three periods: week 1 = home phase, week 2 = adventure camp, and week 3 = after the camp. Safety (time below range 1 [TBR1], 69–54 mg/dL, and time below range 2 [TBR2], p = 0.001). The TBR1 significantly increased during camp compared to week 1 (2.5 ±1.7% vs. 1.3 ± 1.2%; p = 0.009), whereas the TBR2 did not differ. No serious adverse events occurred. This adventure camp without a main focus on education showed feasibility and safety in adolescents with T1D.

Published
2024
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3. Association of two genomic variants with HPV type-specific risk of cervical cancer

Author

Finja Seifert, Rieke Eisenblätter, Julia Beckmann, Peter Schürmann, Patricia Hanel, Matthias Jentschke, Gerd Böhmer, Hans-Georg Strauß, Christine Hirchenhain, Monika Schmidmayr, Florian Müller, Peter Fasching, Alexander Luyten, Norman Häfner, Matthias Dürst, Ingo B. Runnebaum, Peter Hillemanns, Thilo Dörk, and Dhanya Ramachandran

Subjects
Human leukocyte antigen, Single nucleotide polymorphism, Association study, HPV infection, eQTL, VASH1, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Problem: Human papillomavirus infection is integral to developing invasive cervical cancer in the majority of patients. In a recent genome-wide association study, rs9357152 and rs4243652 have been associated with seropositivity for HPV16 or HPV18, respectively. It is unknown whether these variants also associate with cervical cancer triggered by either HPV16 or HPV18. Methods: We investigate whether the two HPV susceptibility variants show association with type-specific cervical cancer in a genetic case-control study with cases stratified by HPV16 or HPV18, respectively. We further tested whether rs9357152 modulates gene expression of any of 36 genes at the human leukocyte antigen locus in 256 cervical tissues. Results: rs9357152 was associated with invasive HPV16-positive cervical cancer (OR 1.33, 95%CI 1.03–1.70, p = 0.03), and rs4243652 was associated with HPV18-positive adenocarcinomas (OR 2.96, 95%CI 1.18–7.41, p = 0.02). These associations remained borderline significant after testing against different sets of controls. rs9357152 was found to be an eQTL for HLA-DRB1 in HPV-positive cervical tissues (pANOVA = 0.0009), with the risk allele lowering mRNA levels. Conclusions: We find evidence that HPV seropositivity variants at chromosome 6 and 14 may modulate type-specific cervical cancer risk. rs9357152 may exert its effect through regulating HLA-DRB1 induction in the presence of HPV. In regard of multiple testing, these results need to be confirmed in larger studies.

Published
2023
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4. Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data

Author

Michael Müller-Korbsch, Antonia Kietaibl, Yves Haufe, and Peter Fasching

Subjects
Automated insulin delivery, Diabetes mellitus type 1, Diabetes technology, Open-source AID, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

The number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted between 2019 and 2021, comparing SAP and open-source AID systems in people with type 1 diabetes. This second-year analysis included 25 PwD and investigated glycemic changes based on ambulatory glucose profiles (AGP). In comparison to the first year, a worsening of mean glucose (125.4 to 135.2 mg/dl, P = 0.038), time in range ((TIR), 84.2 to 77.0%, P = 0.012), time above range ((TAR), 11.6% to 18.5%, P = 0.017) and glycemia risk index ((GRI), 24.8 to 35.0%, P = 0.026) was observed. The reduction of mean glucose and glucose variability with AID in the first year was due to a significant decrease in time in hyperglycemia with resulting higher TIR and lower GRI. In this second-year follow up, TIR and GRI showed a significant deterioration, a familiar phenomenon in diabetology. However, open-source AID systems showed continuous safety, as there was no increase in time below range (TBR) even after two years. Despite the slight deterioration in the glycemic parameters, open-source AID systems were able to demonstrate sufficient glycemic control according to international consensus guidelines while offering the characteristic benefits of a reduced burden of diabetes management. A descriptive comparison of different AID algorithms indicated an improved glycemic control with more advanced features such as basal rate modification, auto bolus function and autotuning.

Published
2023
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5. New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

Author

Antonia-Therese Kietaibl, Peter Fasching, Karl Glaser, and Alexander H. Petter-Puchner

Subjects
diabetes mellitus, diabetic ketoacidosis, surgery, perioperative, sodium-glucose cotransoporter-2 inhibitors, Surgery, RD1-811
Abstract

BackgroundEuglycemic diabetic ketoacidosis (EDKA) is a potentially life-threatening condition and a reported side effect of antidiabetic sodium-glucose-cotransporter-2-inhibitors (SGLT2-I). The analysis of the herein presented case and its management formed the incentive to prepare this multidisciplinary work and includes an overview about perioperative SGLT2-I-induced ketoacidosis.MethodA PubMed search on relevant entries was conducted combining the terms “euglycemic diabetic ketoacidosis” AND “surgery.”ResultsA total of 33 articles on SGLT2-I-induced ketoacidosis in the context of surgical treatment were identified. According to this literature research risk factors for the development are infection, perioperative fasting, surgical stress, and insulin dose reduction.ConclusionUnspecific symptoms mimicking acute abdomen and normoglycemia can lead to delayed diagnosis of EDKA and might harm patients under SGLT2-I therapy in the perioperative setting. SGLT2-I medication should be withheld for at least 24–48 h prior to surgery according to this review of literature and restarted only in stable clinical conditions to avoid the severe complication of EDKA.

Published
2022
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6. Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

Author

Guntram Schernthaner, Naim Shehadeh, Alexander S. Ametov, Anna V. Bazarova, Fahim Ebrahimi, Peter Fasching, Andrej Janež, Péter Kempler, Ilze Konrāde, Nebojša M. Lalić, Boris Mankovsky, Emil Martinka, Dario Rahelić, Cristian Serafinceanu, Jan Škrha, Tsvetalina Tankova, and Žydrūnė Visockienė

Subjects
Type 2 diabetes, Cardiorenal protection, Glucose lowering drugs, Clinical inertia, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract The disclosure of proven cardiorenal benefits with certain antidiabetic agents was supposed to herald a new era in the management of type 2 diabetes (T2D), especially for the many patients with T2D who are at high risk for cardiovascular and renal events. However, as the evidence in favour of various sodium–glucose transporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) accumulates, prescriptions of these agents continue to stagnate, even among eligible, at-risk patients. By contrast, dipeptidyl peptidase-4 inhibitors (DPP-4i) DPP-4i remain more widely used than SGLT2i and GLP-1 RA in these patients, despite a similar cost to SGLT2i and a large body of evidence showing no clear benefit on cardiorenal outcomes. We are a group of diabetologists united by a shared concern that clinical inertia is preventing these patients from receiving life-saving treatments, as well as placing them at greater risk of hospitalisation for heart failure and progression of renal disease. We propose a manifesto for change, in order to increase uptake of SGLT2i and GLP-1 RA in appropriate patients as a matter of urgency, especially those who could be readily switched from an agent without proven cardiorenal benefit. Central to our manifesto is a shift from linear treatment algorithms based on HbA1c target setting to parallel, independent considerations of atherosclerotic cardiovascular disease, heart failure and renal risks, in accordance with newly updated guidelines. Finally, we call upon all colleagues to play their part in implementing our manifesto at a local level, ensuring that patients do not pay a heavy price for continued clinical inertia in T2D.

Published
2020
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7. Biomarkers Predictive for In-Hospital Mortality in Patients with Diabetes Mellitus and Prediabetes Hospitalized for COVID-19 in Austria: An Analysis of COVID-19 in Diabetes Registry

Author

Faisal Aziz, Hannah Stöcher, Alexander Bräuer, Christian Ciardi, Martin Clodi, Peter Fasching, Mario Karolyi, Alexandra Kautzky-Willer, Carmen Klammer, Oliver Malle, Felix Aberer, Erich Pawelka, Slobodan Peric, Claudia Ress, Caren Sourij, Lars Stechemesser, Harald Stingl, Thomas Stulnig, Norbert Tripolt, Michael Wagner, Peter Wolf, Andreas Zitterl, Othmar Moser, Christian Schelkshorn, Susanne Kaser, Harald Sourij, and for the COVID-19 in Diabetes in Austria

Subjects
COVID-19, SARS-CoV-2, diabetes mellitus, biomarker, Microbiology, QR1-502
Abstract

Background: This study assessed the predictive performance of inflammatory, hepatic, coagulation, and cardiac biomarkers in patients with prediabetes and diabetes mellitus hospitalized for COVID-19 in Austria. Methods: This was an analysis of a multicenter cohort study of 747 patients with diabetes mellitus or prediabetes hospitalized for COVID-19 in 11 hospitals in Austria. The primary outcome of this study was in-hospital mortality. The predictor variables included demographic characteristics, clinical parameters, comorbidities, use of medication, disease severity, and laboratory measurements of biomarkers. The association between biomarkers and in-hospital mortality was assessed using simple and multiple logistic regression analyses. The predictive performance of biomarkers was assessed using discrimination and calibration. Results: In our analysis, 70.8% had type 2 diabetes mellitus, 5.8% had type 1 diabetes mellitus, 14.9% had prediabetes, and 8.6% had other types of diabetes mellitus. The mean age was 70.3 ± 13.3 years, and 69.3% of patients were men. A total of 19.0% of patients died in the hospital. In multiple logistic regression analysis, LDH, CRP, IL-6, PCT, AST-ALT ratio, NT-proBNP, and Troponin T were significantly associated with in-hospital mortality. The discrimination of NT-proBNP was 74%, and that of Troponin T was 81%. The calibration of NT-proBNP was adequate (p = 0.302), while it was inadequate for Troponin T (p = 0.010). Conclusion: Troponin T showed excellent predictive performance, while NT-proBNP showed good predictive performance for assessing in-hospital mortality in patients with diabetes mellitus hospitalized with COVID-19. Therefore, these cardiac biomarkers may be used for prognostication of COVID-19 patients.

Published
2022
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8. Red Cell Distribution Width Upon Hospital Admission Predicts Short-Term Mortality in Hospitalized Patients With COVID-19: A Single-Center Experience

Author

Christoph C. Kaufmann, Amro Ahmed, Ulrich Brunner, Bernhard Jäger, Gabriele Aicher, Susanne Equiluz-Bruck, Alexander O. Spiel, Georg-Christian Funk, Michael Gschwantler, Peter Fasching, and Kurt Huber

Subjects
red cell distribution width, COVID-19, short-term mortality, prognosis, pre-COVID-19, Medicine (General), R5-920
Abstract

Background: Coronavirus disease (COVID-19) was first described at the end of 2019 in China and has since spread across the globe. Red cell distribution width (RDW) is a potent prognostic marker in several medical conditions and has recently been suggested to be of prognostic value in COVID-19.Methods: This retrospective, observational study of consecutive patients with COVID-19 was conducted from March 12, 2020 to December 4, 2020 in the Wilhelminenhospital, Vienna, Austria. RDWlevels on admission were collected and tested for their predictive value of 28-day mortality.Results: A total of 423 eligible patients with COVID-19 were included in the final analyses and 15.4% died within 28 days (n = 65). Median levels of RDWwere significantly higher in non-survivors compared to survivors [14.6% (IQR, 13.7–16.3) vs. 13.4% (IQR, 12.7– 14.4), P < 0.001]. Increased RDW was a significant predictor of 28-day mortality [crude odds ratio (OR) 1.717, 95% confidence interval (CI) 1.462–2.017; P = < 0.001], independent of clinical confounders, comorbidities and established prognostic markers of COVID-19 (adjusted OR of the final model 1.368, 95% CI 1.126–1.662; P = 0.002). This association remained consistent upon sub-group analysis. Our study data also demonstrate that RDW levels upon admission for COVID-19 were similar to previously recorded, non-COVID-19 associated RDW levels [14.2% (IQR, 13.3–15.7) vs. 14.0% [IQR, 13.2–15.1]; P = 0.187].Conclusions: In this population, RDWwas a significant, independent prognostic marker of short-term mortality in patients with COVID-19.

Published
2021
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9. AGO-Empfehlungen zur operativen Therapie des Mammakarzinoms: Update 2022

Author

Maggie Banys-Paluchowski, Marc Thill, Thorsten Kühn, Nina Ditsch, Jörg Heil, Achim Wöckel, Eva Fallenberg, Michael Friedrich, Sherko Kümmel, Volkmar Müller, Wolfgang Janni, Ute-Susann Albert, Ingo Bauerfeind, Jens-Uwe Blohmer, Wilfried Budach, Peter Dall, Peter Fasching, Tanja Fehm, Oleg Gluz, Nadia Harbeck, Jens Huober, Christian Jackisch, Cornelia Kolberg-Liedtke, Hans H. Kreipe, David Krug, Sibylle Loibl, Diana Lüftner, Michael Patrick Lux, Nicolai Maass, Christoph Mundhenke, Ulrike Nitz, Tjoung Won Park-Simon, Toralf Reimer, Kerstin Rhiem, Achim Rody, Marcus Schmidt, Andreas Schneeweiss, Florian Schütz, H. Peter Sinn, Christine Solbach, Erich-Franz Solomayer, Elmar Stickeler, Christoph Thomssen, Michael Untch, Isabell Witzel, and Bernd Gerber

Subjects
General Medicine
Abstract

ZusammenfassungDie Empfehlungen der AGO-Kommission Mamma zur operativen Therapie des Mammakarzinoms wurden zuletzt im März 2022 aktualisiert (www.ago-online.de). Da die operative Therapie einen von mehreren Teilschritten bei der Behandlung des Mammakarzinoms darstellt, sind eine umfangreiche diagnostische und onkologische Expertise eines Brustoperateurs und eine gute interdisziplinäre Zusammenarbeit mit den diagnostischen Radiologen von großer Bedeutung. Die wichtigsten Änderungen betreffen die Lokalisationstechniken, die Resektionsränder, das axilläre Management im neoadjuvanten Setting und die Bewertung der Netze in der rekonstruktiven Chirurgie. Aufgrund von Metanaanalysen randomisierter Studien wurde der Empfehlungsgrad der intraoperativen Mammasonografie zur Lokalisation nicht palpabler Befunde auf „++“ erhöht. Somit wird die Technik als gleichwertig zur Drahtlokalisation angesehen, vorausgesetzt, es handelt sich um eine sonografisch gut darstellbare Läsion, der Operateur verfügt über umfangreiche Kenntnisse in der Mammasonografie und hat Zugang zu einem geeigneten Ultraschallgerät während der Operation. Beim invasiven Mammakarzinom wird das Erreichen von negativen Resektionsrändern („no tumor on ink“) angestrebt, unabhängig davon, ob eine extensive intraduktale Komponente vorliegt oder nicht. Onkoplastische Operationen können durch die Vielzahl der existierenden Techniken in ausgewählten Fällen auch eine Mastektomie ersetzen und sind im Vergleich zu einer regulären Segmentresektion hinsichtlich der onkologischen Sicherheit bei vergleichbaren Komplikationsraten gleichwertig. Patientinnen mit cN0-Status, die eine neoadjuvante Chemotherapie erhalten, wird eine Sentinel-Node-Exzision nach Abschluss der Chemotherapie empfohlen. Bei initial suspekten Lymphknoten wird die minimalinvasive Sicherung empfohlen. Nach der neoadjuvanten Chemotherapie stehen Patientinnen mit initial 1–3 suspekten Lymphknoten und gutem Ansprechen (ycN0) die „Targeted axillary Dissection“ und die Axilladissektion als gleichwertige Optionen zur Verfügung.

Published
2023

10. Diabetes und Migration

Author

Sebahat Şat, Kadriye Aydınkoç-Tuzcu, Faize Berger, Alain Barakat, Ina Danquah, Karin Schindler, and Peter Fasching

Subjects
Endocrinology, Diabetes and Metabolism
Published
2023

11. Positionspapier: Operation und Diabetes mellitus (Update 2023)

Author

Antonia-Therese Kietaibl, Joakim Huber, Martin Clodi, Heidemarie Abrahamian, Bernhard Ludvik, and Peter Fasching

Subjects
General Medicine
Abstract

ZusammenfassungDas vorliegende Positionspapier beschreibt die Sicht der Österreichischen Diabetes Gesellschaft hinsichtlich des perioperativen Managements von Menschen mit Diabetes mellitus auf Basis der verfügbaren wissenschaftlichen Evidenz. Dabei wird Bezug genommen auf die präoperative Begutachtung und Vorbereitung sowie auf die perioperative Stoffwechselkontrolle mittels oraler Antidiabetika und/oder injektabler Therapie (Insulin‑/GLP-1-RA-therapie).

Published
2023

13. Antihyperglykämische Therapie bei Diabetes mellitus Typ 2 (Update 2023)

Author

Martin Clodi, Heidemarie Abrahamian, Helmut Brath, Guntram Schernthaner, Johann Brix, Bernhard Ludvik, Heinz Drexel, Christoph H. Saely, Peter Fasching, Gersina Rega-Kaun, Bernhard Föger, Claudia Francesconi, Elke Fröhlich-Reiterer, Alexandra Kautzky-Willer, Jürgen Harreiter, Anton Luger, Michael Resl, Michaela Riedl, Yvonne Winhofer, Sabine E. Hofer, Friedrich Hoppichler, Joakim Huber, Susanne Kaser, Claudia Ress, Monika Lechleitner, Felix Aberer, Julia K. Mader, Harald Sourij, Hermann Toplak, Bernhard Paulweber, Lars Stechemesser, Thomas Pieber, Rudolf Prager, Harald Stingl, Thomas Stulnig, Birgit Rami-Merhar, Michael Roden, Christian Schelkshorn, Thomas C. Wascher, Raimund Weitgasser, and Sandra Zlamal-Fortunat

Subjects
General Medicine
Abstract

ZusammenfassungDie Hyperglykämie ist wesentlich an der Entstehung der Spätkomplikationen bei an Diabetes mellitus Typ 2 erkrankten Patienten/Patientinnen beteiligt. Während Lebensstilmaßnahmen die Eckpfeiler jeder Diabetestherapie bleiben, benötigen im Verlauf die meisten Patienten/Patientinnen mit Typ 2 Diabetes eine medikamentöse Therapie. Bei der Definition individueller Behandlungsziele stellen die Therapiesicherheit, die Effektivität sowie substanzspezifische, kardiovaskuläre Effekte der Therapie die wichtigsten Faktoren dar. In dieser Leitlinie haben wir die rezenten evidenzbasierten Daten für die klinische Praxis zusammengestellt.

Published
2023

14. Psychische und neurokognitive Erkrankungen und Diabetes mellitus (Update 2023)

Author

Heidemarie Abrahamian, Alexandra Kautzky-Willer, Angelika Rießland-Seifert, Diana Lebherz-Eichinger, Peter Fasching, Christoph Ebenbichler, Alexander Kautzky, and Hermann Toplak

Subjects
General Medicine
Abstract

ZusammenfassungDiabetes mellitus ist häufig mit psychischen Erkrankungen assoziiert. Depressive Störungen kommen bei diabetischen Patient:innen doppelt so häufig vor wie in der nicht-diabetischen Population. Andere psychische Erkrankungen, die gehäuft mit Prädiabetes und Diabetes mellitus vorkommen, sind kognitive Dysfunktionen bis zur Demenz, auffälliges Essverhalten, Angststörungen, Schizophrenie, bipolare Störungen und Borderline-Persönlichkeitsstörungen. Die ungünstigen Auswirkungen dieser Koinzidenz auf den Stoffwechsel sind nachhaltig und manifestieren als schlechtere metabolische Kontrolle und vermehrte mikro- und makroangiopathische Komplikationen. Ziel dieses Positionspapieres ist die Sensibilisierung aller involvierten medizinischen Fachkolleg:innen sowie aller anderen mit dem Thema Diabetes befassten Berufsgruppen und Organisationen, um eine Intensivierung der komplexen therapeutischen Interventionen bei Patient:innen zu erreichen.Positive Auswirkungen wären die Verringerung der Inzidenz von Diabetes mellitus bei Patient:innen mit psychischen Erkrankungen, sowie die Reduktion von Spätfolgen des Diabetes mellitus, insbesondere der kardiovaskulären Morbidität und Mortalität und eine verbesserte Lebensqualität der Betroffenen.

Published
2023

15. Diabetes and migration (update 2023)

Author

Kadriye Aydınkoç-Tuzcu, Sebahat Şat, Faize Berger, Alain Barakat, Ina Danquah, Karin Schindler, and Peter Fasching

Subjects
General Medicine
Published
2023

16. Geriatric aspects for the management of diabetes mellitus (Update 2023)

Author

Joakim Huber, Michael Smeikal, Christoph H. Saely, Harald Stingl, Martin Clodi, Monika Lechleitner, and Peter Fasching

Subjects
General Medicine
Abstract

ZusammenfassungEs besteht eine hohe Prävalenz an Diabetes mellitus Typ 2 bei über 70-Jährigen in industrialisierten Ländern. Dieser Artikel enthält Empfehlungen für Diagnose, Prävention und Therapieziele in der Behandlung älterer Menschen mit Diabetes anhand der aktuellen Evidenzlage.

Published
2023

17. Validation of a risk prediction model for early chronic kidney disease in patients with type 2 diabetes: Data from the German/Austrian Diabetes Prospective Follow‐up registry

Author

Stephan Kress, Peter Bramlage, Reinhard W. Holl, Christian Dominik Möller, Steffen Mühldorfer, Jörg Reindel, Jochen Seufert, Rüdiger Landgraf, Ludwig Merker, Sebastian M. Meyhöfer, Thomas Danne, Peter Fasching, Peter R. Mertens, Christoph Wanner, and Stefanie Lanzinger

Subjects
Endocrinology, Endocrinology, Diabetes and Metabolism, Internal Medicine
Abstract

To validate a recently proposed risk prediction model for chronic kidney disease (CKD) in type 2 diabetes (T2D).Subjects from the German/Austrian Diabetes Prospective Follow-up (DPV) registry with T2D, normoalbuminuria, an estimated glomerular filtration rate of 60 ml/min/1.73mSubjects (n = 10 922) had a mean age of 61 years, diabetes duration of 6 years, BMI of 31.7 kg/mThe predictive model achieved moderate discrimination but good calibration in a German/Austrian T2D population, suggesting that the model may be relevant for determining CKD risk.

Published
2022

18. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high-risk, early breast cancer

Author

C.E. Geyer, J.E. Garber, R.D. Gelber, G. Yothers, M. Taboada, L. Ross, P. Rastogi, K. Cui, A. Arahmani, G. Aktan, A.C. Armstrong, M. Arnedos, J. Balmaña, J. Bergh, J. Bliss, S. Delaloge, S.M. Domchek, A. Eisen, F. Elsafy, L.E. Fein, A. Fielding, J.M. Ford, S. Friedman, K.A. Gelmon, L. Gianni, M. Gnant, S.J. Hollingsworth, S.-A. Im, A. Jager, Ó. Þ Jóhannsson, S.R. Lakhani, W. Janni, B. Linderholm, T.-W. Liu, N. Loman, L. Korde, S. Loibl, P.C. Lucas, F. Marmé, E. Martinez de Dueñas, R. McConnell, K.-A. Phillips, M. Piccart, G. Rossi, R. Schmutzler, E. Senkus, Z. Shao, P. Sharma, C.F. Singer, T. Španić, E. Stickeler, M. Toi, T.A. Traina, G. Viale, G. Zoppoli, Y.H. Park, R. Yerushalmi, H. Yang, D. Pang, K.H. Jung, A. Mailliez, Z. Fan, I. Tennevet, J. Zhang, T. Nagy, G.S. Sonke, Q. Sun, M. Parton, M.A. Colleoni, M. Schmidt, A.M. Brufsky, W. Razaq, B. Kaufman, D. Cameron, C. Campbell, A.N.J. Tutt, Paul Sevelda, Ferdinand Haslbauer, Monika Penzinger, Leopold Öhler, Christoph Tinchon, Richard Greil, Sonja Heibl, Rupert Bartsch, Viktor Wette, Christian F. Singer, Claudia Pasterk, Ruth Helfgott, Gunda Pristauz-Telsnigg, Herbert Stöger, Angsar Weltermann, Daniel Egle, Irene Thiel, David Fuchs, Holger Rumpold, Kathrin Strasser-Weippl, Beate Rautenberg, Volkmar Müller, Marcus Schmidt, Stefan Paepke, Mustafa Aydogdu, Christoph Thomssen, Joachim Rom, Christine Mau, Peter Fasching, Uwe-Jochen Göhring, Thorsten Kühn, Stefanie Noeding, Sherko Kümmel, John Hackmann, Elmar Stickeler, Abhishek Joshi, Joanna Dewar, Michael Friedlander, Kelly-Anne Phillips, Yoland Antill, Natasha Woodward, Ehtesham Abdi, Susan Tiley, Mathew George, David Boadle, Annabel Goodwin, Andre van der Westhuizen, George Kannourakis, Nicholas Murray, Nicole McCarthy, Judith Kroep, Maaike de Boer, Joan Heijns, Agnes Jager, Franciscus Erdkamp, Sandra Bakker, Gabe S. Sonke, Amer Sami, John Mackey, Catherine Prady, Andrea Eisen, Christine Desbiens, Erica Patocskai, Cristiano Ferrario, Karen Gelmon, Louise Bordeleau, Haji Chalchal, Saroj Niraula, null ido wolf, Elżbieta Senkus, François Duhoux, null Randal d’Hondt, Sylvie Luce, Daphné t’Kint de Roodenbeke, Konstantinos Papadimitriou, Marleen Borms, Claire Quaghebeur, William Jacot, Etienne Brain, Laurence Venat-Bouvet, Alain Lortholary, Zbigniew Nowecki, Fátima Cardoso, Richard Hayward, Santiago Bella, Mauricio Fernández Lazzaro, Norma Pilnik, Luis E. Fein, Cesar Blajman, Guillermo Lerzo, Mirta Varela, Juan Jose Zarba, Diego Kaen, Maria Victoria Constanzo, Joke Tio, Wulf Siggelkow, Christian Jackisch, Eva Maria Grischke, Dirk Zahm, Sara Tato-Varela, Sabine Schmatloch, Peter Klare, Andrea Stefek, Kerstin Rhiem, Oliver Hoffmann, Mustafa Deryal, Isolde Gröll, Peter Ledwon, Christoph Uleer, Petra Krabisch, Jochem Potenberg, Maren Darsow, Tjoung-Won Park-Simon, Heinz-Gert Höffkes, Till-Oliver Emde, Gerd Graffunder, Oliver Tomé, Dirk Forstmeyer, Jürgen Terhaag, Christoph Salat, Karin Kast, Steffi Weniger, Carsten Schreiber, Bernhard Heinrich, Max Dieterich, Michaela Penelope Wüllner, Raquel Andrés Conejero, José Ángel García Sáenz, Lourdes Calvo Martinez, Angels Arcusa Lanza, Serafín Morales Murillo, Fernando Henao Carrasco, Salvador Blanch Tormo, Isabel Álvarez López, Juan Ignacio Delgado Mingorance, Elena Álvarez Gomez, Marta Santisteban, Josefina Cruz Jurado, Vanesa Quiroga, Manuel Ruiz Borrego, Eduardo Martínez de Dueñas, Jose Enrique Alés Martínez, Juan De la Haba, Noelia Martínez Jañez, Álvaro Rodríguez Lescure, Antonio Antón Torres, Gema Llort Crusades, Santiago González-Santiago, Antonia Marquez Aragones, Ana Laura Ortega, Agusti Barnadas Molins, José Ignacio Chacón López-Muñiz, Miguel Martín Jiménez, Ana Santaballa Bertrán, César Rodríguez, Lucía González Cortijo, Elisabetta Cretella, Laura Cortesi, Enzo Maria Ruggeri, Claudio Verusio, Stefania Gori, Andrea Bonetti, Anna Maria Mosconi, Oskar Johannsson, Guy Jerusalem, Patrick Neven, Tünde Nagy, Graziella Pinotti, Marco A. Colleoni, Antonio Bernardo, Lorenzo Gianni, Eraldo Bucci, Laura Biganzoli, Konstantin Dedes, Urban Novak, Khalil Zaman, Jeremy Braybrooke, Matthew Winter, Daniel Rea, Muireann Kelleher, Sophie Barrett, Stephen Chan, Tamas Hickish, Jane Hurwitz, John Conibear, Apurna Jegannathen, Marina Parton, Andrew Tutt, Rozenn Allerton, Annabel Borley, Anne Armstrong, Ellen Copson, Nicola Levitt, Jean Abraham, Timothy Perren, Rebecca Roylance, Kazushige Ishida, Tatsuya Toyama, Norikazu Masuda, Junichiro Watanabe, Eriko Tokunaga, Takayuki Kinoshita, Yoshiaki Rai, Masahiro Takada, Yasuhiro Yanagita, Rikiya Nakamura, Takahiro Nakayama, Yasuto Naoi, Hiroji Iwata, Seigo Nakamura, Masato Takahashi, Kenjiro Aogi, Koichiro Tsugawa, Hirofumi Mukai, Toshimi Takano, Akihiko Osaki, Nobuaki Sato, Hideko Yamauchi, Yutaka Tokuda, Mitsuya Ito, Takeki Sugimoto, Shakeela W. Bahadur, Patricia A. Ganz, Min J. Lu, Monica M. Mita, James Waisman, Jonathan A. Polikoff, Melinda L. Telli, Samantha A. Seaward, J. Marie Suga, Lara N. Durna, Jennifer Fu Carney, Alex Menter, Ajithkumar Puthillath, Nitin Rohatgi, James H. Feusner, Kristie A. Bobolis, Peter D. Eisenberg, Derrick Wong, Virginia F. Borges, Alexander T. Urquhart, Erin W. Hofstatter, Edward C. McCarron, Claudine Isaacs, Pia Herbolsheimer, Ramya Varadarajan, Adam Raben, Ruby Anne E. Deveras, Frances Valdes-Albini, Reshma L. Mahtani, Jane L. Meisel, Bradley T. Sumrall, Cheryl F. Jones, Samuel N. Ofori, Kenneth N.M. Sumida, Mark Karwal, Deborah W. Wilbur, (Joe) Singh, David M. Spector, John Schallenkamp, Douglas E. Merkel, Shelly S. Lo, Pam G. Khosla, Massimo Cristofanilli, Lisa Flaum, Kent F. Hoskins, Melody A. Cobleigh, Elyse A. Lambiase, Olwen M. Hahn, Ira A. Oliff, Bryan A. Faller, James L. Wade, Nafisa D. Burhani, Amaryllis Gil, Harvey E. Einhorn, Anna M.V. Storniolo, Brian K. Chang, Maitri Kalra, Erwin L. Robin, Bilal Ansari, Priyanka Sharma, Shaker R. Dakhil, Richard L. Deming, John T. Cole, David S. Hanson, Augusto C. Ochoa, Judy E. Garber, Harvey Zimbler, Deborah K. Armstrong, Katherine H.R. Tkaczuk, David A. Riseberg, Brian M. O'Connor, Thomas H. Openshaw, Dana Zakalik, Cynthia M. Vakhariya, Anne F. Schott, Michael S. Simon, Thomas J. Doyle, Tareq Al Baghdadi, Amy VanderWoude, Patrick J. Flynn, Richard T. Zera, Bret E.B. Friday, Kathryn J. Ruddy, Ron Smith, null Ademuyiwa, Foluso Olabisi, Robert Ellis, Jay W. Carlson, null Marchello, Benjamin T, Edward A. Levine, Paul K. Marcom, Cameron B. Harkness, Antoinette R. Tan, William J. Charles, Charles S. Kuzma, Shonda Asaad, James E. Radford, Preston D. Steen, Madhu Unnikrishnan, Grant R. Seeger, Kirsten M.H. Leu, Mehmet S. Copur, Ralph J. Hauke, Gamini S. Soori, Bradley A. Arrick, Jennifer G. Reeder, Deborah L. Toppmeyer, Zoneddy R. Dayao, Sylvia Adams, Eleni Andreopoulou, Magnuson Allison, Jesus D. Anampa Mesias, Ruby Sharma, Bhuvaneswari Ramaswamy, Aaron T. Gerds, Robert R. Shenk, Howard M. Gross, Shruti Trehan, Wajeeha Razaq, Abdul H. Mansoor, Christie J. Hilton, Adam M. Brufsky, Chanh Huynh, Nabila Chowdhury, Susan M. Domchek, Elin R. Sigurdson, Terrence P. Cescon, Marc A. Rovito, Albert S. DeNittis, Victor G. Vogel, Thomas B. Julian, L.E. Boyle, Luis Baez-Diaz, Frank J. Brescia, John E. Doster, Robert D. Siegel, Lucas Wong, Tejal Patel, Julie R. Nangia, Catherine A. Jones, George M. Cannon, Harry D. Bear, Hetal Vachhani, Mary Wilkinson, Marie E. Wood, Fengting Yan, Xingwei Sui, Carol M. van Haelst, Jennifer M. Specht, Ying Zhuo, Rubina Qamar, Matthew L. Ryan, Abigail Stockham, Shamsuddin Virani, Arlene A. Gayle, Steven J. Jubelirer, Sobha Kurian, Mohamad A. Salkeni, Niklas Loman, Barbro Linderholm, Gustav Silander, Anna-Lotta Hallbeck, Anna von Wachenfeldt Väppling, Elsa Curtit, Catarina Cardoso, Sofia Braga, Miguel Abreu, Mafalda Casa-Nova, Mónica Nave, Eva María Ciruelos Gil, Judith Balmaña Gelpi, Adela Fernández Ortega, Josep Gumà Padró, Begoña Bermejo de las Heras, María González Cao, Juan Cueva Bañuelos, Jesús Alarcon Company, Gemma Viñas Villaró, Laura García Estevez, Jens Huober, Steffi Busch, Tanja Fehm, Antje Hahn, Andrea Grafe, Thomas Noesselt, Thomas Dewitz, Harald Wagner, Christina Bechtner, Michael Weigel, Hans-Christian Kolberg, Thomas Decker, Jörg Thomalla, Tobias Hesse, Nadia Harbeck, Jan Schröder Jens-Uwe Blohmer, Marc Wolf Sütterlin, Renske Altena, Chang-Fang Chiu, Shin-Cheh Chen, Ming-Feng Hou, Yuan-Ching Chang, Shang-Hung Chen, Shou-Tung Chen, Chiun-Sheng Huang, Dah-Cherng Yeh, Jyh-Cherng Yu, Ling-Ming Tseng, Wei-Pang Chung, Audrey Mailliez, Thierry Petit, Suzette Delaloge, Christelle Lévy, Philippe Dalivoust, Jean-Marc Extra, Marie-Ange Mouret-Reynier, Anne-Claire Hardy-Bessard, Hélène Simon, Tiffenn L'Haridon, Alice Mege, Sylvie Giacchetti, Camille Chakiba-Brugere, Alain Gratet, Virginie Pottier, Jean-Marc Ferrero, Isabelle Tennevet, Christophe Perrin, Jean-Luc Canon, Sofie Joris, Zhimin Shao, Binghe Xu, ZeFei Jiang, Qiang Sun, Kunwei Shen, Da Pang, Jin Zhang, Shui Wang, Hongjian Yang, Ning Liao, Hong Zheng, Peifen Fu, Chuangui Song, Yongsheng Wang, Zhimin Fan, Cuizhi Geng, Olivier Tredan, László Landherr, Bella Kaufman, Rinat Yerushalmi, Beatrice Uziely, Pierfranco Conte, Claudio Zamagni, Giampaolo Bianchini, Michelino De Laurentiis, Carlo Tondini, Vittorio Gebbia, Mariangela Ciccarese, Tomasz Sarosiek, Jacek Mackiewicz, Anna Słowińska, Ewa Kalinka, Tomasz Huzarski, Seock-Ah Im, Kyung Hae Jung, Joo Hyuk Sohn, Jee Hyun Kim, Keun Seok Lee, Yeon Hee Park, Kyoung Eun Lee, Yee Soo Chae, Eun Kyung Cho, Institut Català de la Salut, [Geyer CE Jr] NRG Oncology/NSABP Foundation, Pittsburgh, USA. Department of Medicine, UPMC Hillman Cancer Center, Pittsburgh, USA. [Garber JE] Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA. [Gelber RD] Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA. Harvard T.H. Chan School of Public Health, Boston, USA. Frontier Science Foundation, Boston, USA. [Yothers G] NRG Oncology/NSABP Foundation, Pittsburgh, USA. Department of Biostatistics, University of Pittsburgh, Pittsburgh, USA. [Taboada M] Oncology Biometrics Department, AstraZeneca, Macclesfield, UK. [Ross L] Department of Data Management, Frontier Science (Scotland), Kincraig, Scotland, UK. [Balmaña J] Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Medical Oncology, Public Health, Virology, Department of Psychology, Education and Child Studies, Internal Medicine, General Practice, and Child and Adolescent Psychiatry / Psychology

Subjects
Neoplasms::Neoplasms by Site::Breast Neoplasms [DISEASES], Medicaments antineoplàstics - Ús terapèutic, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Breast Neoplasms, Other subheadings::Other subheadings::/drug therapy [Other subheadings], olaparib, Article, breast cancer, SDG 3 - Good Health and Well-being, BRCA1/2, células::células germinativas [ANATOMÍA], Humans, Other subheadings::/therapeutic use [Other subheadings], Cells::Germ Cells [ANATOMY], neoplasias::neoplasias por localización::neoplasias de la mama [ENFERMEDADES], Otros calificadores::/uso terapéutico [Otros calificadores], BRCA1 Protein, PARP inhibition, acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos [COMPUESTOS QUÍMICOS Y DROGAS], adjuvant therapy, Hematology, Cèl·lules germinals, Germ Cells, Oncology, Mama - Càncer - Tractament, Phthalazines, Female, Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents [CHEMICALS AND DRUGS]
Abstract

Adjuvant therapy; Breast cancer; Olaparib Terapia adyuvante; Cáncer de mama; Olaparib Teràpia adjuvant; Càncer de mama; Olaparib Background The randomized, double-blind OlympiA trial compared 1 year of the oral poly(adenosine diphosphate-ribose) polymerase inhibitor, olaparib, to matching placebo as adjuvant therapy for patients with pathogenic or likely pathogenic variants in germline BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative, early breast cancer (EBC). The first pre-specified interim analysis (IA) previously demonstrated statistically significant improvement in invasive disease-free survival (IDFS) and distant disease-free survival (DDFS). The olaparib group had fewer deaths than the placebo group, but the difference did not reach statistical significance for overall survival (OS). We now report the pre-specified second IA of OS with updates of IDFS, DDFS, and safety. Patients and methods One thousand eight hundred and thirty-six patients were randomly assigned to olaparib or placebo following (neo)adjuvant chemotherapy, surgery, and radiation therapy if indicated. Endocrine therapy was given concurrently with study medication for hormone receptor-positive cancers. Statistical significance for OS at this IA required P < 0.015. Results With a median follow-up of 3.5 years, the second IA of OS demonstrated significant improvement in the olaparib group relative to the placebo group [hazard ratio 0.68; 98.5% confidence interval (CI) 0.47-0.97; P = 0.009]. Four-year OS was 89.8% in the olaparib group and 86.4% in the placebo group (Δ 3.4%, 95% CI −0.1% to 6.8%). Four-year IDFS for the olaparib group versus placebo group was 82.7% versus 75.4% (Δ 7.3%, 95% CI 3.0% to 11.5%) and 4-year DDFS was 86.5% versus 79.1% (Δ 7.4%, 95% CI 3.6% to 11.3%), respectively. Subset analyses for OS, IDFS, and DDFS demonstrated benefit across major subgroups. No new safety signals were identified including no new cases of acute myeloid leukemia or myelodysplastic syndrome. Conclusion With 3.5 years of median follow-up, OlympiA demonstrates statistically significant improvement in OS with adjuvant olaparib compared with placebo for gBRCA1/2pv-associated EBC and maintained improvements in the previously reported, statistically significant endpoints of IDFS and DDFS with no new safety signals. Funding for this work, which was conducted as a collaborative partnership among the Breast International Group, NRG Oncology, Frontier Science, AstraZeneca, and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, U.S.A. (MSD), was provided by the National Institutes of Health (grant numbers: U10CA 180868, UG1CA 189867, and U10CA 180822) and by AstraZeneca as part of an alliance between AstraZeneca and MSD. Provision of olaparib and placebo was from AstraZeneca.

Published
2022

20. COVID-19 In-Hospital Mortality in People with Diabetes Is Driven by Comorbidities and Age—Propensity Score-Matched Analysis of Austrian National Public Health Institute Data

Author

Faisal Aziz, Felix Aberer, Alexander Bräuer, Christian Ciardi, Martin Clodi, Peter Fasching, Mario Karolyi, Alexandra Kautzky-Willer, Carmen Klammer, Oliver Malle, Erich Pawelka, Thomas Pieber, Slobodan Peric, Claudia Ress, Michael Schranz, Caren Sourij, Lars Stechemesser, Harald Stingl, Hannah Stöcher, Thomas Stulnig, Norbert Tripolt, Michael Wagner, Peter Wolf, Andreas Zitterl, Alexander Christian Reisinger, Jolanta Siller-Matula, Michael Hummer, Othmar Moser, Dirk von-Lewinski, Philipp Eller, Susanne Kaser, and Harald Sourij

Subjects
COVID-19, diabetes, intensive care, mortality, SARS-CoV-2, Microbiology, QR1-502
Abstract

Background: It is a matter of debate whether diabetes alone or its associated comorbidities are responsible for severe COVID-19 outcomes. This study assessed the impact of diabetes on intensive care unit (ICU) admission and in-hospital mortality in hospitalized COVID-19 patients. Methods: A retrospective analysis was performed on a countrywide cohort of 40,632 COVID-19 patients hospitalized between March 2020 and March 2021. Data were provided by the Austrian data platform. The association of diabetes with outcomes was assessed using unmatched and propensity-score matched (PSM) logistic regression. Results: 12.2% of patients had diabetes, 14.5% were admitted to the ICU, and 16.2% died in the hospital. Unmatched logistic regression analysis showed a significant association of diabetes (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.15–1.34, p < 0.001) with in-hospital mortality, whereas PSM analysis showed no significant association of diabetes with in-hospital mortality (OR: 1.08, 95%CI: 0.97–1.19, p = 0.146). Diabetes was associated with higher odds of ICU admissions in both unmatched (OR: 1.36, 95%CI: 1.25–1.47, p < 0.001) and PSM analysis (OR: 1.15, 95%CI: 1.04–1.28, p = 0.009). Conclusions: People with diabetes were more likely to be admitted to ICU compared to those without diabetes. However, advanced age and comorbidities rather than diabetes itself were associated with increased in-hospital mortality in COVID-19 patients.

Published
2021
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21. Translating recent results from the Cardiovascular Outcomes Trials into clinical practice: recommendations from the Central and Eastern European Diabetes Expert Group (CEEDEG)

Author

Guntram Schernthaner, Roger Lehmann, Martin Prázný, Leszek Czupryniak, Kristine Ducena, Peter Fasching, Andrej Janež, Avraham Karasik, Peter Kempler, Emil Martinka, Marina V. Shestakova, Lea Smirčić Duvnjak, and Tsvetalina Tankova

Subjects
Type 2 diabetes, Anti-glycaemic drugs, Cardiovascular disease, Renal disease, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Aims These recommendations aim to improve care for patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk in Central and Eastern Europe. Cardiovascular disease (CVD) and/or chronic kidney disease (CKD) are major interdependent comorbidities in patients with T2D, accounting for 50% of mortality. Following recent CV outcomes trial (CVOT) results, including those from EMPA-REG OUTCOME®, LEADER®, SUSTAIN™-6 and, most recently, the CANVAS study, it is essential to develop regional expert consensus recommendations to aid physicians in interpreting these newest data to clinical practice. Methods The Central and Eastern European Diabetes Expert Group (CEEDEG) followed a Delphi method to develop treatment algorithms to aid physicians in the clinical management of patients with T2D at high CV risk. Results In light of the latest CVOT results, and in particular the EMPA-REG OUTCOME® and LEADER® trials, the diagnosis, assessment, treatment choice and monitoring of patients with T2D and established CVD and/or CKD have been considered together with existing guidelines and presented in two reference algorithms. In addition, adherence, special prescribing considerations and a proposed multidisciplinary management approach have been discussed and are presented with the proposed algorithms. Conclusions The latest available high-level evidence on glucose-lowering drugs has enabled CEEDEG to develop practical consensus recommendations for patients with established CVD and/or CKD. These recommendations represent an update to international and country-level guidelines used for these patients, with the aim of providing a resource not only to endocrinologists, but to cardiologists, nephrologists and primary care physicians in the region.

Published
2017
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22. Appraising the role of previously reported risk factors in epithelial ovarian cancer risk: A Mendelian randomization analysis.

Author

James Yarmolinsky, Caroline L Relton, Artitaya Lophatananon, Kenneth Muir, Usha Menon, Aleksandra Gentry-Maharaj, Axel Walther, Jie Zheng, Peter Fasching, Wei Zheng, Woo Yin Ling, Sue K Park, Byoung-Gie Kim, Ji-Yeob Choi, Boyoung Park, George Davey Smith, Richard M Martin, and Sarah J Lewis

Subjects
Medicine
Abstract

BackgroundVarious risk factors have been associated with epithelial ovarian cancer risk in observational epidemiological studies. However, the causal nature of the risk factors reported, and thus their suitability as effective intervention targets, is unclear given the susceptibility of conventional observational designs to residual confounding and reverse causation. Mendelian randomization (MR) uses genetic variants as proxies for risk factors to strengthen causal inference in observational studies. We used MR to evaluate the association of 12 previously reported risk factors (reproductive, anthropometric, clinical, lifestyle, and molecular factors) with risk of invasive epithelial ovarian cancer, invasive epithelial ovarian cancer histotypes, and low malignant potential tumours.Methods and findingsGenetic instruments to proxy 12 risk factors were constructed by identifying single nucleotide polymorphisms (SNPs) that were robustly (P < 5 × 10-8) and independently associated with each respective risk factor in previously reported genome-wide association studies. These risk factors included genetic liability to 3 factors (endometriosis, polycystic ovary syndrome, type 2 diabetes) scaled to reflect a 50% higher odds liability to disease. We obtained summary statistics for the association of these SNPs with risk of overall and histotype-specific invasive epithelial ovarian cancer (22,406 cases; 40,941 controls) and low malignant potential tumours (3,103 cases; 40,941 controls) from the Ovarian Cancer Association Consortium (OCAC). The OCAC dataset comprises 63 genotyping project/case-control sets with participants of European ancestry recruited from 14 countries (US, Australia, Belarus, Germany, Belgium, Denmark, Finland, Norway, Canada, Poland, UK, Spain, Netherlands, and Sweden). SNPs were combined into multi-allelic inverse-variance-weighted fixed or random effects models to generate effect estimates and 95% confidence intervals (CIs). Three complementary sensitivity analyses were performed to examine violations of MR assumptions: MR-Egger regression and weighted median and mode estimators. A Bonferroni-corrected P value threshold was used to establish strong evidence (P < 0.0042) and suggestive evidence (0.0042 < P < 0.05) for associations. In MR analyses, there was strong or suggestive evidence that 2 of the 12 risk factors were associated with invasive epithelial ovarian cancer and 8 of the 12 were associated with 1 or more invasive epithelial ovarian cancer histotypes. There was strong evidence that genetic liability to endometriosis was associated with an increased risk of invasive epithelial ovarian cancer (odds ratio [OR] per 50% higher odds liability: 1.10, 95% CI 1.06-1.15; P = 6.94 × 10-7) and suggestive evidence that lifetime smoking exposure was associated with an increased risk of invasive epithelial ovarian cancer (OR per unit increase in smoking score: 1.36, 95% CI 1.04-1.78; P = 0.02). In analyses examining histotypes and low malignant potential tumours, the strongest associations found were between height and clear cell carcinoma (OR per SD increase: 1.36, 95% CI 1.15-1.61; P = 0.0003); age at natural menopause and endometrioid carcinoma (OR per year later onset: 1.09, 95% CI 1.02-1.16; P = 0.007); and genetic liability to polycystic ovary syndrome and endometrioid carcinoma (OR per 50% higher odds liability: 0.89, 95% CI 0.82-0.96; P = 0.002). There was little evidence for an association of genetic liability to type 2 diabetes, parity, or circulating levels of 25-hydroxyvitamin D and sex hormone binding globulin with ovarian cancer or its subtypes. The primary limitations of this analysis include the modest statistical power for analyses of risk factors in relation to some less common ovarian cancer histotypes (low grade serous, mucinous, and clear cell carcinomas), the inability to directly examine the association of some ovarian cancer risk factors that did not have robust genetic variants available to serve as proxies (e.g., oral contraceptive use, hormone replacement therapy), and the assumption of linear relationships between risk factors and ovarian cancer risk.ConclusionsOur comprehensive examination of possible aetiological drivers of ovarian carcinogenesis using germline genetic variants to proxy risk factors supports a role for few of these factors in invasive epithelial ovarian cancer overall and suggests distinct aetiologies across histotypes. The identification of novel risk factors remains an important priority for the prevention of epithelial ovarian cancer.

Published
2019
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23. Association Between Obesity and Circulating Tumor Cells in Early Breast Cancer Patients

Author

Marie Tzschaschel, Thomas W.P. Friedl, Fabienne Schochter, Sabine Schütze, Arkadius Polasik, Tanja Fehm, Klaus Pantel, Christian Schindlbeck, Andreas Schneeweiss, Jörg Schreier, Hans Tesch, Ralf Lorenz, Viktoria Aivazova-Fuchs, Lothar Häberle, Peter Fasching, Wolfgang Janni, Brigitte Kathrin Rack, and Visnja Fink

Subjects
Cancer Research, Oncology
Published
2023

24. Association of two genomic variants with HPV subtype-specific risk of cervical cancer

Author

Dhanya Ramachandran, Finja Seifert, Rieke Eisenblätter, Julia Beckmann, Peter Schürmann, Patricia Hanel, M. Jentschke, Gerd Böhmer, Hans-Georg Strauß, Christine Hirchenhain, Monika Schmidmayr, Florian Müller, Peter Fasching, Alexander Luyten, Norman Häfner, Matthias Dürst, Ingo Runnebaum, Peter Hillemanns, and Thilo Dörk

Abstract

Problem: Human papillomavirus infection is integral to developing invasive cervical cancer in the majority of patients. It is unclear how genetic susceptibility to HPV infection directs cervical disease development by affecting host immune response. In a recent genome-wide association study, rs9357152 and rs4243652 have been associated with seropositivity for HPV16 or HPV18, respectively. Methods: We investigate whether the two HPV susceptibility variants show association with subtype-specific cervical cancer in a genetic case-control study (rs9357152: N =560, N = 334; rs4243652: N = 544, N = 115). We further tested whether rs9357152 modulates gene expression of any of 36 genes at the human leukocyte antigen locus in 257 cervical tissues. Results: rs9357152 was associated with invasive HPV16+ve cancer (OR 1.30, 95% CI 1.01-1.66, P= 0.04) whereas rs4243652 was associated with HPV18+ve adenocarcinomas (OR=2.71, 95% CI=1.09-6.75, P= 0.03). rs9357152 was found to be an eQTL for HLA-DRB1 in HPV positive tissues (p =0.0009), with the risk allele lowering mRNA levels. Conclusions: HPV seropositivity variants at chromosome 6 and 14 modulate subtype-specific cervical cancer risk. rs9357152 may exert its effect through regulating HLA-DRB1 in the presence of HPV.

Published
2023

25. Abstract P1-18-15: Real-world efficacy of ribociclib + aromatase inhibitor/fulvestrant, or endocrine monotherapy, or chemotherapy as first-line treatment in women with hormone receptor-positive (HR+), human epidermal growth factor receptor-2-negative (HER2-) locally advanced or metastatic breast cancer: Fourth interim analysis from the RIBANNA study

Author

Diana Lüftner, Cosima Brucker, Thomas Decker, Peter Fasching, Thomas Göhler, Christian Jackisch, Jan Janssen, Andreas Köhler, Kerstin Lüdtke-Heckenkamp, Marion van Mackelenbergh, Frederik Marmé, Arnd Nusch, Beate Rautenberg, Toralf Reimer, Marcus Schmidt, Rudolf Weide, Pauline Wimberger, Naiba Nabieva, Christian Roos, and Achim Wöckel

Subjects
Cancer Research, Oncology
Abstract

Background: Ribociclib (RIB; a selective CDK4/6 inhibitor) + endocrine therapy (ET; aromatase inhibitor or fulvestrant along with ovarian suppression in pre- and perimenopausal patients [pts]) received USFDA and EMA approval for pre-, peri- and postmenopausal pts with HR+, HER2- advanced breast cancer (ABC) based on results from phase 3 MONALEESA (ML) trials. In ML-2 trial, first-line treatment (tx) with RIB + letrozole (LET) vs placebo (PBO) + LET significantly improved median progression-free survival (mPFS) in postmenopausal pts with HR+, HER2- ABC. In ML-3 and ML-7 trials, RIB + ET vs PBO + ET showed a significant improvement in mPFS and overall survival among pts with HR+, HER2- ABC, irrespective of menopausal status, line of tx and combination partner. Real-world evidence on the effectiveness, safety, and tolerability of RIB + ET in pts with HR+, HER2- ABC would help to gain insight into routine clinical practice. Methods: RIBANNA is a prospective, noninterventional study ongoing in Germany since October 2017. Pre-, peri- and postmenopausal pts who received first-line tx with RIB + ET, or ET alone or chemotherapy (CT) for HR+, HER2- ABC in accordance with German tx guidelines were included. Data from routine clinical practice in all 3 cohorts, including further lines of sequential therapy, were collected. The third interim analysis data from RIBANNA study was presented in SABCS 2020. Fourth interim analysis data will be presented during SABCS 2021. Results: Till February 11, 2021, 2594 pts were included in the study (RIB + ET, n = 2183; ET, n = 229; CT, n = 182) and the enrollment was stopped; however, pt follow-up will be continued for an additional 4 years. For the fourth interim analysis, full analysis set (comprising all pts, except screening failures and locked pts, who received at least one dose of study medication [safety analysis set] and for whom ≥ 1 post-baseline evaluation was recorded) included 2131 pts (RIB + ET, n = 1814 [81.2%]; ET, n = 175 [73.8%]; CT, n = 142 [72.1%]), while the safety analysis set comprised 2452 pts (RIB + ET, n = 2062 [92.3%]; ET, n = 216 [91.1%]; CT, n = 174 [88.3%]). Until last patient first visit, among 2594 treated pts (including screening failures), data from first-line (1L) tx are available for 2452 pts (94.5%), from second-line (2L) tx for 343 pts (13.2%), and from third-line (3L) tx for 74 pts (2.9%, Table 1). Overall, 23.9%, 27.9%, and 43.4% of pts discontinued the study in RIB + ET, ET, and CT cohorts, respectively. The fourth interim analysis is planned in October 2021, and the final baseline demographic data as well as updated information on safety will be presented during SABCS 2021. Conclusion: RIBANNA study showed diverse population characteristics among pts who received RIB tx in a real-world setting. The data from fourth interim analysis, which is planned in October 2021, including final baseline demographic data and updated safety data will be presented. Table 1. Patient disposition following last patient first visit on February 11, 2021PatientsTotal. (N = 2594). n (%)RIB + AI/FUL (n = 2183). n (%)ET (n = 229). n (%)CT. (n = 182). n (%)Includeda2594 (100.0)2183 (100.0)229 (100.0)182 (100.0)Treated (including screening failures)2452 (94.5)2062 (94.5)216 (94.3)174 (95.6)1L therapyb2452 (94.5)2062 (94.5)216 (94.3)174 (95.6)2L therapyb343 (13.2)264 (12.1)36 (15.7)43 (23.6)3L therapyb74 (2.9)53 (2.4)10 (4.4)11 (6.0)4L therapyb7 (0.3)7 (0.3)0 (0.0)0 (0.0)Discontinued studyc664 (25.6)521 (23.9)64 (27.9)79 (43.4)aAll pts signing informed consent form, bNumber of data set available till February11, 2021, cEnd of documentation with reason other than ‘end of study. Citation Format: Diana Lüftner, Cosima Brucker, Thomas Decker, Peter Fasching, Thomas Göhler, Christian Jackisch, Jan Janssen, Andreas Köhler, Kerstin Lüdtke-Heckenkamp, Marion van Mackelenbergh, Frederik Marmé, Arnd Nusch, Beate Rautenberg, Toralf Reimer, Marcus Schmidt, Rudolf Weide, Pauline Wimberger, Naiba Nabieva, Christian Roos, Achim Wöckel. Real-world efficacy of ribociclib + aromatase inhibitor/fulvestrant, or endocrine monotherapy, or chemotherapy as first-line treatment in women with hormone receptor-positive (HR+), human epidermal growth factor receptor-2-negative (HER2-) locally advanced or metastatic breast cancer: Fourth interim analysis from the RIBANNA study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-15.

Published
2022

26. Abstract OT2-29-01: neoMono - An adaptive randomized neoadjuvant two arm trial in patients with TNBC comparing a mono atezolizumab window followed by atezolizumab and chemotherapy with atezolizumab and chemotherapy

Author

Cornelia Kolberg-Liedtke, Johannes Schumacher, Ramona Erber, Michael Braun, Bernhard Heinrich, Oliver Hoffmann, Peter Fasching, Helmut Forstbauer, Anke Kleine-Tebbe, Georg Kunz, Michael Lux, Joachim Rom, Christian Schem, Nicole Stahl, Arndt Hartmann, Sabine Kasimir-Bauer, and Hans-Christian Kolberg

Subjects
Cancer Research, Oncology
Abstract

Background: Improvement of systemic treatment of TNBC represents an unmet medical need. Recently, targeted therapy of regulatory immune pathways has become an important option in the treatment of numerous malignancies including breast cancer. Neoadjuvant trials combining chemotherapy and checkpoint inhibitors (KEYNOTE-522 and IMPASSION031) have demonstrated a meaningful benefit regarding pathological complete remission (pCR) and event-free survival (EFS) for the addition of PD-1- and PD-L1-inhibitors to chemotherapy among patients with TNBC, respectively. In addition, initial analyzes have presented promising results regarding event-free survival. In the neoadjuvant GeparNuevo trial only a subgroup of patients with TNBC, receiving a 2-week checkpoint inhibitor monotherapy window before the start of neoadjuvant chemotherapy in combination with checkpoint inhibition, achieved a pCR benefit as compared to patients treated with neoadjuvant chemotherapy alone. Trial Design: NeoMono is a phase 2 randomized multicenter trial recruiting male and female patients with primary TNBC (defined as ER/PR < 10% and HER2 negative). Neoadjuvant treatment in Arm A and B consists of Atezolizumab 1200 mg every 3 weeks in addition to neoadjuvant chemotherapy (i.e. 12 x Carboplatin and Paclitaxel q1w followed by Epirubicin and Cyclophosphamide q3w) In Arm A this therapy is preceded by Atezolizumab 840 mg q2w (Atezolizumab mono window). Study goals are the comparison of efficacy and safety of neoadjuvant chemotherapy with Atezolizumab with and without Atezolizumab two-week window (primary endpoint: pCR) and the identification of biomarkers predicting (early) response to or resistance against Atezolizumab. The broad translational program of the neoMono trial aims at identifying these biomarkers on tumor and patient level. The neoMono statistical design adapts the idea of a proof-of-concept trial and uses Bayesian posterior and predictive probabilities for inference about the primary hypothesis. Up to four planned efficacy interim analyses provide decision points for early stopping for success or futility. The expected maximum number of patients to be recruited is 458. Citation Format: Cornelia Kolberg-Liedtke, Johannes Schumacher, Ramona Erber, Michael Braun, Bernhard Heinrich, Oliver Hoffmann, Peter Fasching, Helmut Forstbauer, Anke Kleine-Tebbe, Georg Kunz, Michael Lux, Joachim Rom, Christian Schem, Nicole Stahl, Arndt Hartmann, Sabine Kasimir-Bauer, Hans-Christian Kolberg. neoMono - An adaptive randomized neoadjuvant two arm trial in patients with TNBC comparing a mono atezolizumab window followed by atezolizumab and chemotherapy with atezolizumab and chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT2-29-01.

Published
2022

27. Treatment with ribociclib shows favourable immunomodulatory effects in patients with hormone receptor-positive breast cancer—findings from the RIBECCA trial

Author

Caroline A. Peuker, Sarvenaz Yaghobramzi, Corinna Grunert, Luisa Keilholz, Enio Gjerga, Steffen Hennig, Sigrid Schaper, Il-Kang Na, Ulrich Keller, Sara Brucker, Thomas Decker, Peter Fasching, Tanja Fehm, Wolfgang Janni, Sherko Kümmel, Andreas Schneeweiss, Martin Schuler, Diana Lüftner, and Antonia Busse

Subjects
Cancer Research, Oncology, Purines, Receptor, ErbB-2, Antineoplastic Combined Chemotherapy Protocols, Medizin, Immunity, Leukocytes, Mononuclear, Aminopyridines, Humans, Breast Neoplasms, Female
Abstract

Inhibitors of the cyclin-dependent kinases 4 and 6 (CDK4/6i) have significantly improved clinical outcomes in patients with advanced hormone receptor-positive (HR+) breast cancer and have demonstrated favourable antitumour immune responses in preclinical studies.Here, we investigated peripheral immune responses to ribociclib in patients with metastatic HR+ breast cancer as a preplanned exploratory subanalysis of the RIBECCA trial (NCT03096847). Peripheral blood mononuclear cells were subjected to immune cell profiling, gene expression analysis of immune-related signatures, and deep T cell receptor profiling before treatment started and after 12 weeks of treatment with ribociclib.Gene expression analysis revealed an upregulation of signatures associated with an activated adaptive immune system and a decrease in immunosuppressive cytokine signalling during treatment with ribociclib. Profiling of peripheral immune cell subpopulations showed a decrease in Treg cell frequencies, which was associated with treatment response. Furthermore, induction of CD4+ naive T cells could be seen, whereas effector and memory T cell populations remained largely unchanged. Correspondingly, T cell repertoire diversity remained mostly unchanged during treatment, although an increase in clonality could be observed in single patients.We show that treatment with ribociclib has significant effects on the peripheral innate and adaptive immune response in patients with HR+ breast cancer. Our data suggest that these effects lead to an activation of an already existing immune response rather than a de novo induction and make a strong case for future combination strategies of CDK4/6i with immunotherapies to enhance the adaptive immune response in HR+ breast cancer.

Published
2022

28. Association of Interleukin-32 and Interleukin-34 with Cardiovascular Disease and Short-Term Mortality in COVID-19

Author

Christoph C. Kaufmann, Amro Ahmed, Marie Muthspiel, Isabella Rostocki, Edita Pogran, David Zweiker, Achim Leo Burger, Bernhard Jäger, Gabriele Aicher, Alexander O. Spiel, Florian Vafai-Tabrizi, Michael Gschwantler, Peter Fasching, Johann Wojta, and Kurt Huber

Subjects
interleukin-34, interleukin-32, COVID-19, General Medicine, short-term mortality, CV disease
Abstract

Background: Excess cardiovascular (CV) morbidity and mortality has been observed in patients with COVID-19. Both interleukin-32 (IL-32) and interleukin-34 (IL-34) have been hypothesized to contribute to CV involvement in COVID-19. Methods: This prospective, observational study of patients with laboratory-confirmed COVID-19 infection was conducted from 6 June to 22 December 2020 in a tertiary care hospital in Vienna, Austria. IL-32 and IL-34 levels on admission were collected and tested for their association with CV disease and short-term mortality in patients with COVID-19. CV disease was defined by the presence of coronary artery disease, heart failure, stroke or atrial fibrillation and patients were stratified by CV disease burden. Results: A total of 245 eligible patients with COVID-19 were included, of whom 37 (15.1%) reached the primary endpoint of 28-day mortality. Of the total sample, 161 had no CV disease (65.7%), 69 had one or two CV diseases (28.2%) and 15 patients had ≥three CV diseases (6.1%). Median levels of IL-32 and IL-34 at admission were comparable across the three groups of CV disease burden. IL-32 and IL-34 failed to predict mortality upon both univariable and multivariable Cox regression analysis. The two CV disease groups, however, had a significantly higher risk of mortality within 28 days (one or two CV diseases: crude HR 4.085 (95% CI, 1.913–8.725), p < 0.001 and ≥three CV diseases: crude HR 13.173 (95% CI, 5.425–31.985), p < 0.001). This association persisted for those with ≥three CV diseases after adjustment for age, gender and CV risk factors (adjusted HR 3.942 (95% CI, 1.288–12.068), p = 0.016). Conclusion: In our study population of hospitalized patients with COVID-19, IL-32 and IL-34 did not show any associations with CV disease or 28-day mortality in the context of COVID-19. Patients with multiple CV diseases, however, had a significantly increased risk of short-term mortality.

Published
2023
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29. Evaluation of lipoprotein(a) in the prevention and management of atherosclerotic cardiovascular disease: A survey among the Lipid Clinics Network

Author

Catapano, Alberico L, Tokgözoğlu, Lale, Banach, Maciej, Gazzotti, Marta, Olmastroni, Elena, Casula, Manuela, Ray, Kausik K, the Lipid Clinics Network, Alaa ABDELRAZIK (University Hospital of North Midland, United Kingdom), Alberto MELLO E SILVA (Sociedade Portuguesa de Aterosclerose, Portugal), Alexander VONBANK (VIVIT Institute, Austria), Alexandros, D TSELEPIS (Dept of Chemistry, Atherothrombosis Research Center, University of Ioannina, Greece), Alper SONMEZ (Department of Endocrinology and Metabolism, Ankara Guven Hospital, Turkey), Angelina PASSARO (Department of Translational Medicine, University of Ferrara &amp, Center for the Study and Treatment of Metabolic Diseases, Atherosclerosis, and Clinical Nutrition, University Hospital of Ferrara Arcispedale Sant’Anna, Italy), Anja VOGT (Medizinische Klinik und Poliklinik IV, Klinikum der Universit¨at München, Germany), Ann MERTENS (Clinical and Experimental Endocrinology, Leuven, Ku, Leuven, Belgium), Ann VERHAEGEN (Antwerp University Hospital, Belgium), Arman, S POSTADZHIYAN (Medical University of Sofia, Saint Anna University Hospital, Departement of Cardiology, Bulgaria), BAHADIR KIRILMAZ (Canakkale Onsekiz Mart University, Medical Faculty Cardiology Dept, Baris GUNGOR (University of Health Sciences Dr. Siyami Ersek Hospital, Turkey), Berit S HEDEGAARD (Aalborg University, Denmark), Bertrand CARIOU (Nantes Universit´e, Chu, Nantes, Cnrs, Inserm, l’institut du thorax, Nantes, France), Britta OTTE (Universit¨atsklinikum Münster, Lipidambulanz, Germany), Bu˘gra ¨OZKAN (Mersin University, Turkey), of cardiology, Christ BERGE (Dept., Unversity Hopsital, Haukeland., Norway), F EBENBICHLER (Department for Internal Medicine I, Christoph, Medical University Innsbruck, Austria), Christoph J BINDER (Medical University of Vienna, Austria), Christoph OLIVIER (Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Conrad AZZOPARDI (Mater Dei Hospital, Malta), Cristina SOLER (Lipid Unit, Hospital de Sta Caterina, Spain), Dan GAITA (Universitatea de Medicina si Farmacie Victor Babes din Timisoara &amp, Clinica de Cardiologie, Institutul de Boli Cardiovasculare Timisoara, Romania), Daniel WEGHUBER (Department of Pediatrics, Paracelsus Medical University, Dilek URAL (Koç University School of Medicine Department of Cardiology, Turkey), Diogo CRUZ (Hospital de Cascais - Dr. Jos´e de Almeida, Portugal), Dragos VINEREANU (University of Medicine and Pharmacy, University and Emergency Hospital, Bucharest, Romania), Elena D PENCU (Grand Hˆopital de Charleroi GHDC, Belgium), Emil HAGSTR¨OM (Dept of medical sciences, Uppsala, University, Sweden), Erik B SCHMIDT (Aalborg University, Denmark), Erik, S STROES (Dept of vascular medicine, Amsterdamumc, The, Netherlands), Evangelos LIBEROPOULOS (1st Department of Propedeutic Medicine, School of Medicine, National and Kapodistrian University of Athens, General Hospital of Athens Laiko, Fabian DEMEURE (CHU UCL Namur - Site Godinne, Belgium), Fabio FIMIANI (Azienda Ospedaliera di Rilievo Nazionale AORN Dei Colli, Monaldi', 'V., Unit of Inherited and Rare Cardiovascular Diseases, Italy, ), Fabio PELLEGATTA (Center for the Study of Atherosclerosis. Bassini Hospital. Cinisello Balsamo, Italy), Fahri BAYRAM (Erciyes University, Turkey), Finn L HENRIKSEN (Department of Cardiology Odense University Hospital, Denmark), Florian H¨OLLERL (1st Medical Department, Landstrasse, Clinic, Vienna Health Association, Francesco CIPOLLONE (Clinica Medica Institute of, Department of Medicine and Aging Sciences, d’Annunzio' University, 'G., Francisco ARAÚJO (Hospital Lusíadas, Portugal), Franck BOCCARA (Sorbonne Universit´e, Groupe de Recherche Clinique number 22, C2MV—Complications Cardiovasculaires et M´etaboliques chez les Patients Vivant avec le Virus de l’Immunod´eficience Humaine, Institut National de la Sant´e et de la Recherche M´edicale Unit´e Mixte de Recherche, S 938, Centre de Recherche Saint-Antoine, Institut Hospital Universitaire de Cardiom ´etabolisme et Nutrition Cardiologie, Hˆopital Saint Antoine Assistance Publique–Hˆopitaux de Paris, Paris, France), François PAILLARD (Cardiologie et Centre Clinico-Biologique des Lipides et Ath´eroscl´erose, Chu, Rennes, France), Imre University Teaching Hospital, Gabor SIMONYI (DBC St., Metabolic, Center, Lipid, Center, Hungary), Gabriella IANNUZZO (Department of Clinical Medicine and Surgery. University of Naples Federico II, Italy), Giuseppe MANDRAFFINO (Department of Clinical and Experimental Medicine, - Lipid Center, University of Messina, Graham BAYLY (Dept Clinical Biochemistry, University Hospitals Bristol, United, Kingdom), Gustavs LATKOVSKIS (Institute of Cardiology and Regenerative Medicine, University of Latvia &amp, Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital &amp, University of Latvia, Latvia), Gy¨orgy PARAGH (Division of Metabolic Disorders, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary), Hana ROSOLOVA (Charles University Prague Medical Hospital in Pilsen, Czech Republic), Handrean SORAN (Central Manchester University Hospital NHS Foundation Trust, United Kingdom), Helle KANSTRUP (Department of cardiology, Aarhus University hospital, Denmark), Hermann TOPLAK (Department of Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Hülya ÇIÇEKÇIO ˘GLU (ankara bilkent city hospital, Turkey), Inanc ARTAC (Department of Cardiology, Kafkas University Hospital, Ioanna GOUNI-BERTHOLD (Center for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Irfan, V DUZEN (Gaziantep University, Cardiology, Department, Isabel M PALMA (CHUPORTO - Centro Hospitalar Universit ´ario do Porto, Portugal), Istvan REIBER (Szent Gyorgy University Teaching Hospital of Fejer County, Hungary), Iveta DZIVITE-KRISANE (Children’s University Hospital, Latvia), Jeanine, E ROETERS VAN LENNEP (Department of Internal medicine, Erasmus MC University Medical Center, Jean-Luc, J BALLIGAND (Institut de Recherche Exp´erimentale et Clinique, Universite catholique de Louvain, Bruxelles), Joao C PORTO (CHUC, Portugal), Jo˜ao, S DUARTE (Hospital Egas Moniz, Lisboa, Portugal), Johan DE SUTTER (AZ Maria Middelares Hospital Gent, Belgium), Jos´e L´OPEZ-MIRANDA (Lipid and Arteriosclerosis Unit. Department of Internal Medicine. Hospital Universitario Reina Sofia. IMIBIC. University of Cordoba. CiberOBN, Spain), Jose M MOSTAZA (Hospital La Paz-Carlos III, Spain), Jurgita PLISIENE (Lithuanian University of Health sciences, Lithuania), Kadir, U MERT (Eskis ¸ehir Osmangazi University, Department of Cardiology, Kirsten, B HOLVEN (Department of Nutrition, University of Oslo and National Advisory unit on FH, Oslo University Hospital, Kjetil RETTERSTØL (The Lipid Clinic, Oslo University Hospital and Department of Nutrition, University of Oslo, Kristian, K THOMSEN (University Hospital of South Denmark, Esbjerg, Denmark), Lale TOKGOZOGLU (Hacettepe University, Turkey), Laszlo BAJNOK (1st Department of Medicine, Medical, School, University of Pecs, Lia E BANG (Copenhagen University Hospital, Denmark), Liliana GRIGORE (IRCCS Multimedica, Italy), Lluís MASANA (Hospital Universitari Sant Joan. Universitat Rovira i Virgili. CIBERDEM. Reus, Spain), Loukianos S RALLIDIS (University General Hospital Attikon, Greece), Maciej BANACH (Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Poland), Małgorzata WALU´S-MIARKA (Jagiellonian University Medical College, Of Metabolic Diseases and Diabetology, Dept., Manuel CASTRO CABEZAS (Franciscus Gasthuis &amp, Vlietland Rotterdam, The Netherlands), Marcello ARCA (Sapienza University of Rome, Italy), Margus VIIGIMAA (North Estonia Medical Centre, Tallinn University of Technology, Estonia), Martin, P BOGSRUD (Unit for Cardiac and Cardiovascular Genetics, Matej MLINARIˇC (Department of Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, Slovenia), Matteo PIRRO (Section of Internal Medicine, Angiology and Arteriosclerosis Diseases, Maurizio AVERNA (Department PROMISE-University of Palermo &amp, Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Palermo, Italy), Meral KAYIKCIOGLU (Ege University Medical School Department of Cardiology, Turkey), Merete HEITMANN (Bispebjerg-Frederiksberg University Hospital, Denmark), Mette MOURIDSEN (Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Michal VRABLIK (3rd Department of Internal Medicine, General University Hospital and 1st Medical Faculty, Charles, University, Prague, Czech, Republic), Michel FARNIER (PEC2, University of Bourgogne Franche-Comt´e, Laboratory Medicine, Michel R LANGLOIS (Dept., Jan Hospital, AZ St., Belgium), Milad KHEDR (Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Muge ILDIZLI DEMIRBAS (Kartal Kosuyolu Research and Training Hospital, Turkey), Myra TILNEY (Lipid Clinic, Mater Dei Hospital &amp, Dept of Medicine, University of Malta Medical School, Malta), Nadia CITRONI (Internal Medicine, APSS Trento Hospital, Of Internal Medicine, Niels P RIKSEN (Dept., Radboud university medical center, Nikolay M RUNEV (UMHAT Alexandrovska, Bulgaria), Nora KUPSTYTEKRISTAPONE (Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Lithuania), Olena MITCHENKO (NSC, Clinical and Regenerative Medicine of the NAMS of Ukraine, Ukraine), Oliver WEING¨ARTNER (Universit¨atsklinikum Jena, Department of Internal Medicine, I, Oner OZDOGAN (University of Health Sciences, Izmir Faculty of Medicine, Tepecik Training and Research Hospital, Ovidio MU˜NIZGRIJALVO (Hospital Virgen del Rocío, Spain), Ozcan BASARAN (Mugla Sitki Kocman University, Pankaj GUPTA (University Hospitals of Leicester, United Kingdom), Paolo PARINI (Cardio Metabolic Unit, Karolinska, Institutet, and Theme Inflammation and Ageing, Karolinska University Hospital Huddinge, Patrizia SUPPRESSA (Department of Internal Medicine and rare disease Centre, Bari, Italy), Paul DOWNIE (Salisbury NHS Foundation trust, United Kingdom), Pavel JESINA (Metabolic Center General University Hospital, Czech Republic), of Internal Medicine, Pavel KRAML (Dept., Third Faculty of Medicine, Charles University and Kr´alovsk´e Vinohrady University Hospital Prague, Pawel BURCHARDT (Department of Cardiology, Cardiovascular, Unit, Hospital, J. Stru´s., Pozna´n, &amp, Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Pozna´n, Poland), Pedro VALDIVIELSO (Hospital VIRGEN DE LA VICTORIA, Spain), Pedro VON HAFE (Instituto Cuf, Portugal), Dept, Peter FASCHING (5th Med., Clinic, Ottakring, Philippe MOULIN (Hospices civils de Lyon/INSERM/Universit ´e Lyon1, Hˆopital Louis Pradel, F´ed´eration, D’Endocrinologie, Quit´eria RATO (Sociedade Portuguesa de Aterosclerose, Portugal), Reinhold INNERHOFER (Medical University Vienna, Austria), Renata C´IFKOV´A (Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, Rene VALERO (Aix Marseille Univ, Aphm, Inserm, Inrae, C2vn, University Hospital La Conception, Department of Nutrition, Metabolic Diseases and Endocrinology, Scicali, Roberto, Robin URB´ANEK (Internal medicine, Obezita-Ormiga, s. r. o., Roma KAVALIAUSKIENE (Klaip˙ eda Seamen’s Hospital, Lituania), Roman CIBULKA (Department of paramedic science, medical diagnostics studies and public health, Faculty of Health Care Studies, University of West Bohemia, Sabina ZAMBON (Department of Medicine, - DIMED, University of Padova, Sergio D’ADDATO (University of Bologna. IRCCS S. Orsola Bologna, Italy), Stanislav ZEMEK (Lipidova ambulance, Czech Republic), Stefano ROMEO (Gothenburg University, Sweden), Stephanie K¨ONEMANN (Department of Internal Medicine, B, University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), Susanne GREBER-PLATZER (Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Thomas STULNIG (Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna &amp, Third Medical Department and Karl Landsteiner Institute for Metabolic Diseases and Nephrology, Clinic, Hietzing, Vienna, Austria), Thomas MUHR (Dept of Cardiology, Link¨oping University Hospital, Tina, Z KHAN (Consultant Cardiologist, Royal Brompton and Harefield Hospitals Part of Guy’s and St Thomas’ NHS Foundation Trust, Tomas FREIBERGER (Centre of Cardiovascular Surgery and Transplantation, Brno &amp, Medical, Faculty, Masaryk, University, Brno, Tom´aˇs ˇS´ALEK (Metabolic Clinic, Tomas Bata Hospital, Zlín, Tomas VASYLIUS (Republican Panevezys hospital, Of Cardiology, Dep., Lithuania), Ulrich LAUFS (Klinik und Poliklinik für Kardiologie, Universit ¨atsklinikum Leipzig, Ulrike SCHATZ (University Hospital Carl Gustav Carus Dresden at the Technical University Dresden, Department of Internal Medicine III, Urh GROSELJ (UMC, - University Children’s Hospital Ljubljana, University of Ljubljana, Victoria MARCO-BENEDI (Hospital Universitario Miguel Servet, Iisa, Cibercv, Vincent MAHER (Advanced Lipid Management and Research ALMAR centre, Tallaght University Hospital, Ireland), Vladimír BLAHA (University Hospital Hradec Kr´alov´e and Charles University, Faculty of Medicine in Hradec Kr´alov´e, 3rd Department of Internal Medicine, - Metabolism and Gerontology, Vladimir SOSKA (Department of Clinical Biochemistry, St. Anne’s University Hospital Brno, 2nd Clinic of Internal Medicine, Masaryk University Brno, Volker JJ SCHETTLER (Centre of Nephrology G¨ottingen, Germany), Wolfgang REINHARDT (SUS Malmoe, Sweden), Xavier PINT´O (Hospital Universitari de Bellvitge-Idibell-UB-CiberObn, Spain), Yoto YOTOV (Second Cardiology Clinic, Marina, University Hospital Sv., Medical University of Varna, Zaneta PETRULIONIENE (Vilnius University Medical Faculty, Vilnius University Hospital Santaros klinikos, Lithuania), ˇZeljko REINER (Department for Metabolic Diseases, University Hospital Center Zagreb, and Croatia, ).

Subjects
Clinicians, Clinical evaluation, Cardiology and Cardiovascular Medicine, Cardiovascular risk, Lipoprotein(a)
Published
2023

30. Author response for 'Validation of a Risk Prediction Model for Early Chronic Kidney Disease in Patients with Type 2 Diabetes: Data from the German/Austrian DPV Registry'

Author

null Stephan Kress, null Peter Bramlage, null Reinhard W. Holl, null Christian Dominik Möller, null Steffen Mühldorfer, null Jörg Reindel, null Jochen Seufert, null Rüdiger Landgraf, null Ludwig Merker, null Sebastian M. Meyhöfer, null Thomas Danne, null Peter Fasching, null Peter R. Mertens, null Christoph Wanner, and null Stefanie Lanzinger

Published
2022

31. Cost-effectiveness of pembrolizumab plus chemotherapy as first-line treatment in PD-L1-positive metastatic triple-negative breast cancer

Author

Min Huang, Peter Fasching, Amin Haiderali, Wilbur Pan, Emma Gray, Zheng-Yi Zhou, Peter Hu, Mitashri Chaudhuri, Celine Le Bailly De Tilleghem, Nicolas Cappoen, and Joyce O’Shaughnessy

Subjects
Lung Neoplasms, Oncology, Carcinoma, Non-Small-Cell Lung, Cost-Benefit Analysis, Immunology, Antineoplastic Combined Chemotherapy Protocols, Immunology and Allergy, Humans, Triple Negative Breast Neoplasms, Antibodies, Monoclonal, Humanized, B7-H1 Antigen
Abstract

Objective: This study evaluated the cost–effectiveness of pembrolizumab/chemotherapy combinations for previously untreated metastatic triple-negative breast cancer patients in the USA with PD-L1 combined positive score ≥10. Methods: A partitioned-survival model was developed to project health outcomes and direct medical costs over a 20-year time horizon. Efficacy and safety data were from randomized clinical trials. Comparative effectiveness of indirect comparators was assessed using network meta-analyses. A series of sensitivity analyses were performed to test the robustness of the results. Results: Pembrolizumab/chemotherapy resulted in total quality-adjusted life-year (QALY) gains of 0.70 years and incremental cost–effectiveness ratio of US$182,732/QALY compared with chemotherapy alone. The incremental cost–effectiveness ratio for pembrolizumab/nab-paclitaxel versus atezolizumab/nab-paclitaxel was US$44,157/QALY. Sensitivity analyses showed the results were robust over plausible values of model inputs. Conclusion: Pembrolizumab/chemotherapy is cost effective compared with chemotherapy as well as atezolizumab/nab-paclitaxel as first-line treatment for PD-L1-positive metastatic triple-negative breast cancer from a US payer perspective.

Published
2022

32. Acute viral myositis: profound rhabdomyolysis without acute kidney injury

Author

Gabor Göndör, Antonia-Therese Kietaibl, Marcus D. Säemann, Peter Fasching, and Maria Fangmeyer-Binder

Subjects
Adult, Male, Creatine kinase elevation, Epstein-Barr Virus Infections, Herpesvirus 4, Human, Anti-nuclear antibody, Extractable nuclear antigens, Short Report, Rhabdomyolysis, Young Adult, AKI, Rheumatology, medicine, Humans, Myositis, Hepatitis, biology, business.industry, Acute kidney injury, Autoantibody, General Medicine, Acute Kidney Injury, medicine.disease, Immunology, biology.protein, Creatine kinase, business
Abstract

Summary Background Acute viral myositis (AVM) may be triggered by influenza A/B, enteroviruses and other viruses. Severe complications including rhabdomyolysis regularly lead to acute kidney injury (AKI). The aim of this short report was to discuss management and differential diagnosis of massive creatine kinase (CK) elevation. Patient, material and methods Herein, we report on a 19-year-old Austrian male of African descent with a history of respiratory tract infections and whole-body pain. He further developed acute viral myositis and massive CK elevation up to 440,000 IU/L but without any signs of AKI. A literature search relating AVM, management and differential diagnosis of rhabdomyolysis was conducted in PubMed and UptoDate. Results A full panel of serological and autoimmune blood work-up including testing for human immunodeficiency virus (HIV), hepatitis, influenza A/B, Epstein-Barr virus (EBV), antinuclear antibodies (ANA) and autoantibodies against various extractable nuclear antigens (ENA) did not reveal evidence for viral originators or autoimmune diseases. This case indicates that in acute viral myositis associated with extreme CK elevation (>400,000 IU/L) AKI might be completely absent. Potential causes for this clinical phenotype, differential diagnosis and management are discussed.

Published
2021

33. Diabetes und Migration

Author

Faize Berger, Peter Fasching, Karin Schindler, Sebahat Şat, Alain Barakat, and Kadriye Aydinkoc-Tuzcu

Subjects
medicine.medical_specialty, business.industry, Diabetes mellitus, Internal medicine, Endocrinology, Diabetes and Metabolism, medicine, medicine.disease, business, Angiology
Published
2021

34. Prevalence of comorbidities in elderly cancer patients

Author

Peter Fasching, Alfa Wenkstetten-Holub, and Maria Fangmeyer-Binder

Subjects
medicine.medical_specialty, business.industry, Cancer, Hematology, Affect (psychology), medicine.disease, Comorbidity, 03 medical and health sciences, 0302 clinical medicine, Oncology, Elderly persons, 030220 oncology & carcinogenesis, Internal medicine, mental disorders, medicine, 030212 general & internal medicine, business
Abstract

SummaryComorbidity is common among cancer patients and increases with age. Comorbid conditions potentially affect treatment, therapy outcomes, and survival of people with cancer. This short review aims at presenting the prevalence of comorbidities, to illustrate their impact on elderly persons with cancer and to discuss their assessment.

Published
2020

36. AGO-Empfehlungen zur operativen Therapie des Mammakarzinoms: Update 2022

Author

Maggie, Banys-Paluchowski, Marc, Thill, Thorsten, Kühn, Nina, Ditsch, Jörg, Heil, Achim, Wöckel, Eva, Fallenberg, Michael, Friedrich, Sherko, Kümmel, Volkmar, Müller, Wolfgang, Janni, Ute-Susann, Albert, Ingo, Bauerfeind, Jens-Uwe, Blohmer, Wilfried, Budach, Peter, Dall, Peter, Fasching, Tanja, Fehm, Oleg, Gluz, Nadia, Harbeck, Jens, Huober, Christian, Jackisch, Cornelia, Kolberg-Liedtke, Hans H, Kreipe, David, Krug, Sibylle, Loibl, Diana, Lüftner, Michael Patrick, Lux, Nicolai, Maass, Christoph, Mundhenke, Ulrike, Nitz, Tjoung Won, Park-Simon, Toralf, Reimer, Kerstin, Rhiem, Achim, Rody, Marcus, Schmidt, Andreas, Schneeweiss, Florian, Schütz, H Peter, Sinn, Christine, Solbach, Erich-Franz, Solomayer, Elmar, Stickeler, Christoph, Thomssen, Michael, Untch, Isabell, Witzel, and Bernd, Gerber

Subjects
Maternity and Midwifery, Medizin, Obstetrics and Gynecology, ddc:610
Abstract

Geburtshilfe und Frauenheilkunde 82(10), 1031-1043 (2022). doi:10.1055/a-1904-6231, Published by Thieme, New York, NY

Published
2022

38. New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

Author

Antonia-Therese Kietaibl, Peter Fasching, Karl Glaser, and Alexander H. Petter-Puchner

Subjects
Surgery
Abstract

BackgroundEuglycemic diabetic ketoacidosis (EDKA) is a potentially life-threatening condition and a reported side effect of antidiabetic sodium-glucose-cotransporter-2-inhibitors (SGLT2-I). The analysis of the herein presented case and its management formed the incentive to prepare this multidisciplinary work and includes an overview about perioperative SGLT2-I-induced ketoacidosis.MethodA PubMed search on relevant entries was conducted combining the terms “euglycemic diabetic ketoacidosis” AND “surgery.”ResultsA total of 33 articles on SGLT2-I-induced ketoacidosis in the context of surgical treatment were identified. According to this literature research risk factors for the development are infection, perioperative fasting, surgical stress, and insulin dose reduction.ConclusionUnspecific symptoms mimicking acute abdomen and normoglycemia can lead to delayed diagnosis of EDKA and might harm patients under SGLT2-I therapy in the perioperative setting. SGLT2-I medication should be withheld for at least 24–48 h prior to surgery according to this review of literature and restarted only in stable clinical conditions to avoid the severe complication of EDKA.

Published
2021

40. Real-world data of 12-month adjunct sodium-glucose co-transporter-2 inhibitor treatment in type 1 diabetes from the German/Austrian DPV registry: Improved HbA1c without diabetic ketoacidosis

Author

Jochen, Seufert, Stefanie, Lanzinger, Thomas, Danne, Peter, Bramlage, Sebastian M, Schmid, Florian, Kopp, Stephan, Kress, Peter, Fasching, Claus, Schäfer, and Reinhard W, Holl

Subjects
Glycated Hemoglobin, Diabetes Mellitus, Type 1, Glucose, Symporters, Austria, Germany, Sodium, Humans, Hypoglycemic Agents, Registries, Sodium-Glucose Transporter 2 Inhibitors, Diabetic Ketoacidosis
Published
2021

41. RtCGM Performance at Different Sensor Wear Sites During Prolonged Aerobic Exercise - Can the rtCGM Sensor be Worn Anywhere on the Body?

Author

Lisa Fruehwald, Peter Fasching, Gersina Rega-Kaun, Maria Fangmeyer-Binder, Michael Müller-Korbsch, and Michael Heer

Subjects
Blood Glucose, medicine.medical_specialty, Prolonged exercise, business.industry, Endocrinology, Diabetes and Metabolism, Blood Glucose Self-Monitoring, Biomedical Engineering, Bioengineering, Diabetes Mellitus, Type 1, Internal Medicine, Physical therapy, Medicine, Aerobic exercise, Humans, business, Letters to the Editor, Exercise
Published
2021

42. 28-LB: RTCGM Performance at Different Sensor Wear Sites during Prolonged Aerobic Exercise

Author

Gersina Rega-Kaun, Michael Heer, Maria Fangmeyer-Binder, Michael Mueller-Korbsch, Lisa Fruehwald, and Peter Fasching

Subjects
Type 1 diabetes, Diabetes diagnosis, business.industry, Continuous glucose monitoring, Endocrinology, Diabetes and Metabolism, Strenuous exercise, medicine.disease, Instructions for use, Anesthesia, Healthy volunteers, Internal Medicine, medicine, Interstitial glucose, Aerobic exercise, business
Abstract

Strenuous exercise may disrupt the local equilibria between vascular and interstitial glucose concentrations. We measured interstitial glucose levels during aerobic exercise in different anatomical regions with continuous glucose monitoring (CGM) sensors and compared them to capillary blood glucose (BG) levels. We enrolled 10 individuals, 7 with type 1 diabetes (T1D) and 3 without (healthy volunteers), for a 50-mile bicycle ride. Three CGM sensors (Dexcom G6) were placed on each participant, with one each in the upper arm, abdomen and thigh. BG values were obtained at the start of the ride and every 30 minutes thereafter. Accuracy of CGM levels was assessed for each insertion site as the mean absolute relative difference (MARD) and bias versus contemporaneous BG levels. Table shows that arm-worn sensors were more accurate in terms of MARD, and also had smaller numerical bias, than sensors placed in either the abdomen or thigh. Sensor accuracy was not significantly affected by the presence or absence of a diabetes diagnosis and accuracy metrics were consistent with those reported in the device’s instructions for use. CGM users may benefit from wearing sensors on the arm during sustained bicycle rides. Disclosure M. Mueller-korbsch: Research Support; Self; Dexcom, Inc., Menarini Group, Novo Nordisk Inc. L. Fruehwald: None. M. Heer: None. G. Rega-kaun: None. M. Fangmeyer-binder: None. P. Fasching: None.

Published
2021

43. Antihyperglykämische Therapie bei Diabetes mellitus Typ 2 (Update 2019)

Author

Birgit Rami-Merhar, Michaela Riedl, Sandra Zlamal-Fortunat, Harald Sourij, Julia K. Mader, Joakim Huber, Peter Fasching, Sabine E. Hofer, Helmut Brath, Hermann Toplak, Johanna Brix, Michael Resl, Bernhard Föger, Michael Roden, Raimund Weitgasser, Yvonne Winhofer-Stöckl, G. Schernthaner, Harald Stingl, Susanne Kaser, Christoph H. Saely, Lars Stechemesser, Friedrich Hoppichler, Thomas C. Wascher, Christian Schelkshorn, Jürgen Harreiter, Alexandra Kautzky-Willer, Bernhard Ludvik, Thomas R. Pieber, Heidemarie Abrahamian, Monika Lechleitner, R. Prager, Martin Clodi, Anton Luger, Elke Fröhlich-Reiterer, Claudia Francesconi, Heinz Drexel, and Bernhard Paulweber

Subjects
medicine.medical_specialty, Health professionals, business.industry, General Medicine, Guideline, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Diabetes mellitus, Lifestyle intervention, medicine, In patient, Disease prevention, 030212 general & internal medicine, Intensive care medicine, business, Glycemic
Abstract

Hyperglycemia significantly contributes to complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety as well as cardiovascular effects is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.

Published
2019

44. Geriatrische Aspekte bei Diabetes mellitus (Update 2019)

Author

Harald Stingl, Christoph H. Saely, Joakim Huber, Michael Smeikal, Peter Fasching, and Monika Lechleitner

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Diabetes mellitus, medicine, 030212 general & internal medicine, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, business, Educational training
Abstract

Es besteht eine hohe Pravalenz an Diabetes mellitus Typ 2 bei uber 70-Jahrigen in industrialisierten Landern. Dieser Artikel enthalt Empfehlungen fur Diagnose, Pravention und Therapieziele in der Behandlung des alteren diabetischen Patienten anhand der aktuellen Evidenzlage.

Published
2019

45. Psychische Erkrankungen und Diabetes mellitus (Update 2019)

Author

Christoph Ebenbichler, Heidemarie Abrahamian, Alexander Kautzky, Hermann Toplak, Angelika Rießland-Seifert, Alexandra Kautzky-Willer, Peter Hofmann, and Peter Fasching

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Diabetes mellitus, Medicine, 030212 general & internal medicine, General Medicine, 030204 cardiovascular system & hematology, Cognitive impairment, business, medicine.disease
Abstract

Diabetes mellitus ist haufig mit psychischen Erkrankungen assoziiert. Depressive Storungen kommen bei diabetischen PatientInnen doppelt so haufig vor wie in der nicht-diabetischen Population. Andere psychische Erkrankungen, die gehauft mit Pradiabetes und Diabetes mellitus vorkommen, sind kognitive Dysfunktionen bis zur Demenz, auffalliges Essverhalten, Angststorungen, Schizophrenie, bipolare Storungen und Borderline-Personlichkeitsstorungen. Die ungunstigen Auswirkungen dieser Koinzidenz auf den Stoffwechsel sind nachhaltig und manifestieren als schlechtere metabolische Kontrolle und vermehrte mikro- und makroangiopathische Komplikationen. Ziel dieses Positionspapieres ist sowohl die Sensibilisierung aller involvierten medizinischen FachkollegInnen sowie sonstiger mit dem Thema befasster Berufsgruppen und Organisationen als auch die Intensivierung der komplexen therapeutischen Interventionen bei PatientInnen. Positive Auswirkungen waren die Verringerung der Inzidenz von Diabetes mellitus bei PatientInnen mit psychischen Erkrankungen, die konsekutive Reduktion von Spatfolgen, insbesondere der kardiovaskularen Morbiditat und Mortalitat sowie eine verbesserte Lebensqualitat der Betroffenen.

Published
2019

46. Diagnostik und Therapie des Typ 1 Diabetes mellitus (Update 2019)

Author

Susanne Kaser, G. Schernthaner, Alexandra Kautzky-Willer, Bernhard Ludvik, Raimund Weitgasser, Martin Clodi, Thomas C. Wascher, Peter Fasching, Friedrich Hoppichler, Yvonne Winhofer-Stöckl, Monika Lechleitner, R. Prager, and Michael Roden

Subjects
medicine.medical_specialty, Type 1 diabetes, business.industry, Insulin, medicine.medical_treatment, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, business
Abstract

Die Leitlinie nimmt Bezug auf die Diagnostik, einschlieslich begleitender Autoimmunerkrankungen, bei Typ 1 Diabetes mellitus, die Insulintherapie und die glykamischen Zielwerte.

Published
2019

47. Insulintherapie bei Typ 2 Diabetes mellitus (Update 2019)

Author

Peter Fasching, Hermann Toplak, Bernhard Föger, Michael Roden, Susanne Kaser, Christoph H. Saely, Heidemarie Abrahamian, Anton Luger, G. Schernthaner, Thomas R. Pieber, Raimund Weitgasser, Claudia Francesconi, Yvonne Winhofer-Stöckl, Harald Sourij, Heinz Drexel, Bernhard Paulweber, Lars Stechemesser, Birgit Rami-Merhar, Michaela Riedl, Christian Schelkshorn, Monika Lechleitner, Johanna Brix, Helmut Brath, Sabine E. Hofer, Thomas C. Wascher, R. Prager, Martin Clodi, Michael Resl, Harald Stingl, Joakim Huber, Friedrich Hoppichler, Alexandra Kautzky-Willer, Julia K. Mader, Bernhard Ludvik, Jürgen Harreiter, Sandra Zlamal-Fortunat, and Elke Fröhlich-Reiterer

Subjects
Gynecology, Thesaurus (information retrieval), medicine.medical_specialty, business.industry, Insulin, medicine.medical_treatment, Type 2 Diabetes Mellitus, General Medicine, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, business
Abstract

Die vorliegende Leitlinie nimmt Bezug auf die Indikation und praktische Umsetzung der Insulintherapie bei Typ 2 Diabetes, insbesondere auch im Hinblick auf die unterschiedlichen Formen der Insulintherapie.

Published
2019

48. Positionspapier: Operation und Diabetes mellitus (Update 2019)

Author

Martin Clodi, Heidemarie Abrahamian, Joakim Huber, Bernhard Ludvik, and Peter Fasching

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Perioperative management, business.industry, Diabetes mellitus, medicine, 030212 general & internal medicine, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, business
Abstract

Das vorliegende Positionspapier beschreibt die Sicht der Osterreichischen Diabetes Gesellschaft hinsichtlich des perioperativen Managements von Patienten mit Diabetes mellitus auf Basis der verfugbaren wissenschaftlichen Evidenz. Dabei wird Bezug genommen auf die praoperative Begutachtung und Vorbereitung sowie auf die perioperative Stoffwechselkontrolle mittels oraler Antidiabetika und/oder injektabler Therapie (Insulin-/GLP-1-RA-therapie).

Published
2019

49. Geschlechtsspezifische Aspekte bei Prädiabetes und Diabetes mellitus – klinische Empfehlungen (Update 2019)

Author

Peter Fasching, Jürgen Harreiter, Monika Lechleitner, Heidemarie Abrahamian, Raimund Weitgasser, F. Hoppichler, and Alexandra Kautzky-Willer

Subjects
Gynecology, medicine.medical_specialty, business.industry, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes-Related Complications, Diabetes mellitus, medicine, 030212 general & internal medicine, Prediabetes, business
Abstract

Metabolische Erkrankungen beeinflussen das Leben von Mannern und Frauen in den verschiedenen Lebensabschnitten in unterschiedlicher und vielfaltiger Weise und stellen eine grose Herausforderung fur das Gesundheitssystem dar. Die behandelnden Arztinnen und Arzte sind mit den unterschiedlichen Bedurfnissen von Mannern und Frauen im klinischen Alltag konfrontiert. Geschlechtsspezifische Unterschiede beeinflussen Screening, Diagnose und Behandlungsstrategien sowie die Entwicklung von Komplikationen und die Mortalitatsraten. Veranderungen im Glukose- und Lipidstoffwechsel, die Regulation von Energiehaushalt und Korperfettverteilung sowie damit assoziierte kardiovaskulare Erkrankungen werden stark von Steroid- und Sexualhormonen beeinflusst. Zusatzlich spielen Erziehung, Einkommen und psychosoziale Faktoren eine wichtige Rolle bei der Entstehung von Adipositas und Diabetes und mussen bei geschlechtsspezifischer Betrachtung mitberucksichtigt werden. Manner weisen im jungeren Alter und bei niedrigerem BMI ein hoheres Risiko fur Typ-2-Diabetes auf als Frauen, die wiederum von einem starken Anstieg im Risiko fur Diabetes-assoziierte kardiovaskulare Erkrankungen nach der Menopause betroffen sind. Frauen durften durch Diabetes auch etwas mehr Lebensjahre verlieren als Manner, wobei die hohere Mortalitat hauptsachlich auf vaskulare Komplikationen zuruckgefuhrt werden kann. Bei Mannern mit Diabetes scheint dafur der Mortalitatsanstieg durch Krebs gewichtiger als bei Frauen zu sein. Bei Frauen sind Pradiabetes und Diabetes meist mit mehr vaskularen Risikofaktoren assoziiert wie erhohte Inflammationsparameter, prothrombotische Veranderungen und hoherem Blutdruck. Sie weisen deshalb ein relativ hoheres vaskulares Risiko auf. Frauen sind ofter stark ubergewichtig und weniger korperlich aktiv, obwohl sie sogar noch mehr als Manner von einem hoheren Bewegungsausmas in ihrer Gesundheit und Lebenserwartung profitieren durften. In Gewichtsreduktionsprogrammen verlieren Manner haufig mehr Gewicht als Frauen. Frauen und Mannern profitieren gleich gut von Praventionsprogrammen mit etwa 40 % Risikoreduktion fur Typ-2-Diabetes nach 3 Jahren. Langzeitdaten konnten bisher eine Reduktion der allgemeinen und kardiovaskularen Mortalitat nur bei Frauen zeigen. Frauen weisen ofter eine gestorte Glukosetoleranz, Manner hingegen erhohte Nuchternblutzuckerspiegel auf. Eine Anamnese eines Gestationsdiabetes oder PCOS sowie hohere Androgenspiegel stellen bei Frauen, das Vorhandensein einer erektilen Dysfunktion oder erniedrigter Testosteronspiegel bei Mannern, wichtige geschlechtsspezifische Diabetesrisikofaktoren dar. Viele Studien zeigen des Weiteren, dass Frauen in der Therapie weniger oft die Zielwerte fur HbA1c, LDL-Cholesterin oder Blutdruck erreichen, wobei die Ursachen unklar sind. Generell sollen in der medikamentosen Behandlung geschlechtsspezifische Unterschiede in der Wirkung, Pharmakokinetik und in den Nebenwirkungen mehr Beachtung finden.

Published
2019

50. Rauchen, Alkohol und Diabetes mellitus (Update 2019)

Author

Peter Fasching, Christian Tatschl, Susanne Kaser, and Helmut Brath

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine.medical_treatment, Health behaviour, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, medicine, Smoking cessation, Alcohol intake, 030212 general & internal medicine, business, Second hand smoke
Abstract

Rauchen und Passivrauchen erhohen Diabetesinzidenz und Wahrscheinlichkeit fur Spatschaden deutlich. Rauchstopp kann zu Gewichtszunahme und erhohtem Diabetesrisiko fuhren, senkt aber trotzdem kardiovaskulare und Gesamtmortalitat. Eine Basisdiagnostik (Fagerstrom-Test, exhalatorisches CO) ist die Grundlage einer erfolgreichen Raucherentwohnung. An medikamentoser Unterstutzung stehen Varenicline, Nikotinersatztherapie und Bupropion zur Verfugung. Soziookonomische und psychische Faktoren spielen fur Rauchen und Rauchstopp eine wichtige Rolle. Moderater Alkoholkonsum senkt moglicherweise Diabetes- und kardiovaskulares Risiko. Selektionsbias und falsche Angaben konnten in Studien allerdings diese Wirkungen zu optimistisch erscheinen lassen. Dem steht ein dosisabhangiges Mehr an Krankheit und gesundheitlich eingeschrankten Lebensjahren gegenuber, v. a. durch Krebs, Lebererkrankungen und Infektionen.

Published
2019

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