Introduction and Objective: Individuals with type 2 diabetes (T2D) typically achieve attenuated weight loss with GLP-1 receptor agonists (GLP-1RAs). We investigated whether comprehensive digital health engagement improves weight loss trajectories in people with T2D initiating GLP-1RA therapy. Methods: This retrospective cohort included adults with T2D (18-75 years; BMI ≥30 kg/m² or ≥27.5 kg/m² with comorbidities) initiating tirzepatide or semaglutide through a UK digital weight management service (2022-2025) over 12 months. Patients were stratified by engagement. Full engagement was defined as remote coaching attendance, weight tracking ≥4/month, and app utilisation. Percentage weight change over 12 months was modelled using MMRM adjusted for age, baseline weight, and comorbidities. Cox regression assessed time to ≥10%, ≥15%, and ≥20% weight loss with hazard ratios (HR). Results: Among 7,642 adults with T2D (age 52.8±12.1 years; 71.8% female; BMI 36.9±7.0 kg/m²), 1,011 (13.2%) were fully engaged. Twelve-month adjusted weight loss was −19.5% (95% CI −20.4, −18.7) in engaged versus −14.6% (−15.2, −13.9) in not-engaged participants, a difference of 5.0 percentage points (p<0.001). Engagement was strongly associated with accelerated milestone attainment: ≥10% HR 2.44 (95% CI 2.22-2.69), ≥15% HR 2.18 (1.93-2.47), ≥20% HR 2.02 (1.70-2.41); all p<0.001. By month 12, 60.1% of engaged versus 29.0% of not-engaged participants achieved ≥10% weight loss, while 51.3% versus 21.1% achieved ≥15% weight loss. Conclusion: Full digital programme engagement yielded greater weight loss and doubled the likelihood of achieving clinically meaningful thresholds in people with T2D, demonstrating that structured digital support substantially improves GLP-1RA treatment outcomes in this population. Disclosure H. Johnson: Employee; Current; Voy t/a Menwell LTD. D. Reisel: Employee; Current; Voy t/a Menwell LTD. D. Huang: Employee; Current; Voy t/a Menwell LTD.
Introduction Hereditary angioedema (HAE) is a rare autosomal dominant disorder typically presenting in early childhood and managed with long-term prophylaxis (LTP). Berotralstat, an oral, small-molecule plasma kallikrein inhibitor is approved in the US for HAE LTP in children aged ≥2 years. This analysis evaluated the impact of berotralstat dose adjustment during the first 48 weeks of the ongoing APeX-P trial. Methods APeX-P (NCT05453968; EU CTN 2024-511257-22-00) is an open-label trial evaluating berotralsat in patients with HAE aged 2 to <12 years weighing ≥12 kg. Patients were assigned to one of four cohorts based on baseline body weight, with dose escalation permitted after week 12 as patients’ weight increased. Patients received berotralstat capsules (≥40 kg) or pellets (<40 kg). Results During the first 48 weeks of APeX-P, 6/29 patients underwent growth-related berotralstat dose adjustment. Patients (2 male, 4 female) had a mean (SD) baseline age of 9.2 (1.47) years and weight of 33.29 (4.37) kg. Children remained on their initial dose for 21.7–42.4 weeks before growth-related dose adjustment, three moved from pellets to capsules; attack rates remained low at 0.097 attacks/month (range: 0–1.27) after dose change. The number of patients reporting treatment-emergent adverse events (TEAEs) (4/6 [66.7%]) and drug-related TEAEs (1/6 [16.7%]) was unchanged following dose change. No drug-related treatment-emergent serious adverse events or discontinuations related to adverse events were reported. Conclusion In this pediatric cohort, growth-related dose adjustment maintained low HAE attack rates with no increase in TEAEs or drug-related TEAEs.
Introduction Solitary fibrous tumours of the pleura (SFTP) are rare neoplasms for which surgical resection is considered the gold standard treatment. Anecdotally, SFTPs are sometimes conservatively managed, but there are little data on this in published literature. In this study, we aimed to collect data on radiological features in SFTP which might be associated with a benign clinical course to assist in risk stratification, and therefore selection for a more conservative management pathway. Methods A service evaluation of outcomes of radiologically diagnosed SFTP was completed in 12 UK centres, between 2005 and 2015. Cases were included via initial search of local radiology databases using key words ("Pleural fibroma" OR "fibrous tumour of the pleura" OR "SFTP"). Baseline characteristics and outcome data were obtained from medical records. Results A total of 270 patients were included in the study. Factors associated with the need for surgical intervention included lesion size (>128 mm), lesion position (abutting the mediastinum or diaphragm), associated pleural effusion, radiological evidence of necrosis within the lesion and heterogeneous density. In multivariate analysis, computed tomography-measured attenuation and homogeneous density were independent risk factors for adverse clinical outcomes in patients with resected fibromas. Conclusion This is the largest study to date on SFTP to include conservatively managed cases who underwent radiological follow-up only. The results suggest several features associated with adverse clinical outcomes, and thereby may identify cases which could be more conservatively (observation only) managed. Further prospective studies are required to assess the identified risk factors as part of a potential radiological scoring system.
