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Disease Knowledge Centres

Internal Medicine - Disease Topic Overview

Internal medicine is described by the European Federation of Internal Medicine as "the core medical discipline that is responsible for the care of adults with one or more complex, acute, or chronic illnesses".¹ This patient centered specialty encompasses both hospital and community care, with a major role in the management of different subspecialties.¹

This broad specialty can be divided into many further subspecialties; adolescent medicine, allergy and immunology, cardiology, critical care, endocrinology, gastroenterology, geriatrics, haematology, infectious disease, nephrology, oncology and rheumatology.

A European study found that the three most common complaints on admission to internal medicine wards were; shortness of breath, chest pain and abdominal pain. On average, at the time of admission, patients had three chronic medical diagnoses and four prescribed drugs.² The majority of patients admitted had existing cardiovascular disease and had subsequent diagnoses of an infectious disease, a general medical condition, gastrointestinal disorder and/or respiratory disease.²

The most important role of the internalist is to treat patients as a whole as apposed to the individual diseases that are managed by subspecialties.¹ However, the role of internal medicine is becoming diluted as a specialty by increasing emphasis on subspecialties such as cardiology and oncology.¹

An ageing population worldwide has meant that the prevalence of patients with multiple chronic diseases is steadily increasing.³ This will mean that the role of internal medicine will be come ever more important in the treatment and management of these patients.

1. Koebberling J. et al. Political Issues in Internal Medicine in Europe. A Position Paper. European Journal of Internal Medicine. June 2005 ; 16 (3) : 214-217.
2. Roger D. et al. Common Diagnoses in Internal Medicine in Europe 2009: A Pan-European, Multi-Centre Survey. European Journal of Internal Medicine. October 2010 ; 21 (5) : 449-452.
3. Kramer M.H.H. et al. Internal Medicine in Europe: How to Cope with the Future?: An Official EFIM Strategy Document. European Journal of Internal Medicine. June 2010 ; 21 (3) : 173-175.

SGLT2-Inhibitors eCME Webcast

Type 2 Diabetes Mellitus affects approximately 20.66 million people across the UK, France, Germany, Spain and Italy¹. This leads to many complications including macrovascular and microvascular disease. Glycaemic control in diabetes is particularly important in reducing these complications; a 1% fall in HBA1C results in a 37.5% and 42.5% reduction in microvascular and peripheral vascular disease respectively².

There are numerous treatments for Type 2 Diabetes Mellitus. These act on receptors within various organs including the pancreas, muscle, adipose tissue, gastrointestinal tract and liver. A new class of drugs, SGLT2-Inhibitors act on the kidney, which itself plays an important role in glycaemic control.

The eCME webcast entitled SGLT2-Inhibitors: Assessing the Evidence and the Potential Impact on Future Clinical Practice is ACCME/EACCME accredited. This activity has been designed to inform healthcare professionals on Type 2 Diabetes Mellitus and the role of SGLT2-Inhibitors in the treatment of this disease. To access the eCME accredited webcast click here.

References
1. IDF Diabetes Atlas 2010. http://www.idf.org/atlasmap/atlasmap.
2. Stratton, I. et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321: 405-412.

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The eCME webcast entitled SGLT2-Inhibitors: Assessing the Evidence and the Potential Impact on Future Clinical Practice is ACCME/EACCME accredited. This activity has been designed to inform healthcare professionals on Type 2 Diabetes Mellitus and the role of SGLT2-Inhibitors in the treatment of this disease.

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Alzheimer's Disease
Alzheimer's disease (AD) is a progressive, neurodegenerative disease which will affect most of us at one point in time - either directly (as the prevalence is expected to quadruple over the next 50 years) or indirectly through the suffering of a loved one.

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Alzheimer's disease(AD) is a progressive, neurodegenerative disease which will affect most of us at one point in time, and it’s prevalence increases with age.

In the early stages in particular, dementia is often difficult to diagnose, since many symptoms are not recognized as such or are trivialized by the patient. 20% of actual dementia cases are reported to be incorrectly diagnosed as a different disease.

In early dementia the symptoms of Alzheimer’s disease include memory loss, disorientation and confusion. These symptoms are caused by the loss of neurons and worsen with continuous neurodegeneration. The pathology of dementia is not solely the result of a cholinergic deficit. It is known that, chronically and pathologically elevated glutamate concentrations play an important role.

In general two main groups of dementia can be distinguished, requiring different types of treatment:
- Cerebro-organic (primary) forms of dementia
- Non-cerebro-organic (secondary) forms of dementia
Depending on the stage of the disease, clinical symptoms of varying intensity dominate. With the progression of AD, treatment is aimed particularly at improving and stabilizing personal everyday functions, so as to keep patients independent for as long as possible.

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What’s in the Alzheimer's Knowledge Centre?
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Atopic Dermatitis
Atopic dermatitis is a highly prevalent disease in developed countries, affecting 10-30% of children and 1-3% of adults in developed countries. Often referred to as 'eczema', atopic dermatitis is a chronic inflammatory skin disorder that starts in childhood and can persist into adolescence and adulthood.

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Atopic dermatitis, a chronic inflammatory skin disorder, affects 10-30% of children and 1-3% of adults^1,2 in developed countries.

Atopic dermatitis has traditionally been characterised by periods of exacerbations, known as flares, interspersed with periods of apparent remission.³ It affects patients to varying degrees and is categorised as mild, moderate or severe. The progression of atopic dermatitis also differs considerably from person to person.

The precise cause of the disease is poorly understood but the most common form, extrinsic atopic dermatitis, is strongly associated with a hypersensitivity reaction to environmental allergens.

The specific combination of signs and symptoms associated with atopic dermatitis varies from person to person. However, patients will usually suffer from dry, erythematous skin, with pruritus being a core symptom of the condition.

Following a diagnosis of atopic dermatitis, the choice of management strategy depends on the severity of the condition, and should take into account the patient's and their family's needs and concerns.

There are a number of different treatment options currently available for atopic dermatitis including non-pharmacological options like emollient creams to improve symptoms, and pharmacological options, such as topical corticosteroids or topical calcineurin inhibitors.⁴

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What's in the Atopic Dermatitis Knowledge Centre?
References

1. Leung DY, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest 2004; 113: 651-7.
2. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998; 351: 1225-32.
3. Langan SM, Thomas KS, Williams HC. What is meant by a ""flare"" in atopic dermatitis? A systematic review and proposal. Arch Dermatol 2006; 142: 1190-6.
4. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology 1993; 186: 23-31.

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Cholesterol

An elevated level of low-density lipoprotein cholesterol (LDL-C) is a form of dyslipidaemia that has been shown to be strongly associated with an increased risk of developing atherosclerosis and cardiovascular disease (CVD), leading to cardiovascular events.

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Diagnosing and managing coronary heart disease (CHD) can be challenging. In most patients, it takes years or even decades before the underlying coronary pathology leads to clinical manifestations. Major emphasis is needed in controlling overall cardiovascular risk factors in CHD as risk factor control remains poor in these patients and increases the risk of an event.¹

The Cholesterol Knowledge Centre offers you a range of tools that will help you identify, diagnose and decide upon an appropriate treatment strategy for your patients at risk of CHD. The Centre's educational aids will allow you to keep up to date with the latest research, recommendations and guidelines. It also offers you tools to help you keep your patients engaged in their therapy, thereby significantly reducing their risk of future cardiovascular events.
ENTER the Cholesterol Knowledge Centre

References
1. Graham I et al. Eur J Cardiovasc Prev Rehab 2007; 14: E1-E40

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COPD
Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the respiratory system resulting in decreased lung function, which is a growing cause of morbidity and mortality worldwide. It has been estimated by The WHO Global Burden of Disease project that COPD was the fourth leading cause of death in 2004 and predicts that by 2030 it will be the third.

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Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the respiratory system resulting in decreased lung function, which is a growing cause of morbidity and mortality worldwide. It has been estimated by The WHO Global Burden of Disease project that COPD was the fourth leading cause of death in 2004 and predicts that by 2030 it will be the third.¹ However it is thought that the current prevalence is an underestimate, due to a lack of awareness among primary care physicians.

The three main symptoms of COPD are dyspnoea (breathlessness), cough and sputum production.² In addition to these symptoms, many patients also experience mild to moderate pulmonary hypertension, cor pulmonale, weight loss and a general deterioration in their feeling of well-being.^3-5

Diagnosis of COPD can be made using a combination of different methods; patient history, physical examination, airflow measurements, chest X-ray, and electrocardiogram.²

This progressive disease has no cure; however treatments for COPD are widely used to reduce the symptoms. Treatment guidelines outline the available treatments for specific stages of COPD.²

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What's in the COPD Knowledge Centre?
- Respiratory System Overview
- Understanding COPD
- Diagnosis of COPD
- Treatment of COPD
- Resources
References:
1. WHO The global burden of disease: 2004 update. Part 2 – Causes of death. Available at: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf (Accessed 11 November 2011).
2. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (updated 2010). Available at: http://www.goldcopd.com/ - (accessed 11 November 2011).
3. Rennard S, Decramer M, Caverley PMA et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J 2002; 20: 799-805.
4. Kumar P and Clark M (Eds.) Chapter 13 – Cardiovascular disease. In: Clinical Medicine 6th ed. Philadelphia, PA: Elsevier Saunders, 2005.
5. Agustí A. Systemic effects of chronic obstructive pulmonary disease – what we know and what we don't know (but should). Proc Am Thorac Soc 2007; 4: 522-525.

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Diabetes

Diabetes is a disease that currently affects approximately 285 million people worldwide and this figure is only expected to increase1. For Europe, the IDF estimates that 55.2 million, or 8.5% of the population aged 20 to 79 years, have diabetes. This is expected to rise to 66.2 million (10.0%) by 2030. Further information on the scale of the type 2 diabetes problem can be found in the overview section of the knowledge centre.

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Diabetes is a disease that currently affects approximately 285 million people worldwide and this figure is only expected to increase1. For Europe, the IDF estimates that 55.2 million, or 8.5% of the population aged 20 to 79 years, have diabetes. This is expected to rise to 66.2 million (10.0%) by 2030. Further information on the scale of the type 2 diabetes problem can be found in the overview section of the knowledge centre.

Complications associated with diabetes mellitus include hypertension, cardiovascular disease, retinopathy, kidney damage, foot ulceration and nerve damage. Discover more about the complications connected to diabetes mellitus, as well as acceptable blood glucose and HbA1C levels and how these differ in people with diabetes mellitus here.

The majority of patients with type 2 diabetes are obese and/or have an increased proportion of visceral fat, factors which in themselves are associated with insulin resistance. Other risk factors include increasing age and sedentary lifestyle. There is also a strong genetic predisposition to type 2 diabetes².

Chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction and failure of various organ systems. Early diagnosis, adequate treatment to control hyperglycaemia, and management of associated risk factors and complications therefore are all essential to reduce the burden of diabetes. Effective screening strategies are therefore of particular importance in reducing this burden. Discover the diagnostic tests necessary to diagnose type 2 diabetes mellitus and intermediate hyperglycaemia or pre-diabetes.

The early and aggressive treatment and management of diabetes mellitus is important for a successful long term outcome in patients with diabetes mellitus. The use of oral agents and lifestyle changes are the generally accepted early treatments followed later by insulin therapy. Current treatment algorithms and IDF guidelines should be used to find the appropriate treatment regime for individual patients.

As with many diseases, our knowledge of diabetes mellitus is increasing through research. Recent developments include the use of new treatments and guidelines in clinical practice. There has been an update to the IDF guidelines concerning GLP-1 agonists. DPP-4 inhibitors are now used in the treatment of diabetes, and SGLT-2 inhibitors are being investigated for this use.

References

1. Unwin, N. et al. The IDF Diabetes Atlas: Providing Evidence, Raising Awareness and Promoting Action. Diabetes Res Clin Pract 87, 2-3 (2010).

2. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 33 Suppl 1, S62-9 (2010).

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Hypertension
Hypertension, an increasingly common and chronic disease, and its consequences like stroke, coronary heart disease, heart failure and renal damage mean an enormous financial burden for the community.

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Hypertension, an increasingly common and chronic disease, and its consequences like stroke, coronary heart disease, heart failure and renal damage mean an enormous financial burden for the community. The risk of cardiovascular morbidity and mortality is proportional to the degree of systolic or diastolic blood pressure elevation at any age and in either sex, and is markedly influenced by risk factors commonly associated with BP elevation.

The term “isolated systolic hypertension” (ISH) describes raised systolic blood pressure with normal or low diastolic blood pressure. Some guidelines recognise two grades of isolated systolic hypertension:^1,3

Increasingly, attention is becoming focused on systolic, rather than diastolic, blood pressure as the major factor to control in patients older than 50 years with essential hypertension.^1,2 Elevated systolic blood pressure (SBP) is a powerful predictor of all-cause mortality, coronary artery disease, stroke and renal disease.⁴

Diagnostic procedures are aimed at: establishing blood pressure levels; identifying secondary causes of hypertension; evaluating the overall cardiovascular risk.

It is now widely recognised that elevated blood pressure is frequently associated with obesity, insulin resistance and dyslipidaemia. The clustering of these symptoms has given rise to the concept of the ‘metabolic syndrome’, which carries a high risk of diabetes and cardiovascular disease.

Guidelines on modern management of hypertension reflect a more preventive approach with reduced target BP and risk factor evaluation. Initiation of antihypertensive treatment is based on two criteria; total level of cardiovascular risk and level of systolic and diastolic BP.

Lifestyle inverventions should be instituted whenever appropriate in all patients. Pharmacological therapy should be started gradually, and target BP achieved progressively. To reach target BP, a large proportion of patients will require combination therapy.

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What’s in the Hypertension Knowledge Centre?
References

1. Williams B, Poulter NR, Brown MJ, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004 - BHS IV. J Hum Hypertens 2004;18:139-185
2. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289:2560-2572
3. ESH Guidelines Committee. 2003 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003;21(6):1011-1053
4. Brooks DP, Ruffolo RR. Pharmacological mechanism of angiotensin II receptor antagonists: implications for the treatment of elevated systolic blood pressure. J Hypertens 1999;17(Suppl 2):S27-S32

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Third Party Website - Asthma and COPD

Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The main physiological feature of asthma is episodic airway obstruction characterized by expiratory airflow limitation. The dominant pathological feature is airway inflammation, sometimes associated with airway structural changes.

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Understanding Asthma

Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.

The chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

Learn more about Asthma…by visiting our website

Understanding Chronic Obstructive Pulmonary Disease (COPD)

COPD’s pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

Learn more about COPD…

Asthma Care

Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

Learn more about Asthma Care…

COPD Care

COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.
Learn more about COPD Care…

Asthma Therapy

Asthma is a chronic disorder with significant impacts on patients, their family and society. Although there is no cure for asthma, appropriate management often leads to control of the disease.

Learn more about Asthma Therapy…

COPD Therapy

COPD is a progressive disease: lung function is expected to worsen over time. Therefore, adherence to therapy and a continuous assessment of the pathology progression are important.

Learn more about COPD Care…

Resources

A wealth of useful resources including a slide sharing portal, device area, expert’s tips, conference and events calendar and more.

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A Description of TIME Wound Assessment and Treatment Strategies

Internal Medicine Drug Data - A-Z English

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Latest Clinical Trials

Blood Markers for Inflammation and Coronary Artery Vasoreactivity Testing in Patients With Chest Pain and Normal Coronary Arteries (ACOVA)

The investigators are hoping to discover the cause of chest pain in patients with a normal coronary arteriogram. For patients with chest pain coronary angiography is the standard method by which the blood vessels of the heart can be visualized and any narrowing can be assessed. In some cases the investigators find totally normal coronary blood vessels or only minor disease. Such a finding is associated with an excellent long term prognosis. However, as a large proportion of patients with normal coronary arteries or mild coronary narrowings often continue to experience recurrent chest pains the investigators are interested in understanding the mechanisms responsible for this. The investigators hypothesise that in many cases, coronary artery spasms are responsible for the recurrent chest pains. These spasms usually respond to treatment with drugs known as vasodilators. The acetylcholine test (ACH-test) has been recommended by the European Society of Cardiology and the American College of Cardiology as a diagnostic test. This test can reveal whether the coronary blood vessels have a tendency to go into spasm. The investigators plan in this study to carry out the test in patients who have chest pains suggestive of coronary narrowings but are found to have normal or only mildly narrowed coronary arteries on angiography. A positive test -indicating a tendency for spasm- may help guiding therapy with vasodilators, which are often very effective to prevent coronary spasms. The investigators would also like to take blood samples during the test (before and after) from every patient to measure blood markers and see if there is a relation between these markers and the result of the ACH-test.

Observatory of Screening Aneurysms of the Abdominal Aorta During Echocardiography. National Epidemiological Survey (E2T3A)

Study of the prevalence of Abdominal Aortic Aneurysms (AAA) (> 3 cm) in patients with echocardiography (transthoracic or) during a specific day, with cardiologists in France. This is a cross-sectional epidemiological investigation, assembling evidence from a routine ultrasound screening for AAA at the waning of echocardiograms performed during a specific day. The study will be offered a list of centers selected by the Scientific Committee in the complete list of locations being in France, the subsidiary of echocardiography Echocardiography of French Society of Cardiology. These centers will be 500 in number representative of the French centers, geographically and by type of centers.

Latest Journal Publications

Journal of Neurology Neurosurgery and Psychiatry

Aim: To evaluate a standardised MRI acquisition protocol and a new image rating scale for disease severity in patients with progressive supranuclear palsy (PSP) and multiple systems atrophy (MSA) in a large multicentre study. Methods: The MRI protocol consisted of two-dimensional sagittal and axial T1, axial PD, and axial and coronal T2 weighted acquisitions. The 32 item ordinal scale evaluated abnormalities within the basal ganglia and posterior fossa, blind to diagnosis. Among 760 patients in the study population (PSP=362, MSA=398), 627 had per protocol images (PSP=297, MSA=330). Intra-rater (n=60) and inter-rater (n=555) reliability were assessed through Cohen's statistic, and scale structure through principal component analysis (PCA) (n=441). Internal consistency and reliability were checked. Discriminant and predictive validity of extracted factors and total scores were tested for disease severity as per clinical diagnosis. Results: Intra-rater and inter-rater reliability were acceptable for 25 (78%) of the items scored (≥0.41). PCA revealed four meaningful clusters of covarying parameters (factor (F) F1: brainstem and cerebellum; F2: midbrain; F3: putamen; F4: other basal ganglia) with good to excellent internal consistency (Cronbach α 0.75–0.93) and moderate to excellent reliability (intraclass coefficient: F1: 0.92; F2: 0.79; F3: 0.71; F4: 0.49). The total score significantly discriminated for disease severity or diagnosis; factorial scores differentially discriminated for disease severity according to diagnosis (PSP: F1–F2; MSA: F2–F3). The total score was significantly related to survival in PSP (p<0.0007) or MSA (p<0.0005), indicating good predictive validity. Conclusions: The scale is suitable for use in the context of multicentre studies and can reliably and consistently measure MRI abnormalities in PSP and MSA.

Journal of Urology

Purpose: Despite the increased morbidity and mortality of radical cystectomy in elderly individuals with bladder cancer numerous studies show that surgery can provide a survival benefit. We sought to better identify patients at substantial risk for postoperative mortality. Materials and Methods: We evaluated 220 consecutive patients 75 years old or older treated with radical cystectomy for bladder cancer at a single institution from 2000 to 2008. The analytical cohort comprised 169 patients with complete preoperative data available. A Cox proportional hazards model was used to determine the value of precystectomy clinical information to predict 90-day survival after radical cystectomy. Results were used to create a nomogram predicting the probability of 90-day survival after radical cystectomy. The model was then subjected to 200 bootstrap resamples for internal validation. Results: Of the 220 patients 28 (12.7%) died within 90 days of surgery. Older age (HR 2.30, 95% CI 1.22–4.32) and lower preoperative albumin (HR 2.50, 95% CI 1.40–4.45) were significant predictors of 90-day mortality. We developed a nomogram based on patient age, clinical stage, Charlson comorbidity index and albumin to predict the likelihood of 90-day mortality with 75% accuracy. Internal validation showed a bootstrap adjusted concordance index of 71%. Conclusions: We developed a nomogram that provides individualized risk estimations to predict the probability of 90-day mortality, potentially enhancing preoperative counseling and providing clinicians with an added tool to individualize treatment decisions in this challenging patient population. These data suggest that albumin is a strong predictor of postoperative mortality and show the importance of assessing this variable before surgery.

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23^rd February 2012

NX 1207 (Recordati/Nymox) starts Phase III trial for BPH Men's Health, Andrology and Urology Page

Recordati and Nymox Pharmaceutical Corporation announced the start of activities aimed to the preparation of a European Phase III clinical trial for NX-1207, following the successful completion of a Scientific Advice meeting with the European Medicines Agency. NX-1207, is a Phase III investigational drug from Nymox and is currently in clinical development in the United States for the treatment of Benign Prostatic Hyperplasia (BPH). The pivotal controlled clinical trial will assess the efficacy and safety of a single TRUS-guided intraprostatic injection of NX-1207 in patients with lower urinary tract symptoms (LUTS) associated with BPH not adequately controlled by medical therapy.The drug is injected by a urologist in an office setting directly into the zone of the prostate where the enlargement occurs and involves little or no pain or discomfort. NX-1207 has successfully completed a series of blinded controlled multi-center U.S. clinical trials where a single dose of NX-1207 has been found to improve the signs and symptoms of BPH, with improvements about double those reported for currently approved BPH drugs, and without the side effects associated with those drugs, which can include sexual problems and blood pressure changes. Follow-up studies have shown evidence of long lasting benefit with a significant proportion of men reporting maintained improvement in BPH symptoms without other treatments for up to 7½ years.

Zelboraf (Daiichi Sankyo/Roche) is EU approved for BRAFV600 mutation Metastatic Melanoma Page

Plexxikon Inc., a member of Daiichi Sankyo Group,has announced that the European Commission has approved Zelboraf (vemurafenib) for the monotherapy treatment of adult patients with BRAFV600 mutation-positive unresectable or Metastatic Melanoma. The cobas 4800 BRAF V600 Mutation Test, a companion diagnostic used to identify patients with the BRAF mutation, is CE marked and commercially available in Europe. Zelboraf is designed to selectively inhibit the BRAF mutation that occurs in about half of all cases of melanoma. Zelboraf and its companion diagnostic have already been approved in the United States, Switzerland, Israel, Brazil, New Zealand and Canada. In the United States, Zelboraf is being co-promoted by Daiichi Sankyo, Inc. and Genentech, a member of the Roche Group. Roche promotes Zelboraf outside of the United States.

CHMP recommends Pixuvri (CTI Life Sciences) for Non Hodgkin's B-cell Lymphoma Oncology Page

The CHMP has given a conditional recommendation for the approval of Pixuvri (pixantrone dimaleate) from CTI Life Sciences for relapsed or refractory aggressive non-Hodgkin’s B-cell Lymphoma. The drug application at the FDA was withdrawn as additional information was requested. The drug is now scheduled to be considered at the FDA Advisory Comitteee meeting in April 2012.