In this episode, Pip and Rich discuss the ADVANCE IV trial: Efficacy and safety of the neonatal Fc receptor inhibitor efgartigimod in adults with primary immune thrombocytopenia: a multicentre, randomised, placebo-controlled, phase 3 trial.

With the help of Professor of Immunohaematology, Prof. Nikki Cooper, Rich and Pip dissect the trial, learning loads about ITP and the difficulties of doing trials in this space.

Links:

Broome C et al. Efficacy and safety of the neonatal Fc receptor inhibitor efgartigimod in adults with primary immune thrombocytopenia (ADVANCE IV): a multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2023 Nov 4;402(10413):1648-1659

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In this episode, Pip and Rich discuss the FRAIL-AF study: Joosten et al. Safety of Switching From a Vitamin K Antagonist to a Non–Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients With Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial. Circulation. 2024;149:279–289.

This trial randomised the switching of elderly frail patients who were established on a vitamin K antagonist to either remain on this treatment or switch to a direct oral anticoagulant. They found increased rates of bleeding in the switch arm. However, there is a lot of detail that is not in the abstract! Pip and Rich take a deep dive into the manuscript, discuss their thoughts with Chief Investigator, Geert Jan Geersing on the trial, and put the findings into context with consultant haematologist David Sutton.

To read more about this trial check out Rich's blog on it: https://classicalcompass.substack.com/p/frail-af

Links

FRAIL-AF: https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.123.066485

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In this, the first episode Drs Pip Nicolson and Rich Buka take a deep dive into the PACER trial: Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. After a quick round up of other trials that have sparked their interest, Pip and Rich discuss about the study aims and outcomes, before interviewing Dr Floor van Baarle, lead study author before discussing the clinical implications of the trial with Prof Simon Stanworth.

Follow Pip, Rich, and HaemSTAR on X/Twitter: @PipNicolson, @RichardBuka, and @HaemSTAR_UK

To claim CPD credits, please email [email protected].

Links

• van Baarle et al. Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. NEJM, 2023.
• Matsushita et al. Phase 3 Trial of Concizumab in Hemophilia with Inhibitors (explorer7). NEJM, 2023.
• Joosten et al. Safety of Switching from a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients with Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial. Circulation, 2023.
• Warkentin et al. Adenovirus-Associated Thrombocytopenia, Thrombosis, and VITT-like Antibodies. NEJM, 2023
• Zhao et al. Intracerebral Hemorrhage Among Blood Donors and Their Transfusion Recipients. JAMA, 2023

HaemSTAR is an independent UK-wide network of registrars in clinical haematology, interested in promoting and performing research in classical haematology. Our focus is on collaborative projects across haemostasis & thrombosis, transfusion, general haematology, and obstetric haematology.

This episode was sponsored by Sobi as a hands-off educational grant. Sobi had no editorial input whatsoever.

Produced by Joe Apperley. All rights reserved.

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