News in brief: Tofacitinib salvage therapy in ASUC; Virtual FOBT clinics offer faster time to colonoscopy; Gender disparity in citations a career barrier for women in medicine

Research

7 Jul 2021

Tofacitinib suceeds as salvage therapy in ASUC

High-dose tofacitinib may have a role as salvage therapy following non-response to infliximab in patients with steroid-refractory acute severe ulcerative colitis (ASUC), Australian clinicians have suggested.

Dr Robert Gilmore and colleagues at the Department of Gastroenterology, Austin Health, Melbourne, have reported a case series in which four out of five patients responded to high-dose tofacitinib 10mg three times a day immediately following non-response to infliximab for steroid-refractory ASUC.

At 90 days, the patients who responded initially to tofacitinib remained colectomy-free, with two patients achieving combined clinical and endoscopic remission. The therapy also appeared to be well tolerated with no adverse events directly attributable to high-dose tofacitinib identified.

“Prospective studies are required to determine the safety and efficacy of high-dose tofacitinib to determine whether it can be routinely recommended as primary or sequential salvage therapy in the setting of steroid-refractory ASUC,” they wrote in the Journal of Crohns and Colitis.


Virtual FOBT clinics offer faster time to colonoscopy

Direct access colonoscopy via a nurse-led virtual clinic appears to be an effective way to reduce colonoscopy waiting times for patients with a positive FOBT.

In a pilot study at St George Hospital, Sydney, clinical nurse consultants triaged 167 patients by telehealth, screened for comorbidities and other relevant history, and determined who was suitable for direct access colonoscopy or medical review.

Patients for direct access colonoscopy were booked to the next available appointment of the endoscopy list.

Compared to the standard of care outpatient clinic, the virtual clinic model reduced waiting time to colonoscopy from date of positive FOBT by 71 days (p = 0.0006) and from date of referral by 66 days (p <0.0001).

“Although both models were able to meet the 180 day target on average, the virtual clinic model had markedly improved waiting times due to direct access colonoscopy.”

There was no significant difference in bowel preparation, adverse events or cancellation rates between each group.

Internal Medicine Journal 


Gender disparity in citations a career barrier for female academics in medicine

Women face an additional barrier to advancement in academic medicine because their articles published in medical journals have fewer citations than those written by men, a US study shows

An analysis of 5,554 articles published in 5 high-impact journals showed that, 36% had a female primary author, and 26% had a female senior author.

However, articles with women as primary author were cited a median of 36 times in other journals, compared to 54 citations of articles with male primary authors.

As senior authors, women were cited a median of 37 times, while male counterparts received a median of 51 citations.

The disparity is likely putting female academics at a disadvantage compared to their male peers because the number of citations of peer-reviewed articles is commonly used as a metric for academic recognition, influence, and in professional evaluations and promotion, the study authors said.

“This imbalance will not be solved through hiring and mentoring more women alone,” said senior author, Dr Rachel Werner of the University of Pennsylvania.

“We must also work to ensure that women already in academic medicine are equally valued and promoted for their contributions and their successes. From the journals publishing this work, to academic institutions promoting articles once published, everyone should be invested in bridging this gender divide.”

 

Already a member?

Login to keep reading.

OR
Email me a login link