Dear doctors, we bring to you the second part of our exclusive weekly feature. Through this series, we will help you and your peers maintain an optimistic approach, by bringing you articles with developments that have been a big hit in the world of medicine this week.

1. Therapy for tuberculosis (TB) gets shorter

We recently reported an international study, which introduced an altered and shorter course of medication for the treatment of tuberculosis. We cannot help but include this story here as this modified therapy lasts only for four months instead of the originally determined six months. The world over, researchers have been trying to reduce the duration of TB therapy and this new study brings in this welcome change after 20+ years of trials.

The altered therapy replaces two drugs in the traditional treatment protocol with two new agents – high-dose Rifapentine and Moxifloxacin. The new therapy is deemed suitable for patients, who do not exhibit drug resistance. What this means for TB patients is that they can resume work sooner and therefore, there would be less of a financial load on the family. This development also gives hope to doctors that they will see reduced non-compliance to TB therapy in their patients – a pattern commonly seen in TB patients in India.

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2. Findings from 2020 that redefined cardiology practices

Several clinical trials pertaining to cardiology that concluded in 2020, offered a new perspective to practising cardiologists. If you missed the previously reported story, here are some noteworthy drugs-related findings:

1. Ticagrelor monotherapy (TICO) after 3 months of DAPT showed better results than 12 months of DAPT therapy for ACS patients on PCI with ultra-thin biodegradable-polymer sirolimus-eluting stents. TICO successfully curbed net ischaemic composite and bleeding events.
2. Empagliflozin offered better outcomes than placebo in HF patients (even if diabetic) with symptomatic healthy HFrEF (EF ≤40 per cent) on excellent guideline medical therapy (GDMT). The outcomes showed a decrease in HF-related hospitalisations, better renal results, and an early and sustained advantage to the KCCQ-CSS.
3. Vericiguat helped increase soluble guanylate cyclase activity in patients < 75 years of age and minimised premature mortality/hospitalisation. They also did not need renal function or electrolyte testing, and the drug was overall, well-accepted.
4. Rivaroxaban in AF/AFL patients with a bioprosthetic mitral valve served as well as, if not better than Warfarin in preventing thromboembolic events.
5. Aspirin showed decreased bleeding and non-procedural bleeding as compared to Aspirin and Clopidogrel combined for patients treated with TAVR and had no indicative anticoagulation.

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3. Patients with mild COVID-19 were found to have antibodies in bone marrow

Researchers at the Washington University School of Medicine in St. Louis presented this finding in a recent study. According to senior author Ali Ellebedy, normally antibodies plateau after an acute infection. However, in the subjects they studied, the team found that the bodies of patients of COVID-19 were producing antibody cells even 11 months after reporting their first symptoms. The cells were found in the bone marrow, which means that they will live, continue producing antibodies, and provide long-lasting immunity.

However, asymptomatic patients may also have a similar antibody secretion happening in their marrows but there is no evidence as yet. Further investigation is needed to find out if those with severe COVID-19 would have immunity against future infection.

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4. Researchers from IIT-Mandi find key protein structure in SARS-CoV-2

Great strides have been made with the advent of vaccines for the new coronavirus. However, we do not yet have any drugs that can act upon the virus and prevent its multiplication. So a team of researchers at IIT-Mandi studied the structure and role of key viral proteins, which are elementary in the development of anti-viral medicines. They conducted their experimental study on SARS-CoV-2 and studied the non-structural protein 1 (NSP1). The team was the first to ever study amino acids 131-180 of NSP1, which significantly suppresses the host immune system.

After observing the structural conformations of the new coronavirus NSP1 in different environments, they discovered that on removing residues of 131-180 (the C-terminal region), NSP1 fails in stopping the ribosome translation. Also, their technical analyses enabled them to understand and present findings around the dynamic structural changes in IDR of NSP1 and functions of NSP1 and other viral proteins, which can further help develop drugs that can directly target the virus.

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Details of researches and studies referred to in the article can be found in the original articles. We hope you like this section and turn to it for a quick read every week.