Don't Just Read the Abstract

On this episode, Pip and Rich discuss Jaber et al. Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial. PEERLESS was a trial that enrolled patients with intermediate-risk (sub-massive) PE and randomised them to either large-bore mechanical thrombectomy or catheter directed thrombolysis. The headline finding from PEERLESS is that mechanical thrombectomy is superior to catheter directed thrombolysis but as ever, if you read beyond the abstract, you will find that it is much more complex than that. The study used an interesting primary endpoint called "win ratio" and the show includes a detailed explanation and analysis of what this is, its benefits, and its drawbacks.

On this episode, Pip and Rich chat to Fouad Al Noor, CEO of ThinkSono. ThinkSono have developed an AI-powered handheld scanning tool for DVT that enables anyone to perform a diagnostic quality ultrasound scan for the diagnosis of DVT. The images are then reviewed by a radiologist, providing a rapid answer for most patients. The tool is entering use within the NHS and in this podcast, Pip and Rich discuss the story and the evidence behind ThinkSono as well as the challenges and opportunities that the tool provides.For more information, visit www.thinksono.com and to access the evidence, head to www.thinksono.com/research.Pip and Rich have no relevant conflicts of interest for this episode. The podcast was initially started thanks to a hands off grant from Sobi who have had no editorial input into the show.

In this episode, Rich and Pip discuss de Latour et al. Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria. NEJM 2024. Iptacopan is a proximal complement inhibitor and the first oral treatment for paroxysmal nocturnal haemoglobinuria. The study randomised patients to either continuation of a C5 inhibitor or switch to ictacopan and found that a significant proportion of patients achieved hemoglobin levels of 120 g/L or higher without the need for transfusions. The treatment was generally well-tolerated, with a safety profile consistent with previous studies, suggesting that iptacopan is a viable alternative to existing therapies.Join us as we delve into the study's methodology, results, and implications for the future management of PNH.

In this episode, Pip and Rich discuss plasma exchange free treatment of thrombotic thrombocytopenic purpura with Dr Lucas Kuhne and Professor Paul Brinkoetter, authors of a recent study in Blood: Kühne et al. Management of immune thrombotic thrombocytopenic purpura without therapeutic plasma exchange.The study is an observational, retrospective study reporting outcomes of patients with TTP who were treated without plasma exchange, which is currently considered the standard of care. The advent of a novel nanobody against vWF called caplacizumab, that targets and prevents catastrophic thrombosis that is seen in TTP, has allowed the study of this approach.

In this episode, Rich and Pip discuss a paper a German/Austrian study published in Blood: Kühne et al. Management of immune thrombotic thrombocytopenic purpura without therapeutic plasma exchange.The study is an observational, retrospective study reporting outcomes of patients with TTP who were treated without plasma exchange, which is currently considered the standard of care. The advent of a novel nanobody against vWF called caplacizumab, that targets and prevents catastrophic thrombosis that is seen in TTP, has allowed the study of this approach. Rich and Pip discuss the nuances of the paper and offer critical analysis. In a follow-up episode, Rich and Pip will interview the study authors.

In this episode, Rich and Pip discuss gene therapy for sickle cell disease, focusing on Frangoul et al. Exagamglogene Autotemcel for Severe Sickle Cell Disease, NEJM 2024.