severe lesions. Studies of mild AD that use low EASI scores as an inclusion criterion may enroll a diverse mixture of patients with different extent and lesional severity. These results shed light on the interpretation of EASI scores in the mild range. Previous interpretability studies found that EASI scores of 0 to 7.0 encompass almost clear or mild AD, 6 yet this encompasses a heterogeneous group of patients. In EASI, the lowest surface area category is quite broad at 1% to 9% and equally weights cases with a 1-cm plaque or 9% of the body site affected. EASI may be a poorer measurer than oSCORAD when assessing patients with more limited disease. Alternatively, it is possible that oSCORAD/SCORAD is a poor measure of mild disease with too broad a range of values. We believe this to be less likely, because unlike EASI, the oS-CORAD/SCORAD scores had linear relationships with POEM. Nevertheless, inclusion of xerosis in the oSCORAD/ SCORAD might reduce its responsiveness, because xerosis may be present in the absence of active AD lesions. Moreover, assessing xerosis can be challenging in clinical trials because it varies by the frequency, vehicle, and time of last application of emollients/moisturizers. In conclusion, the present results provide further support for the inclusion of oSCORAD and/or SCORAD in addition to EASI in clinical trials. oSCORAD/SCORAD correlated better with POEM than did EASI. However, the merits of assessing both EASI and SCORAD in trials has to be weighed against the excess burden of data collection for investigators and patients, as well as difficulties in training investigators in how to assess both scales.

The incidence of acute myeloid leukemia (AML) increases with age. Intensive induction chemotherapy containing cytarabine and an anthracycline has been part of the upfront and salvage treatment of AML for decades. Anthracyclines are associated with a significant risk of cardiotoxicity (especially anthracycline-related left ventricular dysfunction [ARLVD]). In the older adult population, the higher prevalence of cardiac comorbidities and risk factors may further increase the risk of ARLVD. In this article of the Young International Society of Geriatric Oncology group, we review the prevalence of ARLVD in patients with AML and factors predisposing to ARLVD, focusing on older adults when possible. In addition, we review the assessment of cardiac function and management of ARLVD during and after treatment. It is worth noting that only a minority of clinical trials focus on alternative treatment strategies in patients with mildly declined left ventricular ejection fraction or at a high risk for ARLVD. The limited evidence for preventive strategies to ameliorate ARLVD and alternative strategies to anthracycline use in the setting of cardiac comorbidities are discussed. Based on extrapolation of findings from younger adults and nonrandomized trials, we recommend a comprehensive baseline evaluation of cardiac function by imaging, cardiac risk factors, and symptoms to risk stratify for ARLVD. Anthracyclines remain an appropriate choice for induction although careful risk-stratification based on cardiac disease, risk factors, and predicted chemotherapy-response are warranted. In case of declined left ventricular ejection fraction, alternative strategies should be considered.

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sterols (all P > 0.05). Summing up, circulating PCSK9 is increased by cholesterol synthesis and absorption inhibitors. Increased PCSK9 expression may partly explain the strong reductions of LDL-cholesterol achieved with PCSK9-antibodies after such pretreatment. On the other hand, treatment with PCSK9-antibodies does not significantly change the balance between cholesterol synthesis and absorption.

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