No abstract

Objective: To review the mechanism of action, clinical efficacy, safety, dosage, administration, and role of copanlisib in the treatment of relapsed follicular lymphoma (FL). Data Sources: Sources of information were identified through searches of PubMed (August 2014 to January 2019) using the key terms copanlisib, Aliqopa, PI3K inhibitor, and BAY 80-6946. Unpublished abstract information was obtained from the American Society of Clinical Oncology. Study Selection and Data Extraction: Review articles and studies in the English language evaluating the pharmacology, efficacy, and safety of copanlisib were included. Data Synthesis: Copanlisib is the first intravenous phosphatidylinositol 3-kinase (PI3K) inhibitor approved for the treatment of relapsed FL in patients who have received at least 2 prior systemic therapies. The safety and efficacy of copanlisib has been studied in the multicenter, single-arm, phase II CHRONOS-1 study. The results reported for FL patients were an objective response rate of 59%, a complete response of 14%, median duration of response of 22.6 months, and median progression-free survival of 11.2 months. The most common adverse events reported were hyperglycemia and hypertension, which were infusion related and transient. Relevance to Patient Care and Clinical Practice: Copanlisib is unique in that it is a pan–class I PI3K inhibitor with preferential inhibitory activity against the PI3K-α and PI3K-δ isoforms. It has a more favorable safety profile than the other agents in its class with no late-onset toxicities. Conclusions: Copanlisib provides an alternative option for patients with relapsed FL. It is safe and effective and has an acceptable toxicity profile.

Background: Data collection by smartphone is becoming more widespread in healthcare research. Previous studies reported racial/ethnical differences in the use of digital health technology. However, cross-language group comparison (Chinese-and Englishspeaking older adults) were not performed in these studies. This project will expand to smartphone technology use in diverse older populations with a focus on Chinese American older adults who are monolingual Chinese-speakers.Method: The Alzheimer's Disease Research Center (ADRC) at Icahn School of Medicine at Mount Sinai (ISMMS) evaluates diverse older populations using National Alzheimer's Coordinating Center's Uniform Data Set (NACC UDS). The UDS has different language versions, including English and Chinese. The evaluation includes a medical examination, cognitive assessments, and a research blood draw. Smartphone ownership and usage were captured using a local questionnaire developed by our ADRC. The questionnaire, available in English and Chinese, was administered by our ADRC coordinators during the COVID-19 pandemic. Multivariate analysis of variance (MANOVA) was used to examine differences in technology ownership and usages between the two language groups, while controlling for age, gender, education, and cognitive status (measured by Clinical Dementia Rating).Result: 33 Chinese-and 117 English-speaking older adults who received a diagnosis of normal cognition or mild cognitive impairment at consensus were included in the data analysis. Results reveal a high prevalence of smartphone ownership in our Chinese-(100%) and English-speaking older participants (86.3%). Participants in both language groups use mobile technology for a wide range of purposes, such as getting news and other information (Chinese=90.9%; English=87.2%), sending/receiving text (Chinese=97.0%; English=96.6%), watching videos/TV shows (Chinese=78.8%; English=69.2%), and taking classes (Chinese=57.5%; English=57.3%). However, Chinese-speaking older adults were less likely than English-speaking older adults to use mobile technology to post their own reviews

Objective: The AHA Life’s Simple 7 (LS7) defines cardiovascular health with smoking, physical activity, diet quality, body mass index (BMI), blood pressure, total cholesterol, and blood glucose. We examined changes in LS7 score and its components in older adults over seven years of follow-up. Methods: We analyzed 2,234 adults aged 65+ in the Cardiovascular Health Study who had all LS7 components measured at baseline (1989) and seven years later (1996). We scored each component as ideal (2), intermediate (1), or poor (0). LS7 score was the sum of components, ranging from 0 (worst) to 14 (best), then categorized as ideal (10-14), intermediate (5-9), or poor (0-4). Results: Mean LS7 score at baseline was 8.71, declining by 0.24 points (95% CI: 0.17, 0.31) to 8.47 seven years later. At baseline, LS7 score was ideal in 35% of participants, intermediate in 63%, and poor in 1.7%. Seven years later, the distribution shifted down, with 31% scoring ideal, 67% scoring intermediate, and 2.0% scoring poor. Of those scoring ideal at baseline, 57% (95% CI: 53%, 60%) maintained ideal scores seven years later (Figure, Panel A). Of those scoring intermediate at baseline (Panel B), 18% (95% CI: 16%, 20%) improved to ideal. Of those scoring poor at baseline (Panel C), 76% (95% CI: 63%, 90%) improved to intermediate, but none improved to ideal. For components, maintenance of baseline ideal status was 95% for smoking, 86% for glucose, 80% for BMI, 77% for cholesterol, and 55% for physical activity, but only 35% for blood pressure and 7% for diet (Panel A). Decline of baseline intermediate status to poor was 33% for blood pressure and 24% for diet (Panel B). Improvement of baseline poor status to intermediate or ideal was >50% for cholesterol and physical activity and >40% for smoking and diet (Panel C). Conclusions: While cardiovascular health declined on average in an aging population, some older adults improved their cardiovascular health as they aged. Declines in diet quality and blood pressure control contributed to overall declines in cardiovascular health.

Objective: The AHA Life’s Simple 7 (LS7) defines cardiovascular health with smoking, physical activity, diet quality, body mass index (BMI), blood pressure, total cholesterol, and blood glucose. We examined associations of LS7 score and its components with cognitive decline in older adults. Methods: The Cardiovascular Heart Study is a longitudinal cohort of 5,888 adults aged 65 and above. We analyzed 4,165 who had LS7 score measured at baseline (1989), complete covariate data, and at least one Modified Mini-Mental State Examination (3MS) score during follow-up (through 1998). We scored each LS7 component as ideal (2), intermediate (1), or poor (0), summed all components to a total LS7 score ranging from 0 (worst) to 14 (best), and categorized total LS7 score as ideal (10-14), intermediate (5-9), or poor (0-4). 3MS is a measure of global cognition ranging from 0 (worst) to 100 (best) and was obtained annually during a mean follow-up of 6.8 years. Using linear mixed models, we estimated associations of LS7 score and its components with annual rate of cognitive decline, adjusted for demographic, behavioral, and clinical factors. Results: In adjusted models, mean annual decline in 3MS score was 0.83 points (95% CI: 0.61, 1.04) for those with poor LS7 scores at baseline, 0.63 points (95% CI: 0.59, 0.67) with intermediate scores, and 0.42 points (95% CI: 0.37, 0.47) with ideal scores (p < 0.0001 for difference in mean annual decline across LS7 categories). Better physical activity, diet quality, blood pressure control, and blood glucose control were all associated with slower cognitive decline (Table). BMI, however, was opposite, with obesity (poor) associated with slower decline, and normal weight (ideal) associated with faster decline (p <0.0001). Conclusions: Better cardiovascular health measured by LS7 in old age is associated with slower average cognitive decline. The role of BMI as a component of LS7 in older adults may warrant reconsideration, as lower BMI in late-life may represent frailty and increased risk for cognitive decline.