💡Bottom line Resmetirom showed clinically meaningful histologic & metabolic benefits in NASH in fibrosis #NEJM #NASH

📊 Key Highlights from our discussion ✅Phase 3 trial design ✅Randomized, double-blind, placebo-controlled design ✅Weighted Bonferroni approach ✅1:1:1 randomization

🎯 Multiple Endpoints (52 wks) - NASH resolution without worsening fibrosis -Fibrosis improvement without worsening NASH -Secondary outcomes: MRI-PDFF, lipids, serum biomarkers, adverse events (nausea, diarrhea)

📌 PICO Summary P: Adults with biopsy-confirmed NASH + stage F1b-F3 fibrosis I: Resmetirom (80mg, 100mg daily) C: placebo O: Histologic NASH resolution or fibrosis improvement at 52 weeks Study included ~1,000 patients, double blind, randomized✅

This week for journal club, we covered this phase 3 RCT on #NASH #LiverDisease #Resmetirom with our moderators @RMAtkinsMD and @RyanNipp! Let’s break it down with a PICO summary, multiple endpoints, and key topics of discussion!

🔬Topics we covered today! ✅ internal & external validity ✅ noninferiority trial results/stats interpretation 👩‍⚕️what changes would we have made in designing this trial? 👨‍⚕️how do we apply this work to our patients and our practice?

📝Conclusion 🩺Extended anticoagulation with reduced dose apixaban was non-inferior to full-dose apixaban for recurrent VTE prevention in patients with active cancer

📈Results 💊Recurrent VTE occurred in 18 pts in reduced dose vs 24 pts in full dose group 🩸Clinically relevant bleeding occurred in 102 pts in reduced dose vs 136 pts in full dose group

💡The PICO breakdown🧐 👥 Population: patients w cancer and VTE who completed 6 mo of AC 💊Intervention: 1:1 randomization to reduced dose apixaban 2.5mg BID vs control 🆚Control: full dose apixaban 5mg BID 🎯Outcome: Recurrent VTE & bleeding events over 12mo follow up period

🩸This’s week journal club feature:  Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism 🔗: https://t.co/v2k1mcT6B3 Presenter: @anhbl9 Moderator: @RMAtkinsMD

🗣️ Always ask yourself: Is this clinically relevant to my patients? 📚 Stay sharp. Think deeper. Question more. #MedTwitter #EBM #Journalclub #CriticalAppraisal #OPTIMISEtrial #Geriatrics #OUHSC #PICO

What we learned: 🧪 Dive Deeper into Methods 🧩 Subpopulations ⚖️ Non-inferiority vs Superiority 🧠 Intention-to-Treat vs Per-Protocol 👀 Hawthorne Bias (esp. in unblinded trials!)

📈 Conclusion: In older patients on multiple antihypertensives, med reduction was non-inferior to usual care for BP control at 12 weeks. 🩺 No major impact on BP control = consider thoughtful de-prescribing

Thinking critically about clinical trials? Don’t just read — dissect! 🔬 📌 PICO: 👥 Population: Adults >80 yrs, SBP ≥150 mmHg, on ≥2 anti-HTN meds 💊 Intervention: 1:1 randomization to med reduction vs 🆚 Control: Usual care 🎯 Outcome: SBP <150 mmHg at 12-wk follow-up

🧠🔍 Journal Club Recap! This Monday we discussed the OPTIMISE Trial — de-escalation of antihypertensive meds in adults >80 yrs. 👨‍⚕️ Moderators: Dr @RyanNipp and Dr @RMAtkinsMD 🔗: https://t.co/JOpGrd4ykp

Some of our outstanding @StephensonCC team at #ASCO25!! Our fellow @Noha_Soror presented a prospective inpatient PRO study at OU with mentorship of @RyanNipp! Also my first time seeing @TheDrWood in-person since his move!! What an amazing collaborative space we are in🩵

Happening right now!! Check out these posters from @OUCollegeofMed trainees at #ASCO25 in the Quality Care/HSR poster session!! Meet me at poster 411 to learn about our national survey project seeking to understand reported health experiences of immigrant patients with cancer!

Dr. Liles representing OU at ASCO! Congrats Jon!

I’m truly grateful for the opportunity to serve as one of the 24-25 @OU_internalmed Chiefs. It’s been an incredible year of growth for me. I couldn’t have asked for a more dedicated group of co-chiefs who always placed residents first. Looking forward to all that lies ahead!

Our Pre Chiefs at the AAIM conference. They will be taking over in just a few months! The program will be in great hands with them.