Blinatumomab replaces chemotherapy cycles in childhood leukaemia; an anti-IL-33 antibody cuts COPD exacerbations; OM-85 fails to prevent wheeze

The edition in brief

In AIEOP-BFM ALL 2017, 709 children with newly diagnosed high-risk B-cell acute lymphoblastic leukaemia were randomised to two cycles of blinatumomab or two cycles of chemotherapy after consolidation. At a planned interim analysis (median follow-up 2.9 years), estimated 4-year event-free survival was 83.0% with blinatumomab and 70.3% with chemotherapy (hazard ratio 0.51, 95% CI 0.35 to 0.73). Treatment-related infection occurred in 23.9% against 69.4%, while neurotoxic events were more frequent with blinatumomab (12.0% vs 3.2%). Two replicate phase 3 trials (OBERON and TITANIA) of the interleukin-33 inhibitor tozorakimab in COPD with prior exacerbations showed rate ratios of about 0.70 for moderate or severe exacerbations over 52 weeks; no approval or availability in India is established. A multinational biopsy-based study of 18,326 people with metabolic dysfunction-associated steatotic liver disease found lean patients had milder histology but similar outcomes, with fibrosis stage rather than body mass index tracking prognosis. Finally, the ORBEX trial of 822 high-risk infants found no reduction in wheezing lower respiratory illness with the bacterial lysate OM-85 given for 24 months (hazard ratio 1.16, 95% CI 0.82 to 1.64).