Weekly review: Nipocalimab data, precocious puberty treatment, and more

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Get caught up with our journal! Review some of the top stories from the Contemporary Pediatrics website over the last week, and catch up on anything you may have missed.

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Thank you for visiting the Contemporary Pediatrics® website. Take a look at some of our top stories from last week (Monday, August 19, to Friday, August 23, 2024), and click on each link to read and watch anything you may have missed.

Nipocalimab promising for preventing fetal, newborn hemolytic disease

Nipocalimab, an investigational drug, shows promise in mitigating hemolytic disease of the fetus and newborn (HDFN), according to the phase 2 UNITY trial published in the New England Journal of Medicine. HDFN occurs when a pregnant woman's immune system attacks the fetus's red blood cells, leading to severe anemia or even fetal death. Nipocalimab works by blocking the transfer of harmful antibodies from the mother to the fetus. The UNITY trial involved 13 high-risk pregnant women, where 46% of the babies did not require blood transfusions during the fetal or neonatal periods, and 54% reached 32 weeks without needing intrauterine transfusions.

The trial showed improved survival rates, with 12 out of 13 babies surviving, compared to a 38% survival rate in similar cases. Nipocalimab was also deemed safe, with no increased risk of severe infections. These results support further investigation in a larger phase 3 trial.

Click here for full study details.

Exploring an individualized treatment approach for central precocious puberty

Central precocious puberty (CPP) is marked by the early onset of puberty—before age 8 in females and 9 in males—due to premature activation of the hypothalamic-pituitary-gonadal axis. Pediatric endocrinologists emphasize the importance of early detection and individualized treatment.

Key signs include breast development in girls and testicular enlargement in boys, which can be subtle. Routine puberty exams during well-child visits are crucial for early identification. If CPP is suspected, pediatricians should perform initial evaluations, such as bone age studies and blood tests, and promptly refer patients to pediatric endocrinologists. These specialists can differentiate CPP from similar conditions and conduct further tests, including hormone stimulation, pelvic ultrasounds, and brain MRIs, to confirm diagnosis and tailor treatment.

Addressing CPP early helps prevent complications like compromised adult height and psychosocial challenges, particularly in girls. Collaboration between primary care providers and endocrinologists is essential for optimal outcomes.

Click here for more.

HIV Roundtable: Managing medications after diagnosis

Welcome to the first episode of our 3-episode series; HIV Roundtable, a collaborative project from Contemporary Pediatrics, Contagion, and Contemporary OB/GYN.

This series discusses several aspects of HIV including clinical management, therapies, vaccines, and multidrug resistance.

In this episode, our panel offers their approaches to care in terms of medications and management when patients are first diagnosed and a discussion around long-acting injectables for HIV management.

Click here for episode 1 of our HIV Roundtable.

FDA approves, authorizes updated mRNA COVID-19 vaccines

The FDA has approved and granted emergency use authorization (EUA) for updated mRNA COVID-19 vaccines for the 2024-2025 season, designed to target the currently circulating variants of COVID-19 more effectively. These updates include a monovalent component that corresponds to the Omicron variant KP.2 strain of SARS-CoV-2, with vaccines manufactured by Pfizer and ModernaTX.

The FDA emphasized that vaccination remains crucial for COVID-19 prevention, particularly with waning immunity from previous infections and vaccinations. The agency assessed the manufacturing and nonclinical data to support the changes, noting that these vaccines are expected to provide protection against circulating variants. The FDA plans to reassess COVID-19 vaccine composition annually.

Click here for full approval and authorization details from the FDA.

Lynn Malec, MD, discusses hemophilia A and the role of pediatricians

Dr. Lynn Malec, a leading expert in hemophilia treatment, emphasized the essential role pediatricians play in managing children with bleeding disorders. While specialized care is typically provided at hemophilia treatment centers (HTCs), pediatricians are crucial in ensuring comprehensive care for these patients.

Malec highlighted the advancements in hemophilia therapies, such as ALTUVIIIO (Sanofi), which have significantly improved the quality of life for children with severe bleeding disorders. These therapies offer excellent protection against bleeding, enabling children to lead healthier and more active lives.

Pediatricians work closely with hematologists to ensure that children with hemophilia receive routine care, including regular well-child visits, and are encouraged to participate in activities previously considered risky. Malec emphasized that as treatment standards evolve, the collaboration between HTCs and pediatricians remains vital in providing optimal care and improving health outcomes for children with bleeding disorders.

Click here for the full video interview.

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