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The Update

Issue #20, May 2021

The Update is a monthly digest of all that is interesting, exciting and new in the world of medicine and medical science, presented in a curated and convenient package.

1.  Polypill More Effective Than Usual Care for Reducing Cardiovascular Risks

Polypill for Diabetes: Metformin, Aspirin, Statin and Ace-Inhibitors
  • In a recent RCT, patients at intermediate CV risk randomized to a polypill containing simvastatin, atenolol, hydrochlorothiazide, ramipril, and 75 mg aspirin had reduced CV events at an average 4.6 years vs placebo, with modest reductions in LDL cholesterol and blood pressure
  • Attempts to deliver efficient, inexpensive guideline-directed therapy to manage CV risk and disease have led to multiple polypill proposals, eg for diabetes (metformin, aspirin, statin, ACE inhibitor [image]) and heart failure (β-blockers, RAS blockers with neprilysin inhibitors, mineralocorticoid receptor antagonists)
  • There is a perception among some that polypills could represent suboptimal care for disease prevention and control in individuals despite the success of fixed-dose combination therapy for other diseases (eg, HIV/AIDS, tuberculosis, malaria)
Read more

2. Can progesterone improve COVID-19 outcomes in men?

Progesterone Injection Used to Improve COVID-19 Outcomes in Hospitalized Men
  • A small-scale (42 men) pilot study tested whether injectable progesterone (dose of 100 mg twice daily by subcutaneous injection) improved outcomes in men hospitalized with moderate-to-severe COVID-19.
  • The study is based on the ability of progesterone to dampen the exaggerated immune response or the “cytokine storm” that causes severe lung injury, which sometimes leads to fatalities in people with a SARS-CoV-2 infection
  • The overall clinical score of the patients who took the hormone was higher than those who only received standard care. And by the 7th day, 50% of patients in the progesterone group remained hospitalized compared to 86% of patients in the control group. Mechanical ventilation was initiated in four of 22 control patients on day 3. In the progesterone group, however, nobody required ventilation.
  • The study concludes that further research is required to assess progesterone’s safety and efficacy for the treatment of COVID-19 in a larger, more diverse population.
Read more

3. Breast Cancer Metastases Supported by Bone Microenvironment

Breast Cancer Metastasis Locations
  • Breast cancer mostly metastasizes to the bone; however, it has remained a mystery why, in more than two-thirds of cases, metastases will subsequently occur in other organs and eventually cause death.
  • In the two studies, the researchers applied a series of models and techniques they had previously developed to determine cancer-bone interactions at a single-cell resolution to observe what happens to ER+ breast cancer cells when they metastasize to the bone.
  • “Using several approaches, including parabiosis and an evolving barcode system, we demonstrated that the bone microenvironment facilitates breast and prostate cancer cells to further metastasize and establish multi-organ secondary metastases. We uncovered that this metastasis-promoting effect is driven by epigenetic reprogramming that confers stem cell-like properties on cancer cells disseminated from bone lesions,” wrote the researchers.
  • “Surprisingly, we discovered that when ER+ breast cancer cells locate in the bone, they reduce their expression of ER, which makes them less susceptible to endocrine therapies directed at ER,” added author Igor Bado
Read more


Dr. Maryam Matar, MD, PhD. Founder & Chairperson of UAE Genetic Diseases Association (UAEGDA)
Dr. Maryam Matar is one of the scientist pioneers of the UAE, her contribution to research and innovation is a true inspiration. She had made great changes in the UAE through her work, of which she had conceptualized a national body on a genetic disorder, awareness, and prevention and founded the UAE's Genetic Diseases Association (UAEGDA) and Sheikh Zayed Research Centre in 2004. 

She is currently serving on the panel of the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease. The Global Commission will develop an actionable roadmap to help the rare disease field to shorten the multi-year diagnostic journey, considered a key to a longer, healthier life.

As the founder of GCC Genomics Society, in partnership with Saudi Genome Project, she is dedicated to the development of studies, bringing the regional experts together, and help the research community to the potential of genomics. This project aims to connect the global and regional research centers and also create a GCC-wide knowledge bank. 
Copyright © 2021 RAK Medical & Health Sciences University, All rights reserved.

For comments and corrections, please contact the authors:
Nour Kamal Saba'neh - 
Science & Technology Officer | +971551227108
Ruba Hassan - Member, Committee on Science & Technology
Abdullah Ahmed Tariq - Member, Committee on Science & Technology
Zaki Emad - Member, Committee on Science & Technology

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