Meningococcal disease: My survival story

2025-04-28T08:01:00

(BPT) – By Jonathan Deguzman

The doctors who saved my life in 2005 had to amputate all 10 of my fingers and both of my feet, in order to do so.

The loss of my limbs was due to gangrene, which was caused by a highly contagious and deadly infection called meningococcal disease, a form of bacterial meningitis. I hadn’t been vaccinated against the disease as the shot wasn’t recommended by the Centers for Disease Control and Prevention (CDC) at that time. The consequences were devastating. I learned my fingers and feet had been amputated after I emerged from a 12-day coma.

The first few hours of a case of meningococcal disease are easy to dismiss as nothing too serious, like a common cold or case of influenza. The initial meningococcal disease symptoms I experienced looked a lot like the flu: Shivers. A headache. Stiff neck. It’s not unusual for everyone to mistake the early symptoms of IMD for a more common viral infection. But making that mistake can be deadly. With meningitis, membranes surrounding the brain and spinal cord become inflamed. Meningococcal disease is fatal for 10 to 15 in 100 people, sometimes within only a matter of hours. It’s one of the reasons why I support the CDC’s recommendation to vaccinate 11- and 12-year-olds against the disease — and why any change to these recommendations should be carefully considered.

The proposed potential changes to the MenACWY recommendation would eliminate the recommendation that has been in place for almost 20 years to give a dose of this vaccine to kids at ages 11-12 years, leaving only a single dose at age 16, meaning healthcare professionals would miss out on a critical opportunity to help protect children entering the high-risk adolescent age group. At ages 11 and 12, children are not only at risk of contracting meningitis, they are also more likely than older teenagers to receive routine preventive care. These check-ups and vaccine appointments are critical opportunities for young adolescents to be educated on the symptoms of meningococcal disease. At this age, they are starting to participate in the activities that might lead them to catch this disease. Meningococcal meningitis is contagious and can spread via respiratory droplets or from contact with saliva, meaning it can spread through activities like kissing or sharing beverages.

I grew up during the pre-vaccination era for meningococcal disease. Back then, the risk of contracting meningococcal disease among adolescents began to increase as early as age 11. Fortunately, the current CDC-recommended, two-part vaccination schedule, which advises that a first dose be given at ages 11-12 and a booster dose at 16 years old, has contributed to a significant decrease in disease incidence in the adolescent age group.

If I had known about meningococcal disease, and if I had known a vaccine was available, I believe I wouldn’t be using prosthetics today. I had never even heard the word “meningitis” until I emerged from a coma 19 years ago and learned about my diagnosis from my father. My mother, however, was speechless. When I was in that coma for nearly two weeks, my parents had started planning for my funeral. She knew then, and we never forget, even two decades later, how lucky we are.

Like me, one in five survivors of meningococcal disease will experience long-term effects from the disease, such as deafness, brain damage, nervous system problems, and loss of limbs. Although rare, cases can be deadly, with case fatality rates ranging from 10 to 15 percent. Statistics and stories like mine can be hard to talk about. But I never forget that up to 15 percent of the people who contract meningococcal disease cannot tell their own story. I tell mine for them — and so that other people won’t share our experience.

This article was published with the support of Sanofi.

Tardive Dyskinesia Awareness Week Advances Education, Early Screening & Care

2025-04-28T08:01:00

(BPT) – Tardive dyskinesia (TD) is an involuntary movement disorder characterized by uncontrollable movements of the face, torso, limbs, and fingers or toes. TD is associated with the use of antipsychotic medication that may be necessary to treat individuals living with mental illnesses.

May 4-10, 2025, marks the 8th annual TD Awareness Week, a week dedicated to elevating discussions on TD to reduce the stigma and empower those impacted by the condition. Talk to your doctor about routine screenings for TD, how to recognize symptoms and ways to manage including treatment options at TalkAboutTD.com. Sponsored and developed by Neurocrine Biosciences, Inc.

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Are You Missing the Signs? 5 Health Conditions Women Often Overlook

2025-04-28T08:01:00

(BPT) – Sometimes your body sends signals that something’s not quite right, but those signals don’t always match what you’d expect. Many common health conditions show up differently in women than in men, yet most medical research and education have traditionally focused on male symptoms. Combined with cultural assumptions and conflicting information, it’s no surprise that some signs get missed in women. In fact, according to a recent MD Live by Evernorth survey, while two-thirds of women say they feel confident recognizing symptoms, most were unable to correctly identify female-specific signs of common health issues from heart disease to mental health conditions.

“When symptoms are vague or don’t fit the usual description, they’re easy to miss or misinterpret, especially in women,” explains Dr. Maggie Williams, Medical Director of Primary Care at MD Live. “The more women understand the ways their bodies communicate distress, the quicker they can act on them and the better they can advocate for the care they deserve.”

Dr. Williams breaks down five common health conditions where women’s symptoms may look different and explains how to spot the signs that you should seek care.

1. Heart Attack

While chest pain is a hallmark heart attack symptom for both men and women, women are much more likely to experience accompanying or alternative symptoms that are subtler and easier to dismiss. These can include nausea, vomiting, shortness of breath, jaw, neck and back pain, and overwhelming fatigue. As a result, these symptoms are often mistaken for anxiety, acid reflux, or run-of-the-mill tiredness, which can cause women to delay seeking care right away.

2. ADHD

ADHD has long been associated with hyperactivity and impulsivity traits that are more commonly seen and diagnosed in boys. However, in girls and adult women, symptoms can be far more subtle and internalized: trouble focusing, constant disorganization, forgetfulness, internal restlessness and frequent mood changes. These symptoms are often confused with anxiety, burnout, or simply undesirable personality traits. Men are more likely to have the hyperactive type of ADHD, so they tend to get flagged earlier in childhood, while women often go undiagnosed until adulthood.

3. Perimenopause

Perimenopause the transition phase before menopause can last for years and bring a wide range of physical and mental changes. In addition to hot flashes and irregular periods, many women experience brain fog, sleep issues, mood swings, and even joint stiffness or pain. Because these symptoms are gradual, they often go unrecognized or are misattributed, especially when they begin earlier than expected.

4. Thyroid Disorders

Thyroid issues, like an overactive or underactive thyroid, are much more common in women. They affect the body’s metabolism and can lead to symptoms that affect every part of the body: mood swings, joint pain, unexplained weight changes, hair loss, sensitivity to temperature, and menstrual changes. Since many of these symptoms overlap with stress-related concerns, thyroid disorders may be falsely blamed on lifestyle or age.

5. Depression

Depression in women doesn’t always mean feelings of constant sadness. Additional common signs are low energy, ongoing physical pain (especially headaches or digestive problems), excessive guilt, feelings of worthlessness and sleeping more than usual.

The best thing women can do for their health is listen to their bodies. If something feels “off” or doesn’t have a clear explanation, don’t ignore it. Virtual care options like those available through MD Live can offer an easier and more convenient way to talk to a board-certified doctor, ask questions, and get guidance on what to do next. Check with your health insurer to see what virtual care options are covered by your plan. However, if symptoms feel severe or you think you may be experiencing a medical emergency, call 911 or go to the nearest emergency department right away.

6 Expert Tips to Keep Your Routine on Track

2025-04-21T09:19:58

(BPT) – Wellness is a full-body experience that requires creativity to avoid burning out and losing sight of your end goal. Sports RD, Dawn Jackson Blatner, is sharing six expert-approved tips to keep your exercise routine fun while incorporating proper recovery habits — like eating almonds for their exercise recovery benefits — during the day to keep your goals on track.

1. Nourish your body to feel good

Wellness isn’t about perfection — it’s about treating your human body with the gratitude and care it deserves. Focus on eating and moving in ways that feel good and energize you. Just one serving of almonds (23 almonds) has 6g plant-based protein, 4g fiber, riboflavin (25% DV), hard-to-get magnesium (20% DV), antioxidant vitamin E (50% DV), 13g of good unsaturated fats, and only 1g saturated fat. They are a simple way to fulfill your body’s needs and stay satisfied longer. When you focus on what makes you feel good, wellness becomes a lifestyle.

2. Set intentional goals

Life can be fast-paced and full of curveballs, but setting intentional goals like exercising more, eating better, or improving sleep can help you stay focused and on-track. I set goals by “gamifying” them to stay motivated and engaged. This means I set mini-challenges, track my progress, and then level up to keep it fresh. For example, I’ll give myself a 7-day challenge to drink water before my coffee every day or add an extra 30-minute daily walk. If I get 100%, I’ll move on to a new challenge, just like making it to the next level in a game.

3. Exercise recovery is key

Through my experience in sports dietetics, I’ve discovered that focusing on proper recovery is one of the best additions to any routine. Exercise recovery isn’t just about rest though, it’s about providing the right nutrients to rebuild and strengthen your body. Without proper recovery, soreness and exhaustion can steal your motivation. Build in recovery with nourishing snacks, such as almonds. Almonds are my go-to because research1 conducted over 4 weeks among 64 healthy, non-smoking male and female U.S. adults ages 30-65 who are occasional exercisers shows that eating 57g of almonds daily supports a positive influence on metabolic health.

These study results show that almonds are an ideal food to support muscle function and recovery. The best part? It doesn’t matter when you eat your almonds. This small step can make a big difference in recharging your body and crushing your wellness goals!

4. Beat burnout by adding joy to your wellness routine

Burnout happens when wellness feels like a chore — but it doesn’t have to! The key is adding positivity and fun. Enjoy vibrant, colorful meals that make you smile and move your body in ways that feel exciting, like dancing or jumping rope. When joy leads the way, wellness feels fun and totally doable!

5. Make snacking easy and fun

Busy days can make it tough to eat well, but a mini snack box is the perfect anytime solution! My personal favorite includes veggies like carrots or celery, cubed cheese and a crunchy nut, like almonds, for extra nutritional benefits.

6. Celebrate the small wins

I worked as the head dietitian for a professional baseball team for 10 years and I have a game-winning ring to show for it! I’ve realized that you can’t win the championship without focusing on one game at a time. Try your best each day and recover so you can get back out there. When you celebrate small wins, it keeps you energized to keep going after your dreams.

Purple yoga mat with water bottle, towel, weights and a tin of Almonds on the floor of a sunroom.

Wellness and exercise don’t have to be boring, so take control of your journey and get creative to avoid burnout and stay on track with your goals! Check out almonds.com for more information on how you can make the most of your wellness routine.

[1] Nieman, D. C., Omar, A. M., Kay, C. D., Kasote, D. M., Sakaguchi, C. A., Lkhagva, A., Weldermariam, M. M., & Zhang, Q. (2023). Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise. Frontiers in Nutrition. DOI: 10.3389/fnut.2022.1042719.

Head and neck cancer survivor gets new Jaw in a Day

2025-04-18T11:39:00

(BPT) – Looks matter. And for cancer survivors who’ve undergone major facial surgeries, changes to their appearance and function can be emotionally and physically devastating. For many, reclaiming a sense of normalcy after facial reconstruction is an uphill battle.

Now, a multidisciplinary team at the Hollings Cancer Center at the Medical University of South Carolina (MUSC), the state’s only National Cancer Institute-designated cancer center, is offering new hope through an advanced procedure called Jaw in a Day. This groundbreaking surgery restores both function and appearance in a single operation, allowing patients to leave the hospital able to eat, speak and smile with confidence.

Previously offered at MUSC only for benign cases, the procedure is now available for patients with head and neck cancer, many of whom require jawbone removal as part of treatment or as a result of radiation-related side effects.

“That we can fix a devastating side effect of cancer treatment and give them back the shape of their face and their teeth — and do it in a way that’s timely so they leave the OR that day with a set of smiling teeth instead of waiting maybe nine months between surgeries, which is a long time to go with missing teeth, is important for cancer survivors,” said Evan Graboyes, M.D., a head and neck cancer surgeon.

Graboyes is part of a highly trained surgical team alongside Greer Albergotti, M.D., and Byung Joo Lee, D.D.S., a maxillofacial prosthodontist. The team was already highly proficient in ensuring that almost 100% of patients with head and neck cancer undergoing surgery to remove part of their jawbone left the operating room with endosteal implants, which later hold the artificial teeth, in their jawbone transplant. But they wanted to do more for people with head and neck cancer who’ve already been through so much, so the trio traveled to Dallas for specialized training in the Jaw in a Day procedure and waited for the right candidate to benefit from the procedure.

That patient was Tammy Duncan, a cancer survivor from Greenville, South Carolina, who developed osteoradionecrosis — dead bone caused by radiation — more than a decade after successful treatment for adenoid cystic carcinoma.

After two unsuccessful surgeries to remove dead bone, Duncan was referred to MUSC. The damage was too extensive, and her condition had progressed. Fortunately, she was a fit for the Jaw in a Day procedure.

Reconstructing a jaw — and a smile

In the 10-hour operation, the team removed the dead jawbone and replaced it with a piece of Duncan’s fibula — the smaller bone in the lower leg. Before transplanting it, they inserted titanium implants into the fibula, attached custom-made teeth and shaped the new jawbone using precise 3D modeling and cutting guides.

The procedure required exceptional precision; virtual surgical planning was a critical aspect of the procedure, and every step was meticulously planned and executed. “Every millimeter mattered,” Lee said.

While the fibula was still connected to its blood supply, the implants and teeth were secured. The bone was then transplanted into her jaw and connected to a new blood supply. A titanium plate was added to stabilize everything until the bone could fuse and heal.

After the surgery, Duncan woke up with a full set of “smiling” teeth — though she’ll need time before using them to chew. “Being cancer-free is always the top priority,” said Albergotti, “but helping patients come out of surgery as close to the best version of themselves as possible is also incredibly important.”

Patient facing camera smiling

A team effort

The Jaw in a Day procedure demands a high level of coordination. “You have to work together as a team,” Lee said. “One or two surgeons alone can’t pull this off.” He explained that advanced imaging, cutting-edge modeling and in-house fabrication of implants and teeth make this level of precision possible.

Duncan’s case also illustrates a growing focus on cancer survivorship and the long-term impact of treatment. “We’re thinking beyond the cure,” said Graboyes, who leads Hollings’ Survivorship and Cancer Outcomes Research (SCOR) program. “Jaw in a Day is a prime example of how a comprehensive interdisciplinary team approach can restore a patient’s dignity, confidence and quality of life.”

To learn more about the Jaw in a Day procedure for neck and cancer patients, visit HollingsCancerCenter.MUSC.edu.

Comedian Kenan Thompson Doesn’t Think GERD is So Funny

2025-04-17T13:31:00

(BPT) – Actor, author and comedian Kenan Thompson can find humor in just about anything. However, one thing he cannot find the humor in is the heartburn due to Non-Erosive gastroesophageal reflux disease (Non-Erosive GERD) — and he is sharing that GERD is no joke. “Even though GERD is a funny word, it’s definitely not a funny thing to have,” said Thompson. When Thompson first started experiencing heartburn about two years ago, it started to affect him more and more frequently, but he didn’t know exactly what was causing it or how to treat it. He tried taking other medications, but they just weren’t doing the trick.

“I would get this horrible burning pain in the middle of my chest. Heartburn was affecting my sleep because it would happen over and over again throughout the night — then having an early call time the next morning for work was not my idea of a good time,” said Thompson. “In my line of work, I sing a lot and yell a lot, because being loud is funny. Heartburn was also impacting my voice and sometimes making it hoarse, and I need to maintain the strength of my vocal tone. It’s hard to do comedy when you don’t feel your best.”

After seeing his doctor, Thompson was diagnosed with Non-Erosive GERD. He learned that many acidic foods he loved, like pizza and pasta with marinara sauce, could trigger his symptoms. He also learned about a treatment that could help to relieve his heartburn, VOQUEZNA® (vonoprazan), a prescription medication available in the United States. VOQUEZNA is approved for heartburn relief in adults with Non-Erosive GERD (gastroesophageal reflux disease) and healing and related heartburn relief in adults with Erosive Esophagitis, also known as Erosive GERD.

Thompson’s experience with Non-Erosive GERD and his treatment, VOQUEZNA, has led him to partner with Phathom Pharmaceuticals, the makers of VOQUEZNA, on the GERD IS NO JOKE campaign, where he is taking part in a new TV commercial portraying the comedic role of a chef in a “Kick Some Acid Cooking Show,” which is a humorous nod to how VOQUEZNA has helped him better control his heartburn. Thompson is encouraging people suffering from the condition to speak to their doctor about this treatment option. Keep reading to learn more.

IMPORTANT SAFETY INFORMATION

Do not take VOQUEZNA if you:

  • are allergic to vonoprazan or any of the other ingredients in VOQUEZNA. Allergic reaction symptoms may include trouble breathing, rash, itching, and swelling of your face, lips, tongue or throat.
  • are taking a medicine that contains rilpivirine (EDURANT, COMPLERA, JULUCA, ODEFSEY) used to treat HIV-1 (Human Immunodeficiency Virus).

Please see Indication and full Important Safety Information below.

What is GERD?

GERD occurs when stomach acid flows into the esophagus and causes irritation. It’s one of the most common gastrointestinal (GI) diseases with over 65 million people in the U.S. living with the condition. Heartburn is one the most frequent symptoms of GERD. However, depending on its severity, GERD can cause heartburn, regurgitation, difficulty eating and drinking plus damage to the esophageal lining. It can also impact physical and social activities and your daily life.

There are two main types of GERD. About 30% (~20 million Americans) have Erosive GERD, also called Erosive Esophagitis, which occurs when stomach acid damages the lining of the esophagus. The other main type of GERD — and the largest subset of this common GI disease — is Non-Erosive GERD, which affects about 45 million U.S. adults. People with Non-Erosive GERD may experience reflux-related symptoms such as heartburn and regurgitation, but no acid-related damage to the esophagus. Without effective management, however, GERD can lead to serious complications.

Finding relief from heartburn

The first step is to talk to your doctor about what you’re experiencing.

“I get it, it can be intimidating, but go talk to your doctor,” advised Thompson. “They’re the only one who can actually diagnose GERD and get you feeling better and back to doing the things you love. For me, that’s making people laugh!”

Thompson’s doctor prescribed VOQUEZNA which has helped relieve his heartburn.

VOQUEZNA, the first and only FDA-approved treatment of its kind, a potassium-competitive acid blocker (PCAB). It is approved for the relief of heartburn related to Non-Erosive GERD and Erosive GERD, as well as for the healing and maintenance of Erosive GERD.

If you have questions about your symptoms, check out Thompson’s tips for talking to a doctor about GERD — including VOQUEZNA as a treatment option — and learn more about Thompson’s personal story at GERDIsNoJoke.com.

INDICATION AND IMPORTANT SAFETY INFORMATION

What is VOQUEZNA?

  • VOQUEZNA® (vonoprazan) is a prescription medicine used in adults:
    • for 8 weeks to heal acid-related damage to the lining of the esophagus (called Erosive Esophagitis) and for relief of heartburn related to Erosive Esophagitis.
    • for up to 6 months to maintain healing of Erosive Esophagitis and for relief of heartburn related to Erosive Esophagitis.
    • for 4 weeks for relief of heartburn related to gastroesophageal reflux disease (GERD).

It is not known if VOQUEZNA is safe and effective in children.

Do not take VOQUEZNA if you:

  • are allergic to vonoprazan or any of the other ingredients in VOQUEZNA. Allergic reaction symptoms may include trouble breathing, rash, itching, and swelling of your face, lips, tongue or throat.
  • are taking a medicine that contains rilpivirine (EDURANT, COMPLERA, JULUCA, ODEFSEY) used to treat HIV-1 (Human Immunodeficiency Virus).

Before taking VOQUEZNA, tell your healthcare provider about all your medical conditions, including if you:

  • have low magnesium, calcium, or potassium in your blood, or you are taking a medicine to increase urine (diuretic).
  • have kidney or liver problems.
  • are pregnant, think you may be pregnant, or plan to become pregnant. It is not known if VOQUEZNA will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if VOQUEZNA passes into your breast milk. You and your healthcare provider should decide if you will take VOQUEZNA or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

VOQUEZNA may affect how other medicines work, and other medicines may affect how VOQUEZNA works. Especially tell your healthcare provider if you take medicine that contains rilpivirine (EDURANT, COMPLERA, JULUCA, ODEFSEY).

What are the possible side effects of VOQUEZNA?

VOQUEZNA may cause serious side effects including:

  • A type of kidney problem (acute tubulointerstitial nephritis): Some people who take VOQUEZNA may develop a kidney problem called acute tubulointerstitial nephritis. Call your healthcare provider right away if you have a decrease in the amount that you urinate or if you notice blood in your urine.
  • Diarrhea caused by an infection (Clostridioides difficile) in your intestines: Call your healthcare provider right away if you have watery stools, stomach pain, and fever that does not go away.
  • Bone fractures (hip, wrist, or spine): Bone fractures in the hip, wrist, or spine may happen in people who take multiple daily doses of another type of medicine that reduces acid in your stomach known as proton pump inhibitors (PPI medicines) for a long period of time (a year or longer). Tell your healthcare provider if you have a bone fracture, especially in the hip, wrist, or spine.
  • Severe skin reactions: VOQUEZNA can cause rare, but severe skin reactions that may affect any part of your body. These serious skin reactions may need to be treated in a hospital and may be life threatening:
    • Skin rash which may have blistering, peeling, or bleeding on any part of your skin.
    • You may also have fever, chills, body aches, shortness of breath, or enlarged lymph nodes.

    If you experience any of these symptoms, stop taking VOQUEZNA and call your healthcare provider right away. These symptoms may be the first sign of a severe skin reaction.

  • Low vitamin B-12 levels: VOQUEZNA lowers the amount of acid in your stomach. Stomach acid is needed to absorb Vitamin B12 properly. Tell your healthcare provider if you have symptoms of low vitamin B12 levels, including irregular heartbeat, shortness of breath, lightheadedness, tingling or numbness in the arms or legs, muscle weakness, pale skin, feeling tired, or mood changes. Talk with your healthcare provider about the risk of low vitamin B12 levels if you have been on VOQUEZNA for a long time.
  • Low magnesium levels in the body can happen in people who take VOQUEZNA. Tell your healthcare provider right away if you have symptoms of low magnesium levels, including seizures, dizziness, irregular heartbeat, jitteriness, muscle aches or weakness, or spasms of the hands, feet, or voice.
  • Stomach growths (fundic gland polyps): A certain type of stomach growth called fundic gland polyps may happen in people who take another type of medicine that reduces acid in your stomach known as proton pump inhibitors (PPI medicines) for a long time. Talk with your healthcare provider about the possibility of fundic gland polyps if you have been on VOQUEZNA for a long time.

The most common side effects of VOQUEZNA for treatment of Erosive Esophagitis and/or relief of heartburn related to gastroesophageal reflux disease include:

  • stomach inflammation
  • diarrhea
  • stomach bloating
  • stomach pain
  • nausea
  • indigestion
  • constipation
  • high blood pressure
  • urinary tract infection

These are not all the possible side effects of VOQUEZNA. For more information, ask your healthcare provider or pharmacist. Call your healthcare provider for medical advice about side effects.

You are encouraged to report suspected adverse reactions by contacting Phathom Pharmaceuticals at 1-888-775-PHAT (7428) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please see Patient Information and full Prescribing Information for VOQUEZNA.

© 2025 Phathom Pharmaceuticals. All rights reserved.

VOQUEZNA, Phathom Pharmaceuticals, and their respective logos are registered trademarks of Phathom Pharmaceuticals, Inc.

04/25 US-VPZ-24-0763

Finding Balance with Primary Immunodeficiency: Karla’s Journey

2025-04-15T11:01:00

(BPT) – Karla has always found solace in the outdoors. Growing up on a large cattle ranch, she spent her days surrounded by wide-open fields, tending to animals and doing farm chores with her sister. But unlike her sister, Karla often found herself sidelined by illness. As a young child she frequently battled colds, flu and pneumonia. “Some family members started labeling me as ‘lazy’ which made me feel isolated and alone,” she recalls. As she grew older, her health challenges intensified, affecting not only school, but also work and her relationships.

A Long Road to Answers

By adulthood, Karla’s struggles became impossible to ignore. “By my 20s, it felt like I was getting sick more often, and it was hard to explain because people in my life couldn’t believe that anyone could be this sick.”

After years of doctor visits and treatments for recurring infections, the turning point came when Karla’s daughter, Sadie, was referred to an immunologist after exhibiting similar symptoms as a baby. “I found an immunologist who not only helped Sadie but also acknowledged my medical history and tested my immune system to understand what was going on with me,” she recalls. “The doctor made me feel incredibly validated.”

When the immunologist reviewed the comprehensive immune panel results, she said, “Oh my goodness, Karla. It’s not that you have problems with your immune system. It’s that your immune system is hardly there.” The bloodwork revealed Karla had specific antibody deficiency (SAD), a form of primary immunodeficiency (PI). PI is an umbrella term used to describe a group of ~550 disorders that weaken the immune system, making it harder to fight infections.

Finding a Treatment That Fits

The immunologist recommended that Karla start a type of treatment called immunoglobulin (IG) therapy to help give her body the antibodies it needed to protect itself against infection. Initially, she wasn’t sick as often, but she did get sick in between infusions. That’s when her doctor suggested treatment adjustments—including increasing her doses and an alternative IG treatment that allowed for more frequent infusions—to find the right treatment for her.

Living in a Remote Area: A Consideration for Treatment

Living in a rural area of Wyoming meant long travel times to in-office infusion appointments for Karla. She had to consider logistics, flexibility and convenience when discussing treatment options with her doctor. After discussing her options with her specialist, she was introduced to CUVITRU® [Immune Globulin Subcutaneous (Human)] 20%, a medicine approved for PI in patients two years and older.

What is CUVITRU?

CUVITRU is a ready-to-use liquid medicine that is given under the skin (subcutaneously) to treat primary immunodeficiency (PI) in people 2 years and older.

IMPORTANT SAFETY INFORMATION

What is the most important information I need to know about CUVITRU?
CUVITRU can cause the following serious reactions:
  • Severe allergic reactions causing difficulty in breathing or skin rashes
  • Decreased kidney function or kidney failure
  • Blood clots in the heart, brain, lungs, or elsewhere in the body
  • Severe headache, drowsiness, fever, painful eye movements, or nausea and vomiting
  • Dark colored urine, swelling, fatigue, or difficulty breathing

Please continue reading for additional Important Safety Information.

Karla’s doctor explained that after proper training from a health care professional such as a nurse, Karla could self-administer CUVITRU, eliminating the need for her to make frequent trips to an infusion clinic. “Since I live in such a rural area, being able to administer treatment at home felt like a more manageable option for my individual needs.”

Embracing a New Routine

At first Karla wasn’t sure what to expect, but over time she developed a routine that worked for her. “Infusion days at home became something to look forward to. Sadie and I make these our special nights, complete with movies and our favorite snacks. Instead of feeling like another chore, infusion days have become moments of connection and self-care.”

With her treatment plan in place, Karla feels like she has more control over her health. She continues to take precautions—like minimizing unnecessary germ exposure and staying in touch with her health care providers.

Most importantly, Karla wants others with PI to know they are not alone. “If you take one thing away from my story, I want it to be this: You are in control of your life—PI is not. Be empowered to advocate for yourself and your health.

Individual experiences with PI may vary. Always consult your health care provider for medical advice or services.

To learn more about CUVITRU, visit https://www.cuvitru.com.

This content was provided by Takeda. Karla has been compensated by Takeda for sharing her story.

IMPORTANT SAFETY INFORMATION (Continued)

Who should not use CUVITRU?
Do not use CUVITRU if you:
  • Have had a severe allergic reaction to immune globulin or other blood products.
  • Have a condition called selective (or severe) immunoglobulin A (IgA) deficiency

What should I avoid while taking CUVITRU?

  • CUVITRU can make vaccines (like measles/mumps/rubella or chickenpox vaccines) not work as well for you. Before you get any vaccines, tell your healthcare provider (HCP) that you take CUVITRU.
  • Tell your HCP if you are pregnant, or plan to become pregnant, or if you are nursing.

What are the possible or reasonably likely side effects of CUVITRU?

CUVITRU can cause serious side effects. If any of the following problems occur after starting CUVITRU, stop the infusion immediately and contact your HCP or call emergency services:

  • Hives, swelling in the mouth or throat, itching, trouble breathing, wheezing, fainting or dizziness. These could be signs of a serious allergic reaction.
  • Bad headache with nausea, vomiting, stiff neck, fever, and sensitivity to light. These could be signs of irritation and swelling of the lining around your brain.
  • Reduced urination, sudden weight gain, or swelling in your legs. These could be signs of a kidney problem.
  • Pain, swelling, warmth, redness, or a lump in your legs or arms. These could be signs of a blood clot.
  • Brown or red urine, fast heart rate, yellow skin or eyes. These could be signs of a liver or blood problem.
  • Chest pain or trouble breathing, or blue lips or extremities. These could be signs of a serious heart or lung problem.
  • Fever over 100ºF. This could be sign of an infection.

The following one or more possible side effects may occur at the site of infusion. These generally go away within a few hours, and are less likely after the first few infusions.

  • Mild or moderate pain
  • Redness
  • Itching

The most common side effects that may occur are:

  • Headache
  • Nausea
  • Fatigue
  • Diarrhea
  • Vomiting

These are not all the possible side effects. Talk to your HCP about any side effect that bothers you or that does not go away.

For additional safety information, click for Information For Patients and discuss with your HCP.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

©2025 Takeda Pharmaceuticals U.S.A., Inc. 500 Kendall Street, Cambridge, MA 02142. 1-877-TAKEDA-7 (1-877-825-3327). All rights reserved. Takeda and the Takeda Logo are registered trademarks of Takeda Pharmaceutical Company Limited. CUVITRU is a registered trademark of Baxalta Incorporated. US-CUV-0849v1.0 04/25

New nonopioid approved for moderate-to-severe acute pain

2025-04-15T07:01:00

(BPT) – Acute pain can affect anyone.1 Short-term pain (acute) starts suddenly following an injury or medical procedure and lasts less than three months.2,3 Acute pain can impact your quality of life, disrupt your day, and can affect your professional and emotional well-being.4,5 Forming a treatment plan with your doctor to help manage your acute pain is important, as inadequate pain management can have consequences that affect a patient’s quality of life.4

There are approximately 80 million U.S. adults prescribed acute pain medication annually, and about 40 million receive opioids to manage their pain.6 While opioids can be effective, they also carry a risk of addiction.7 In fact, each year, Vertex Pharmaceuticals estimates approximately 85,000 patients develop opioid use disorder (OUD) within one year of starting an opioid treatment.8

Health care providers may prescribe either acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) as alternatives.7 While these treatments are generally well tolerated, they may have limited effectiveness, particularly for moderate-to-severe acute pain.7

A new path to pain management

Today, adult patients have a new option to treat their moderate-to-severe acute pain. As of January 2025, the Food and Drug Administration (FDA) approved JOURNAVX™ (suzetrigine), the first new class of medicine for acute pain in more than 20 years.9-12

JOURNAVX is an oral, nonopioid, selective NaV1.8 pain signal inhibitor approved for the treatment of moderate-to-severe acute pain in adults.9,13 JOURNAVX reduces pain by targeting a specific sodium channel in the peripheral nervous system that blocks pain signals prior to reaching the brain.9,13 Opioid medications can act on both the peripheral nervous system and the central nervous system (CNS). Acting on the CNS triggers the brain reward system, which may lead to opioid misuse, addiction and opioid use disorder.14-17

JOURNAVX is a prescription medicine used to treat adults with moderate-to-severe short-term (acute) pain.9 It is widely available and is now on the shelves in retail pharmacies across the country. For more information about JOURNAVX, visit JOURNAVX.com or speak with your doctor.

This article was sponsored by Vertex Pharmaceuticals Incorporated.

INDICATION AND USAGE

JOURNAVX is a prescription medicine used to treat adults with moderate-to-severe short-term (acute) pain.

It is not known if JOURNAVX is safe and effective in children.

IMPORTANT SAFETY INFORMATION

Patients should not take JOURNAVX if they take certain medicines that are strong inhibitors of an enzyme called CYP3A. Patients should ask their healthcare providers if they are not sure.

Before taking JOURNAVX, patients should tell their healthcare provider about all of their medical conditions, including if they: have liver problems, as people with liver problems may have an increased risk of getting side effects from taking JOURNAVX; are pregnant or plan to become pregnant, as it is not known if JOURNAVX will harm an unborn baby. Patients and their healthcare providers should decide if they will take JOURNAVX while they are pregnant, are breastfeeding, or are planning to breastfeed, as it is not known if JOURNAVX passes into breast milk. Patients and their healthcare providers should decide if they will take JOURNAVX while they are breastfeeding.

Patients should tell their healthcare provider about all the medicines they take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking JOURNAVX with certain other medicines may affect the way JOURNAVX and the other medicines work and may increase patients’ risk of side effects. Patients should ask their healthcare provider or pharmacist for a list of these medicines if they are not sure.

Patients should especially tell their healthcare provider if they take hormonal birth control medicine (contraceptives) containing progestins other than levonorgestrel or norethindrone. If they take one of these contraceptives (progestins other than levonorgestrel or norethindrone), they may not work as well during treatment with JOURNAVX. Patients should also use nonhormonal contraceptives such as condoms or use other forms of hormonal birth control during treatment with JOURNAVX and for 28 days after they stop taking JOURNAVX. Medicines that are substrates of the CYP3A enzyme may become less effective during treatment with JOURNAVX. Their healthcare provider may need to adjust the dose of patients’ medicine when starting or stopping JOURNAVX. Patients should know the medicines they take and keep a list of them to show their healthcare provider and pharmacist when they get a new medicine. Patients should not take food or drink containing grapefruit while taking JOURNAVX.

JOURNAVX can cause side effects: The most common side effects for patients treated with JOURNAVX include itching, muscle spasms, increased blood level of creatine phosphokinase, and rash. JOURNAVX may temporarily reduce the chance of females becoming pregnant while on treatment. Patients should talk to their healthcare provider if they have concerns about becoming pregnant. If patients are using contraceptives, continue to use contraceptives during treatment with JOURNAVX. Patients should tell their healthcare provider if they have any side effect that bothers them or that does not go away. These are not all of the possible side effects of JOURNAVX. Patients should call their healthcare provider for medical advice about side effects. Patients may report side effects to the FDA at 1-800-FDA-1088.

Please click here for the full Prescribing Information, including Patient Information, for JOURNAVX.

JOURNAVX is manufactured for Vertex Pharmaceuticals Incorporated.

JOURNAVX is a trademark of Vertex Pharmaceuticals Incorporated.

© 2025 Vertex Pharmaceuticals Incorporated | VXR-US-43-2500326 (v1.0) | 04/2025

  1. “Ouch, that hurts!” The science of pain. NIH MedlinePlus Magazine. Accessed February 20, 2025. https://magazine.medlineplus.gov/article/ouch-that-hurts-the-science-of-pain.
  2. Pain management center. International Association for the Study of Pain (IASP). Accessed February 20, 2025. https://www.iasp-pain.org/resources/toolkits/pain-management-center/chapter1/.
  3. Acute pain. International Association for the Study of Pain (IASP). January 12, 2023. Accessed February 20, 2025. https://www.iasp-pain.org/resources/topics/acute-pain/.
  4. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11(12):1859-1871. doi:10.1111/j.1526-4637.2010.00983.x.
  5. Strassels S, McNichol E, Wagner A, et al. Persistent postoperative pain, health-related quality of life, and functioning 1 month after hospital discharge. Acute Pain. 2004;6(3-4): 95-104. doi:10.1016/j.acpain.2004.08.002.
  6. Lopez A, Jones J, Menzie AM, Peta S, Ippolito A, Rubin J. An evaluation of the prevalence of acute and chronic pain medication use in the United States: a real-world database analysis. Presented at: ASRA Annual Pain Medicine Meeting; November 10-11, 2023; New Orleans, LA.
  7. Blondell RD, Azadfard M, Wisniewski AM. Pharmacologic therapy for acute pain. Am Fam Physician. 2013;87(11):766-772.
  8. Data on file. Vertex Pharmaceuticals Incorporated. Boston, MA. REF-25086 (v1.0); 2024.
  9. JOURNAVX [prescribing information]. Vertex Pharmaceuticals Incorporated. Boston, MA; January 2025.
  10. Conaghan PG. A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity. Rheumatol Int. 2012;32(6):1491-1502. doi:10.1007/s00296-011-2263-6.
  11. Drug Therapeutics & Regulation in the U.S. U.S. Food & Drug Administration. January 31, 2023. Accessed February 20, 2025. https://www.fda.gov/about-fda/fda-history-exhibits/drug-therapeutics-regulation-us.
  12. Timeline of Selected FDA Activities and Significant Events Addressing Substance Use and Overdose Prevention. January 13, 2025. Accessed February 20, 2025. https://www.fda.gov/drugs/food-and-drug-administration-overdose-prevention-framework/timeline-selected-fda-activities-and-significant-events-addressing-substance-use-and-overdose.
  13. Osteen JD, Immani S, Tapley TL, et al. Pharmacology and mechanism of action of suzetrigine, a potent and selective NaV1.8 pain signal inhibitor for the treatment of moderate to severe pain. Pain Ther. doi:10.1007/s40122-024-00697-0.
  14. Oesterle TS. What are opioids and why are they dangerous? Mayo Clinic. August 26, 2023. Accessed March 25, 2025. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270.
  15. Amaechi O, Huffman MM, Featherstone K. Pharmacologic therapy for acute pain. Am Fam Physician. 2021;104(1):63-72.
  16. How opioid use disorder occurs. Mayo Clinic. July 20, 2024. Accessed December 10, 2024. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372.
  17. Sehgal N, Smith HS, Manchikanti L. Peripherally acting opioids and clinical implications for pain control. Pain Physician. 2011;14(3):249-258.

© 2025 Vertex Pharmaceuticals Incorporated | VXR-US-43-2500326 (v1.0) | 04/2025

Holistic health is within reach with a new series from the U.S. Army

2025-04-11T16:01:01

(BPT) – Many young Americans continue to struggle with their physical and mental health — with 1 in 7 children ages 10-19 experiencing a mental health disorder, and 17% of children ages 6-17 experiencing obesity. But in an increasingly crowded landscape of armchair experts and fragmented fitness offerings, it can be difficult to know where to go for help. Enter the U.S. Army.

The Army has long been synonymous with “fitness,” but as the force continues to optimize Soldier performance and readiness, it’s taken the latest research and best industry practices to develop a holistic approach to Soldier health. Developed in 2020 and modeled after Special Forces and professional and collegiate athletic training, the Holistic Health and Fitness (H2F) system is changing the Army’s wellness culture by moving away from a one-size-fits-all model to acknowledge the uniqueness of every Soldier, unit and mission across five domains of readiness — physical, mental, sleep, nutrition and spiritual.

The results are paying off, with units who participate in the system reporting that Soldiers are 55% less likely to require additional care for musculoskeletal injuries, 18% more likely to pass the Army Combat Fitness Test (ACFT), 7.7% less likely to have a behavioral health profile and 59% less likely to have a substance abuse profile.

But Soldiers aren’t the only ones who can benefit from the H2F system. Now, the Army is pulling back the curtain with its new video series, “All You.” Published on YouTube and available to everyone, “All You” takes the guesswork out of holistic health by delivering quick, actionable and effective wellness techniques directly from Army experts. The guidance you can expect on your journey with “All You” includes:

1. Try a functional workout to minimize injury and build strength

While Soldiers require a high level of physical readiness to complete the demands of their missions, many of the Army’s tried-and-true workouts can be easily modified for a civilian lifestyle. Staff Sgt. Michael Matis, H2F Academy Instructor, stresses the importance of simply starting where you are, and building consistent habits to build the strength and endurance needed to reach your fitness goals. Incorporating functional movements that mimic daily activity into your workout routine is a great way to increase performance and prevent injury.

Two men wearing army shirts and shorts while working out on the treadmill in a gym

An easily adaptable exercise is the ruck march. A cornerstone of an Army Soldier’s experience, the ruck march incorporates long-distance walking and running with a weighted rucksack to not only improve strength, endurance and cardiovascular health, but also build morale and camaraderie among Soldiers. Anyone can make their own ruck by adding a few weights to a backpack and taking a quick 20-minute walk outdoors or on a treadmill.

2. Practice mindful breathing to increase mental resilience

It is imperative that Soldiers build their mental resilience to adapt during difficult situations. 1st Lt. Brandan Wolfolk, an Army Occupational Therapist and yoga instructor, encourages his fellow Soldiers to proactively explore their mental resilience by practicing different techniques — such as yoga, meditation or mindfulness — and forming them into core habits.

Man on a mat practicing yoga

A quick and easy way to practice mindfulness is through intentional breathing. The practice of controlling your breath can work to reduce stress and anxiety, balance the nervous system, and increase energy levels. By slowing down and breathing in for a count of four, holding the breath for a count of seven, and exhaling for a count of eight, you can help calm the mind and bring your attention back to the present.

3. Build a colorful plate to fuel your nutrition goals

With endless options at the grocery store and the constant string of new diets and eating trends, building healthy nutrition habits can easily become overwhelming and complicated. Capt. Jewel Ory, 193rd H2F Nutrition Program Director, shares the importance of bringing nutrition back to the basics, and focusing on the needs of an individual when planning meals. Ory stresses that it’s not about perfection — it is better to practice consistency. Creating intentional nutrition habits 80% of the time will lead to better results than striving for flawless habits that can only be maintained 20% of the time.

Man dishing up lunch on a tray in the mess hall

By incorporating a variety of basic food groups onto your plate, you are setting yourself up for success without overcomplicating the process. Aim to include lean proteins (fish, chicken or turkey that is baked, broiled, or grilled), whole grains for a sustained source of energy (like oats, brown rice, or quinoa), a variety of fruits and veggies (the wider the variety of colors, the better), and a low-fat source of dairy (like Greek yogurt or cottage cheese).

4. Build a sleep routine to achieve optimal rest

Sleep is often the first thing that is sacrificed when life gets overwhelming — however, it is the secret to reaching your full potential in all aspects of health and performance. While eating a nutritious diet and putting in time at the gym is crucial, those efforts can begin to suffer, along with the other pillars of health, without sufficient, high-quality sleep.

Female meditating in a room.

For Capt. Chris Enke, 165th Infantry Brigade H2F Mental and Sleep Readiness Program Director, a go-to tool when evaluating the quality of an individual’s sleep is the acronym SLANT. Applicable to Soldiers and civilians alike, SLANT represents several factors that may impact sleep:

  • Surface: Ensure that your mattress, pillow and bedding is comfortable and supportive
  • Lighting: Make your room as dark as possible and place your phone out of sight
  • Air Quality: Sleep in a room with fresh, clean airflow
  • Noise: Introduce white or pink noise to your environment to drown out any disturbances
  • Temperature: Adjust the temperature to stay between 65-68 degrees Fahrenheit for optimal sleep performance

5. Find your people and strengthen friendships

Spiritual readiness can be a surprising, yet crucial, aspect to an individual’s holistic health. In addition to religious affiliation, the Army uses philosophical and human values to help Soldiers find purpose, motivation, core values and connection to help them endure stress or adversity.

Men in fatigues marching through the woods.

Chaplain (Major) Scott Lovejoy, 193rd H2F Spiritual Domain lead, encourages his Soldiers to explore the importance of camaraderie. In this always-online world, it can be easy to push away meaningful conversations or stay hidden in your phone, but challenging yourself to call a friend instead of text or ask an acquaintance out for coffee can make a huge difference in feeling lonely and isolated versus feeling further connected.

Published bi-weekly by 11 a.m. EDT beginning Friday, April 11, “All You” is applicable to every stage of a person’s holistic health journey. Whether you’re curious where to start, rehabbing from an injury, or are well on your way to achieving your next wellness goal, start your battle-tested training with “All You” at GoArmy on YouTube.

Reading your brain waves to treat a debilitating disease

2025-04-07T07:01:00

(BPT) – Liza Bobrow didn’t think it was a big deal when her handwriting suddenly went haywire.

“It was just so bizarre,” she remembers. “My handwriting was getting teeny-tiny. I couldn’t even sign a check. I had just turned 50 so I thought ‘I’m getting old. I must have arthritis, or a pinched nerve or writer’s cramp.’ So, when the doctors told me it was Parkinson’s Disease, I was terrified.”

Medication helped at first.

Her handwriting returned to near normal. But Parkinson’s is a progressive disease – it usually worsens over time.

Two years after her diagnosis, the medication began triggering bouts of dystonia. She suffered painful muscle spasms in her feet that made walking difficult. Her right arm would suddenly shoot out and she would have to cradle it back in with her left arm.

“The pain was so bad that I didn’t want to take the medication,” she said. “But without the medicine I struggled with motor skills. It was a terrible time.”

Neurologists eventually suggested deep brain stimulation (DBS), a surgical procedure in which electrodes are implanted in specific spots in the brain to deliver electrical stimulation to help control tremor, rigidity, and bradykinesia. Bobrow and her husband spent six months researching DBS and consulting her doctors before deciding to proceed.

“I had never had surgery in my life, so the idea of brain surgery was pretty scary,” she said. “But I had an incredible experience, and the results are profound. My motor skill fluctuation is less and in general it’s just a feeling of relaxation and comfort in my body that I just didn’t have before DBS.”

Liza’s story is based on her individual experience. Not all patients will experience similar results.

Revolutionary leap in DBS therapy

DBS has been around for decades. A pacemaker-like device is implanted in the upper chest and thin wires lead to precise locations in the brain, where electrodes deliver electrical stimulation that can help control some of the symptoms from Parkinson’s.

Even though traditional DBS is proven as a safe and effective treatment for Parkinson’s, the level of stimulation is constant/pre-programmed. But it has limitations. The human body and brain are constantly changing and adjusting, as the various symptoms of Parkinson’s disease and medication levels can fluctuate in intensity throughout the day. So, the amount of electrical stimulation needed to optimally treat Parkinson’s may also change.

“I went through a lot of programming sessions to refine the device settings,” Bobrow said. “You can’t just set it and forget about it.”

For many patients, that’s about to change.

The United States Food and Drug Administration (FDA) recently approved the Medtronic Adaptive Deep Brain Stimulation (aDBS) system for use in the U.S. for patients with Parkinson’s disease. With aDBS, the electrodes that deliver electrical stimulation can also sense the patient’s brain signals and automatically adjust the level of stimulation to meet the patient’s needs.1 A few programming adjustment visits may be needed in the first few months after turning on Adaptive Therapy. Patients programmed with Adaptive Therapy may require more programming adjustment visits if they experience stimulation-related side effects or need to further personalize programming settings.

“The aDBS system listens to these brain waves, and then algorithms adjust the stimulation in real time according to what the brain waves tell us about their symptoms. It’s a very exciting development,” said Dr. Simon Little, a neurologist at the University of California San Francisco (UCSF).

As with traditional DBS, there are risks and benefits of aDBS. Risks of DBS may include surgical complications, infection, failure to deliver therapy as needed and/or worsening of some symptoms. Talk to your doctor about your medical condition and the risks and benefits of this therapy. A prescription is required, only your doctor can determine whether this therapy is right for you.

The Medtronic Adaptive Deep Brain Stimulator

Living the dream

Liza Bobrow received her DBS device before the FDA approval of aDBS; however, a software upgrade to aDBS does not require surgery. Her device already includes the brain-sensing technology; if her doctors decide she is a candidate for aDBS, it would be a matter of activating this technology in her current device.

“Adaptability is obviously the next frontier. I can tell that my body has ebbs and flows, and clearly real-time stimulation adjustment is something that interests me,” Liza said.

Dr. Philip Starr, professor of neurological surgery at UCSF, adds: “So the dream of these brain pacemakers, which is really what they are, is to go that route and understand brain signals – and how they relate to specific signs and symptoms of movement disorders or other disorders – to understand those signals well enough to use them to auto-adjust stimulator levels. So adaptive deep brain stimulation is really synonymous with closed-loop stimulation.”

Brief Statement: https://www.medtronic.com/en-us/l/patients/treatments-therapies/deep-brain-stimulation-parkinsons-disease/important-safety-information.html

† The sensing feature of the Percept™ PC and Percept™ RC system is intended for use in patients receiving DBS where chronically recorded bioelectric data may provide useful, objective information regarding patient clinical status.

References:

  1. Stanslaski S, Summers RLS, Tonder L, et al. Sensing data and methodology from the Adaptive DBS Algorithm for Personalized Therapy in Parkinson’s Disease (ADAPT-PD) clinical trial. NPJ Parkinsons Dis. 2024;10(1):174.