Instead, they may cause adverse effects (AEs) that affect patients’ skin and nails, and are also associated with oral toxicities, Chari explains. GPRC5D-targeted agents are associated with fewer infectious deaths, Chari notes. If the primary cause of death in some patients is not disease progression, then the safety profiles of these agents should be further understood, according to Chari. These infections tend to be unusual, opportunistic infections, Chari says, adding that he encourages his colleagues to always be aware of the possibility of non-progression–related deaths when treating patients with BCMA-directed bispecific antibodies. BCMA-directed agents tend to lead to higher rates of infections than GPRC5D-directed agents with longer follow-up, Chari continues. Notably, agents that target GPRC5D are associated with similar efficacy outcomes and rates of cytokine release syndrome as those targeting BCMA, Chari expands. However, the differences between these targeted agents become more apparent when considering the agents’ toxicity profiles. The bispecific antibody most recently approved for patients with relapsed/refractory multiple myeloma is the GPRC5D-targeted agent talquetamab-tgvs (Talvey), which received FDA approval for this population in August 2023, he explains. Therefore, when choosing which agent to treat a patient with, it is important to consider factors such as treatment convenience, schedule, and cost, Chari says, noting that it is beneficial for patients to have several available treatment choices. Although the BCMA-directed class is one of the most crowded classes of bispecific antibodies, Chari explains that there are no major differences in efficacy and safety between these drugs. The first 2 BCMA-targeted bispecific antibodies that were FDA approved for the treatment of patients with multiple myeloma were teclistamab-cqyv (Tecvayli), which was approved in October 2022, and elranatamab-bcmm (Elrexfio), which was approved in August 2023. EMA adheres well, so the nail plate should only need to have the shine removed with a 180-grit soft buffer.Ajai Chari, MD, director, clinical research, Multiple Myeloma Program, UCSF Helen Diller Family Comprehensive Cancer Center, discusses the current landscape of bispecific antibodies in relapsed/refractory multiple myeloma. Nails Bars using MMA will need to use an electric file (drill) or an extremely coarse file to prepare the surface of the nail. Nail Prep – MMA has terrible adhesion so the nail surface needs to be much rougher for it to stick. I personally wouldn’t pay less than $85 for a set of Acrylic Enhancements. Price – EMA Liquid costs around $200 a litre and MMA Liquid costs around $20 a litre so price is another good indicator of whether a salon is using safe products.Then again, we hear a lot of stories of nails bars pouring MMA into EMA-labelled bottles so even then it wouldn’t be a fail safe test. It will either say Ethyl Methacrylate (EMA) or Methyl Methacrylate (MMA). Labels – If I were you I would ask to see their bottle of Monomer and look at the ingredients list.Q: Hi Penny! Would you be able to tell me which salons near me use EMA instead of MMA?Ī: I would love to be able to give you that information but I can’t imagine an MMA salon ever making that information public! Here are a few tips for making a judgement call –
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