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Toripalimab for Recurrent or Metastatic Nasopharyngeal Carcinoma
- Cardiology ·
- Pregnancy ·
- Technology ·
Physician-Optimized Self-Management of Blood Pressure After Hypertensive Pregnancy
- Obesity ·
Obesity Management in Adults
- Diabetes ·
- Pediatrics ·
- Technology ·
Automated Insulin Delivery Systems in Pediatric Type 1 Diabetes
- Diabetes ·
Sustained Effectiveness of Shared Decision-making for Diabetes Prevention Interventions
Translating Vaccine Effectiveness to Acceptance
COVID-19 Vaccine Effectiveness Against Post-COVID-19 Condition
Erdafitinib in Advanced or Metastatic Urothelial Carcinoma
PNN JournalWatch — 11.27.23
Other Recent Stories
Peptic Ulcer Risk With NSAIDs + Cholinesterase Inhibitors
An increased risk of peptic ulcers should be considered when cholinesterase inhibitors (ChEIs) are prescribed to older adults who are using NSAIDs, a study shows.
Semaglutide and Cardiovascular Outcomes in Obesity Without Diabetes
In the SELECT trial, subcutaneous semaglutide 2.4 mg once weekly produced superior outcomes compared with placebo in patients with preexisting cardiovascular disease and overweight or
Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation
Compared with aspirin, apixaban lowered the risk of stroke or systemic embolism but increased the risk of major bleeding in patients with subclinical atrial fibrillation,
Coadministration of Influenza, COVID-19 Vaccines
Coadministration of the BNT162b2 BA.4/5 bivalent mRNA COVID-19 vaccine (BNT162b2-biv) and seasonal influenza vaccine (SIV) in the community setting produced similar effectiveness and outcomes as when
SARS-CoV-2 Virologic Rebound With Nirmatrelvir–Ritonavir Therapy
Of people treated for acute COVID-19 with nirmatrelvir–ritonavir (N-R), 20% experienced virologic rebound (VR), according to a Boston-area multicenter health system study. Many patients with
Pharmacotherapy for Alcohol Use Disorder
Oral naltrexone 50 mg/d and acamprosate should be first-line pharmacotherapies for alcohol use disorder, according to a systematic review and meta-analysis of randomized clinical trials
2023 Canadian Thoracic Society Guideline on Pharmacotherapy in Stable COPD
An update of the 2019 the Canadian Thoracic Society (CTS) Guideline provides “recommendations from a comprehensive systematic review with a meta-analysis and expert-informed clinical remarks
Sharing the Good News of Weight Loss Interventions
Clinicians should present weight loss treatments as positive opportunities when discussing excess weight during clinical visits rather than framing the conversation in negative terms, a
Reducing Second-Line Antibiotic Prescriptions for UTIs in Women
In 128 general practices in Germany, a multimodal intervention significantly reduced the proportion of second-line antibiotics and all antibiotic prescriptions for uncomplicated urinary tract infections
Prediction of Antipsychotic Response Using a Connectome-Based Neural Signature
A connectome-based functional signature proved to be a promising early predictor of individualized response to antipsychotic treatment in first-episode psychosis. The results in a discovery
Thalidomide for Recurrent Bleeding of Small-Intestinal Angiodysplasia
For treating recurrent bleeding caused by small-intestinal angiodysplasia (SIA), thalidomide significantly reduced bleeding compared with placebo, a Chinese study shows. “The results of the current trial
Landiolol Effects on Organ Failure From Septic Shock
Infusions of the beta-blocker landiolol did not significantly reduce organ failure in patients with septic shock and norepinephrine-treated tachycardia, compared with standard care, the STRESS-L
Nirmatrelvir–Ritonavir for Preventing Post–COVID-19 Conditions
In a retrospective target trial emulation study of U.S. veterans following acute COVID-19, ritonavir-boosted nirmatrelvir reduced the frequency of just 1 of 31 potential post–COVID-19
Lower Diabetes Risk After COVID-19 Vaccination
In a cohort study, unvaccinated people with COVID-19 had a 62% higher chance of developing new-onset diabetes mellitus (DM), while vaccinated individuals with breakthrough COVID-19
Guideline-Directed Statin Primary Prevention in Patients With Diabetes
In high-risk patients with diabetes in a contemporary healthcare system, “significant gaps” remain in the use of guideline-directed statin intensity (GDSI) for primary prevention, a
Automated Insulin Delivery for Management of Type 1 Diabetes During Pregnancy
In 124 patients with pregnancy complicated by type 1 diabetes, the use of hybrid closed-loop insulin therapy significantly improved maternal glycemic control, researchers report. The
Tongxinluo and Clinical Outcomes With Acute Myocardial Infarction
Used as adjunctive therapy, a traditional Chinese medicine compound, Tongxinluo, improved 30-day and 1-year clinical outcomes among patients with acute ST-segment elevation myocardial infarction (STEMI),
Inappropriate Prescribing to Older Patients by NPs, PCPs
In a study of inappropriate prescribing to older adults, nurse practitioners (NPs) and primary care physicians performed similarly, researchers report. “Broad efforts to improve the
HPV Vaccination and Surveillance of Type-Specific HPV in England
The prevalence of human papillomavirus (HPV) vaccine-types and closely related HPV types declined sharply among vaccine-eligible females during 10 years of high-coverage HPV vaccination in
Rosuvastatin vs. Atorvastatin Treatment in Coronary Artery Disease
Efficacy measures were similar in adults with coronary artery disease when treated with rosuvastatin or atorvastatin, but a secondary analysis of the LODESTAR trial showed
Comprehensive Pharmaceutical Care Intervention in Older Patients With Cancer
At a 1,000-bed teaching hospital in France, drug-related problems (DRPs) occurred less frequently in older patients with cancer cared for using the RECAP (phaRmaceutical care
Evaluating the New STOPP/START Criteria in the Care of Older Adults
“Version 3 of the STOPP/START criteria is a welcome addition to geriatric pharmacotherapy,” write authors of a commentary. “The START criteria are a unique tool
Enzalutamide Treatment Outcomes in Biochemically Recurrent Prostate Cancer
Compared with leuprolide therapy alone, enzalutamide plus leuprolide improved metastasis-free survival in patients with prostate cancer with high-risk biochemical recurrence, a study shows. “Enzalutamide monotherapy
The Million Hearts Model, Cardiovascular Disease, and Medicare Spending
Launched by CMS in 2017 and funded through 2021, the Million Hearts Model successfully reduced first-time myocardial infarctions (MIs) and strokes in Medicare beneficiaries aged
Improving Sepsis Outcomes: Pay-for-Performance, Electronic Quality Measures
A position paper from 6 medical organizations presents concerns with the CMS Severe Sepsis/Septic Shock Management Bundle (SEP-1), which was introduced as a pay-for-reporting measure
AHA Guidelines for Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning
The management of several cardiac-related poisonings is updated in guidance from the American Heart Association (AHA). Focusing on the resuscitation of patients with cardiac arrest,
Adjunctive Dexamethasone for Tuberculous Meningitis in HIV-Positive Adults
Compared with placebo in adults living with HIV, adjunctive dexamethasone did not improve survival or any of several secondary outcomes of tuberculous meningitis, researchers report.
Drug Misadventures in Shiga Toxin–Producing Escherichia coli Diarrhea
The difficulties of managing pharmacotherapy in patients with Shiga toxin–producing Escherichia coli (STEC) are discussed in a review article on associated hemolytic-uremic syndrome. “It is important to
Xylazine Adulteration of the Illicit Heroin–Fentanyl Drug Supply
“Xylazine pharmacology, animal and human clinical effects, and what is known to date about care of patients experiencing acute overdose, xylazine–fentanyl withdrawal, and xylazine-associated wounds”
Early vs. Delayed Antihypertensive Treatment in Acute Ischemic Stroke
Early antihypertensive treatment was not effective in reducing the 90-day odds of functional dependency or death in patients with mild-to-moderate acute ischemic stroke and elevated
Esketamine Nasal Spray for Treatment-Resistant Depression
Administered with a selective serotonin reuptake inhibitor (SSRI) or a serotonin–norepinephrine reuptake inhibitor (SNRI), esketamine nasal spray produced greater remission at week 8 compared with
Tirzepatide With Basal Insulin in Type 2 Diabetes
Compared with insulin lispro 3 times daily in patients with type 2 diabetes who were also receiving basal insulin, once-weekly tirzepatide reduced hemoglobin A1c(HbA1c) and weight
Passive Clinical Decision Support Tool for Reducing Potentially Inappropriate Medications in Older Adults
Positive changes in prescribing of potentially inappropriate medications (PIM) for older adults were associated with the use of a passive clinical decision support (CDS) tool
Edoxaban in Atrial High-Rate Episodes
The incidence of a primary outcome of a composite of cardiovascular death, stroke, or systemic embolism was not reduced by anticoagulation with edoxaban in patients
Nonvaccination for Influenza Among Patients With CKD
Among 3,692 participants in the Chronic Renal Insufficiency Cohort Study (CRIC), factors associated with not receiving influenza vaccination were younger adults, Black individuals, and adverse
Vitamin D Therapy in Adults With Chronic Kidney Disease
Among people with chronic kidney disease (CKD), vitamin D therapy does not lower all-cause mortality in comparison with placebo, according to a systematic review and
Once-Weekly Insulin Icodec in Insulin-Naive Type 2 Diabetes
In the ONWARDS 5 trial, once-weekly insulin icodec titrated with a dosing guide app (icodec with app) was significantly more efffective than once-daily basal insulin
Guidance on Evaluation and Management of Allergic Reactions to COVID-19 Vaccines
Revaccination of people who had previous allergic reactions to COVID-19 vaccines is addressed in a guidance update of the 2021 GRADE (Grading of Recommendations Assessment,
Solanezumab in Preclinical Alzheimer’s Disease
An agent that targets monomeric amyloid in persons with elevated brain amyloid levels, solanezumab was not more effective than placebo in slowing cognitive decline in
Outpatient Treatment of Confirmed COVID-19: Guidelines and Literature Review
The American College of Physicians (ACP) updates its living, rapid practice points focusing on 22 outpatient treatments for COVID-19 and provides a literature review to
ASCO Guideline: Vulnerabilities of Older Adults Undergoing Chemotherapy
An expert panel has updated the guideline of the American Society of Clinical Oncology for practical assessment and management of vulnerabilities in older adults receiving
Opportunistic Infections Associated With Long-term Glucocorticoid Therapies
Widely used as anti-inflammatory agents, systemic glucocorticoids can increase patients’ susceptibility to opportunistic infections with unintended consequences, according to authors of a review article. “The
Lorundrostat for Uncontrolled Hypertension
Compared with placebo, the aldosterone synthase inhibitor lorundrostat lowered blood pressure among patients with uncontrolled hypertension in the TARGET-HTN trial, researchers report. “Blood pressure reduction
Venous Thromboembolism Associated With Hormonal Contraception and NSAIDs
In a nationwide study of women of reproductive age in Denmark, NSAID use was positively associated with venous thromboembolism, researchers report, and the risk was
Toxic THC Doses in Pediatric Cannabis Edible Ingestions
A threshold of 1.7 mg/kg of tetrahydrocannabinol (THC) in children younger than 6 years of age “may guide medical management and preventive regulations,” investigators conclude based
Small-Molecule Oral GLP-1 Receptor Agonist for Obesity
Orforglipron, a once-daily oral therapy under development for use in adults with obesity, was associated with weight reduction in a phase 2 trial. Adverse events
Availability of Low-Cost Generic Medicines for Cardiovascular Diseases
A study of evidence-based medicines for 6 cardiovascular diseases (CVDs; atrial fibrillation, heart failure, hyperlipidemia, hypertension, post–acute coronary syndrome secondary prevention, and stable angina) shows
Atogepant for Preventive Treatment of Chronic Migraine
In a phase 3 trial conducted at 142 clinical research sites in 16 countries, 778 adults with a 1-year or more history of chronic migraine
Risks and Benefits of Cannabis Use
Clinical evidence supports effectiveness of cannabis-based medicines in people with multiple sclerosis, chronic pain, and inflammatory bowel disease, and in palliative medicine, according to a
Sublingual Buprenorphine for Pain Control in Critical Care
In critically ill patients, sublingual buprenorphine was as effective as oral or enteral oxycodone in terms of pain control and opioid consumption, according to a retrospective, parallel,
Concizumab Prophylaxis of Hemophilia with Inhibitors
In the company-funded explorer7 phase 3 trial, patients with hemophilia A or B with inhibitors had a lower annualized bleeding rate with concizumab prophylaxis than
Semaglutide in Heart Failure With Preserved Ejection Fraction and Obesity
Compared with placebo in the STEP-HFpEF trial, once-weekly semaglutide 2.4 mg reduced symptoms and physical limitations, improved exercise function, and produced weight loss, investigators report.
Oral Semaglutide for Type 2 Diabetes, Obesity
In a pair of company-sponsored clinical trials, oral semaglutide had positive effects on glycemic parameters and weight in patients with type 2 diabetes and on
Vaccine Interventions Among Healthcare Workers
In a large academic hospital in Philadelphia, a COVID-19 vaccine mandate for healthcare personnel (HCP) increased the vaccination rate from 86.0% to 98.7%, a cohort
Pitavastatin for CVD Prevention in HIV Infection
Compared with placebo in people with HIV infection, pitavastatin decreased the risk of major adverse cardiovascular events over a median follow-up of 5.1 years, researchers
USPSTF Recommendation Statement: Preexposure Prophylaxis to Prevent Acquisition of HIV
Based on findings in an evidence report (covered in a separate PNN article), the U.S. Preventive Services Task Force (USPSTF) makes an “A” recommendation that clinicians
Real-World Use of Closed-Loop Insulin Delivery Systems and Continuous Glucose Monitoring
Two reports examine the use of hybrid closed loop (HCL) insulin delivery systems and continuous glucose monitoring (CGM) in real-world settings. In National Health Service
Once-Weekly Tirzepatide for Obesity in Patients With Type 2 Diabetes
In a phase 3 trial of patients with obesity and type 2 diabetes, the dual-action agonist tirzepatide administered once weekly enabled about 80% of participants
Anxiety, Benzodiazepines, and Incident Dementia
In a retrospective cohort study of 72,496 older adults (65 years or older), benzodiazepines and anxiety disorders were associated with increased risk for dementia, but when
Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma
In the phase 3 Vorasidenib in Glioma (INDIGO) trial, patients with isocitrate dehydrogenase (IDH)–mutant grade 2 gliomas had significantly better progression-free survival and time to
Triple G Agonist Retatrutide for Treatment of Type 2 Diabetes
In a phase 2 trial of patients with type 2 diabetes, retatrutide provided clinically meaningful glycemic control and “robust reductions in body weight,” researchers report.
Triple G Agonist Retatrutide for Treatment of Obesity
Retatrutide (LY3437943) — an agonist of the glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and glucagon receptors — produced substantial reductions in body weight in adults
Atorvastatin for Anthracycline-Associated Cardiac Dysfunction
Atorvastatin reduced the incidence of cardiac dysfunction among patients with lymphoma treated with anthracycline-based chemotherapy in the STOP-CA (Statins to Prevent the Cardiotoxicity of Anthracyclines)
Shared Decision-Making Regarding Long-Acting Reversible Contraception
“Contraception counseling and provision are vital components of comprehensive health care,” write authors of an In the Clinic review of contraception. “An unplanned pregnancy can
Fatal Drug Overdose Risks of American Health Care Workers
Healthcare workers in the U.S. are at increased risk of dying from drug overdoses compared with non-healthcare workers, a study shows. The results suggest “the
Acute Pain Relief Through Selective Inhibition of Voltage-Gated Sodium Channels With VX-548
An oral, highly selective inhibitor of the NaV1.8 voltage-gated sodium channel, VX-548 was more effective than placebo when used at its highest doses for 48
USPSTF Reaffirms Folic Acid Recommendations During Pregnancy
In an important reaffirmation of prior guidance, the U.S. Preventive Services Task Force (USPSTF) “recommends that all persons planning to or who could become pregnant
Age and LDL Cholesterol Response to Statins
A nationwide study from Denmark shows a greater LDL cholesterol response for adults aged 75 years or older to low- to moderate-intensity statins than in
Weekly Insulin Icodec in Type 2 Diabetes Without Previous Insulin
In the phase 3a ONWARDS 1 trial, weekly doses of the investigational agent insulin icodec produced significantly better glycemic control than once-daily insulin glargine U100
Efficacy of Antibiotics for Pediatric Acute Sinusitis
Antibiotic use could be reduced by testing for specific bacteria when children present with acute sinusitis, a study shows. For those without nasopharyngeal bacterial pathogens
Demographic Disparities in Guideline-Recommended Statin Use
Among participants in the National Health and Nutrition Examination Survey for 2015–20, variations in guideline-recommended statin use among minoritized racial/ethnic groups and women “are not
Opioid Analgesia for Acute Low Back Pain and Neck Pain
In a 12-week trial conducted in Australia, opioids were no better than placebo for relief of acute low back pain and neck pain, researchers report.
Dupilumab for COPD With Type 2 Inflammation
In a phase 3 trial, dupilumab therapy improved outcomes in patients with COPD who had type 2 inflammation as indicated by elevated blood eosinophil counts.
Donanemab in Early Symptomatic Alzheimer Disease
Clinical benefits were evident in patients with early symptomatic Alzheimer disease after 76 weeks of treatment with the amyloid-targeting monoclonal antibody donanemab, according to findings of
Global Burden of Diabetes Through 2050
Type 2 diabetes is a preventable disease, but unless trends change, more than 10% of the population in nearly half the world’s countries will have
Pharmacists’ Roles in Person-Centered Models for Cardiovascular Care
In published reports, pharmacist-led cardiovascular care models on ensuring guideline-directed medical therapy have been “instrumental in promoting medication safety through medication reconciliation, medication adherence, dose
Cardiovascular Safety of Testosterone-Replacement Therapy in Middle and Older Adulthood
In the TRAVERSE trial, testosterone-replacement therapy was noninferior to placebo with respect to the incidence of major adverse cardiac events in men aged 45 to
Extended-Duration Dosing of Cytisinicline for Smoking Cessation
A nonprescription agent used outside the United States, the naturally occurring plant-based alkaloid cytisinicline (historically known as cytisine) is used by patients 6 times daily
Reducing Unnecessary Antibiotic Treatment of Asymptomatic Bacteriuria Through Diagnostic Stewardship
Reducing unnecessary urine cultures through diagnostic stewardship is an effective way of reducing antibiotic treatment of patients with asymptomatic bacteriuria (ASB), according to findings of
Therapeutic Value of Approved First and Supplemental Drug Indications in U.S. and Europe
Among indications of drugs approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) in 2011–2020, the therapeutic value of
AAP Policy Statement: Postnatal Corticosteroids for Chronic Lung Disease Following Preterm Birth
In a policy statement, the American Academy of Pediatrics provides “guidance on the use of postnatal corticosteroids to manage or prevent chronic lung disease following
Menopausal Hormone Therapy and Incident Dementia
Use of menopausal hormone therapy is associated with increased risk of dementia in a nationwide, nested case-control study conducted in Denmark. The relationship held even
Early Versus Later Anticoagulation for Stroke With Atrial Fibrillation
In persons with atrial fibrillation who have had an acute ischemic stroke, early use of direct oral anticoagulants (DOACs) lowered by 0.5 to 2.8 percentage
Mirikizumab as Induction and Maintenance Therapy for Ulcerative Colitis
Mirikizumab, a p19-directed antibody against interleukin-23, was “more effective than placebo in inducing and maintaining clinical remission in patients with moderately to severely active ulcerative
Dual Antiplatelet Therapy in Minor Nondisabling Acute Ischemic Stroke
Dual antiplatelet therapy (DAPT) was noninferior to intravenous thrombolysis with alteplase in a trial of patients with minor nondisabling acute ischemic stroke presenting within 4.5
Guideline-Directed Heart Failure Management in Older Adults With Frailty
In 2015–19, the use of angiotensin receptor neprilysin inhibitor (ARNI) and guideline-directed medical therapy (GDMT; renin-angiotensin blockers, beta-blockers, and mineralocorticoid receptor antagonists) was low among
Beta-Blocker Doses for Heart Failure With Reduced Ejection Fraction in Older Adults
While the guideline for the management of heart failure (HF) with reduced ejection fraction (HFrEF) recommends titrating the dose of beta-blockers to the maximum target
Ketamine for Treatment-Resistant Major Depressive Disorder
In patients referred for electroconvulsive therapy (ECT) for treatment-resistant major depression without psychosis, subanesthetic intravenous ketamine was noninferior to ECT for reducing depressive symptoms by
High-Dose Influenza Vaccine and Reduced Mortality Among Older Adults With Breakthrough Influenza
Among older adults, receipt of high-dose (HD) influenza vaccine was associated with lower post-influenza mortality compared with standard-dose (SD) products or no vaccination, a study
Dexamethasone vs. Surgery for Chronic Subdural Hematoma
In a trial comparing dexamethasone with surgery in patients with chronic subdural hematoma, “dexamethasone treatment was not found to be noninferior to burr-hole drainage with
Small Interfering RNAs: mRNA Targeted in Treatment of Disease
“Programmable [small interfering RNA (siRNA)] therapeutics have demonstrated effectiveness for treating an increasing number of rare conditions,” write authors of a review article. “The approach
Once-Weekly Insulin Icodec in Type 2 Diabetes
Compared with once-daily insulin glargine U100 (glargine) in patients with type 2 diabetes, once-weekly insulin icodec (icodec) showed similar improvements in glycemic control, with fewer
Early Diagnosis and Treatment of Gestational Diabetes Mellitus
In a study of 802 women in early pregnancy and a diagnosis of gestational diabetes, immediate treatment before 20 weeks’ gestation was more effective than
DOACs vs. LMWHs for Cancer-Associated Recurrent VTEs
In patients with cancer and venous thromboembolism (VTE) events, prophylaxis of recurrence with direct oral anticoagulants (DOACs) was noninferior to low-molecular-weight heparins (LMWHs), a study shows.
Nirmatrelvir–Ritonavir or Molnupiravir for COVID-19 Among U.S. Veterans
For improving 30-day outcomes among U.S. veterans with COVID-19, ritonavir-boosted nirmatrelvir reduced both hospitalizations and mortality, while molnupiravir reduced mortality but not hospitalizations, researchers report.
Medication Review Intervention in Older Adults
Use of an electronic clinical decision support system (eCDSS) to improve prescribing of medications for older adults was safe but not statistically beneficial in a study
Tirofiban for Stroke With Nonocculded Large or Medium-Sized Vessels
Intravenous tirofiban was associated with a greater likelihood of an excellent outcome than low-dose aspirin in heterogeneous groups of patients in China with stroke of
SARS-CoV-2 Outcomes During Delta and Omicron Waves Based on Vaccination Status
During periods of delta and omicron variant dominance, U.S. veterans who had received SARS-CoV-2 vaccinations had significantly lower odds of 30-day morbidity and mortality compared
Is COVID-19 the Direct Cause of a Rising Incidence of Diabetes?
While an increased incidence of diabetes has been documented since the start of the COVID-19 pandemic and SARS-CoV-2 is known to infect the pancreas, data
Hydrocortisone in Severe Community-Acquired Pneumonia
Compared with placebo, hydrocortisone reduced the 28-day mortality risk among critically ill patients with severe community-acquired pneumonia, according to results of the Community-Acquired Pneumonia: Evaluation
Images of Medication-Related Osteonecrosis of the Jaw
Radiographic, dermatological, and oral manifestations of medication-related osteonecrosis of the jaw are illustrated in an Images in Clinical Medicine feature: “Medication-related osteonecrosis of the jaw
Group-Based Intervention for Reducing Opioid Use for Chronic Pain
In a trial of 608 U.K. participants with chronic pain from nonmalignant causes, a group-based intervention significantly reduced opioid use but not affecting perceived pain
COPD and New Use of Combination Inhalers
Among new users of combination medication inhalers for chronic obstructive pulmonary disease (COPD), those on long-acting muscarinic antagonists (LAMAs) with long-acting β-agonists (LABAs) had a
Bleeding-Related Hospitalizations During Use of Amiodarone and Direct Oral Anticoagulants
The prohemorrhage interaction of amiodarone with direct oral anticoagulants produces a greater risk for bleeding-related hospitalizations with apixaban or rivaroxaban than with flecainide or sotalol,
Spironolactone for Acne in Women
As an alternative to oral antibiotics, spironolactone improved outcomes at week 24 in women with persistent acne, a placebo-controlled study shows. The Spironolactone for Adult
Peresolimab for Adults with Rheumatoid Arthritis
In a phase 2a trial, the humanized IgG1 monoclonal antibody peresolimab demonstrated potential efficacy in 98 adults with rheumatoid arthritis. This agent stimulates the endogenous
Global Variations in Heart Failure Etiology, Management, and Outcomes
In a study of heart failure (HF) in 40 countries with varying income levels, hospitalization rates were higher and mortality rates lower in patients from
Allopurinol, Physical Disability, and Frailty in Older Adults
In the ASPirin in Reducing Events in the Elderly (ASPREE) trial, older adults with gout taking allopurinol had a reduced risk of persistent physical disability,
Need for Ultra-Orphan Oncolytic Drug Designation
Based on an analysis of 170 FDA-approved drugs across 455 cancer indications from 2000 to 2022, researchers conclude that a “distinct ultra-orphan designation with greater
2023 AGS Beers Criteria Emphasize Anticoagulants, Nephrotoxic Drugs
The American Geriatrics Society has released its 2023 revision of the Beers Criteria with detailed discussions of anticoagulant use in adults aged 65 years or
Prophylactic Antibiotics and Mortality in Severe Alcohol-Related Hepatitis
At 60 days, survival among patients hospitalized with severe alcohol-related hepatitis was no higher with amoxicillin-clavulanate combined with prednisolone than with prednisolone alone, researchers report.
Adverse Cardiovascular Events With Antidiabetic Agents
In veterans without preexisting cardiovascular disease, a retrospective cohort study from 2001 to 2019 showed that the addition of glucagon-like peptide-1 receptor agonists (GLP1RAs) was
Comparing Wakefulness-Promoting Agents for Excessive Daytime Sleepiness in Obstructive Sleep Apnea
Solriamfetol is likely superior to armodafinil–modafinil and pitolisant for reducing excessive daytime sleepiness (EDS) for patients with [obstructive sleep apnea (OSA)] already on conventional therapy,
First RSV Vaccine for Older Adults Approved by FDA
FDA yesterday approved the respiratory syncytial virus vaccine, adjuvanted (Arexvy, GlaxoSmithKline Biologicals) for the prevention of lower respiratory tract disease (LRTD) caused by RSV in
CEA of Quality Measures in Care of Acute Ischemic Stroke
Of the 15 process measures for acute ischemic stroke (AIS) endorsed by the American Heart Association and American Stroke Association (AHA/ASA), benefits are highly concentrated
Molnupiravir and Risk of Postacute Sequelae of COVID-19
Molnupiravir use within 5 days of a positive SARS-CoV-2 test was associated with a reduction of postacute sequelae of SARS-CoV-2 (PASC) in a large VA
Improving Antibiotic Management in Pediatric Cough and Respiratory Infection Cases
In English primary care practices, a multifaceted antibiotic stewardship intervention was not effective for improving prescribing patterns or outcomes in children aged 0 to 9
Contributors to Variation in Weight-Loss Response to Liraglutide
Factors affecting the weight-loss response to liraglutide are identified and discussed in a review article: “Obesity treatment requires a chronic state of negative energy balance. Obesity
Treating Asthma in the COVID-19 Era
The need for new therapies and adaptations in treating severe asthma with SARS-CoV-2 circulating and COVID-19 a common respiratory illness are discussed in a review
Melatonin and CBD in U.S. Melatonin Gummies
In a study of melatonin gummy products purchased in the U.S., “the great majority … were inaccurately labeled, with most products exceeding the declared amount
COVID-19 Treatment Guidelines Updated
The COVID-19 Treatment Guidelines Panel last week updated its COVID-19 treatment guidelines, adding sections on pregnancy and lactation, revising information on therapeutic management of nonhospitalized
Trastuzumab Deruxtecan in HER2-Positive Metastatic Breast Cancer
In the DESTINY-Breast02 trial, patients with HER2-positive metastatic breast cancer had a favorable benefit-risk response to trastuzumab deruxtecan in comparison to treatment of physician’s choice,
Type 2 Diabetes & Denosumab Use in Osteoporosis
Adults with osteoporosis had a lower incidence of type 2 diabetes when treated with denosumab compared with oral bisphosphonates, a population-based study shows. “This study
ASCO: Managing Anxiety & Depression in Adult Survivors of Cancer
In a guideline from the American Society of Clinical Oncology, a multimodal, stepped-care approach is recommended for managing anxiety and depression in adult cancer survivors.
Oral Fluvoxamine With Inhaled Budesonide for Early-Onset COVID-19
At 12 clinical sites in Brazil, ambulatory patients with early COVID-19 at high risk of progression to severe disease requiring advanced care responded positively to
Inflammation vs. Cholesterol for Predicting Cardiovascular Events During Statin Therapy
High-sensitivity C-reactive protein (CRP) is a stronger predictor of cardiovascular risk and death than LDL cholesterol levels in patients taking contemporary statins, investigators conclude based
Anthracycline- and Taxane-containing Chemotherapy for Early-Stage Operable Breast Cancer
Favorable results for anthracycline-taxane regimens for early-stage operable breast cancer challenges “the current trend in clinical practice and guidelines towards non-anthracycline chemotherapy, particularly shorter regimens,
Physician–Pharmacist Team-Guided Therapeutic Optimization in Heart Failure
Guideline-directed medical therapy (GDMT) of patients with heart failure delivered virtually by physician-pharmacist teams was safe and improved GDMT across several hospitals in an integrated
Bempedoic Acid & Cardiovascular Outcomes in Statin-Intolerant Patients
During a median follow-up of 40.6 months, statin-intolerant patients had a 13% reduction in risks of major adverse cardiovascular events when treated with the ATP
Heterogeneity in Antihypertensive Drug Response & the Need for Personalized Therapy
Wide variations in responses to antihypertensive agents in a randomized controlled trial suggest the possibility of personalized therapy for patients with hypertension. “Given the size
Nirmatrelvir & Risk of Post-COVID-19 Condition
In a cohort study of people with 1 or more risk factors for progression to severe COVID-19, post-COVID-19 condition (PCC) occurred less often among those
Anticoagulation in Patients With Hypoxemic COVID-19 Pneumonia
A randomized trial of 334 patients with severe hypoxemic COVID-19 pneumonia supports the empirical use of high-dose prophylactic anticoagulation (HD-PA). “The results of the ANTICOVID
Drug Treatment for Type 2 Diabetes
Findings of a network meta-analysis of drug treatments for type 2 diabetes “highlight the need for continuous assessment of scientific progress to introduce cutting edge
Opioids, OTCs Top List of Fatal Poisonings Among Young Children
Opioids are an increasingly common cause of fatal poisoning among children ages 5 years or younger, followed by nonprescription pain, cold, and allergy products, according
RSV Vaccine During Pregnancy to Prevent Illness in Neonates and Infants
Administered during the last trimester of pregnancy, a bivalent respiratory syncytial virus (RSV) prefusion F protein–based (RSVpreF) vaccine reduced medically attended severe RSV-associated lower respiratory
Treat-to-Target Strategies for Coronary Artery Disease
A more personalized treat-to-target strategy for coronary artery disease based on LDL cholesterol levels was as effective as high-intensity statin therapy in a noninferiority trial
Real-World Effectiveness of COVID-19 Monoclonal Antibodies
In a real-world cohort study of 2,571 people, the use of monoclonal antibodies to treat COVID-19 within 2 days of receiving a positive COVID-19 test
Communicating Information About Anticancer Drugs
In Europe, patients frequently do not receive sufficient information about the benefits and risks of anticancer drugs from regulated information sources to make an informed
Verapamil & Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes
Compared with placebo, verapamil partially preserved stimulated C-peptide secretion among children and adolescents with newly diagnosed type 1 diabetes at 52 weeks, a study shows.
COVID-19 Pandemic Policies & Behaviors: Economic & Educational Trade-offs
Policymakers and public health officials can learn much from the COVID-19 pandemic, including how COVID-19 pandemic policies and behaviors affected economic and educational outcomes, as
Treatment-Resistant Geriatric Depression: Augmenting vs. Switching Antidepressants
In the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) trial, outcomes were better when current antidepressants were augmented with aripiprazole rather than discontinued
REMS for Phentermine–Topiramate to Prevent Exposure During Pregnancy
Among women of child-bearing potential, a study shows less prenatal exposure to phentermine-topiramate — a product that requires a Risk Evaluation and Mitigation Strategy (REMS)
Disparities in Statin Prescribing Following Hospital Discharge for Stroke or TIA
In the Comprehensive Post-Acute Stroke Services (COMPASS) Study, statin prescribing remains lower among White patients, in those with transient ischemic attack (TIA), and in those
Antibiotics, ICIs, Survival & the Gut Microbiome
In a population-level study of older adults with cancer, exposure to fluoroquinolones and other antibiotics months before immune checkpoint inhibitor (ICI) treatment was associated with
Management of Heart Failure With Preserved Ejection Fraction
First-line therapy for 3 million U.S. patients with heart failure with preserved ejection fraction (HFpER) should include sodium-glucose cotransporter type 2 (SGLT2) inhibitors, exercise, heart
Comprehensive Management of Type 2 Diabetes During Pregnancy
With the prevalence of type 2 diabetes (T2D) during pregnancy increasing over the past 10 years from 1.8 to 7.3 per 1000 deliveries, multidisciplinary teams
Current Clinical Challenges in Overweight/Obesity
Advances in the understanding and management of obesity and overweight are summarized based on discussions of an expert panel convened last week by the American
Inflammation, Hypercholesterolemia as CVD Event Predictors During Statin Therapy
A study linking residual inflammation with adverse cardiovascular events in patients receiving statins could indicate a need for “combined use of aggressive lipid-lowering and inflammation-inhibiting
Shorter Course for Tuberculosis Treatment
Initial treatment of rifampin-sensitive tuberculosis with an 8-week course of bedaquiline and linezolid was noninferior to a standard 24-week antitubercular regimen, according to the TRUNCATE-TB
Electronic Reminders to Increase Influenza Vaccination Uptake
In Denmark, electronically delivered letters provided a “low-touch, inexpensive, and highly scalable” way of increasing the uptake of influenza vaccination among older adults, researchers report. Letters
Adjunctive Cariprazine for Major Depressive Disorder
The second-generation antipsychotic agent (SGA) cariprazine, a dopamine D3-preferring D3/D2 and serotonin 5-HT1A receptor partial agonist, was effective for reducing depressive symptoms in a trial of adults with
Penicillin Allergy Labels in Pediatric Primary Care
In two major U.S. pediatric networks, penicillin allergy labels were judged to be “uninformative,” researchers report, “and children were infrequently referred to allergists. Future quality
Tight Glycemic Control, Verapamil in Newly Diagnosed Pediatric Type 1 Diabetes
The effects of tight glycemic control and verapamil on pancreatic beta-cell function are explored in children and adolescents newly diagnosed with type 1 diabetes. Glycemic
Relics of Prescribing Cascades in Older Adults
Using the example of potassium supplements remaining in a patient’s drug regimen after discontinuation of loop diuretics, authors remind clinicians to be aware of the
Valoctocogene Roxaparvovec Therapy for Hemophilia A
Two years after gene transfer using valoctocogene roxaparvovec, recipients had sufficient factor VIII activity and bleeding reduction, a study shows. “Models of the risk of
Etranacogene Dezaparvovec for Hemophilia B
A clinical trial of etranacogene dezaparvovec gene therapy demonstrates its superiority over prophylactic factor IX with respect to annualized bleeding rate, researchers report, with a
Higher-Dose Ivermectin for Outpatients With COVID-19
Among ambulatory patients with mild-to-moderate COVID-19, doses of ivermectin of up to 600 mg/day for 6 days failed to improve time to sustained recovery, researchers
Pharmacist Independent Prescribers in U.K. Care Homes
In the large, 6-month Care Homes Independent Pharmacist Prescriber Study (CHIPPS), weekly visits to care homes by pharmacist independent prescribers (PIPs) significantly reduced the Drug Burden
Efficacy & Safety of Ad26.RSV.preF–RSV preF Protein Vaccine in Older Adults
In a phase 2b trial of 5,782 older adults, an adenovirus serotype 26 respiratory syncytial virus (RSV) vector encoding a prefusion F (preF) protein (Ad26.RSV.preF) protein
RSV Prefusion F Protein Vaccine in Older Adults
In an international, phase 3 trial of 24,966 older adults, a single dose of an AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein–based candidate vaccine (RSVPreF3
Low-Concentration Atropine Eyedrops & Myopia Incidence in Children
Nightly use of atropine 0.05% eyedrops significantly lowered the incidence of myopia and the percentage of participants with fast myopic shift at 2 years compared
2023 Adult Immunization Schedule
The CDC’s Advisory Committee on Immunization Practices provides consolidated, summarized information in its 2023 immunization schedule for adults aged 19 years or older, published in
Pregnancy Outcomes & COVID-19 Vaccine Effectiveness During Omicron Dominance
COVID-19 caused by the omicron variant (B.1.1.529) during pregnancy is associated with increased maternal morbidity and mortality, particularly in women who are symptomatic or unvaccinated,
Vitamin D & Type 2 Diabetes in People With Prediabetes
The risk of progressing to type 2 diabetes is reduced by vitamin D therapy in people with prediabetes, according to a systematic review and meta-analysis.
12-Gene Pharmacogenetic Panel for Preventing Adverse Drug Reactions
A 12-gene pharmacogenetic panel significantly reduced the incidence of clinically relevant adverse drug reactions when implemented across diverse European healthcare systems, researchers report. “Large-scale implementation”
Baxdrostat for Treatment-Resistant Hypertension
In the BrigHTN trial, patients with treatment-resistant hypertension had dose-related reductions in blood pressure when taking the aldosterone synthase inhibitor baxdrostat. “The reduction in blood
Molnupiravir as Early Treatment for At-Risk Adults With COVID-19
In the PANORAMIC trial, high-risk, community-dwelling, vaccinated adults had similar rates of COVID-19-associated hospitalizations and death with molnupiravir compared with usual care. Participants in the
Cannabis-Associated Emergency Department Visits in California
Asking older adults about cannabis use and educating them about its effects should be a routine aspect of medical care, according to authors who studied
Antiretroviral Therapy & Adverse Pregnancy Outcomes
Of the 1.3 million persons living with human immunodeficiency virus (HIV) who become pregnant each year worldwide, approximately 1.1 million (85%) receive antiretroviral therapy (ART)
Treating the Acute Phase of Major Depressive Disorder: ACP Updates Living Guideline
Cognitive-behavioral therapy (CBT) and/or second-generation antidepressants (SGAs) can be used for initial therapy of adults in the acute phase of moderate-to-severe major depressive disorder (MDD),
Aspirin or LMWHs for Thromboprophylaxis After Fractures
Aspirin was noninferior to low-molecular-weight heparins for thromboprophylaxis in patients with surgically treated extremity fractures or with any pelvic or acetabular fracture, researchers report. The
LDL-C, CAC Scores & Risk of Atherosclerotic Cardiovascular Disease Events
LDL cholesterol is a predictor of future atherosclerotic cardiovascular disease (ASCVD) events in middle-aged people “almost exclusively” when there is evidence of coronary atherosclerosis based on
Recommendations for Use of Antiretroviral Agents for Prevention, Treatment of HIV Infection in Adults
Updated comprehensive recommendations provide clinicians with guidance on using antiretroviral therapy (ART) to prevent and treat HIV infections in adults. The 2022 Recommendations of the
Guideline for Diabetes Management in Chronic Kidney Disease
In an update of the 2020 Kidney Disease: Improving Global Outcomes (KDIGO) guideline, key recommendations on diabetes management in patients with chronic kidney diseases cover
PBMs & the FTC
The implications of the Federal Trade Commission (FTC) investigation of pharmacy benefits managers (PBMs) remain to be seen, write the authors of a Viewpoint article
Bimekizumab for Psoriatic Arthritis
In a pair of phase 3 trials, bimekizumab — a monoclonal immunoglobulin G1 antibody that inhibits interleukin (IL)-17A and -17F — was superior to active
Obesity and Overweight in Children With Complex Medical Conditions
The use of obesogenic medications is a factor in a higher prevalence of overweight and obesity among children with complex medical conditions (CMC), researchers report.
Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults
In updated recommendations on pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults, the American College of Physicians (ACP) incorporates
ADA’s 2023 Standards of Care in Diabetes
Among the changes and refinements in the 2023 Standards of Care in Diabetes are the addition of tirzepatide as a glucose-lowering option in obesity management,
Vaccine Attitudes, Decisions Among Parents of Children With Kidney Disease
The importance of better education and strong vaccine recommendations for parents of children with chronic kidney disease or primary hypertension is evident in a results
Chronic Hepatitis C: Impact of Direct-Acting Antiviral Therapy
Insured patients with chronic hepatitis C (CHC) had better hepatic and nonhepatic outcomes and improved long-term survival after treatment with direct-acting antiviral agents (DAAs), a
Cost of Discarded Medicare Part B Drugs in 2017–2020
During 2017 through 2020, the cost of drugs reported as administered but discarded was $3.0 billion, according to an analysis of the Medicare Part B
Aspirin Use & Ovarian Cancer Risk
Frequent aspirin use “is associated with lower ovarian cancer risk regardless of the presence of most other ovarian cancer risk factors,” conclude authors of an
Cardiovascular Events With Chlorthalidone vs. Hydrochlorothiazide
Older adults taking chlorthalidone for hypertension did not have a lower occurrence of major cardiovascular events or non–cancer-related deaths than those on hydrochlorothiazide in the
Beyond the Guidelines: Management of Chronic Insomnia
Recent guidelines from the American Academy of Sleep Medicine (AASM) make a strong recommendation only for multicomponent cognitive behavioral therapy (CBT), according to a Beyond
Melanoma Treatments & Mortality Rate Trends
Use of newer pharmacological therapies for melanoma — including dual immunotherapy such as ipilimumab-nivolumab — appears to be reducing the long-term melanoma mortality rate (MMR)
Discontinuation of RAS Inhibitors in Advanced Chronic Kidney Disease
Renin-angiotensin system (RAS) inhibitors are useful for slowing the progression of mild-to-moderate chronic kidney disease (CKD). Some studies have suggested that stopping the agents when
Lecanemab Efficacy, Safety in Early Alzheimer’s Disease
In results released yesterday from the highly anticipated CLARITY SF phase 3 study, the monoclonal antibody lecanemab “reduced markers of amyloid in early Alzheimer’s disease
Outpatient Treatment of Confirmed COVID-19: Evidence & Practice Points
Molnupiravir, nirmatrelvir-ritonavir, and remdesivir can be used in specific clinical situations for ambulatory patients with mild-to-moderate COVID-19, advises the Scientific Medical Policy Committee (SMPC) of
Pemafibrate, Triglyceride Lowering & Cardiovascular Risk
Pemafibrate, a selective peroxisome proliferator-activated receptor α modulator, did not lower the incidence of cardiovascular events compared with placebo in the phase 3 PROMINENT trial of
Oral Zinc for Treating COVID-19
In a study of ambulatory and hospitalized patients with COVID-19, oral zinc for 15 days decreased the 30-day death rate, lowered the intensive care unit
Antivirals Effective, But BA.4.6 Evades Neutralizing Antibodies
The omicron subvariant BA.4.6, now increasing in prevalence in the U.S., appears to evade the neutralizing antibodies induced by currently available vaccines or prior COVID-19,
Identifying, Managing High-Need, High-Cost Patients
Two research studies, one in pharmacy and the other in medicine, address the challenge of managing care for the small number of patients who account
Aspirin vs. Clopidogrel as Long-Term Post-PCI Monotherapy
In patients maintained on dual antiplatelet therapy without clinical events after percutaneous coronary intervention (PCI) with drug-eluting stents, clopidogrel performed better than aspirin as monotherapy
Pharmacotherapy of Hypertension
For the 116 million Americans and more than 1 billion people worldwide who have hypertension, cardiovascular disease is a leading cause of related morbidity and
COPD Exacerbations in Patients Receiving Antidiabetic Agents
In a real-world cohort study from the U.K., patients had fewer COPD exacerbations when diabetes was treated with GLP-1 agonists or SGLT-2 inhibitors than with
Effects of Semaglutide on Prediabetes in People With Overweight/Obesity
In the Semaglutide Treatment Effect in People with obesity (STEP) 1, 3, and 4 trials, participants with baseline prediabetes had improved glucose metabolism and a
New Obesity Guidelines for Adults Emphasize Long-Term Pharmacotherapy
Adults with overweight and obesity who do not lose enough weight on lifestyle interventions alone should receive long-term pharmacotherapy with antiobesity medications (AOM) such as
Prevention and Treatment of Monkeypox
To curb the monkeypox epidemic in both endemic areas in Africa and elsewhere, the effectiveness of existing treatments, vaccines, and vaccination strategies needs to be
Low-Dose Immunotherapy in Head and Neck Cancer
Lower doses of checkpoint inhibitors may be an effective option for patients who cannot tolerate full doses, according to investigators who studied nivolumab in patients
Influenza Vaccines During the 2010s
Despite “great advances in our ability to follow influenza occurrence and determine vaccine effectiveness (VE)” during the 2010–2020 decade, outcomes remain suboptimal for influenza vaccines,
Ruxolitinib Cream for Vitiligo
Compared with a placebo vehicle in a pair of phase 3 trials, topical application of the JAK inhibitor ruxolitinib improved pigmentation of vitiligo lesions while
Treatment of Myocarditis
Conventional treatment of patients with myocarditis begins with guideline-directed management of arrhythmias and heart failure. When specific causes can be identified, targeted therapy is indicated,
USPSTF Recommends Screening for Adolescent Depression but Not Suicide Risk
In an update to its 2014 and 2016 recommendations, the U.S. Preventive Services Task Force (USPSTF) recommends screening for major depressive disorder (MDD) in adolescents 12
Allopurinol in Ischemic Heart Disease
In the ALL-HEART trial, the use of allopurinol or usual care produced similar outcomes in older adults with ischemic heart disease and no history of
Home Care for Bronchiolitis in Infants
Home oxygen therapy is a feasible option for infants with bronchiolitis, according to authors of a systematic review and meta-analysis. Studies conducted at both high
Adjuvant Nivolumab ± Ipilimumab in Resected Stage IV Melanoma
Administered with or without ipilimumab, adjuvant nivolumab improved recurrence-free survival in patients with stage IV melanoma with no evidence of disease who were at high
Management of Heart Failure
New guidelines for heart failure (HF) update recommendations for medical therapy across the spectrum of ejection fraction (EF) values. The 2022 American College of Cardiology/American
Higher-Dose Fluvoxamine in Mild-to-Moderate COVID-19
In the ACTIV-6 trial, fluvoxamine was not effective in reducing the duration of mild-to-moderate COVID-19 among ambulatory patients. “Although one-third fewer health care use events