Opinion: Natural health products should be sold separately from drugs

26Jun
2017

Editorial: Natural health products should be sold separately from drugs – Canadian Medical Association Journal (free)

“Separate “natural” products from drugs to protect consumers, says @drstanbrook” (RT @CMAJ see Tweet)

 

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection

26Jun
2017

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis – Gastroenterology (free)

Source: EvidenceAlerts (free resource to find articles of interest)

In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.

 

Tamiflu: an expensive lesson in panic stockpiling

26Jun
2017

What happens when an expensive drug is approved based on a lower bar of proof?

25Jun
2017

Insurers Battle Families Over Costly Drug for Fatal Disease – The New York Times (10 articles per month are free)

“A new drug can cost over a million dollars, even though it’s unclear if it works. Now, insurers are refusing to pay” (RT @NYTHealth see Tweet)

 

Update on anti-TNF agents and other new drugs for IBD

23Jun
2017

Performance Improvement: Phenytoin Toxicity

22Jun
2017

Performance Improvement: Phenytoin Toxicity – JAMA (free)

Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)

 

The Challenge of Polypharmacy

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money

21Jun
2017

Your vitamin D tests and supplements are probably a waste of money – VOX (free)

Related: Why Are So Many People Popping Vitamin D? – The New York Times (10 articles per month are free)

“Screening for vitamin D has exploded — with no good evidence that it helps people.”

 

The pressure of Big Pharma

21Jun
2017

The pressure of Big Pharma – The Globe and Mail (a few articles per month are free) (RT @CADTH_ACMTS see Tweet)

“Financial conflicts of interest are commonplace in clinical practice guidelines”

 

Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness

19Jun
2017

Hundreds died while taking an arthritis drug, but nobody alerted patients

19Jun
2017

Pain and Opioids in Cancer Care: Benefits, Risks, and Alternatives

16Jun
2017

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction

15Jun
2017

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentary: NOAC Doses: Just Stick to the Label – MedPage Today (free registration required)

“Among the 1,473 patients with a renal indication for dose reduction, 43.0% were potentially overdosed, which was associated with a higher risk of major bleeding”

 

Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex for Iron-Deficiency Anemia

15Jun
2017

Effect of Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex on Hemoglobin Concentration in Young Children With Nutritional Iron-Deficiency Anemia: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

The JAMA Network – For the Media: Treating Nutritional Iron-Deficiency Anemia in Children (free)

Commentaries: Ferrous Sulfate Drops Tied to Higher Hemoglobin Increases in Kids with Anemia – Physician’s First Watch (free) AND Traditional treatment is better for iron-deficiency anaemia in children – OnMedica (free) AND Ferrous Sulfate Effective for Iron-Deficiency Anemia in Kids – Medscape (free registration required)

Researchers expected that Iron Polysaccharide Complex would restore hemoglobin more effectively, because it is designed to be tolerated better, but the proportion of infants and children with a complete resolution of iron-deficiency anemia was higher in the ferrous sulfate group (29 percent vs 6 percent).

 

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events

15Jun
2017

Essential medicines require essential diagnostics

15Jun
2017

Essential medicines require essential diagnostics – The Huffington Post Canada Blogs (free)

See more about the new WHO list of essential medicines in our June 7th issue, see #1.

“To use essential medicines, have to know what you’re treating says @paimadhu so need essential diagnostics list too” (RT @markcha see Tweet)

 

Real-World Effectiveness of Antipsychotic Treatments

15Jun
2017

Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia – JAMA Internal Medicine(link to abstract – $ for full-text)

Commentaries: Oral clozapine, long-acting injectables tied to lower relapse risk in schizophrenia – Clinical Psychiatry News (free registration required) AND Long-Acting Antipsychotics Tied to Superior Outcomes – Medscape (free registration required)

“The risk of rehospitalization is about 20% to 30% lower during long-acting injectable treatments compared with equivalent oral formulations”

 

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes

14Jun
2017

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes – New England Journal of Medicine (free)

Commentary: CANVAS: Canagliflozin Reduces CV Events, but at Cost of Amputations – Medscape (free registration required)

Patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation and fractures. The benefits and harms were likely small. See interesting commentaries on the trade-offs by @AnilMakam, see Tweet 1Tweet 2Tweet 3Tweet 4Tweet 5Tweet 6Tweet 7Tweet 8; and Tweet 9.

 

Association of Adverse Events With Antibiotic Use in Hospitalized Patients

14Jun
2017

Association of Adverse Events With Antibiotic Use in Hospitalized Patients – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentary: Antibiotic-Associated Adverse Events Common – Medscape (free registration required)

“20% of hospitalized patients receiving antibiotics had adverse drug event. Of those, 20% of regimens inappropriate” (RT @PeterPronovost see Tweet)

 

More Treatments on Deck for Alcohol Use Disorder

14Jun
2017

Medical News & Perspectives: More Treatments on Deck for Alcohol Use Disorder – JAMA (free)

 

Drugs may help people pass larger kidney stones

13Jun
2017

Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor

9Jun
2017

Management of polypharmacy

8Jun
2017

Value-based drug pricing makes sense, but is difficult to pull off

8Jun
2017

WHO updates Essential Medicines List

7Jun
2017

#ASCO2017 – Biosimilar May Be As Effective as Trastuzumab for Early Breast Cancer

7Jun
2017

Prenatal antidepressant use and risk of attention-deficit/hyperactivity disorder in offspring

7Jun
2017

#ASCO2017 – Abiraterone for Prostate Cancer

5Jun
2017

Hepatotoxic risk of alcohol consumption in patients with rheumatoid arthritis taking methotrexate

4Jun
2017

Practice guidelines for pharmacists: The management of osteoarthritis

4Jun
2017

Drug-Drug Interactions With Statins and HIV Medications

4Jun
2017

Prophylactic Acid-Suppressive Therapy in Hospitalized Adults

2Jun
2017

Diabetes – Injection and Infusion Technique Recommendations

1Jun
2017

Triple Therapy Versus Biologic Therapy for Active Rheumatoid Arthritis

31May
2017

B-Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction

30May
2017

B-Blockers and Mortality After Acute Myocardial Infarction in Patients Without Heart Failure or Ventricular Dysfunction – Journal of The American College of Cardiology (free)

Commentary: Some heart attack patients may not benefit from beta blockers – University of Leads, via Science Daily (free)

Large cohort suggests there may be no benefit in continuing B-Blockers in patients who do not develop heart failure or ventricular dysfunction after myocardial infarction.

 

Switching to biosimilar

16May
2017

Measuring the Burden of Medications in Older Adults near the End of Life

16May
2017

Deprescribing proton pump inhibitors guideline

15May
2017

Treatment Deintensification Is Uncommon in Adults With Type 2 Diabetes Mellitus

15May
2017

Ten Principles of Good Prescribing

11May
2017

Risk of acute myocardial infarction with NSAIDs

11May
2017

One-Third Of New Drugs Had Safety Problems After FDA Approval

10May
2017

Reducing inappropriate prescribing easier said than done

6May
2017

Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

4May
2017

PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library

3May
2017

Systematic review: PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library (free summary – $ for full-text))

The evidence so far suggests that PCSK9 inhibitor use probably leads to little or no difference in mortality and leads to a modest absolute risk reduction (often less than 1%) in cardiovascular events in high-risk patients.

 

Advil, Motrin and other NSAIDs painkillers should be prescription only, Danish study says

28Apr
2017

Azithromycin doesn’t seem to increase the risk of ventricular arrhythmia

26Apr
2017

Cohort study: Use of azithromycin and risk of ventricular arrhythmia – Canadian Medical Association Journal (free)

Source: No Major Azithromycin Arrhythmia Risk in Huge European Cohort – Medscape (free registration required)

Contradicting a previous study (free) and a 2013 safety warning from the US Food and Drug Administration (free), this large cohort did not show an association between azithromycin and ventricular arrhythmia when compared to amoxicillin.

 

New warnings about the use of codeine and tramadol

24Apr
2017

β-Blocker Exposure in Pregnancy and Risk of Fetal Cardiac Anomalies

20Apr
2017

Associations of Maternal Antidepressant Use and Complications in Offspring

19Apr
2017

Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring – JAMA (link to abstract – $ for full-text)

Contradicting a previous study showing increased risk of autism with antidepressant use during pregnancy (free), this large retrospect cohort study of 1 580 629 Swedish offspring did not show an association of antidepressant use during pregnancy and autism or other neurodevelopment problems.

 

Insulin pump didn’t improve glycemic control compared to training on injections

18Apr
2017

Short term use of oral corticosteroids and related harms

13Apr
2017

Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study – The BMJ (free)

Corticosteroids, even if used for short periods of time, seems to be associated with significant morbidity and mortality. In this retrospective cohort with 1.5 million adults, the incidence of acute adverse events (sepsis, venous thromboembolism, fracture) increased by twofold to fivefold above background rates.

 

How Many Pills Are Too Many?

12Apr
2017

How Many Pills Are Too Many? – The New York Times (10 articles per month are free)

“Evidence has mounted about the dangers of taking multiple, perhaps unnecessary, medications” (from Tweet)

 

Seniors are given so many drugs, it’s madness

10Apr
2017

Seniors are given so many drugs, it’s madness – The Globe and Mail (free) (RT @RasoiniR)

“While most prescribing is well-intentioned, it’s also unco-ordinated; there is a tendency to overmedicate and leave people on drugs for too long”.

 

Antipsychotics May Boost Respiratory Failure Risk in COPD – MedPage Today

7Apr
2017

Inhaled Corticosteroids May Raise Women’s Risk of the Metabolic Syndrome

6Apr
2017

Anti-leukotriene agents in persistent asthma

3Apr
2017

Addition of anti-leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma – Cochrane Database of Systematic Reviews (link to summary – $ required for full-text)

Source: EvidenceAlerts

In patients with asthma not controlled with daily low-dose inhaled corticosteroids, adding anti-leukotriene agents reduced by half the number of patients with asthma exacerbations requiring an oral corticosteroid and improved lung function and asthma control.

 

WHO Launches Global Effort to Halve Medication-Related Errors in 5 Years

30Mar
2017

Non–Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease

30Mar
2017

Non–Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease – Journal of the American College of Cardiology (free)

Source: SciCombinator

Except for patients with moderate/severe mitral stenosis or mechanical heart valves, who were excluded in most trials, high-dose NOACs was as effective and safe for patients with valvular heart disease as for patients without valvular disorders.

 

Prevention of everolimus-related stomatitis

30Mar
2017

Prevention of everolimus-related stomatitis in women with hormone receptor-positive, HER2-negative metastatic breast cancer using dexamethasone mouthwash (SWISH): a single-arm, phase 2 trial – The Lancet Oncology (link to abstract – $ required for full-text)

See also: SWISH Four Times a Day to Keep Oral Mucositis Away – Medscape (free registration required)

This simple and inexpensive treatment resulted in a more than ten-times reduction in the incidence of grade 2 or higher stomatitis.

 

New recommendations for the management of rheumatoid arthritis

29Mar
2017

Efficacy of Heat-Stable Oral Rotavirus Vaccine

23Mar
2017

Pregabalin for Acute and Chronic Sciatica

23Mar
2017

Trial of Pregabalin for Acute and Chronic Sciatica – New England Journal of Medicine (link to abstract – $ required for full-text)

Pregabalin did not reduce pain and was associated with higher incidence of adverse events.

 

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