Debbie Rigby rounds up the latest in research news

Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder

A systematic review and network meta-analysis has concluded that agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine are more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone are the least efficacious drugs (0·51–0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates. 

Lancet 2018;391:1357-66.

 

Prevention and management of statin adverse effects: A practical approach for pharmacists

This practical guide identifies 6 key principles in the management of patients with goal-inhibiting statin intolerance: ensuring a valid indication, identifying risk factors for intolerance, ensuring the patient is informed of the benefits and risks, encouraging nondrug therapies/not advocating for supplements to prevent statin-associated myopathy, using a systematic challenge/dechallenge/rechallenge approach and recommending nonstatin therapy, if necessary.

Canadian Pharmacist Journal, First Published April 4, 2018

 

Once-daily fluticasone furoate/vilanterol versus twice-daily fluticasone propionate/salmeterol in patients with asthma well controlled on ICS/LABA

In this 24 week RCT, once-daily fluticasone furoate/vilanterol 100/25 µg was non-inferior to twice-daily fluticasone propionate/salmeterol 250/50 µg in adults/adolescents with asthma well controlled on inhaled corticosteroid/long-acting β2 agonist (ICS/LABA). These data suggest that patients well controlled on FP/SAL could step across to FF/VI without loss of control.

Journal of Asthma, 2018.

 

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks

This meta-analysis of 10 trials involving 77 917 participants demonstrated that supplementation with marine-derived omega-3 fatty acids for a mean of 4.4 years had no significant association with reductions in fatal or nonfatal coronary heart disease or any major vascular events. The majority of patients included in the trials had a high cardiovascular risk, with two-thirds of participants had a prior history of CHD, 28% had a prior stroke and 37% had prior diabetes. These results provide no support for recommendations to use omega-3 fatty acids 1G daily in people with a history of CHD.

JAMA Cardiol. 2018;3(3):225-234.

Comment