Research Roundup


Debbie Rigby rounds up the latest in research news 

Overdiagnosis of Penicillin Allergy Leads to Costly, Inappropriate Treatment

A growing body of evidence suggests that as few as 10% of people who report they’re allergic to the antibiotic really are. In many cases, patients labeled as allergic to penicillin might have developed diarrhea or a rash after being treated with the antibiotic as children. Even those who have experienced a true allergic reaction have about an 80% chance of losing their sensitivity to penicillin within 10 years. An oral challenge is the best way to check whether people labeled penicillin allergic based on a history of low-risk symptoms really are allergic.

JAMA. Published online October 24, 2018.

 

Effects of vitamin D supplementation on musculoskeletal health

A systematic review, meta-analysis, and trial sequential analysis has concluded that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density. There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.

Lancet Diabetes & Endocrinology 2018;6(11):847-58.

 

Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus

Results of the ASCEND study show aspirin use prevented serious vascular events in persons who had diabetes and no evident cardiovascular disease at trial entry, but it also caused major bleeding events. In this study over 15,000 patients with diabetes and no evidence cardiovascular disease were treated with aspirin 100mg daily or placebo. The authors conclude that absolute benefits were largely counterbalanced by the bleeding hazard.

N Engl J Med 2018; 379:1529-1539.

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Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions

This review examines evidence for the effectiveness of cannabinoids in chronic noncancer pain. Across neuropathic pain, fibromyalgia, rheumatoid arthritis and 48 other types of chronic noncancer pain the change in pain intensity was 3mm reduction on a 100mm visual analogue scale greater than placebo. The number needed to harm was 6. There were no significant impacts on physical or emotional functioning, and low-quality evidence of improved sleep and patient global impression of change.

Pain 2018;159:1932-54.

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2 Comments

  1. David Senator
    04/12/2018

    So where do we stand with Vitamin D supplement as all our previous “evidence” is now defunct? Should this be discussed with GPs who are prescribing for Vit D deficiency or are we misleading the public?

    • Lisa Simpson
      08/12/2018

      I am confused. It seems this meta-analysis is just examining the effects of vitamin D supplementation in isolation. That is, not taking into account calcium deficiency (or examining dietary intake) or indeed other nutrient co-factors that improve bone uptake of calcium like magnesium, vit K etc I think it is difficult to make broad statements on the use of nutrients like they are drugs, when it is more important to consider all the factors at play in creating low bone density. Only 25% of the studies used calcium, the majority examining vit D supplementation on its own. Even then, calcium carbonate (mostly prescribed) is poorly absorbed in the over 65 year age group if low stomach acidity!

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