Debbie Rigby rounds up the latest in research news
Evidence suggests that short-acting beta-agonist (SABAs) inhalers continue to be responsible for high levels of poorly controlled asthma and even asthma deaths. Increased SABA use at the time of worsening asthma symptoms leads to symptom relief but does nothing to suppress the increased burden of airway inflammation, therefore masking the underlying problem. The authors of this review conclude that as required beta-agonists should always be combined with additional corticosteroid.
Eur Respir J 2019;53:1802223.
This meta-analysis evaluates the efficacy and safety of direct-acting OACs (DOACs) compared with warfarin in older patients with nonvalvular atrial fibrillation (AF). DOACs as a group were found to have superior efficacy compared with warfarin in reducing stroke or systemic embolization. The rate of major bleeding was similar, but intracranial hemorrhage was significantly lower in patients randomized to a DOAC. Apixaban was the only DOAC that significantly reduced all 3 outcomes of systemic embolization, major bleeding, and intracranial hemorrhage compared with warfarin.
American Journal of Cardiology, 2019.
A Cochrane review has concluded that overall evidence suggests a moderate protective effect of probiotics for preventing antibiotic-associated diarrhea (number needed to benefit of 9). For high dose probiotics (e.g. Lactobacillus rhamnosus or Saccharomyces boulardii) (5-40 billion CFUs per day) the NNTB to prevent one case of diarrhea is 6.
Cochrane Database of Systematic Reviews 2019, Issue 4.
Abnormal vitamin D metabolism may play a role in the pathogenesis of psoriasis. A small randomised controlled trial of vitamin D 60,000IU once every 2 weeks for 6 months versus placebo has shown a signbificant improvement in Psoriasis Area and Severity Index (PASI) score at 3 and 6 months after treatment. Oral vitamin D2 supplementation in patients with psoriasis increased the serum vitamin D level over this period.
Dermatology Research and Practice 2019.