Debbie Rigby rounds up the latest in research news
New clinical trials suggest a reduced benefit of aspirin for preventing first CVD events, but confirm sizable bleeding harms. After a CVD-defining event, use of aspirin, another antiplatelet agent, or both remains mandatory, although aspirin is underused for secondary prevention. Shared decisions about initiation, continuation, and discontinuation of aspirin for primary prevention should focus on individual patient risks and preferences.
JAMA. Published online June 28, 2019.
A cross-sectional study in six South Australian residential aged care services shows half of all residents received a PPI, of whom the majority had documented clinical indications or received medications that may increase bleeding risk. Over half (51%) of all 383 residents in the study received a PPI, with 23% prescribed a high dose. The authors concluded an opportunity exists to “step down” therapy and deprescribe PPIs in this setting.
Drugs – Real World Outcomes, First Online: 01 July 2019.
In this 3 year nested case-control study of 58 769 patients with a diagnosis of dementia and 225 574 matched controls, there were statistically significant associations of dementia risk with exposure to anticholinergic antidepressants, antiparkinson drugs, antipsychotic drugs, bladder antimuscarinics, and antiepileptic drugs after adjusting for confounding variables.
JAMA Intern Med. Published online June 24, 2019.
Recently, evidence from a large randomised controlled trial (RCT) negated efficacy of Lactobacillus rhamnosus GG for treating acute gastroenteritis in children. However a systemtaic review of current evdience (including this trial) shows that, overall, L rhamnosus GG reduced both the duration of diarrhoea (with a higher impact in European countries) and hospitalisation in inpatients.
Alimentary Pharmacology and Therapeutics, first published 25 April 2019.