Debbie Rigby rounds up the latest in research news
A systematic review and meta-analysis of randomised controlled trials has concluded that lipid lowering is as effective in reducing cardiovascular events in patients aged 75 years and older as in patients younger than 75 years. The authors conclude that the results should strengthen guideline recommendations for the use of lipid-lowering therapies, including non-statin treatment, in older patients.
Lancet, published 10 November 2020.
This analysis showed that ICS withdrawal did not increase exacerbation risk in patients taking triple therapy. Patients with a history of frequent exacerbations and higher blood eosinophil counts (≥ 100 cells/μL) could benefit from continuation of ICS-based therapy. Patients with blood eosinophil counts of ≥300 cells/μL had a greater likelihood of experiencing exacerbations following ICS withdrawal.
International Journal of Chronic Obstructive Pulmonary Disease 2020;15:2879-88.
This review article details the principles of management through a combination of lifestyle modifications, diagnostic testing, pharmaceuticals (mainly to suppress or counteract gastric acid secretion), and surgery. For PPIs, maintenance therapy should be adjusted to the minimal level of acid suppression necessary to maintain symptom relief. PPI safety is also put into perspective.
This paper is an important retraction of previous report of infant mortality caused by opioid overdose from breast feeding attributed to the mother’s status as a rapid metaboliser of codeine to the active morphine metabolite. The case report has been cited over 600 times since its publication and its findings have had a significant effect on the way that postpartum analgesic medication is prescribed.