Research Roundup

Debbie Rigby takes a look at the latest research news

Is pyridoxine effective and safe for post-partum lactation inhibition?

A systematic review of 7 randomised controlled trials has shown inconsistent and insufficient evidence on the role of pyridoxine  in the inhibition of post-partum lactation. The studies compared pyridoxine with placebo, bromocriptine and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450-600 mg for 5-7 days.

Journal of Clinical Pharmacy and Therapeutics 2017;42(4):373-82.

Prophylaxis of migraine headaches with riboflavin

A systematic review of 11 clinical trials has shown mixed evidence for use of riboflavin in migraine prophylaxis. Most trials showed modest reductions in migrain headache frequency in adults. Five trials showed a consistent positive therapeutic effect in adults; four clinical trials show a mixed effect in paediatric and adolescent patients, and two clinical trials of combination therapy have not shown benefit. Daily doses ranged from 50 to 400mg per day.

Journal of Clinical Pharmacy and Therapeutics 2017;42(4):394-403.

Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT)

A randomised controlled trial of 411 patients has highlighted the value of multidisciplinary collaborative care for patients with diabetes. In this 6 month trial patients in the intervention arm were followed up by pharmacists regularly, in addition to receving usual care.  Mean HbA1c was reduced from 8.6% to 8.1%, with reduced diabetes-related distress and greater satisfaction with their treatment.

Journal of Clinical Pharmacy and Therapeutics 2017;42(4):475-82.

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction

Dose reduction of non–vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. Analysis of a large U.S. administrative database of 14,865 patients with AF shows 43% were potentially overdosed and 13.3% were potentially underdosed. Patients prescribed high doses had a higher risk of major bleeding; and a higher risk of stroke was seen in patients with underdosing.

J Am Coll Cardiol. 2017;69(23):2779-2790.