Debbie Rigby takes a look at the latest in research news
A large cohort study of over 600,000 people aged 40 and over with a median of 3 years follow-up has shown discontinuation of low-dose aspirin in the absence of major surgery or bleeding is associated with a >30% increased risk of cardiovascular events. Risk increased soon after treatment discontinuation and did not seem to lessen over time.
A small study of 53 patients confirms that β-blockers may protect patients with thick cutaneous melanoma from disease recurrence. In this cohort study, patients with confirmed melanoma and no evidence of metastasis took propranolol 80mg daily. Use of propranolol was associated with an 80% risk reduction in recurrence of melanoma.
JAMA Oncol. Published online September 28, 2017.
Fibromyalgia is a debilitating and often unrecognised syndrome, affecting 2% of the population with a peak incidence in middle-aged women. Management aims to improve symptoms, function and quality of life. Drug therapy only has a supportive role in symptom management, and includes antidepressants and antiepileptic drugs. Pure mu-opioid receptor agonists, such as codeine, fentanyl and oxycodone, are contraindicated because of poor clinical response and increased risk of opioid-induced hyperalgesia.
Aust Prescr 2017;40:179-83.
Frailty is associated with greater exposure to polypharmacy and medicines with anticholinergic and sedative effects, which may increase the risk of adverse outcomes including falls. People who are frail experience a higher incidence and severity of adverse drug events because of their medicine use and potential changes in pharmacokinetics and pharmacodynamics. Frequently review all medicines for frail older patients is recommended to ensure that they are receiving net benefit.
Aust Prescr 2017;40:174-8.