Research Roundup

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Debbie Rigby takes a look at the latest in research news

Onabotulinum toxin A in the treatment of chronic migraine: patient selection and special considerations

Onabotulinum toxin A (BoNT-A) is approved treatment for the prevention of chronic migraine. Its efficacy increases considerably over time during long-term treatments, significantly varying among patients. Short duration of migraine, regardless of being episodic or chronic, would predict a positive response to BoNT-A treatment.

Journal of Pain Research 2017:10 2319–2329.


Replacing Warfarin with a Novel Oral Anticoagulant

Results from the ROAR study show that a significant proportion of patients treated with warfarin for atrial fibrillation develop major bleeding events when switched to direct-acting oral anticoagulants. Nearly two-thirds of patients has a repeat major bleeding event on DOACs. A higher CHA2DS2VASC score was associated with repeat systemic thromboembolism.

J Cardiovasc Electrophysiol. 2017;28(8):853-861.


Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

New guidelines detail management of functional lower urinary tract disorders with or without benign prostatic hyperplasia, primarily managed by conservative therapy and medications, such as α1-blockers and phosphodiesterase-type 5 inhibitors. 5α-Reductase inhibitors and anticholinergics or β3 agonists are indicated for men with enlarged prostates and overactive bladder symptoms, respectively.

International journal of Urology 2017;24:716-29.


Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease

The landmark COMPASS study demonstrates a new indication for rivaroxaban in patients with stable atherosclerotic vascular disease. In this double-blind trial, 27 395 participants were randomised to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). Fewer patients in the rivaroxaban-plus-aspirin group experienced the primary outcome of a composite of cardiovascular death, stroke, or myocardial infarction than in the aspirin-alone group.

N Engl J Med 2017; 377:1319-1330

Medscape summary


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