Debbie Rigby takes a look at the latest in research news 

Deprescribing antihyperglycemic agents in older persons

This guideline provides practical recommendations for making decisions about deprescribing antihyperglycemic agents. Deprescribing can include stopping the medication, dose reduction, or prescription substitution. Deprescribing antihyperglycemic agents is recommended when agents are known to contribute to hypoglycaemia, and in patients experiencing or at risk of adverse effects.

Canadian Family Physician 2017;63:832-43.

Antihyperglycaemic deprescribing algorithm

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Stepwise dose increase of febuxostat is comparable with colchicine prophylaxis for the prevention of gout flares during the initial phase of urate-lowering therapy

Febuxostat is a xanthine oxidase inhibitor with a potent serum urate-lowering effect. A prospective multicentre randomised study has shown stepwise dose increase of febuxostat (from 10mg to 40mg/day) and low-dose colchicine prophylaxis (0.5mg/day) effectively reduced gout flares in comparison with fixed-dose febuxostat alone. Stepwise dose increase of febuxostat may be an effective alternative to low-dose colchicine prophylaxis during the introduction of urate-lowering therapy.

Annals of Rheumatic Diseases 2017.

 

Lack of asthma and rhinitis control in general practitioner-managed patients prescribed fixed-dose combination therapy in Australia

A pharmacist-led structured in-depth asthma review of 200 patients has shown the incidence of controlled asthma is low with a high risk of future asthma exacerbations. Asthma medication use and inhaler technique were sub-optimal; only 41.0% of the preventer users reported everyday use. Undiagnosed and undertreated comorbid allergic rhinitis was prevalent and asthma medication use was sub-optimal.

Journal of Asthma 2017.

 

A practical approach to the management of nocturia

Clinically relevant nocturia (≥2 voids per night) affects 2%-18% of those aged 20-40 years, rising to 28%-62% for those aged 70-80 years. This review article recommends a focus on identification of underlying causes and lifestyle modifications, with medications in those with sustained bother. The timing of diuretics is an important consideration, and they should be taken mid-late afternoon, dependent on the specific serum half-life.

Int J Clin Pract 2017;71:e13027.