Research Roundup


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Digoxin, opioids, yoga… Debbie Rigby takes a look at the latest in research news

Digoxin and Mortality in Patients With Atrial Fibrillation

In patients with AF taking digoxin, the risk of death was independently related to serum digoxin concentration and was highest in patients with concentrations ≥1.2 ng/ml. Initiating digoxin was independently associated with higher mortality in patients with AF, regardless of heart failure.

Journal of the American College of Cardiology 2018;71(10):1062-74.

Medscape summary

 

Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain

In this randomized clinical trial conducted over 12 months that included 240 patients, the use of opioid vs nonopioid medication therapy did not result in significantly better pain-related function over 12 months (3.4 vs 3.3 points on an 11-point scale at 12 months, respectively). Adverse medication-related symptoms were significantly more common in the opioid group over 12 months. This study does not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.

JAMA. 2018;319(9):872-882.

Medscape summary

 

Yoga vs a Low-FODMAP Diet in Patients With Irritable Bowel Syndrome

Irritable bowel syndrome is the most frequent gastrointestinal disorder. This small randomised controlled trial of 59 patients received two yoga sessions weekly for 12 weeks or 3 nutritional counselling sessions. No statistically significant difference was found between the intervention groups, with both groups showing a reduction in gastrointestinal symptoms.

Aliment Pharmacol Ther. 2018;47(2):203-211.

 

Management of opioid use disorders

Opioid use disorder is often a chronic, relapsing condition associated with increased morbidity and death. The Canadian national clinical practice guideline strongly recommends opioid agonist treatment with buprenorphine–naloxone as the preferred first-line treatment. Methadone is recommended when treatment with buprenorphine–naloxone is not the preferred option. Withdrawal management alone is not recommended.

CMAJ March 05, 2018 190 (9) E247-E257.

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