Debbie Rigby rounds up the latest in research news
Non-persistence to therapy may be a significant barrier to the use of metformin. Data from this retrospective cohort study show low starting dose of metformin is associated with significantly lower rates of reported side effects and non-persistence. Many providers routinely used ER metformin as an initial treatment; while this practice may have benefits, it may negatively impact on persistence.
BMJ Open 2018;8:e021505.
Sulfonylureas are oral antidiabetic drugs recommended as second line treatment in patients with type 2 diabetes. Sulfonylureas as second line drugs are associated with an increased risk of myocardial infarction, all cause mortality, and severe hypoglycaemia, compared with remaining on metformin monotherapy. Continuing metformin when introducing sulfonylureas appears to be safer than switching.
A systematic review and meta-analysis has shown conflicting results between antenatal blood vitamin D level and asthma/wheeze in later life. Three RCTs showed no association, whereas pooled results from 33 cohort studies suggest that antenatal vitamin D intake may influence childhood asthma > 5 years or childhood wheeze. Vitamin D intake during pregnancy may have a protective effect against wheeze.
BMC Pulmonary Medicine 2018;18:120.
Almost all of the available treatment options for endometriosis suppress ovarian function and are not curative. Combined oral contraceptives and progestins are commonly administered to patients in order to ameliorate pain symptoms. Gonadotropin-releasing hormone-agonists (goserelin, nafarelin) are prescribed when first-line therapies are ineffective, not tolerated or contraindicated. Aromatase inhibitors should be reserved only for women who are refractory to other treatments.
Expert Opinion on Pharmacotherapy 2018;19(10):1109-1125.