Daily ReCAP April 7, 2017


The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Long-Term Use of Osteoporosis Drug Deemed Safe

A new study confirms findings that denosumab is safe both short- and long-term in patients with postmenopausal osteoporosis. Adverse events (AEs) noted in a pivotal clinical trial of women aged 60 to 90 years who were treated for 3 years, showed no tendency to increase after an additional 3 years of treatment, according to the study published in theJournal of Bone and Mineral Research. Women who switched from 3 years of placebo to 3 years of denosumab did not have an increase in AEs compared with women treated for the initial 3 years. “All of this is consistent with an excellent safety and tolerability profile for denosumab treatment for osteoporosis,” said lead author Dr Nelson Watts.

Acute: New Drug Reduces Symptoms of Tardive Dyskinesia

A new medication can significantly reduce symptoms of tardive dyskinesia (TD) in patients with schizophrenia, schizoaffective disorder, and mood disorder. TD is an adverse effect of antipsychotic medications that can occur in some patients. It causes stiff, jerky, involuntary movements of the face and body, such as tongue protrusions or excessive eye blinking. In a study published in theAmerican Journal of Psychiatry, investigators found that the drug valbenazine—–when administered once daily––can significantly reduce TD. Valbenazine is a selective vesicular monoamine transporter 2 inhibitor. Included in the randomized, double-blind, placebo-controlled study were 225 patients with schizophrenia, schizoaffective disorder, or a mood disorder. Forty percent of patients who received 80 mg of valbenazine per day improved by at least 50%, compared to 8% in the placebo group. Overall, valbenazine was well tolerated and AEs were drowsiness, restlessness, and dry mouth.

Preventive: Bigger Women Have Higher Risk of Atrial Fibrillation

Women with a higher body surface area (BSA) have nearly 3 times greater risk of atrial fibrillation, according to a study presented at EuroPrevent 2017. Included in the study were more than 1.5 million women with a first pregnancy aged 28 years on average who were followed up for more than 30 years. The investigators used data on weight early in pregnancy, height, age, diabetes, hypertension, and smoking from the Swedish Medical Birth Registry. Information regarding hospitalization with atrial fibrillation was gathered from the Swedish Inpatient Registry. During a maximum follow-up of 33.6 years, the results of the study showed that 7001 women were hospitalized for atrial fibrillation at an average age of 49 years, compared with women in the lowest BSA quartile. Those in the second, third, and forth (highest) quartiles had a 1.16, 1.55, and 2.61 times increased risk of atrial fibrillation, respectively. “Atrial fibrillation is the result of obesity-related metabolic changes but there is also a second cause,” said author Annika Rosengren. “Big people—–not necessarily fat, but big––have a larger atrium, which is where atrial fibrillation comes from. People with a bigger atrium have a higher risk of atrial fibrillation.” Atrial fibrillation is the most common heart rhythm disorder, with a 20% lifetime risk. “In general, young women need not worry about their risk of atrial fibrillation, whatever their body size,” Rosengren said. “For older women and men, being big could be an indicator that you are at an increased risk of atrial fibrillation.”

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