Articles related to GUIDELINES/RECOMMENDATIONS

Clinicians are directed to the American College of Cardiology/American Heart Association pooled cohort equation, which takes into account age, gender, blood pressure, lipids, diabetes mellitus, and tobacco use but not family history. The USPSTF now advises against starting aspirin therapy in individuals 60 and older since there is no net benefit and the risk of damage may outweigh the benefit. The USPSTF guidelines are based on evidence from 13 trials, which show that aspirin has a slight advantage for select adults aged 40 to 59, but no net benefit (with the potential for harm) for patients aged 60 and older.

Internal medicine physicians play a crucial role in addressing osteoporosis challenges. Many at-risk patients are not screened or educated about fracture prevention, and a significant number of individuals with high fracture risk remain undiagnosed and untreated. Efforts should focus on recognizing fractures as diagnostic indicators, expanding screening, and implementing effective treatments. The recent clinical guideline emphasizes bisphosphonates as first-line therapy, denosumab as second-line, and injectable medications for high-risk cases. Primary care physicians should take an active role in screening, diagnosing, and treating osteoporosis to prevent future fractures, even without immediate subspecialist care. Risk assessment tools, healthy lifestyles, and consideration of benefits, harms, patient values, and costs in medication selection are important. Empowering primary care doctors is vital in bridging the treatment gap and preventing fractures.

On April 25, 2023, the American Urological Association (AUA), in partnership with the Society of Urologic Oncology (SUO), released the 2023 clinical practice guideline amendment for the management of advanced prostate cancer. This guideline contains a total of 40 recommendations, and the revision includes updates to recommendations under these disease states:

In the first update in more than five years, these new guidelines review dosing recommendations for 41 antimicrobials, as applicable for patients with a BMI greater than or equal to 30 kg/m.

Check out the updated guideline for changes prevention and treatment of VTE in a variety of cancer settings.

A recent guideline update published in the Journal of Clinical Oncology offers updated recommendations for managing noncastrate advanced, recurrent, or metastatic prostate cancer. The authors recommend five separate standards of care, including docetaxel, abiraterone, enzalutamide, apalutamide, or darolutamide, all administered with androgen deprivation therapy (ADT). Triplet therapy is superior to doublet therapy, and there are no recommendations for the use of any of these agents in any other combination or series apart from the triplet therapies of docetaxel plus abiraterone plus ADT and docetaxel plus darolutamide plus ADT. Docetaxel plus ADT should be offered to patients with metastatic noncastrate prostate cancer with high-volume disease who are unwilling or unable to receive triplet therapy. Triplet therapy should be offered to patients with de novo metastatic noncastrate prostate cancer with high-volume disease who are being offered ADT plus docetaxel chemotherapy, with significant overall survival and radiographic progression-free survival benefits. Overall, patients should be informed that doublet therapy (docetaxel plus ADT) has been proven inferior to triplet therapy such as abiraterone and prednisone plus docetaxel plus ADT.