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Annals of Internal Medicine
Explore the study’s analysis, which also uncovers potential cardiovascular benefits associated with SGLT2i initiation among patients with gout and type 2 diabetes.
Cardiology August 3rd 2023
Medical Professionals Reference (MPR)
Brenzavvy, the latest addition to the diabetes treatment landscape, promises a cost-effective approach to managing type 2 diabetes. Discover how this newly approved drug could redefine the treatment paradigm for patients.
Endocrinology, Diabetes, Metabolism July 27th 2023
Dive into how the FDA-approved Farxiga is changing the heart failure treatment landscape. Colleagues, let’s dive into a remarkable milestone. Farxiga, known as dapagliflozin, now has FDA approval. This is groundbreaking for heart failure treatment. It applies to all patients, regardless of their left ventricular ejection fraction (LVEF) status. The approval didn’t happen overnight. Let’s talk about the DELIVER trial, a vital part of the process. It involved over 6,000 patients, all over 40. Each had heart failure, LVEF above 40%, and may or may not have had type 2 diabetes. They took either dapagliflozin or a placebo daily, plus their usual therapy. The trial had a clear goal: time to the first composite event. This included CV death, heart failure hospitalization, or an urgent heart failure visit. The goal applied to everyone, including patients with LVEF less than 60%. Fast forward about 2.3 years, the results were significant. Dapagliflozin cut the composite outcome by 18% versus the placebo. Both worsening heart failure and CV death rates dropped in the dapagliflozin group. The best part? These findings were consistent, even in patients with lower LVEF or diabetes. Expanding the picture, let’s consider two trials together: DELIVER and DAPA-HF. Over 22 […]
Cardiology May 24th 2023
ACP Internist
Delve into the changes in the updated Beers criteria and their implications for medication use in older patients. The American Geriatrics Society (AGS) has recently revised the Beers criteria. Significantly, these guidelines advise physicians to be cautious when prescribing medications like warfarin and sodium-glucose cotransporter-2 (SGLT2) inhibitors for patients over 65. Importantly, warfarin is now a drug to avoid in initial therapy for venous thromboembolism or nonvalvular atrial fibrillation unless alternatives are contraindicated or face significant usage barriers. The Beers criteria are organized into five distinct categories. These include potentially inappropriate medications, ones that might be inappropriate for patients with certain conditions, medications requiring careful usage, potential drug-drug interactions, and medications needing renal function-based dosage adjustments. An expert panel sifted through evidence from June 1, 2017, to May 31, 2022, to create these updates. These guidelines apply to patients aged 65 years and older in most care settings in the US, excluding hospice and end-of-life care situations. Among the notable changes since 2019 is the inclusion of warfarin. For older patients using warfarin long-term, continuation might be reasonable if they show well-controlled international normalized ratios and no adverse effects. Additional drugs introduced since 2019 include ticagrelor and SGLT2 inhibitors (use […]
A retrospective cohort study was conducted to investigate the effectiveness of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in preventing major adverse cardiac events (MACE) for individuals without preexisting cardiovascular disease. The study included US veterans aged 18 or older who were receiving care from the Veterans Health Administration. The cohort consisted of patients who added either GLP1RA, SGLT2i, or dipeptidyl peptidase-4 inhibitors (DPP4i) to their existing diabetes treatments. The outcomes measured were MACE and heart failure hospitalization. The results showed that the addition of GLP1RA was associated with a lower incidence of MACE and heart failure compared to DPP4i. However, the addition of SGLT2i did not show a significant association with primary prevention of MACE.
Cardiology May 18th 2023
Endocrinology Advisor
The SGLT2 inhibitor bexagliflozin is now available under the brand name Brenzavvy. Approval was based on monotherapy trials versus glimepiride, where the new drug was non-inferior, and in combination with metformin.
Endocrinology, Diabetes, Metabolism February 15th 2023