“Medicine sometimes snatches away health, sometimes gives it,” wrote the Roman poet Ovid in his collection of poems, titled Tristia. This week, the pharmaceutical industry proves this quote true as studies showed both the pros and cons for patients with diabetes and other cardiac disease states.
First, the European Union OK’d AstraZeneca’s Crestor for preventive care measures after a substudy of the JUPITER trial showed that the drug had the potential to reduce rates of adverse events in older patients with heightened C-reactive protein levels.
The substudy published in the Annals of Internal Medicine compared the results of a 20 mg dose of rosuvastatin and placebo in patients and showed that patients 70 years or older in the rosuvastatin arm had fewer heart problems and incidence of stroke. Additionally, the rates of MACE, including MI, arterial revascularization and mortality, were also lower in the patients who were administered the drug.
In other news, a Lancet study found that an injection of Novo Nordisk’s liraglutide (Victoza) better controls glucose for type 2 diabetics compared to an oral dose of Merck’s sitagliptin (Januvia).
Declines in HbA1c levels have been linked to a decreased risk of microvascular complications and risk of death. During the study, researchers found that after 26 weeks, HbA1c levels showed the greatest decline in the patients administered 1.8 mg of liraglutide.
On the flip side, a study in the Journal of General Internal Medicine showed the diabetics with uncontrolled glycemic levels and prolonged diagnoses have a 40 percent greater risk in developing atrial fibrillation (AF). Results showed that for each additional year patients are diagnosed with the comorbidity the risk of AF surges by 3 percent.
Additionally, after the FDA slapped a black box warnings on Plavix due to the fact that certain patients may not be able to fully metabolize the drug, a study at the University of North Carolina is attempting to assess alternative treatments for cardiac patients to better understand the warnings.
“For the vast majority, [clopidogrel] is still a very good medicine but what we are trying to do is to individualize therapy and find those patients who don't respond to Plavix and then through the study sort out the best way to treat those patients,” George “Rick” Stouffer, MD, PhD, told Cardiovascular Business News.
The trial will perform genetic and platelet function testing, and also test whether or not an increased dose of Plavix could be beneficial in patients with the inability to metabolize the drug.
With clinical medicine, often one flawed aspect is replaced with a noble treatment or finding. While one study shows the pitfalls of a certain treatment or outlines the risk of disease incidence, other studies, like the one enrolling patients at UNC, work to provide us with answers and alternatives to improve patient care.
On these issues or others, please feel free to contact me.