Medications Archive

Research we're watching

Among people who have atrial fibrillation (afib), those who take anti-clotting medications may be less likely to develop dementia later in life than those who don't take the drugs, a new study finds.

Afib, a disorder marked by a rapid, irregular heartbeat, raises the risk of stroke as well as dementia. Anti-clotting drugs are known to lower the risk of stroke, but the drugs' effects on dementia weren't clear. So Swedish researchers examined hospital and pharmacy registry data from nearly half a million people who were diagnosed with afib between 2006 and 2014.

Precision medicine offers a personalized approach for prevention and treatment of cancer and other diseases.

 Image: © Pogotskiy/Thinkstock

If you have a stomachache or cold, you go to the pharmacy and grab the same remedy that everyone else uses, and it often works. But is that always the best approach? Your reaction to an infection may be quite different from someone else's, so perhaps you need a treatment designed just for you and your ailment.

That's the philosophy behind precision medicine (sometimes referred to as personalized medicine), an emerging approach to prevention and treatment that takes into account a person's genes, environment, and lifestyle and eliminates the one-size-fits-all approach to health care.

In the journals

People who take prescription drugs do not always know about side effects that could increase their risk of driving accidents, suggests a study published online Oct. 31, 2017, by the Journal of Studies on Alcohol and Drugs.

Researchers asked 7,405 drivers about their prescription drug use. Nearly 20% used medication that could affect their driving skills — for example, by causing drowsiness or impairing cognitive or motor function — yet almost all were unaware of these potential side effects. Either they did not receive or remember a warning from their doctor or pharmacist, or they did not recognize or recall a warning on the drug label.

Being vigilant about what you're taking can reduce your risk of a harmful drug reaction.

There's an old expression that the cure is sometimes worse than the disease. That rings true when it comes to a common problem in health care — medication errors.

Medication mix-ups and mistakes sometimes lead to harmful drug reactions, which cause about 700,000 emergency department visits and 100,000 hospital admissions each year, according to the Agency for Healthcare Research and Quality.

Research we're watching

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A new test might help doctors better treat patients with urinary tract infections, according to a study published in the Oct. 4, 2017, issue of Science Translational Medicine. These infections prompt some eight million doctor visits each year, and doctors often prescribe antibiotics to treat the condition. However, sometimes the bacteria they are attempting to treat are resistant to first-line antibiotics. The delay caused by the ineffective medication can, in some cases, cause the patient's condition to worsen and lead to complications. To eliminate this antibiotic guesswork, researchers developed a new quick-acting antimicrobial susceptibility test that not only tells the doctor within 30 minutes whether the patient has a urinary tract infection, but also what type of bacteria caused it and what drugs will best treat it. The test can also quickly identify cases where antibiotics aren't needed at all, preventing overuse of antibiotics, which can promote resistance. The same type of rapid testing, might eventually be of use in identifying the best anti-biotics for other types of bacterial infections as well.

News briefs

People with coronary artery disease or strong risk factors for developing it are often treated with statin drugs. Statins were developed to treat high levels of LDL (bad) cholesterol, because such high levels increase the risk of coronary artery disease. Studies convincingly showed that statins do indeed reduce both cholesterol and the risk of coronary artery disease, as expected. However, a large Harvard study published in 2008 found that statins also lowered the risk even in people with normal LDL levels. Why? Many doctors speculated that the reason might be that statins also reduce inflammation, another contributor to heart attacks and stroke. A new Harvard study, published online August 27, 2017, by The New England Journal of Medicine used a novel medication called canakinumab, which attacks inflammation but does not lower LDL cholesterol. The study involved over 10,000 people who had suffered a heart attack and whose blood showed a modest level of inflammation. The inflammation-fighting medicine lowered the rates of heart attacks, strokes, and death from heart disease. This study supports the theory that the beneficial effects of statins may result from their ability to both lower cholesterol and tamp down inflammation. It also will lead to further study of this new drug as well as other treatments for inflammation.

Avoid taking these drugs when they're not needed.

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It's the time of year again for sneezing, sniffling, and sore throats. But if you don't escape it, you can just head to the doctor for an antibiotic, and you'll be healthy again in no time. Right?

Probably not.

"Each year millions of Americans are treated with antibiotics when they don't need to be," says Dr. Erica Shenoy, an infectious disease physician, who is associate chief of the Infection Control Unit at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School.

Ask the doctor

Q. I recently started taking low-dose aspirin, per my doctor's advice. But I heard that for some people, aspirin doesn't help prevent heart attacks. Is this true, and is there any way to find out if I'm one of those people?

A. The phenomenon you're referring to is sometimes called aspirin resistance. However, true aspirin resistance is very uncommon. There are tests for the problem, but I don't recommend them.

A novel anti-inflammatory drug may discourage repeat heart attacks.

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Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular disease. However, identifying a drug therapy that leverages this link has been more elusive. With the results of the recent Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), published in the Sept. 21, 2017, issue of The New England Journal of Medicine, it appears that the dots are finally beginning to connect.

"For the first time, we have an anti-inflammatory therapy that can reduce the chance that a person who has already had a heart attack will have a repeat occurrence," says Dr. Peter Libby, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "This opens up a new field of treatment and offers hope to our patients." He is one of the co-authors of the study, which was led by his colleague and fellow Harvard Medical School professor Dr. Paul Ridker.