🗞️ Journal Club: Fresh Off the Press
|
✅ Study of the Month: Tirzepatide for HFpEF |
❤️ What is the role of tirzepatide in patients with HFpEF and obesity? -
The SUMMIT trial (November 2024, n=731) compared tirzepatide (2.5 mg SC weekly, up to 15 mg SC weekly for at least 52 weeks) to a matching placebo in patients with HFpEF and obesity. The key exclusion criteria included a major cardiovascular event in the past 90 days, acute decompensated HF in the past 4 weeks, noncardiac causes of functional impairment, uncontrolled diabetes, pancreatitis, proliferative diabetic retinopathy, or diabetic maculopathy.
-
There was a significant decrease in CV death or worsening HF (9.9% vs. 15.3%; HR 0.62, 95% CI 0.41 to 0.95, NNT=18). One of the secondary outcomes showed a significantly greater reduction in mean body weight at week 52 (13.9% vs. 2.2%; MRD 11.6, 95% CI 10.4 to 12.9) and a significantly greater improvement in mean 6-minute walk distance (26 m vs. 10.1 m; MD 18.3, 95% CI 9.9 to 26.7).
Conclusion: In patients with HFpEF and obesity, tirzepatide was superior to placebo with respect to CV death or worsening HF.
You’ll find more of the latest studies relevant to primary care below. For a more comprehensive catalog of recent practice-changing trials, head over to Pathway!
|
💩What is the role of centralized CRC screening outreach in patients at average risk for CRC? -
The SCORE trial (November 2024, n=4002) compared centralized cancer screening (centralized fecal immunochemical testing by mail with patient navigation to schedule colonoscopy if needed) to usual care alone, including opportunistic visit-based CRC screening in adults aged 50-75 years at average risk for CRC and due for CRC screening. The key exclusion criteria included IBD, personal or family history of CRC, and major comorbidities.
-
There was a significant increase in the rate of completion of CRC screening within 6 months (30% vs. 9.7%; AD 20.3%, 95% CI 17.9 to 22.7, NNT=4). One of the secondary outcomes saw a significant increase in the rate of detection of advanced colorectal neoplasia within 12 months of randomization (1.4% vs. 0.7%; AD 0.68%, 95% CI 0.05 to 1.35).
Conclusion: In adults aged 50-75 years at average risk for CRC and due for CRC screening, centralized cancer screening was superior to usual care with respect to the rate of completion of CRC screening within 6 months.
🦠 Is antibiotic treatment for 7 days non-inferior to treatment for 14 days in hospitalized patients with bloodstream infection? -
The BALANCE trial (November 2024, n=3608) compared 7-day antibiotic therapy to 14-day antibiotic therapy in hospitalized patients with a bloodstream infection. The key exclusion criteria included severe immunocompromised state, prosthetic heart valves or endovascular grafts, an infectious syndrome that required prolonged treatment, and a positive culture with a common contaminant, among others.
- There was a difference not exceeding the non-inferiority margin in the rate of death from any cause by 90 days after diagnosis (14.5% vs. 16.1%; ARD -1.6, 95% CI -4 to 0.8). There was also a significant decrease in the median number of days in the hospital (10 days vs. 11 days; AD -1 days, 95% CI -1.5 to -0.5).
Conclusion: In hospitalized patients with bloodstream infection, 7-day antibiotic therapy was non-inferior to 14-day antibiotic therapy with respect to the rate of death from any cause by 90 days after diagnosis. Acknowledgements: - Editorial Team: Jeremy Swisher, MD, Cole Phillips, MD, Khudhur Moh, MD, Hovhannes Karapetyan, MD
|
|
|
