Bedtime BP drugs best

Taking blood pressure tablets at night rather than in the morning significantly reduces cardiovascular events and mortality, according to a large study published in the European Heart Journal.
The Spanish primary-care-based study randomly assigned 19 084 hypertensive patients to take their daily dose of antihypertensive drugs at …

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Advice on aspirin and primary prevention

‘Aspirin for primary prevention: generally no, though occasionally yes’ is the aide-mémoire proposed by the authors of a recent Drug and Therapeutics Bulletin (DTB) review.
Unlike in secondary prevention, aspirin use to prevent first cardiovascular events has remained controversial. Three large studies conducted in 2018 failed …

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Male infertility linked to prostate cancer risk

Men who have children through assisted reproduction are at increased risk of early onset prostate cancer.
According a Swedish study, published in the British Medical Journal, men who became fathers through either in vitro fertilisation (IVF) or intra-cytoplasmic sperm injection (ICSI) had a statistically significantly increased …

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Post-cystectomy chemo delay still effective

Delaying the initiation of adjuvant chemotherapy following radical cystectomy for locally advanced bladder cancer does not impact overall survival, according to a study reported in Urology.
The retrospective cohort study used the National Cancer Data Base from 2006 to 2013 and included 3590 patients who underwent …

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Statin-driven low cholesterol safe in elderly men

Lowering cholesterol with statins in men over 70 years of age is safe and not associated with adverse cardiovascular outcomes according to a study published in Heart (doi: 10.1136/heartjnl-2019-315449).
Low levels of total cholesterol (TC) have been associated with adverse outcomes in older populations, but whether …

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Caution urged on vaping

A ‘State of the Art’ review in the British Medical Journal (doi.org/10.1136/bmj.l5275) is urging health professionals to be cautious in their recommendations to patients around e-cigarettes.
According to the authors, no long-term vaping toxicological/safety studies have been done in humans and without these data, saying with …

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Drug sequencing in prostate cancer

With an increasing number of drugs to choose from to manage prostate cancer, the order in which they should be used in often unclear.
A recently published study in the New England Journal of Medicine (DOI: 10.1056/NEJMoa1911206) shows the benefit of using cabazitaxel in patients with …

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New PrEP approaches needed

New drugs, technologies and delivery systems for pre-exposure prophylaxis (PrEP) against HIV infection are needed that can provide protection for a wide variety of people with different needs over the course of their sexually active lifespan, according to a paper in The Lancet HIV (doi.org/10.1016/S2352-3018(19)30238-3)
Pre-exposure …

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Five-year melanoma survival boost with drug combo

A combination of two immunotherapy drugs can increase overall survival in advanced melanoma to over 50% at five years.
The results of the CheckMate 067 trial published in The New England Journal of Medicine (DOI: 10.1056/NEJMoa1910836) show that overall survival at five years was 52% in …

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Addition of apalutamide incurs no QOL cost

Adding apalutamide to standard androgen deprivation therapy (ADT) in patients with metastatic castration-sensitive prostate cancer does not adversely affect overall quality of life (QOL), including pain and fatigue.
The phase 3 TITAN study showed that the addition of apalutamide to ADT significantly improved overall survival and …

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