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March 2018 Briefing – Pharmacy

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy for March 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

3, 6 Month Adjuvant CAPOX Equally Effective for Colon Cancer

THURSDAY, March 29, 2018 (HealthDay News) — For patients with stage III colon cancer, three months of capecitabine and oxaliplatin (CAPOX) therapy is not noninferior to six months of therapy overall, according to a study published in the March 20 issue the New England Journal of Medicine.

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ACA Has Provided Better Access to Care for Cancer Survivors

FRIDAY, March 30, 2018 (HealthDay News) — Cancer survivors are more likely to have difficulty accessing and affording health care, but the proportion reporting these issues is decreasing, according to a study published online March 29 in JAMA Oncology.

Pharmacists Have Responsibility to Check Opioid Rx Are Legitimate

THURSDAY, March 29, 2018 (HealthDay News) — Pharmacists should be aware that they are expected to take steps to make sure opioid prescriptions are written for legitimate medical purposes, and should document these efforts, according to a report published in Drug Topics.

Scale of Online Marketplace for Marijuana Increasing

THURSDAY, March 29, 2018 (HealthDay News) — The scale of the online marketplace for marijuana increased from 2005 to 2017, according to a study published online March 22 in the American Journal of Preventive Medicine.

Duration of Antibiotics Often Exceeds Guidelines for Sinusitis

THURSDAY, March 29, 2018 (HealthDay News) — The durations of most courses of antibiotic therapy for adult outpatients with sinusitis exceed guideline recommendations, according to a research letter published online March 26 in JAMA Internal Medicine.

Lower Thromboembolic Risk With New A-Fib After CABG Versus NVAF

THURSDAY, March 29, 2018 (HealthDay News) — For patients post coronary artery bypass graft (CABG) surgery, new-onset postoperative atrial fibrillation (POAF) is associated with lower long-term thromboembolic risk than that seen among patients with nonvalvular atrial fibrillation (NVAF), according to a study published online March 28 in JAMA Cardiology.

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Low-Dose Abiraterone Acetate Noninferior for Prostate Cancer

WEDNESDAY, March 28, 2018 (HealthDay News) — For castration-resistant prostate cancer (CRPC), low-dose abiraterone acetate (AA) with a low-fat breakfast is noninferior to standard dose with fasting in terms of the mean change in prostate-specific antigen (PSA), according to a study published online March 28 in the Journal of Clinical Oncology.

Children With ASD, Younger Siblings Are Undervaccinated

WEDNESDAY, March 28, 2018 (HealthDay News) — Compared with the general population, children with autism spectrum disorder (ASD) and their younger siblings are undervaccinated, according to a study published online March 26 in JAMA Pediatrics.

Menopausal Hormone Therapy Linked to Reduced Abdominal Fat

WEDNESDAY, March 28, 2018 (HealthDay News) — Women who receive menopausal hormone therapy (MHT) have reduced age-adjusted visceral adipose tissue (VAT), according to a study published online March 27 in the Journal of Clinical Endocrinology & Metabolism.

Total Estimated Cost of Diagnosed Diabetes $327 Billion in 2017

WEDNESDAY, March 28, 2018 (HealthDay News) — The total estimated cost of diagnosed diabetes in 2017 was $327 billion, including $237 billion in direct medical costs, according to a study published online March 22 in Diabetes Care.

EHR Usability Contributes to Possible Patient Harm Events

TUESDAY, March 27, 2018 (HealthDay News) — Electronic health record (EHR) usability may contribute to possible patient harm events, according to a research letter published in the March 27 issue of the Journal of the American Medical Association.

Educational Attainment Down With In Utero Exposure to AEDs

TUESDAY, March 27, 2018 (HealthDay News) — Exposure to sodium valproate or a combination of antiepileptic drugs (AEDs) in utero is associated with worse attainment on national educational tests for 7-year-olds, according to a study published online March 26 in the Journal of Neurology, Neurosurgery & Psychiatry.

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Geographic, Social Variances Tied to Higher Drug-Related Mortality

TUESDAY, March 27, 2018 (HealthDay News) — County-level economic and other social conditions explain the geographic disparities in overdose rates across the country, according to a study published online March 26 in the American Journal of Preventive Medicine.

Only Half of Adults With Familial Hypercholesterolemia on Statins

MONDAY, March 26, 2018 (HealthDay News) — Only about 50 percent of adults with familial hypercholesterolemia (FH) are on statin therapy, and approximately 30 percent of those are taking high-intensity statins, according to a study published online March 26 in Circulation.

Intravitreal Anti-VEGF Use Not Tied to Systemic Adverse Events

MONDAY, March 26, 2018 (HealthDay News) — Intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment is not associated with increased risk of systemic adverse events for patients with neovascular age-related macular degeneration, diabetic macular edema, or retinal vein occlusion, according to a review published online March 22 in JAMA Ophthalmology.

Lean Approach May Help Tackle Burnout in Health Care Providers

FRIDAY, March 23, 2018 (HealthDay News) — The Lean approach, which emphasizes reducing waste and improving customer value by focusing on the big picture, can be used to address physician burnout, according to a report published in Medical Economics.

NSAID Use Linked to A-Fib Risk in Middle-Aged Asian Population

FRIDAY, March 23, 2018 (HealthDay News) — Nonsteroidal anti-inflammatory drug (NSAID) use is associated with increased risk of atrial fibrillation (AF) in a middle-aged Asian population, according to a study published online March 20 in the British Journal of Clinical Pharmacy.

Nivolumab Plus Ipilimumab Tops Sunitinib for Advanced Renal CA

FRIDAY, March 23, 2018 (HealthDay News) — For patients with previously untreated clear-cell advanced renal-cell carcinoma, nivolumab plus ipilimumab is associated with better overall survival than sunitinib, according to a study published online March 21 in the New England Journal of Medicine.

Siponimod Cuts Risk of Disability Progression in Multiple Sclerosis

FRIDAY, March 23, 2018 (HealthDay News) — For patients with secondary progressive multiple sclerosis, the selective sphingosine 1-phosphate (S1P) receptor1,5 modulator, siponimod, is associated with reduced relative risk of confirmed disability progression, according to a study published online March 22 in The Lancet.

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Unique Risks Associated With Texting Medical Orders

THURSDAY, March 22, 2018 (HealthDay News) — Despite the popularity, convenience, and speed of texting medical orders, there are unique and alarming risks associated with the practice, according to a report published in Drug Topics.

Dipeptidyl Peptidase-4 Inhibitors in T2DM Linked to IBD

THURSDAY, March 22, 2018 (HealthDay News) — Dipeptidyl peptidase-4 (DPP-4) inhibitors are associated with increased risk of inflammatory bowel disease among patients with type 2 diabetes, according to a study published online March 21 in The BMJ.

Short-Term PPIs Tied to Higher Hip Fracture Risk in Alzheimer’s

THURSDAY, March 22, 2018 (HealthDay News) — Short-term proton pump inhibitor use, but not long-term or cumulative use, is associated with an increased risk of hip fracture among Alzheimer’s patients, according to a study published online March 6 in Alimentary Pharmacology and Therapeutics.

Hydrochlorothiazide Tied to Non-Melanoma Skin Cancer Risk

THURSDAY, March 22, 2018 (HealthDay News) — Use of the diuretic hydrochlorothiazide is associated with a substantially increased risk of non-melanoma skin cancer, according to a study published in the April issue of the Journal of the American Academy of Dermatology.

H. Pylori Treatment Tied to Lower Metachronous Gastric Cancer Risk

WEDNESDAY, March 21, 2018 (HealthDay News) — Antibiotic treatment for Helicobacter pylori (H. pylori) in patients who underwent endoscopic resection of early-stage gastric cancer or high-grade adenoma is associated with a reduced rate of metachronous gastric cancer, according to a study published in the March 22 issue of the New England Journal of Medicine.

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Oxyntomodulin Augments Glucose Homeostasis

WEDNESDAY, March 21, 2018 (HealthDay News) — In obese subjects with and without type 2 diabetes mellitus (T2DM), oxyntomodulin (OXM) significantly augments glucose-dependent insulin secretion, according to a study published online March 15 in Diabetes.

Adjuvant Long-Acting Muscarinic Antagonist Improves Asthma

WEDNESDAY, March 21, 2018 (HealthDay News) — For patients with persistent asthma, the use of long-acting muscarinic antagonists (LAMAs) versus placebo as an adjunct to inhaled corticosteroids, and combined use of inhaled corticosteroids and long-acting β-agonists (LABAs), termed single maintenance and reliever therapy (SMART), are associated with a reduced risk of exacerbations, according to two reviews published online March 19 in the Journal of the American Medical Association.

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Adcetris FDA Approval Expanded to Include Later-Stage Hodgkin’s

TUESDAY, March 20, 2018 (HealthDay News) — U.S. Food and Drug Administration approval of Adcetris (brentuximab vedotin) has been expanded to include adults with untreated stage III or IV classical Hodgkin’s lymphoma, the agency said Tuesday in a news release.

Personal Health Info Found in Recycling at Five Hospitals

TUESDAY, March 20, 2018 (HealthDay News) — A considerable amount of personal health information (PHI) and personally identifiable information (PII) was found in the recycling at five Canadian teaching hospitals, according to a research letter published in the March 20 issue of the Journal of the American Medical Association.

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Integrative Medicine Training Tied to Less Antibiotic Prescribing

TUESDAY, March 20, 2018 (HealthDay News) — General practitioners (GPs) additionally trained in integrative medicine or complementary and alternative medicine (IM GPs) have lower antibiotic prescribing rates after general surgery than traditional practitioners, according to a study published in the March issue of BMJ Open.

Tamoxifen, Raloxifene Linked to Improvements in MD in Mice

TUESDAY, March 20, 2018 (HealthDay News) — Tamoxifen and raloxifene are associated with improvements in muscular dystrophy caused by mutations of the Fukutin-related protein (FKRP) gene in a mouse model, according to a study published in the April issue of The American Journal of Pathology.

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Vaginal Moisturizer, Estradiol Tablet No Better Than Placebo

TUESDAY, March 20, 2018 (HealthDay News) — Neither low-dose vaginal estradiol tablets nor a vaginal moisturizer reduces postmenopausal vulvovaginal symptoms more than placebo vaginal tablets and gel, according to a study published online March 19 in JAMA Internal Medicine.

2013 to 2016 Saw No Change in Antibiotic Prescribing Practices

FRIDAY, March 16, 2018 (HealthDay News) — From 2013 to 2016, annual national outpatient antibiotic prescribing practices remained unchanged, according to a study published online Feb. 27 in Infection Control & Hospital Epidemiology.

Generic Clopidogrel Noninferior to Plavix in Seniors With ACS

FRIDAY, March 16, 2018 (HealthDay News) — For patients aged older than 65 years with an acute coronary syndrome (ACS) hospitalization, generic clopidogrel is noninferior to Plavix for the composite of death and recurrent hospitalization for ACS, according to a study published online March 13 in Circulation: Cardiovascular Quality and Outcomes.

Oseltamivir Not Linked to Suicide Risk in Pediatric Patients

FRIDAY, March 16, 2018 (HealthDay News) — Oseltamivir does not appear to be associated with suicide risk in pediatric patients, according to a study published in the March/April issue of the Annals of Family Medicine.

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Grass Peptide Immunotherapy Cuts Seasonal Allergy Symptoms

THURSDAY, March 15, 2018 (HealthDay News) — Immunotherapy with peptide hydrolysates from Lolium perenne (LPP) reduces seasonal allergy symptoms and is generally well tolerated, according to a study published online March 7 in Allergy.

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VTE Risk Up in Most Emergency General Surgery Patients

THURSDAY, March 15, 2018 (HealthDay News) — Almost all emergency general surgery (EGS) patients treated operatively and nonoperatively have increased risk of venous thromboembolism (VTE) and should receive prophylactic treatment, according to a review published online March 14 in JAMA Surgery.

Digoxin Tied to Higher Mortality in Patients With Atrial Fibrillation

WEDNESDAY, March 14, 2018 (HealthDay News) — Digoxin is independently associated with higher mortality in patients with atrial fibrillation (AF) regardless of whether they have heart failure, according to a study published in the March 13 issue of the Journal of the American College of Cardiology.

Editorial (subscription or payment may be required)

Drug Copayments Often Exceed Prescription Drug Costs

WEDNESDAY, March 14, 2018 (HealthDay News) — Drug copayments frequently exceed prescription drug costs, with overpayments affecting 23 percent of all prescriptions, according to a research letter published in the March 13 issue of the Journal of the American Medical Association.

Depression Seen in One in 20 Childbearing-Aged Women

WEDNESDAY, March 14, 2018 (HealthDay News) — A substantial proportion of non-pregnant women of childbearing age have untreated depression, according to a study published online March 8 in Obstetrics & Gynecology.

PTs Support Interprofessional Model of Care With Pharmacists

TUESDAY, March 13, 2018 (HealthDay News) — The majority of Canadian physical therapists positively view a new interprofessional model of care with pharmacists, according to a study published online March 6 in the Journal of Evaluation in Clinical Practice.

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U.S. Spends Twice As Much for Similar Health Care Utilization

TUESDAY, March 13, 2018 (HealthDay News) — Spending on health care is much higher in the United States than other high-income countries, but utilization rates are similar, according to a study published in the March 13 issue of the Journal of the American Medical Association.

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Editorial 2 (subscription or payment may be required)

Editorial 3 (subscription or payment may be required)

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Opioid Receipt Up for Teens With Mental Health Conditions

TUESDAY, March 13, 2018 (HealthDay News) — Adolescents with pre-existing mental health conditions and treatments are more likely to receive any opioid and to transition to long-term opioid therapy, according to a study published online March 12 in JAMA Pediatrics.

Editorial (subscription or payment may be required)

Great Recession Linked to Increase in BP, Blood Glucose

TUESDAY, March 13, 2018 (HealthDay News) — The 2008 to 2010 Great Recession (GR) had a negative impact on the health of U.S. adults, with significant elevations in blood pressure and fasting glucose, according to a study published online March 12 in the Proceedings of the National Academy of Sciences.

Considerable Resource Use, Costs for Cardiovascular Care

MONDAY, March 12, 2018 (HealthDay News) — The 10-year costs associated with cardiovascular disease (CVD) are considerable, according to a study published in the March 13 issue of the Journal of the American College of Cardiology.

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Three-Pronged Approach Can Improve Physician Engagement

MONDAY, March 12, 2018 (HealthDay News) — The three-pronged approach implemented by one practice successfully improved physician engagement, according to an article published in Medical Economics.

Odds of Opioid Prescriptions Up in Head and Neck Cancer Patients

MONDAY, March 12, 2018 (HealthDay News) — The odds of opioid prescription are increased for patients with head and neck cancer (HNCA) versus those with lung or colon cancer (LCCA), according to a research letter published online March 8 in JAMA Otolaryngology-Head & Neck Surgery.

No Safety Concerns Noted in Study of Intranasal Insulin Use

MONDAY, March 12, 2018 (HealthDay News) — Intranasal insulin application appears to be safe, according to a review published online March 6 in Diabetes, Obesity and Metabolism.

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Median Household Income Predicts Survival in Anal Cancer

MONDAY, March 12, 2018 (HealthDay News) — Lower median household income (MHI) is associated with worse survival for patients with squamous cell carcinoma of the anus (SCCA), according to a study published online March 12 in Cancer.

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NCCN Recommends New Drugs Beyond FDA-Approved Indications

FRIDAY, March 9, 2018 (HealthDay News) — The National Comprehensive Cancer Network (NCCN) often makes recommendations for new molecular entities beyond the indications approved by the U.S. Food and Drug Administration, according to a study published online March 7 in The BMJ.

Botulinum Toxin Injections Improve Facial Surgical Scars

FRIDAY, March 9, 2018 (HealthDay News) — Botulinum toxin injections in surgical wound closure immediately after surgery improve facial surgery scars, according to a small study published in the March issue of Plastic and Reconstructive Surgery.

Increase in Acetaminophen Use, Overuse in Cold/Flu Season

FRIDAY, March 9, 2018 (HealthDay News) — During cold/flu season (CFS) there is an increase in acetaminophen use and overdosing, according to a study published online March 7 in the British Journal of Clinical Pharmacology.

Pharmacists Play Key Roles in Cardiac Disease Management

THURSDAY, March 8, 2018 (HealthDay News) — For patients with cardiac disease, pharmacists in all practice settings have an important role in the management of the chronic disease state, according to a report published in Drug Topics.

No Link Found Between Marijuana Use, Kidney Function

THURSDAY, March 8, 2018 (HealthDay News) — There are no significant associations between current or past self-reported marijuana use and measures of kidney function, according to a study published recently in the American Journal of Medicine.

Pharmacists Encouraged to Learn More About Herbal Supplements

WEDNESDAY, March 7, 2018 (HealthDay News) — Pharmacists should be aware of the increasing use of supplements, and should learn about both the supplements and possible medication interactions to be able to answer patients’ questions, according to an article published in Drug Topics.

No Benefit for Aggressive Therapy in Metastatic Prostate Cancer

WEDNESDAY, March 7, 2018 (HealthDay News) — For men with metastatic prostate cancer, there is no survival advantage for aggressive therapy over conservative androgen deprivation therapy only, according to a study published online March 2 in Cancer.

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Vaccine Exposure in First 23 Months Has No Adverse Impact

WEDNESDAY, March 7, 2018 (HealthDay News) — The estimated cumulative vaccine antigen exposure through age 23 months does not differ significantly for children with versus those without hospital visits for infectious diseases not targeted by vaccines from age 24 to 47 months, according to a study published in the March 6 issue of the Journal of the American Medical Association.

Editorial (subscription or payment may be required)

Cannabidiol Is Effective Add-On for Treatment-Resistant Epilepsy

WEDNESDAY, March 7, 2018 (HealthDay News) — For pediatric-onset treatment-resistant epilepsy, cannabinoids are effective as an adjunctive treatment for reducing seizure frequency by 50 percent or more, according to a review published online March 6 in the Journal of Neurology, Neurosurgery & Psychiatry.

Repeated Ranibizumab Doesn’t Impair Macular Perfusion

WEDNESDAY, March 7, 2018 (HealthDay News) — For patients with diabetic macular edema, repeated ranibizumab treatment does not appear to be associated with impaired macular perfusion, according to a study published online March 1 in JAMA Ophthalmology.

Aspirin Therapy Appears Safe Before Thyroid Surgery

WEDNESDAY, March 7, 2018 (HealthDay News) — Continuing aspirin therapy before thyroid surgery does not appear to increase the risk of intraoperative bleeding, according to a study published online March 1 in JAMA Otolaryngology-Head & Neck Surgery.

FDA Approves New Medication for Drug-Resistant HIV

TUESDAY, March 6, 2018 (HealthDay News) — Trogarzo (ibalizumab-uiyk) has been approved by the U.S. Food and Drug Administration to treat adult patients living with HIV who have not responded to other antiretroviral medications.

Opioids Don’t Top Non-Opioids for Pain-Related Function

TUESDAY, March 6, 2018 (HealthDay News) — Opioid treatment is not superior to non-opioid treatment for improving pain-related function over 12 months, according to a study published in the March 6 issue of the Journal of the American Medical Association.

Carboxytherapy Found to Be Effective As Alopecia Treatment

TUESDAY, March 6, 2018 (HealthDay News) — Carboxytherapy appears to be a promising therapeutic option for treatment of alopecia, according to a study published online Feb. 20 in the Journal of Cosmetic Dermatology.

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Quintupled Glucocorticoid Dose No Help in Pediatric Asthma

TUESDAY, March 6, 2018 (HealthDay News) — Quintupling the dose of inhaled glucocorticoids seems not to be effective for preventing exacerbations among children with asthma, while quadrupling the dose may be beneficial for adolescents and adults, according to two studies published online March 3 in the New England Journal of Medicine.

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Prophylaxis Can Prevent HCV Infection in Kidney Recipients

TUESDAY, March 6, 2018 (HealthDay News) — Direct-acting antiviral prophylaxis is safe and prevents chronic hepatitis C virus (HCV) infection after kidney transplantation from HCV-infected donors to noninfected recipients, according to a study published online March 6 in the Annals of Internal Medicine.

Minorities Face Worse Prognosis and Complications in T1DM

TUESDAY, March 6, 2018 (HealthDay News) — Compared to whites, blacks and Hispanics have increased markers of poor prognosis of type 1 diabetes at diagnosis and three years afterward, according to a study published online March 1 in Diabetes Care.

ACP Updates Guidance for HbA1c Targets for Adults With T2DM

MONDAY, March 5, 2018 (HealthDay News) — Guidance has been developed for hemoglobin A1c (HbA1c) targets for glycemic control among nonpregnant adults with type 2 diabetes; the guidance statement was published online March 6 in the Annals of Internal Medicine.

Domperidone Tied to Modest Increase in Breast Milk Supply

MONDAY, March 5, 2018 (HealthDay News) — Domperidone is well tolerated and effective in producing a moderate short-term increase in expressed breast milk volume among mothers of preterm infants, according to a review published online Feb. 22 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Global Costs of Diabetes Will Continue Rising Through 2030

MONDAY, March 5, 2018 (HealthDay News) — The global costs of diabetes are high and will increase substantially by 2030, according to a study published online Feb. 23 in Diabetes Care.

Dexmedetomidine Found to Prevent Delirium in Critically Ill

MONDAY, March 5, 2018 (HealthDay News) — Low-dose dexmedetomidine significantly reduces delirium in critically ill adults, according to a study published online March 2 in the American Journal of Respiratory and Critical Care Medicine.

Calcium ± Vit D Supplements Up Risk of Colon Adenomas, Polyps

FRIDAY, March 2, 2018 (HealthDay News) — Calcium supplements, taken with or without vitamin D, may increase the risk of sessile serrated adenomas or polyps (SSA/Ps), according to a study published online March 1 in Gut.

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