Primary Category:  Cardiology Key point:  Administration of antihypertensive medications at bedtime resulted in improved nighttime blood pressure (BP) readings and resulted in a greater reduction in cardiovascular (CV) events compared with administration in the morning, according to results of a study published in European Heart Journal. Finer points:  Some data have suggested that bedtime dosing of antihypertensives may result in improved outcomes compared with morning dosing. However, the available data are based on small studies, and additional research is needed to confirm these fi ..read more

Primary Category:  Respiratory Key point:  Treatment with nintedanib (Ofev—Boehringer Ingelheim) slowed the rate of decline in pulmonary function in adults with interstitial lung disease (ILD) associated with systemic sclerosis, according to a study published in the New England Journal of Medicine. Finer points:  Nintedanib, a tyrosine kinase inhibitor, has been shown to have antifibrotic and anti-inflammatory effects in preclinical models of systemic sclerosis and ILD. The drug was first approved in 2014 to treat adults with idiopathic pulmonary fibrosis. In September 2019, on the bas ..read more

Primary Category:  Focus on Lipids Care Key point:  Patients on higher doses of statins were at an increased risk of osteoporosis compared with controls, whereas those on lower doses of statins had a decreased risk of osteoporosis, according to results of a retrospective, observational study published in Annals of the Rheumatic Diseases.   Finer points:  The literature discussing statin use and the risk of osteoporosis has been conflicting, with some publications suggesting that statins have a positive effect on bone mineral density (BMD) and fracture risk, and other publications quest ..read more

Primary Category:  Focus on Asthma Care Key point:  Black children with uncontrolled asthma responded equally well to either an increased dose of their inhaled corticosteroid (ICS) or to the addition of a long-acting beta-agonist (LABA) to low-dose ICS. However, black adolescents and adults were more likely to experience improved asthma control with the addition of a LABA to a low-dose ICS compared with increasing their dose of inhaled ICS, according to results of two trials published in the  New England Journal of Medicine.   Finer points:  Asthma guidelines recommend the addition of ..read more

Generic Name:  Voxelotor Trade Name:  Oxbryta Company:  Global Blood Therapeutics Notes:  FDA granted accelerated approval to voxelotor, a hemoglobin S polymerization inhibitor for adults and children ages 12 years and older with sickle cell disease. Efficacy was evaluated in 274 patients with sickle cell disease in HOPE, a randomized, double-blind, placebo-controlled, multicenter trial. The primary efficacy outcome measure was hemoglobin (Hb) response rate, defined as an Hb increase of > 1 g/dL from baseline to week 24. The response rate for voxelotor was 51.1% (46/90) compared wit ..read more

Primary Category:  Focus on Asthma Care Key point:  As-needed use of a combination inhaler containing budesonide, an inhaled corticosteroid (ICS), and formoterol, a fast-onset long-acting beta-agonist (LABA) for quick relief reduced severe asthma exacerbations compared with low-dose ICS (budesonide) maintenance plus an as-needed short-acting beta-agonist (SABA; terbutaline) inhaler, according to a recent study published in the Lancet. Finer points:  Treatment of mild persistent asthma has included maintenance with low-dose ICS and as-needed inhaled SABA to minimize symptoms and prevent ..read more

Primary Category:  Cardiology Key point:  Data from the National Health Interview Survey published in the Annals of Internal Medicine suggest that approximately 29 million Americans are taking daily aspirin for primary prevention of cardiovascular disease (CVD), including those in which use is not recommended, such as older people and those with bleeding risk factors. Finer points:  Over the past decade, numerous guidelines have supported the use of aspirin for primary prevention of CVD. However, more recent data from well-designed, prospective, randomized outcomes trials demonstrated ..read more

Primary Category:  Focus on Asthma Care Key point:  Addition of a long-acting muscarinic antagonist (LAMA) to inhaled corticosteroid (ICS) plus long-acting beta-2-agonist (LABA) therapy improved lung function and reduced exacerbations in adults with uncontrolled asthma, according to an analysis of two clinical trials published in the Lancet. Finer points:  Many patients with asthma can achieve good control, especially with a combination of an ICS plus LABA. However, until recently, few options were available for patients who could not achieve control with such combinations. Researchers ..read more

Primary Category:  OTC Medicines Corner Key point:  Women who were able to obtain oral contraceptives OTC without a prescription had higher rates of OTC continuation over time, according to the results of a systematic review published in BMJ Global Health. Finer points:  Oral contraceptives require a prescription in the United States, which may hinder access for some patients, especially those who lack access to health care. A 2015 review of oral contraceptive access in 147 countries found 102 countries had oral contraceptives available without a prescription. Kennedy and colleagues co ..read more

Generic Name:  Riluzole oral film Trade Name:  Exservan Company:  Aquestive Therapeutics Notes:  Aquestive Therapeutics announced FDA approval of riluzole oral film for treatment of amyotrophic lateral sclerosis (ALS). It can be administered without water to patients with ALS who have trouble swallowing. According to Aquestive, studies have demonstrated riluzole's pharmacokinetic bioequivalence to the reference listed drug, Rilutek. The recommended dosage is 50 mg twice daily, taken at least 1 hour before or 2 hours after a meal.  Common adverse reactions are oral hypoesthesia, astheni ..read more