Recent Tools for Practice
Tools for Practice #381 – Pharm for Fibro, Round 2: Can gabapentinoids ease the pain?
Do gabapentinoids reduce pain in patients with fibromyalgia?
About 40% of people with fibromyalgia on pregabalin 300-600mg/day experience a meaningful reduction in pain (pain reduced by ≥30%) versus 30% on placebo at 8-14 weeks. Lower doses (example: 150mg) may not be effective; however, higher doses cause more harm, with up to ~30% of people stopping due to side effects (versus 10% on placebo). Based on one small randomized, controlled trial (RCT), gabapentin is also effective. Read More
Tools for Practice #380 Is the secret to treating depression hidden in your genes?
Can genetic testing improve the efficacy and safety of antidepressants?
Pharmacogenomics testing to guide treatment in patients with depression might increase response and remission rates at 8 weeks by about 5% (example response rate 29% with pharmacogenomics versus 25% usual care), with no clear effects on tolerability. Studies have significant limitations. Cost (up to > $2000) and genes tested vary widely. Read More
Tools for Practice #379 Bumpin’ Up the Protection? RSV Vaccine in Pregnancy
How effective and safe is the respiratory syncytial virus (RSV) vaccine (AbrysvoTM) when given during pregnancy?
The RSV vaccine (AbrysvoTM), approved by Health Canada in pregnancy, reduces severe RSV infections (0.5% infection rate versus 1.8% placebo) and RSV hospitalizations (0.5% versus 1.3%) at 180 days in infants. Preterm births were numerically, but not statistically, higher with this vaccine versus placebo. Administration is limited to 32-36 weeks’ gestation to mitigate this potential risk. Guidelines recommend nirsevimab for infants over prenatal vaccine where indicated. Read More
Tools for Practice #378 Tony Romo-sozumab: Winning touchdown in osteoporosis or interception for the loss?
What is the efficacy and safety of romosozumab in postmenopausal women with osteoporosis?
Tools for Practice #377 – How to slow the flow IV: Combined oral contraceptives
In premenopausal heavy menstrual bleeding due to benign etiology, do combined oral contraceptives (COC) improve patient outcomes?
About 80% of women on COC will see improvement in mean blood loss, compared to 40% on placebo. Additionally, their use of sanitary items is reduced by approximately half (compared to 20% for placebo), and hemoglobin improves. Levonorgestrel-containing intrauterine systems, however, are more effective. Read More
