–Study: prescriptions spiked in direct response to blizzard of ‘Low T’ ads Television ads for testosterone products were highly successful, leading to dramatic increases in the number of men taking testosterone drugs, according to a new study published in the Journal of the American Medical Association. J. Bradley Layton (University of North Carolina, Chapel Hill)…
Another HDL Therapy Crashes and Burns
March 19, 2017 by 3 Comments
–Failure of pre-beta HDL mimetic puts another nail in the HDL coffin Once again, an HDL-inspired therapy has failed when put to the test in a clinical trial. Although there are still ongoing trials with other HDL-related therapies, most experts now feel that it is time for the field to turn its attention elsewhere and…
Ebbinghaus Study May Help Refute Doctor Google
March 18, 2017 by 3 Comments
–No neurocognitive adverse effects linked to very low LDL levels Reaching very low LDL levels with a PCSK9 inhibitor was not associated with any increase in neurocognitive adverse events, according to the largest and most rigorous study to assess the topic to date. Small and preliminary studies have raised concerns over the possibility of the…
Novel Drug Delivers Long Term Cholesterol Reduction
March 17, 2017 by 1 Comment
A novel drug that dramatically lowers LDL cholesterol and needs to be administered only a few times a year has reached a new milestone. Positive results from a phase II study with the drug, now known as inclisiran, were reported at the American College of Cardiology meeting in Washington, DC and published simultaneously in the…
FOURIER Shows New Cholesterol Drugs Work, But Are They Worth It?
March 17, 2017 by 6 Comments
–Doctors and patients now must wrestle with a modestly effective but expensive drug. As it turns out the PCSK9 inhibitor saga ends not with a bang but a whimper. The results of the highly anticipated FOURIER trial show that the drugs work, though not as powerfully as many had hoped and expected. The question now…
Has Nutrition Science Been Poisoned?
March 9, 2017 by 9 Comments
–The inevitable weaknesses of observational and diet studies “Science is the great antidote to the poison of enthusiasm and superstition,” Adam Smith wrote more than 200 years ago. Unfortunately, it often seems as if the science of nutrition has itself been poisoned. Two recently published papers illustrate this problem. Nutrition and Mortality A good example of…
Call For More Calcium Screening Gets Pushback
March 6, 2017 by 2 Comments
–But a zero calcium score can be useful to avoid statins, some argue Coronary artery calcium (CAC) scans should be widely used in routine clinical practice to improve the detection of coronary disease in people without known disease, according to the authors of a new review in JACC: Cardiovascular Imaging. But many experts urged caution,…
Top Cardiologist Blasts Nutrition Guidelines
February 27, 2017 by 15 Comments
–Salim Yusuf says new evidence fails to support many major diet recommendations. One of the world’s top cardiologists says that many of the major nutrition guidelines have no good basis in science. “I’m not a nutrition scientist and that may be an advantage because every week in the newspaper we read something is good for…
International Experts Call Salt Guidelines Far Too Restrictive
February 14, 2017 by 5 Comments
A broad group of international experts are recommending a far more modest and less draconian approach to sodium restriction than current U.S. and international guidelines. In a new paper, published online in the European Heart Journal, they also focused on the broad gaps of knowledge in the field and drew attention to the paucity of…
Enormous Rivaroxaban Study Stopped Early For ‘Overwhelming Efficacy’
February 8, 2017 by Leave a Comment
(Updated) –Oral anticoagulant reduced CV events in patients with coronary and peripheral disease. The very large COMPASS study has been stopped early for “overwhelming efficacy,” according to a press release issued by Bayer AG and Janssen, manufacturers of rivaroxaban (Xarelto). The phase 3 trial randomized 27,402 patients with coronary artery disease (CAD) and peripheral artery…
New Questions Raised About SPRINT
February 8, 2017 by Leave a Comment
More questions are being raised about SPRINT, the enormous NIH-funded blood pressure lowering trial. Two recent developments will likely add more obstacles to the already difficult task of applying the results of the trial in the real world. Even before the full results of the trial were first made public the NIH and the SPRINT…
27,000 Patient PCSK9 Inhibitor Trial Meets Main Endpoints
February 2, 2017 by 3 Comments
(Updated) –Cardiovascular outcomes finally available for PCSK9 inhibitors. Amgen announced on Thursday afternoon that the FOURIER trial had met both its primary composite endpoint (cardiovascular death, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or coronary revascularization) and the even more rigorous key secondary composite endpoint (cardiovascular death, non-fatal MI or non-fatal stroke). The company…
Screen-And-Treat to Prevent Diabetes Doomed to Fail
January 4, 2017 by 7 Comments
Screening must be supplemented by broader public health approaches. Screen and treat strategies to prevent type 2 diabetes are doomed to failure, according to a large new systematic review and meta-analysis published in The BMJ. Instead, the authors said and outside experts agreed, any effort to combat the already enormous and still growing problem of type 2…
More Shots Fired in ‘Sugar War’
December 19, 2016 by 1 Comment
–Industry-sponsored study questions current guidelines on dietary sugar. Dietary guidelines relating to sugar— all of which recommend significant reductions in sugar intake— are based on weak evidence and are not trustworthy, according to a systematic review published in Annals of Internal Medicine. But an accompanying editorial points out that the systematic review is itself not…
Genetic Studies Offer Hint Of Clinical Benefits-And Risks- of PCSK9 Inhibitors
November 30, 2016 by 2 Comments
–Both cardiovascular benefits and increase in diabetes seem likely. There is no more eagerly awaited question in cardiovascular medicine than the clinical role of the PCSK9 inhibitors. The first reports from a series of outcomes trials are not due until next year. But two large genetic studies published this week deliver strong indirect evidence that…
Saturated Fats Linked To Heart Disease Once Again
November 27, 2016 by 10 Comments
–But critics say that observational studies can’t establish causal relationship. A prominent group of nutrition researchers have once again linked saturated fats to increased coronary heart disease. The new paper, published in BMJ, is the third paper in the past year to decry saturated fats. Along with the previous two papers, published in JACC and JAMA Internal…
Guest Post: Two Nations Separated by 5.3 mm
November 23, 2016 by 1 Comment
Editor’s note: This guest post is by Saurabh Jha, MBBS, a radiologist at the University of Pennsylvania. This post will also be published on The Health Care Blog, where Jha is the associate editor. A popular meme is that the US spends more on healthcare than other developed nations but has nothing to show for…
Mixed Results For ApoA-1 Therapies
November 16, 2016 by Leave a Comment
–It’s still not time to write the obituary for all HDL therapies. There was good news and bad news for a category of experimental drugs that attempt to mimic the putative beneficial effect of HDL at the American Heart Association meeting in New Orleans. Thirteen years after setting the field on fire with a promising…
Lunchroom Scandal At The AHA: Day Two Of Buttergate
November 15, 2016 by 5 Comments
–After a CardioBrief investigation the American Heart Association changes the lunchroom menu There is no better proof that journalism can change the world– both for the good and the bad– than Buttergate. Yesterday your intrepid reporter exposed the ongoing scandal of Buttergate taking place within the press lunchroom at the American Heart Association meeting in New…
More Progress For Novel PCSK9 Drug
November 15, 2016 by Leave a Comment
–The PCSK9 synthesis inhibitor from The Medicines Company is getting close to phase 3 trials. More early information continues to accumulate about a novel cholesterol drug under development by The Medicines Company. The drug, which was initially created by Alnylam Pharmaceuticals, uses RNA interference technology to inhibit the synthesis of PCSK9 in the liver. The main…
Is The American Heart Association Trying To Kill Health Reporters?
November 14, 2016 by 4 Comments
The answer is no. The AHA is not trying to kill us. But its dietary advice is consistently confusing and occasionally wrong, and health reporters in New Orleans may end up as collateral damage. Just take a look at what’s being served in the press room at the big American Heart Association meeting going on now…
Statin Nation ‘Census’ Highlights Major Disparities
November 14, 2016 by Leave a Comment
–Women, minorities treated at significantly lower rates Anyone reading this is almost certainly aware of the enormous importance of statins in the current health scene. But until now they may have had a hard time to bring precise numbers and statistics to this all important story. Now data from a large federal survey confirm that…
No Cognitive Benefit from Heart Drugs in HOPE-3
November 13, 2016 by Leave a Comment
–Substudy finds mental function unimproved by BP, cholesterol treatments NEW ORLEANS — A large substudy of the HOPE-3 trial found no benefit relating to cognitive function in patients who took cholesterol or blood pressure-lowering drugs. In recent years cognitive decline and dementia have emerged as a concern equal if not even greater than cardiovascular disease…
Debate Ensues As USPSTF Finalizes Statin Primary Prevention Guideline
November 13, 2016 by Leave a Comment
–Broad disagreement about how, when, and if to use statins. The U.S. Preventive Services Task Force (USPSTF) has issued final recommendations regarding the use of statins for primary prevention of cardiovascular disease in adults. The recommendations, first proposed last December, are broadly consistent with the 2013 American College of Cardiology/American Heart Association guidelines. But accompanying the…
Novel Cholesterol Therapy Flops And Company Ends Development
November 8, 2016 by Leave a Comment
–13 years after ApoA-1 Milano sparked excitement the novel HDL therapy appears to be dead. After 13 years and despite the efforts of 3 separate companies, the novel cholesterol therapy known as ApoA-1 Milano appears to be dead. On Monday afternoon the Medicines Company announced that it had discontinued development of the drug and would…
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