Current medical research and opinion
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Increasing demand for reliable evidence in patient care and its delivery has necessitated the development of several approaches for generating quality evidence. In particular, the solicitation of expert opinion has been recognised as a reliable data collection method. However, there are variations and limitations in study approaches using expert opinion as a method of data collection, thereby necessitating the development of a standardised, novel consensus method. ⋯ Existing consensus methodologies have undergone significant modifications by successive authors over time, including ones contradicting core principles where an original method had been defined. The Jandhyala method for generating group consensus and awareness is unique in observing consensus and measuring awareness of subject matter across experts. The Jandhyala method also improves upon the traditional Delphi-style methodologies, through the introduction of new insights into awareness of subject matter in the expert group. A wider application of the Jandhyala method is required to corroborate findings from this research.
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To explore current recommendations for intravenous (IV) iron use in clinical guidelines for iron deficiency anemia (IDA) across different therapeutic areas and identify recommendations, if any, for the treatment of IDA. ⋯ While national and international guidelines for management of IDA exist, many are outdated and do not reflect current evidence including, but not limited to, parenteral iron use. Urgent consideration should be given to updating and clarifying management guidelines for IDA using the latest treatment modalities and options, particularly in the US.
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We conducted a systematic literature review (SLR) to determine the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyps (CRSwNP) and to describe how the addition of biologics has affected outcomes for patients with CRSwNP. ⋯ CRSwNP is fairly prevalent in the general population. Despite the significant efficacy of existing treatments, several unmet needs remain. The high burden of uncontrolled symptoms, frequent recurrence of nasal polyps after surgery, and long-term adverse effects of oral corticosteroids indicate that new therapies addressing these unmet needs should be developed. Although data on biologics from randomized controlled trials look promising, the efficacy of biologics in the real world has yet to be established. The SLR of the epidemiology and clinical burden of CRSwNP revealed key gaps in the literature. There was a paucity of prevalence data across many geographic areas, and no prevalence projections could be determined. Studies showed varying efficacy of non-biologics and no studies directly compared biologics for efficacy. Data regarding clinical efficacy of agents for eosinophilic CRSwNP or severe CRSwNP were lacking, and these patient populations would be served by more trials.
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The efficacy and safety of ticagrelor and clopidogrel in East Asian patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains uncertain. The purpose of this study was to compare the efficacy and safety of ticagrelor and clopidogrel in East Asian patients with CAD treated with PCI. ⋯ Ticagrelor was associated with a lower incidence of MACCEs and an increased risk of TIMI bleeding events in East Asian patients with CAD receiving PCI.
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Randomized Controlled Trial
Lasmiditan in patients with common migraine comorbidities: a post hoc efficacy and safety analysis of two Phase 3 randomized clinical trials.
Determine whether common migraine comorbidities affect the efficacy and safety of lasmiditan, a 5-HT1F receptor agonist approved in the United States for the acute treatment of migraine. ⋯ The efficacy and safety of lasmiditan for treatment of individual migraine attacks appear to be independent of comorbid conditions.