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Sunday, December 28, 2008

rosuvastatin reduces the risk of cardiovascular events by 54% in people who do not have high cholesterol level after 2 years

The JUPITER (Justification for the Use of Statins in Primary Prevention Intervention) trial has shown that rosuvastatin reduces the risk of cardiovascular events by 54% in people who do not have high cholesterol level but have raised high sensitive C reactive protein. The trial was scheduled for a follow up of 4 years, but after nearly two years as there was a significant reduction in the primary end point at two years tyhe trial was stopped.

The original research article and an editorial was recently published in NEJM. There are two important issues regarding the results of this trial

1. Long term safety of rosuvastatin is not yet established. If we are going to start rosuvastatin for a low risk subject without any clinical disease for primary prevention, he will be taking it for a long period say 20 years. In such case without long term safety being established, it should not be advised.

2. Secondly the patency of rosuvastatin is now held by Astra Zeneca and the drug is very costly now. If this protective effect is a class effect then the cheaper statins which have become generic can be substituted.

Tuesday, December 16, 2008

Software for Research Methodology

Software ReMe ver1.0.0 - 'Research Methodology for Undergraduates'
The software is absolutely free and anyone can download it from http://www.ampiweb.org/indphar/sware.htm. It is a fully working CAL software to learn about research methodology. Though the software is aimed at UGs, it would still be useful for anyone who is yet to be inducted into research/dissertation work. It includes modules for planning & conducting a simulated experiment on animals, analysing data and drawing conclusions. Background text material for each topic (such as how to search literature,animal research ethics, random allocation, allocation concealment, statistical analysis of data etc.) is available for the user to help him plan and execute the study.
If you download and use it, I would appreciate receiving your comments

Aggressively lowering of blood sugar lead to more deaths

The National Institutes of Health's (NIH) National Heart, Lung and Blood Institute has announced the early cancellation of one part of a major diabetes and cardiovascular disease study after discovering that patients undergoing that treatment were more likely to die from heart attacks and strokes.The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study included 10,251 adults with Type 2 diabetes who were considered to be at especially high risk of heart attacks and strokes. One of the treatments in the study involved using combinations of FDA-approved diabetes drugs to aggressively lower participants' blood sugar to levels as close to normal as possible."Of these, 257 in the intensive treatment group have died, compared with 203 within the standard treatment group," the NIH announced. At the time of the experiment's cancellation, patients had been undergoing treatment for an average of four years.The NIH said that it does not know what caused the increased risk of death among patients undergoing intensive treatment, but it does not believe that the risk came from any individual drug or combination of drugs. Rather, there appears to be some negative effect on the body from so aggressively lowering blood sugar levels."This presents a real dilemma to patients and their physicians," said Richard Kahn, chief scientific and medical officer for the American Diabetes Association. "How intensive should treatment be? We just don't know."Previously, health experts have believed that the closer to normal a diabetic's blood sugar can be lowered, the better. The NIH findings have offered a major challenge to that conventional wisdom.Approximately 21 million people in the United States suffer from Type 2 diabetes, and the numbers increase every year. The elevated blood sugar that is characteristic of the disease is well-established to lead to a host of other health problems, including an elevated risk of cardiovascular disease, heart attack and stroke

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