October 13th, 2014
Selections from Richard Lehman’s Literature Review: October 13th
CardioExchange is pleased to reprint this selection from Dr. Richard Lehman’s weekly journal review blog at BMJ.com. Selected summaries are relevant to our audience, but we encourage members to engage with the entire blog.
Lancet 11 October 2014 Vol 384
Once-Weekly Dulaglutide vs. Once-Daily Liraglutide in Metformin-Treated Patients with Type 2 Diabetes (pg. 1349): If I were Oscar Wilde, I would stretch my legs and declare, “My dear, if I have to read another of these trials I shall simply die of tedium.” The object of despair is called: “Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): a randomised, open-label, phase 3, non-inferiority trial.” Spending on type 2 diabetes in the UK is rising disproportionately, driven by incretin mimetic drugs with unknown long term effects. So here is a single blinded trial run by Eli Lilly to test its me-too contender. The language used is rather strange. “An independent external committee adjudicated deaths and non-fatal cardiovascular adverse events in a masked manner, with prespecified event criteria based on the preponderance of the evidence and clinical knowledge and experience.” What does that actually mean? And if that is obscure, look at the conclusion, presented in statistic-wonkese: “Once-weekly dulaglutide is non-inferior to once-daily liraglutide for least-squares mean reduction in HbA1c, with a similar safety and tolerability profile.” Delve deeper those who will: for my part I shall yawn and send for a good cigar, a glass of hock and seltzer, and a green carnation for my buttonhole.
The BMJ 11 October 2014 Vol 349
Variation in Patients’ Perceptions of Elective Percutaneous Coronary Intervention in Stable Coronary Artery Disease: Speaking of informed choice before procedures, how many patients accurately perceive the benefits of elective percutaneous coronary intervention in stable coronary artery disease? I don’t know the answer for British patients, but John Spertus and his team have tried to find out about Americans. The answer, of course, is not very many: 90% thought that the procedure would extend life and 88% thought it would prevent a future heart attack. So much for the public understanding of evidence based medicine versus the vested interests of interventional cardiologists.