December 15th, 2014
Selections from Richard Lehman’s Literature Review: December 15th
Richard Lehman, BM, BCh, MRCGP
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.
NEJM 11 December 2014 Vol 371
Factor XI Antisense Oligonucleotide for Prevention of Venous Thrombosis (OL): The prevention of venous thrombosis is one of the biggest markets in medicine, and it seems strange now that for decades we got by using nothing but heparin and warfarin. Devilish cunning is now employed to find new ways to interrupt the clotting cascade in such a way as to prevent unwanted thrombosis without increasing the risk of bleeding. A new target is factor XI, and you will be interested to learn that factor XI levels can be lowered with FXI-ASO (ISIS 416858), a 2′-O-(2-methoxyethyl) (2′-O-MOE) second generation antisense oligonucleotide that specifically reduces human factor XI messenger RNA expression in the liver. Well, Isis Pharmaceuticals would like you to be interested anyway, and have persuaded the NEJM to accept what appears to be a phase 2 open label trial of the drug in 300 patients about to undergo unilateral knee replacement, with enoxaparin as the comparator. Their drug had an equal protective effect with less bleeding. But when you are thinking of giving a preventive treatment to millions of healthy people, you need quite a lot more evidence than this.
Lancet 13 December 2014 Vol 384
Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent vs. Durable Polymer Everolimus-Eluting Stent for Percutaneous Coronary Revascularization (pg. 2111): Does the world need new stents? No, but device companies need new products for when current ones go off patent. And the Lancet needs to sell article reprints as part of its stated business plan. But do you, dear reader, really need to read a paper entitled “Ultrathin strut biodegradable polymer sirolimus-eluting stent versus durable polymer everolimus-eluting stent for percutaneous coronary revascularisation (BIOSCIENCE): a randomised, single-blind, non-inferiority trial?” I would suggest not.
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