Internal Medicine Alert – December 30, 2023
December 30, 2023
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Who Benefits Most from Tirzepatide Among Patients with Type 2 Diabetes?
Females, patients of white or Asian race, younger patients, and those taking metformin benefit the most from treatment with tirzepatide.
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Peak SARS-CoV-2 Viral Loads Delayed
In an effort to characterize the hypothetical utility of rapid COVID-19 antigen kits, the authors of this study examined cycle threshold values in symptomatic adults infected with SARS-CoV-2 relative to the onset of symptoms.
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Slow-Wave Sleep and Risk of Dementia
In this long-term observational study of sleep efficiency in the Framingham Heart Study population, researchers found a strong correlation between a decline in duration of slow-wave sleep during aging and the risk of incident dementia from all causes. However, a direct cause-and-effect relationship cannot be determined from this observational study.
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Apixaban Dose in Atrial Fibrillation Patients with Chronic Kidney Disease
A large nationwide health systems database study comparing 5 mg apixaban vs. 2.5 mg twice daily in patients with stage 4/5 chronic kidney disease not on dialysis shows that the 5 mg dose increases the risk of bleeding compared to 2.5 mg without any improvement in the risk of stroke, systemic emboli, or death.
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Treatable Causes of Rapidly Progressive Dementias
Many cases of rapidly progressive dementia are caused by prion diseases and have no effective treatments. But, with the greater awareness of the presentation for autoimmune encephalitis, these disorders make up an increasing percentage of presenting cases and can be aggressively and successfully treated. The STAM3P score helps to identify potentially treatable cases of this disorder.
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Vonoprazan Fumarate Tablets (Voquezna)
The U.S. Food and Drug Administration has approved vonoprazan for the treatment of all grades of erosive esophagitis. Vonoprazan is a potassium-competitive acid blocker that originally was approved in 2022 for use in combination with amoxicillin or with amoxicillin and clarithromycin for the treatment of Helicobactor pylori infection.