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Clinical Trends for July 2017

Ryan Syrek

July 28, 2017

Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook!

Clinical Trend of the Week (July 22-28): Vitiligo

A potentially promising treatment for a fairly common condition is responsible for this week’s top search term. Vitiligo, which has a prevalence rate of 1%-2%, is notoriously difficult to treat. This is why the potential use of Janus kinase (JAK) inhibitors represents an exciting development. A recent proof-of-concept study found that twice-daily topical ruxolitinib 1.5% cream was associated with a 23% overall improvement in Vitiligo Area Scoring Index (VASI) totals. The scores were most improved for facial vitiligo, and side effects were mild. The next step is randomized, placebo controlled clinical trials that will help quantify the efficacy and clarify the safety. Further news is no doubt eagerly awaited by patients with vitiligo and those that treat them.

For more information on vitiligo, read here.

Clinical Trend of the Week (July 15-21): Ketamine

A new study that may lead to the development of safer alternatives for a psychoactive drug is responsible for this week's top search term. Results published in Nature found that ketamine blocks the N-methyl-D-aspartate receptor (NMDAR), allowing for an initial antidepressant effect. The study also found that the ketamine metabolite hydroxynorketamine (HNK) may extend the length of the antidepressant effect, which could help in the quest for safer alternatives. These findings are somewhat in conflict with another recent study, meaning further investigation is needed in order to provide a safe treatment for individuals with depression.

Clinical Trend of the Week (July 8-14): Proton Pump Inhibitors

Potentially serious consequences associated with a particularly popular drug class resulted in this week's top search term. A study in BMJ Open that included more than 6 million people determined that proton-pump inhibitors (PPIs) may be associated with an increased risk for death. PPIs are available by prescription and over-the-counter and are used to treat gastroesophageal reflux and peptic ulcer disease. Use of the medication nearly doubled from 1999-2000 to 2011-2012. The study found that PPI use was associated with a 25% increased risk for death from all causes, compared with histamine-2 blocker use. These findings reiterate the need to limit use of these drugs only where specifically indicated. Guidelines for deprescribing have been recently published to help clinicians reduce unnecessary PPI use.

For more information on gastroesophageal reflux treatment, read here.

Clinical Trend of the Week (July 1-7): Lyme Disease

With many experts suggesting this "tick season" could be the worst ever, this week's top search term is not much of a surprise. Increased concerns about the Powassan virus have pushed tick-borne diseases into the "Lyme" light, as has concern about long-term antibiotic use and other treatments for chronic Lyme disease. Although evidence to support administration of prolonged antibiotics, immunoglobulin therapy, or other treatments in patients with chronic Lyme disease is considered insufficient, some clinicians prescribe them anyway, leading to serious harm. Just as the key to avoiding the disease itself is increased awareness, more information regarding appropriate treatment for Lyme disease is needed to avoid associated risks.

For more information on Lyme disease, read here.

 

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