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Pharmacology/Pharmaceutical Industry

Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.

29 Jul, 2021 | 11:38h | UTC

Ivermectin for preventing and treating COVID‐19 – Cochrane Library

Summary: Ivermectin for preventing and treating COVID-19 – Cochrane Library

Commentary: Ivermectin treatment in humans for COVID-19 – Liverpool School of Tropical Medicine

Related:

Why was a major study on ivermectin for covid-19 just retracted?

RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”.

Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”.

Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials

RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19

 

PRINCIPLE RCT: Doxycycline does not improve outcomes in outpatients with suspected COVID-19 at high risk for adverse outcomes.

29 Jul, 2021 | 11:36h | UTC

Doxycycline for community treatment of suspected COVID-19 in people at high risk of adverse outcomes in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial – The Lancet Respiratory Medicine

Commentary: PRINCIPLE: a community-based COVID-19 platform trial – The Lancet Respiratory Medicine

 

Commentary on Twitter

https://twitter.com/LancetRespirMed/status/1420302490864603142

 

Covid-19 breakthrough infections in vaccinated health care workers.

29 Jul, 2021 | 11:30h | UTC

Covid-19 Breakthrough Infections in Vaccinated Health Care Workers – New England Journal of Medicine

 

Commentary on Twitter (thread – click for more)

 

What is a breakthrough infection? 6 questions answered about catching COVID-19 after vaccination.

29 Jul, 2021 | 11:28h | UTC

What is a breakthrough infection? 6 questions answered about catching COVID-19 after vaccination – The Conversation

 

2021 ACC expert consensus decision pathway for cardiovascular risk reduction in patients with persistent hypertriglyceridemia.

29 Jul, 2021 | 11:15h | UTC

2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee – Journal of the American College of Cardiology

Key points: ACC Consensus on ASCVD Risk Reduction in Hypertriglyceridemia – American College of Cardiology

 

Commentary on Twitter

 

Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show.

29 Jul, 2021 | 11:19h | UTC

Efficacy of Pfizer/BioNTech Covid vaccine slips to 84% after six months, data show – STAT

Original study (preprint): Six Month Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine – medRxiv

 

Commentary on Twitter (thread – click for more)

https://twitter.com/hildabast/status/1420481872212070404

 

ESC Position Paper: Cardiac, renal, and metabolic effects of SGLT2 inhibitors.

29 Jul, 2021 | 11:13h | UTC

Cardiac, renal, and metabolic effects of sodium–glucose co-transporter 2 inhibitors: a position paper from the European Society of Cardiology ad-hoc task force on sodium–glucose co-transporter 2 inhibitors – European Journal of Heart Failure

 

Evidence Analysis: Is piperacillin-tazobactam safe in patients with penicillin allergy?

29 Jul, 2021 | 11:05h | UTC

Is piperacillin-tazobactam safe in patients with penicillin allergy? – PulmCrit

 

Cohort study: Evidence of a potentially inappropriate and harmful prescribing cascade of gabapentinoid followed by a diuretic among older adults with lower back pain.

29 Jul, 2021 | 11:02h | UTC

Evidence of a gabapentinoid and diuretic prescribing cascade among older adults with lower back pain – Journal of the American Geriatrics Society (link to abstract – $ for full-text)

Related:

Are you the victim of a prescribing cascade?

Study: Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults with Hypertension

Prescribing Cascade in a Cardiology Practice

 

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees.

28 Jul, 2021 | 10:19h | UTC

Very rare thrombosis with thrombocytopenia after second AZD1222 dose: a global safety database analysis – The Lancet

Related:

WHO Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19).

AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.”

ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia

Case series: therapeutic plasma exchange in 3 patients with vaccine-induced immune thrombotic thrombocytopenia.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) – a novel clinico-pathological entity with heterogeneous clinical presentations.

Case report: Thrombosis with Thrombocytopenia After the Messenger RNA–1273 Vaccine.

Laboratory testing for suspected COVID-19 vaccine–induced (immune) thrombotic thrombocytopenia.

Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk – “Two people in Australia have died from thrombosis with thrombocytopenia after 3.8 million doses of the AstraZeneca vaccine delivered”.

Case series: Adjunct immune globulin for vaccine-induced thrombotic thrombocytopenia.

Case report: Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

[Preprint] Meta-analysis of risk of vaccine-induced immune thrombotic thrombocytopenia following ChAdOx1-S recombinant vaccine – Overall risk is 1 in 139,000; for age 65 and over, about 1 in 1,000,000; for age under 55, between 1 in 20,000 to 60,000.

Cohort study: Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S. 11 excess venous thromboembolic events per 100 000 vaccinations; 2.5 excess cerebral venous thrombosis per 100 000 vaccinations.

Case series of 12 patients with cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination – all women younger than 60 years, with symptoms from 6 to 15 days after vaccination

Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions

Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination

Editorial: SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia – “The very low prevalence of this complication of vaccination, however severe, relative to the benefits of preventing Covid-19 must be emphasized”

Case Report: Thrombotic Thrombocytopenia after Johnson & Johnson Vaccine

Papers Confirm Rare Thrombocytopenia Link to AstraZeneca Vaccine

Guidance on syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus Vaccination

 

Commentary on Twitter

 

RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.

28 Jul, 2021 | 10:03h | UTC

Effect of 7 vs 14 Days of Antibiotic Therapy on Resolution of Symptoms Among Afebrile Men With Urinary Tract Infection: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Shorter Courses of Antibiotics for Urinary Tract Infection in Men (free for a limited period)

Commentary: Study Supports Shorter Antibiotic Course for Afebrile Men With UTI – MPR

 

Commentary on Twitter

 

ESC Consensus Document: Antithrombotic therapies in aortic and peripheral arterial diseases in 2021.

28 Jul, 2021 | 09:56h | UTC

Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy – European Heart Journal

Key Points to remember: ESC Consensus on Antithrombotic Therapies in Aortic and Peripheral Artery Diseases – American College of Cardiology

 

Commentary on Twitter

 

Review: Anabolic Therapy for Osteoporosis.

28 Jul, 2021 | 09:48h | UTC

Anabolic Therapy for Osteoporosis – JAMA (free for a limited period)

Author interview: Anabolic Therapy for Osteoporosis

 

The use and impact of monoclonal antibody biologics during pregnancy.

28 Jul, 2021 | 09:43h | UTC

The use and impact of monoclonal antibody biologics during pregnancy – Canadian Medical Association Journal

 

Another study shows increased immune response with heterologous Oxford-AstraZeneca/mRNA vaccination.

27 Jul, 2021 | 03:48h | UTC

Immunogenicity and reactogenicity of heterologous ChAdOx1 nCoV-19/mRNA vaccination – Nature Medicine

Commentary: A ‘mix and match’ approach to SARS-CoV-2 vaccination – Nature Medicine

Related:

WHO warns against mixing and matching COVID vaccines.

Germany issues world’s strongest recommendation for mixing Covid-19 vaccines.

Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

Heterologous Oxford–AstraZeneca and BioNTech/Pfizer Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.

[Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”.

Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”.

RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.

 

Commentary on Twitter

 

[Preprint] Covid-19: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity.

27 Jul, 2021 | 03:50h | UTC

News release: Longer interval between Covid-19 Pfizer vaccine doses boosts immunity – Newcastle University

Original Study (preprint): Sustained T cell immunity, protection and boosting using extended dosing intervals of BNT162b2 mRNA vaccine

Commentaries:

Commentary: Covid-19: Longer interval between Pfizer doses results in higher antibody levels, research finds – BMJ

Expert reaction to preprint from PITCH study looking at interval between two Pfizer vaccine doses, and antibody and T-cell responses – Science Media Centre

Related:

Debate: Should we delay second vaccine doses to give one dose of the Covid-19 vaccine to more people? (several texts on the subject)

 

Safety evaluation of the second dose of mRNA COVID-19 vaccines in patients with immediate reactions to the first dose.

27 Jul, 2021 | 03:42h | UTC

Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose – JAMA Internal Medicine

Commentaries:

Second COVID-19 mRNA vaccine dose found safe following allergic reactions to first dose – Massachusetts General Hospital

No anaphylaxis after second dose of mRNA COVID vaccine, study finds – CIDRAP

 

Commentary on Twitter

 

[Preprint] Test-negative case-control study: Effectiveness of Oxford-AstraZeneca vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted effectiveness was 77.9% for symptomatic Covid-19, 87.6% against hospitalization, and 93.6% against death.

27 Jul, 2021 | 03:41h | UTC

Effectiveness of the ChAdOx1 vaccine in the elderly during SARS-CoV-2 Gamma variant transmission in Brazil – medRxiv

 

Commentary on Twitter (thread – click for more)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

[Preprint] Test-negative case-control study: Effectiveness of CoronaVac vaccine in older people during SARS-CoV-2 Gamma variant transmission in Brazil – Adjusted vaccine effectiveness was 41.6% for symptomatic Covid-19, 59.0% against hospitalizations and 71.4% against deaths.

27 Jul, 2021 | 03:39h | UTC

Effectiveness of the CoronaVac vaccine in the elderly population during a Gamma variant-associated epidemic of COVID-19 in Brazil: A test-negative case-control study – medRxiv

 

Commentary on Twitter (thread – click for more)

https://twitter.com/MHitchingsEpi/status/1418599162795360260

 

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness.

27 Jul, 2021 | 03:38h | UTC

CoronaVac vaccine: its results are patchy, but the world can’t ignore its usefulness – The Conversation

Related:

RCT: CoronaVac showed efficacy of 83.5% for preventing symptomatic SARS-CoV-2 infection.

Prospective national cohort in Chile showed CoronaVac effectiveness was 65.9% for symptomatic Covid-19, 87.5% for hospitalization, 90.3% for ICU admission, and 86.3% for death.

Phase 1/2 RCT: CoronaVac is well tolerated and safe and induces strong humoral responses in children and adolescents aged 3–17 years.

Perspective | Are Chinese COVID vaccines underperforming? a dearth of real-life studies leaves unanswered questions.

WHO approval of Chinese CoronaVac COVID vaccine will be crucial to curbing pandemic.

Brazilian town experiment shows mass vaccination can wipe out COVID-19.

WHO validates Sinovac-CoronaVac COVID-19 vaccine for emergency use and issues interim policy recommendations.

[Press release – not published yet] The city of Serrana in Brazil has seen a 95% drop in Covid-19 deaths after almost all adults were vaccinated with Chinese CoronaVac – The findings suggest the pandemic can be controlled after 75% of people are fully vaccinated.

[Not published yet] Observational study in Uruguay found CoronaVac reduced mortality by 97 percent – “In people who had received two doses, it reduced infection with the coronavirus by 57 percent and intensive care admissions by 95 percent”.

 

[Preprint] RCT: In patients with COVID-19 and severe hypoxia, dexamethasone 12 mg did NOT result in statistically significant improved outcomes compared to dexamethasone 6 mg – “Mortality at 28 days was 27.1% and 32.3% in patients assigned to 12 mg and 6 mg, respectively (adjusted relative risk 0.86, 99% CI, 0.68-1.08)”.

26 Jul, 2021 | 03:01h | UTC

Dexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxia: an international, randomized, blinded trial – medRxiv

 

Study: Among kidney transplant recipients who did not respond after 2 doses, a third dose of an mRNA-1273 vaccine induced a serologic response in 49% of patients.

26 Jul, 2021 | 02:54h | UTC

Antibody Response After a Third Dose of the mRNA-1273 SARS-CoV-2 Vaccine in Kidney Transplant Recipients With Minimal Serologic Response to 2 Doses – JAMA

Commentary: Case Mounts for COVID Vaccine Boosters in Kidney Transplant Recipients – MedPage Today (free registration required)

Related:

Case series: Safety and immunogenicity of a third dose of SARS-CoV-2 vaccine in solid organ transplant recipients.

[Preprint] 3rd AstraZeneca shot gives strong immunity.

 

Commentary on Twitter

 

Editorial | Antibiotic overuse: managing uncertainty and mitigating against overtreatment.

26 Jul, 2021 | 02:16h | UTC

Antibiotic overuse: managing uncertainty and mitigating against overtreatment – BMJ Quality & Safety

 

Commentary on Twitter

 

WHO: Vaccine inequity undermining global economic recovery.

23 Jul, 2021 | 10:53h | UTC

News release: Vaccine inequity undermining global economic recovery – World Health Organization

Dashboard: Global Dashboard for Vaccine Equity

Commentaries: Urgent need for COVID-19 vaccine equity – University of Oxford AND COVID-19 Vaccine Inequity Undermines Global Economic Recovery  – Health Policy Watch

 

Commentary on Twitter (thread – click for more)

 

Opinion | Tocilizumab in COVID-19 therapy: who benefits, and how? – the researchers suggest that maybe IL-6 inhibitors should be given only to patients with high IL-6.

23 Jul, 2021 | 10:51h | UTC

Tocilizumab in COVID-19 therapy: who benefits, and how? – The Lancet

Related: A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19. AND M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”. AND RECOVERY trial: In hospitalized COVID-19 patients with hypoxia and systemic inflammation (C-reactive protein ≥75 mg/L), tocilizumab improved survival and other clinical outcomes AND Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less. AND M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.

 

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