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Randomized Trials

RCT: Spinal Anesthesia not Superior to General Anesthesia for Hip Surgery in Older Adults.

12 Oct, 2021 | 00:07h | UTC

Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)

News release: Myth busted: General anesthesia just as safe as spinal anesthesia after broken hip surgery – Penn Medicine

Commentary: Study Finds Spinal Anesthesia Not Superior to General Anesthesia for Hip-Fracture Surgery – BreakingMed

Related: RCT: Similar long-term survival after combined epidural–general anesthesia vs. general anesthesia alone.

 

RCT: In stable patients who have undergone PCI for acute myocardial infarction, de-escalation from aspirin + ticagrelor to aspirin + clopidogrel after 1 month reduced bleeding events without increasing cardiovascular risk.

12 Oct, 2021 | 00:06h | UTC

Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial – The Lancet (link to abstract – $ for full-text)

Commentary: Adopting a clopidogrel-based DAPT strategy after PCI boosts outcomes for heart attack patients – Cardiovascular Business

 

RCT: Among patients with metastatic colorectal cancer, those randomized to systemic treatment alone had lower sixty-day mortality compared to those randomized to primary tumor resection followed by systemic treatment.

12 Oct, 2021 | 00:01h | UTC

Sixty-Day Mortality of Patients With Metastatic Colorectal Cancer Randomized to Systemic Treatment vs Primary Tumor Resection Followed by Systemic Treatment: The CAIRO4 Phase 3 Randomized Clinical Trial – JAMA Surgery (free for a limited period)

Editorial: Primary Tumor Resection and Patients With Asymptomatic Colorectal Cancer and Nonresectable Metastases: Results of Recent Randomized Trials – JAMA Surgery (free for a limited period)

Commentary: Systemic Therapy Alone Bests Surgical Tx for Metastatic CRC – BreakingMed

 

Commentary on Twitter

 

RCT: Early treatment with mild aerobic exercise safely speeds recovery from sport-related concussion in adolescents.

11 Oct, 2021 | 23:58h | UTC

Early targeted heart rate aerobic exercise versus placebo stretching for sport-related concussion in adolescents: a randomised controlled trial – The Lancet Child & Adolescent Health

News release: Aerobic exercise after a sport-related concussion speeds recovery in adolescent athletes – University at Buffalo

Related:

Randomized Trial: Early Aerobic Exercise for Sport-Related Concussion

RCT: Limiting screen time for young adults after concussion results in shorter duration of symptoms.

Selected issues in sport-related concussion for the team physician: a consensus statement – “Current evidence suggests strict rest after SRC slows recovery and increases the probability of prolonged symptoms”.

RCT: Prescribed light exercise vs. standard management for emergency department patients with acute mild traumatic brain injury

 

Commentaries on Twitter

 

RCT: Transanal drainage tube use does not prevent anastomotic leakage after laparoscopic low anterior resection in patients with rectal cancer.

7 Oct, 2021 | 10:27h | UTC

Transanal Drainage Tube Use for Preventing Anastomotic Leakage After Laparoscopic Low Anterior Resection in Patients With Rectal Cancer: A Randomized Clinical Trial – JAMA Surgery (free for a limited period)

Invited commentary: Transanal Drainage Tubes—Prevention of Leaks or Unnecessary Sump? – JAMA Surgery (free for a limited period)

 

RCT: REGEN-COV antibody combination reduces hospitalizations in outpatients with Covid-19.

30 Sep, 2021 | 10:33h | UTC

REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19 – New England Journal of Medicine

 

RCT: Maintenance vs. discontinuation of antidepressants in patients who felt well enough to discontinue antidepressant therapy.

30 Sep, 2021 | 10:22h | UTC

Maintenance or Discontinuation of Antidepressants in Primary Care – New England Journal of Medicine

Commentaries:

Many can stop anti-depressants without relapse – BBC

Study highlights difficulty of stopping antidepressants – Associated Press

 

RCT: Neurolytic splanchnic nerve block and pain relief, survival, and quality of life in unresectable pancreatic cancer.

30 Sep, 2021 | 10:16h | UTC

Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial – Anesthesiology

 

Commentary on Twitter

 

RCT: Overall survival benefit with Tebentafusp in metastatic uveal melanoma.

28 Sep, 2021 | 09:03h | UTC

Overall Survival Benefit with Tebentafusp in Metastatic Uveal Melanoma – New England Journal of Medicine

 

Commentary on Twitter

 

RCT: Tamsulosin may prevent postoperative urinary retention following female pelvic reconstructive surgery.

17 Sep, 2021 | 09:56h | UTC

Tamsulosin vs placebo to prevent postoperative urinary retention following female pelvic reconstructive surgery: a multicenter randomized controlled trial – American Journal of Obstetrics & Gynecology (link to abstract – $ for full-text)

 

RCT: Effect of Camrelizumab vs. placebo added to chemotherapy on survival and progression-free survival in patients with advanced or metastatic esophageal squamous cell carcinoma.

15 Sep, 2021 | 08:51h | UTC

Effect of Camrelizumab vs Placebo Added to Chemotherapy on Survival and Progression-Free Survival in Patients With Advanced or Metastatic Esophageal Squamous Cell Carcinoma: The ESCORT-1st Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Immunotherapy for Advanced Esophageal Squamous Cell Carcinoma—Renewed Enthusiasm and a Lingering Challenge – JAMA Oncology (free for a limited period)

 

Commentary on Twitter

 

RCT: Convalescent plasma does not improve outcomes and may be harmful to hospitalized patients with COVID-19.

10 Sep, 2021 | 05:37h | UTC

Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial – Nature Medicine

News release: Major study finds convalescent plasma doesn’t help seriously ill COVID-19 patients – McMaster University

Related:

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.

RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.

 

Commentary on Twitter

 

RCT: In patients undergoing major surgery, targeting light anesthesia reduced the risk of postoperative delirium and cognitive impairment at one year.

10 Sep, 2021 | 05:19h | UTC

Anaesthetic depth and delirium after major surgery: a randomised clinical trial – British Journal of Anaesthesia (link to abstract – $ for full-text)

 

[Preprint] RCT: Additional heterologous vs. homologous booster vaccination in immunosuppressed patients without SARS-CoV-2 antibody seroconversion after primary mRNA vaccination.

9 Sep, 2021 | 09:55h | UTC

Additional heterologous versus homologous booster vaccination in immunosuppressed patients without SARS-CoV-2 antibody seroconversion after primary mRNA vaccination: a randomized controlled trial – medRxiv

 

Commentary on Twitter (thread – click for more)

 

RCT: A Seven-days course of antibiotics for the treatment of bloodstream infections by Enterobacterales was noninferior to a 14-days course.

9 Sep, 2021 | 09:03h | UTC

Seven versus 14-days course of antibiotics for the treatment of bloodstream infections by Enterobacterales. A randomized, controlled trial – Clinical Microbiology and Infection

 

Commentary on Twitter

 

RCT: No benefit from Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis.

9 Sep, 2021 | 08:59h | UTC

Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis (EXAFIP): a randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)

 

RCT: Baricitinib reduced mortality in hospitalized adults with COVID-19.

2 Sep, 2021 | 10:17h | UTC

Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial – The Lancet Respiratory Medicine

Commentaries:

Baricitinib: the first immunomodulatory treatment to reduce COVID-19 mortality in a placebo-controlled trial – The Lancet Respiratory Medicine

Rheumatoid Arthritis Drug Combined with Standard of Care May Help Reduce Mortality for Hospitalized COVID-19 Patients – Vanderbilt University Medical Center

 

Commentaries on Twitter

(thread – click for more)

 

RCT: Among critically ill patients, targeting oxygenation to a low-normal range vs. high-normal range did not result in a reduction in organ dysfunction.

2 Sep, 2021 | 08:23h | UTC

Effect of Low-Normal vs High-Normal Oxygenation Targets on Organ Dysfunction in Critically Ill Patients: A Randomized Clinical Trial – JAMA (free for a limited period)

Related:

M-A of randomized trials: Conservative oxygen therapy for critically ill patients.

Oxygen administration for patients with ARDS – Journal of Intensive Care

Randomized trial: Similar outcomes with lower vs. higher oxygenation targets for acute hypoxemic respiratory failure

Systematic Review: Higher vs. Lower Fraction of Inspired Oxygen or Targets of Arterial Oxygenation for Adults Admitted to the Intensive Care Unit

 

Commentary on Twitter

 

RCT: In patients with acute hypoxemic respiratory failure, a strategy of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal was not associated with improved outcomes.

2 Sep, 2021 | 08:21h | UTC

Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care Ventilation on 90-Day Mortality in Patients With Acute Hypoxemic Respiratory Failure: The REST Randomized Clinical Trial – JAMA (free for a limited period)

Related: Randomized Trial: Low vs Intermediate Tidal Volume Strategy in ICU Patients Without ARDS

 

Commentary on Twitter

 

RCT: Ketamine administration in patients with acute painful sickle cell crisis was effective for pain control and reduced the cumulative morphine dose in the emergency department.

2 Sep, 2021 | 08:11h | UTC

Ketamine Administration for Acute Painful Sickle Cell Crisis: A Randomized Controlled Trial – Academic Emergency Medicine (link to abstract – $ for full-text)

 

#ESCCongress – RCT: SGLT2 inhibition reduced the combined risk of cardiovascular death or hospitalization in patients with heart failure and a preserved ejection fraction, regardless of the presence or absence of diabetes.

29 Aug, 2021 | 18:19h | UTC

Empagliflozin in Heart Failure with a Preserved Ejection Fraction – New England Journal of Medicine

News release: Trial reports first successful results for heart failure with preserved ejection fraction – European Society of Cardiology

Commentary: Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction – EMPEROR-Preserved – American College of Cardiology

 

Commentary on Twitter

 

#ESCCongress – RCT: In patients with A. Fibrillation who underwent TAVR, Edoxaban was noninferior to Vit. K Antagonist regarding the composite primary outcome of adverse clinical events, but resulted in a higher incidence of major bleeding.

29 Aug, 2021 | 18:17h | UTC

Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR – New England Journal of Medicine

Commentaries:

ENVISAGE-TAVI AF: Edoxaban Disappoints in TAVI Setting – TCTMD

ENVISAGE-TAVI AF: Edoxaban vs. Warfarin Following Heart Valve Replacement – American College of Cardiology

Edoxaban vs. Standard of Care and Their Effects on Clinical Outcomes in Patients Having Undergone Transcatheter Aortic Valve Implantation–Atrial Fibrillation – ENVISAGE-TAVI AF – American College of Cardiology

 

#ESCCongress – RCT: In patients who underwent PCI at high bleeding risk, 1 month of dual antiplatelet therapy was noninferior to the continuation of dual therapy for at least 2 additional months and resulted in a lower incidence of bleeding events.

29 Aug, 2021 | 18:16h | UTC

Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk – New England Journal of Medicine

Commentaries:

Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated vs. Standard DAPT Regimen – MASTER DAPT – American College of Cardiology

MASTER-DAPT: Abbreviated DAPT vs. Standard DAPT in High-Risk Patients Post-PCI – American College of Cardiology

 

#ESCCongress – RCT: Finerenone reduced CV events in patients with kidney disease and type 2 diabetes (12.4% vs. 14.2% during a median follow-up of 3.4 years), but the risk of hyperkalemia was increased (10.8% vs. 5.3%).

29 Aug, 2021 | 18:14h | UTC

Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes – New England Journal of Medicine

News release: Finerenone benefits patients with diabetes across spectrum of kidney disease – European Society of Cardiology

Commentaries:

Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease – FIGARO-DKD – American College of Cardiology

FIGARO-DKD and FIDELITY Findings Show Benefits of Finerenone to Improve Outcomes in Patients With Kidney Disease, Diabetes – American College of Cardiology

Related:

[Abstract Only] Randomized trial: Effect of Finerenone on chronic kidney disease outcomes in Type 2 diabetes

 

Commentary on Twitter

 

#ESCCongress – RCT: Immediate coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation did not improve outcomes compared to delayed/selective angiography.

29 Aug, 2021 | 18:12h | UTC

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation – New England Journal of Medicine

News release: Trial does not support early coronary angiography in cardiac arrest without ST elevation – European Society of Cardiology

Commentaries:

Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation – TOMAHAWK – American College of Cardiology

TOMAHAWK: Immediate Coronary Angiography vs. Delayed Angiography in OHCA Patients Without ST-Segment Elevation – American College of Cardiology

 

Commentary on Twitter

 

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