ATTEST: AFib ablation slows progression to persistence
It’s friday november 15th and this is the daily medical news my md edge where we bring you the top medical headlines plus a closer look at the day’s biggest story i’m nick andrews and i’m mary ellen schneider today an fda panel gives a thumbs down to an mpeg low flows an indication for type one diabetes drug spending is driving up medicare part b premiums in 2020
The american college of physicians offers new solutions to rising drug prices and methotrexate eases joint erosions but not pain in erosive hand osteoarthritis plus atrial fibrillation ablation may put the brakes on the progression to persistent arrhythmia but first thanks to all of you who’ve helped us make this podcast better by taking our short listener survey
If you haven’t please take a moment to complete the survey by following the link in the show notes and now the news well an fda advisory panel voted against recommending approval of my flows in for type 1 diabetes the drug is already approved for patients with type 2 diabetes under the supplemental new drug application and pack life flows in would be used as an
Adjunct to insulin therapy to improve glycemic control in adults with type 1 diabetes members of the fda’s endocrine illogic and metabolic drugs advisory committee weren’t convinced in a 14-2 to vote against the indication panelists cited persisting concerns about the risk of diabetic ketoacidosis seen with the drug patients with type 1 diabetes are at increased
Risk for a dka the panel also pointed to the limited pool of evidence presented to support the indication the agency said it typically receives two major studies support applications for drug approvals but the emig left flows and application rests largely on a single phase 3 trial the fda is not required to accept its advisory panels as recommendations but it often
Does medicare part b beneficiaries paying the standard premium will see their monthly bill rise nearly seven percent next year to $144 deductibles are also going up next year to 198 dollars that’s a 7 percent rise cms blames the hikes on rising spending for physician administered drugs those costs ripple out and push part b premiums and deductibles higher cms and
Congress are looking at several options to help contain the spending on drugs those options include the use of an international pricing index to put us spending more in line with the lower prices offered in foreign countries regulators and lawmakers are also considering automatic rebates when drug prices rise faster than the rate of inflation promoting the use of
Lower-cost generics and introducing annual out-of-pocket spending caps are just two of the ideas rolled out by the american college of physicians to help tame the rising price of drugs the acp outlined its price prescriptions in two position papers published in the annals of internal medicine the acps first recommendation is to modify the medicare part d low-income
Subsidy program to encourage the use of lower-cost generic or biosimilar drugs cms has estimated that medicare could have passed on three billion dollars in savings to the part d program and its beneficiaries if available equivalent generics were prescribed instead of brand-name drugs the acp second recommendation calls for annual out-of-pocket spending caps for
Medicare part d beneficiaries who reach the catastrophic phase of coverage during 2007 to 2015 the number of seniors who reach that catastrophic coverage limit doubled to more than 1 million the acp also supports repeal of the law that prevents medicare from negotiating directly with pharmaceutical manufacturers over the price of drugs for a complete look at the
Acps proposals click the link in the podcast notes the daily medical news we’ll be right back after this methotrexate didn’t top placebo at reducing pain in patients with symptomatic erosive osteoarthritis of the hand but it may have a role in reducing joint damage and increasing bone remodeling those are the key findings from the randomized controlled atom
Trial researchers from cote d’azur university in nice france presented the findings at the annual meeting of the american college of rheumatology sixty-four patients with symptomatic erosive hand osteoarthritis were randomized to 10 milligrams of methotrexate per week or placebo at 12 months improvements in hand pain scores were similar in methotrexate and placebo
Patients roughly a 25% improvement in both groups joint segregation wasn’t significantly higher in the placebo group than in the methotrexate group but at 12 months the methotrexate patients saw a significantly greater number of erosive joints progressing to a remodeling phase compared with the placebo group and finally today radiofrequency catheter ablation of
Afib is not just a more definitive rhythm control treatment than anti-arrhythmic drugs it’s also much more effective at slowing a phibbs progression from proximal to persistent in the attest study ablation cut the incidence of progression to persistent afib by 89% compared with medically managed patients it’s a statistically significant difference that documents
And unappreciated benefit of catheter ablation the ability to slow a fib progression a test enrolled older patients with paroxysmal afib who had not fully responded to one or two rhythm or rate controlled drugs the trials 255 patients were randomly assigned to radiofrequency catheter ablation or medical management they were then followed for three years after one
Year 1% of the ablation patients developed persistent afib compared with 7% of the patients assigned to drug management after three years the respective rates of progression were 2% and 18 percent respectively the rate of serious adverse events was low occurring in 12% of ablated patients and 5% of controls dr. carl heine’s cuck of the asclepius clinic st. george
In hamburg germany presented the findings at the annual congress of the european society of cardiology he says assessing progression to persistent afib is a new end point for ablation and it’s an important one because that progression has been linked with increased mortality strokes and hospitalizations if the findings are confirmed dr. cox says they could lead
To a new indication for catheter ablations in patients with paroxysmal afib and that’s it for today’s daily medical news be sure to catch the newest episodes of cardio cast and the post call podcast new episodes of cardio cast in post call drop each and every friday for md edge i’m nick drew’s our stories this week were contributed by therese borden andrew bowser
Doug brung steve cimino jeff craven richard frankie alesia gallegos amy karen bianca no grady kauri oaks alex otto will pass jenny smith michelle sullivan greg trotman carrie dooley young and mitchell zoeller our editors include terry rudd kathy skarbek denise fulton teresa borden katie lennon glenn williams richard pz laura nikolaidis katherine illest jeff evans
Elizabeth met scotty laura mcquaid marc lesney gina henderson and katherine hackett and i’m mary ellen schneider if you like what you hear on the daily medical news please leave us a review or rating on apple podcasts and check out the full stories available via the links in the podcast notes have a great weekend and we’ll see you next week you
Transcribed from video
AFib ablation slashed progression risk; FDA panel pans empagliflozin for type 1 diabetes By MDedge news and insights for busy physicians