Lamotrigine (Lamictal), used to treat seizures in children and bipolar disorder in adults

Lamotrigine (Lamictal), used to treat seizures in children and bipolar disorder in adults

ARB's increase cancer

The FDA is reviewing the safety of angiotensin-receptor blockers after a recent meta-analysis suggested a small increase in new cancer diagnoses in patients using the drugs.


The agency will update the public with its conclusions as soon as the review is complete. In the meantime, it says the benefits of ARBs outweigh any potential risks, and it advises that the drugs continue to be used as recommended.


Clinicians should report any ARB-related adverse events to the FDA's MedWatch program.

lorcaserin new weight loss drug

Lorcaserin, a selective serotonin 2C receptor agonist, helps patients both lose weight and maintain their weight loss, according to a phase III study conducted by the drug's manufacturer and published in the New England Journal of Medicine.


Some 3200 overweight or obese adults were randomized to take lorcaserin or placebo twice daily for a year, after which lorcaserin recipients continued the drug or switched to placebo for another year. All participants also received nutrition and exercise counseling.


At 1 year, more patients in the lorcaserin group than placebo group had lost at least 5% of their body weight (48% vs. 20% of patients; mean weight loss: 5.8 kg vs. 2.2 kg). In addition, lorcaserin patients who stayed on the drug for a second year were more likely to maintain their weight loss than those who switched to placebo.


Serious adverse events did not differ between lorcaserin and placebo recipients. Unlike some other serotonergic agents, lorcaserin did not increase risk for valvular heart disease.

vitamin e/beta carotene may increase cvd

A systematic review of antioxidants for primary prevention of cardiovascular disease identified four RCTs of vitamin E; the review found no benefits for vitamin E [1). One of the RCTs identified in the review found that vitamin E may increase death from subarachnoid hemorrhage [2). The review also identified six RCTs of beta-carotene; the review found no benefit for beta-carotene. Pooled analysis of four of these six RCTs found that beta-carotene may increase cv mortality

asa lowers MI but increases stroke

The role of aspirin in primary prevention remains uncertain. In a meta-analysis of five RCTs, Foster and colleagues found that aspirin slightly reduced the risk of a serious vascular event (odds ratio, 0.86; 95% CI: 0.80–0.90) and reduced the relative risk of myocardial infarction by about a third (OR, 0.71; 95% CI: 0.60–0.80], but had an uncertain effect on stroke (OR, 1.05; 95% CI: 0.90–1.20) [1]. The meta-analysis found that there were 0.1 excess intracranial bleeds per 1,000 patients treated per year with aspirin, and 0.7 major extracranial bleeds per 1,000 patients treated per year with aspirin. The authors found “insufficient evidence from RCTs to identify which individuals would benefit overall and which would be harmed by regular treatment with aspirin, although those at high and intermediate rather than low risk would be more likely to gain benefit.” ...More

up regulation and down regulation

down-regulation - A reduction in the number of receptors for a control substance, e.g., a hormone, local hormone, neurotransmitter, or a drug, in response to a prolonged excess of the control substance; this is an internal adjustment which usually helps restore homeostasis in a disease state.

up-regulation - An increase in the number of receptors for a control substance, e.g., a hormone, local hormone, neurotransmitter, or a drug, in response to a prolonged decrease of the control substance; this is an internal adjustment which usually helps restore homeostasis in a disease state.

fibrates may lower coronary events not mortality, stroke or HF

Fibrates appear to lower the risk for coronary events, according to a meta-analysis in the Lancet.


Researchers examined data from 18 placebo-controlled trials of fibrates for primary or secondary prevention; some 45,000 adults were included. Overall, coronary events were significantly less common in patients taking fibrates than in those on placebo (8.7% vs. 11.6%). Fibrates were also associated with significant reductions in coronary revascularization, progression of albuminuria, and retinopathy.


There was no benefit in terms of stroke, mortality, or heart failure. Serious drug-related events, including rhabdomyolysis, were not increased with fibrates.


The authors conclude: "The magnitude of effect is moderate, but in high-risk individuals and in those with combined dyslipidemia, clinically meaningful reductions in risk could be achieved."