Stroke Subtypes; Statin Flop for Cancer; A Better Aneurysm Coil
By medpagetoday.com
Head-to-head evaluation of three stroke classification systems showed that all did fairly well, with the major stroke subtypes distinct irrespective of the system used, researchers reported in a study appearing in JAMA Neurology.
The Causative Classification of Stroke (CCS), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and ASCO (A for atherosclerosis, S for small-vessel disease, C for cardiac source, and O for other cause) classification systems had area under the receiver operating characteristic curves for 90-day recurrence of 0.71, 0.61, and 0.66, respectively.
While all had similar discrimination for 90-day mortality, CCS "generates discrete etiologic categories with more diverse clinical, imaging, and prognostic characteristics than either TOAST or ASCO," the researchers noted.
Nevertheless, this validation study says the scales perform "fairly well" overall, so it's reasonable to stick with any of the three, commented Philip Gorelick, MD, MPH, of Michigan State University in Grand Rapids.
Statins Flop As Cancer Tx
Statins' pleiotropic benefits don't extend to cancer, according to the phase III LUNGSTAR trial showing that adding pravastatin to standard chemotherapy didn't improve survival or secondary outcomes in small cell lung cancer.
Despite promising preclinical and observational findings, this is the fifth placebo-controlled trial of statin use in patients with cancer to show no benefit.
"Given the findings from our trial and the other published, double-blind, randomized controlled trials, independent monitoring committees of studies that are still recruiting or in follow-up should examine interim analyses of clinical endpoints and stop early if there is sufficient evidence for futility, thus saving resources," the authors concluded in their paper online in the Journal of Clinical Oncology.
See MedPage Today's coverage here.
A Better Aneurysm Coil
Novel next-generation endovascular coils for treating medium-sized intracranial aneurysms reduced adverse outcomes among patients, according to the randomized GREAT trial reported at the International Stroke Conference.
MicroVention's HydroSoft or HydroFrame coils, filled with a hydrogel that expands upon contact with liquid to increase packing density, reduced the composite rate of major aneurysm recurrence at 18 months, retreatment for major recurrences within 18 months, morbidity that prevented angiographic follow-up, or death by an absolute 8.4% compared with standard platinum coils.
"In the U.S., most patients get the classic coil or the clip," commented Mark Alberts, MD, of Hartford Healthcare in Connecticut. "But this could potentially be an advance."
See the full MedPage Today story here.
Arthritic Heart Woes
Heart attack and rheumatoid arthritis are well known partners in crime, but other types of arthritis are culprits as well, a 25-study meta-analysis reported in the Annals of the Rheumatic Diseases.
MI risk was elevated most with rheumatoid arthritis but also significant for gout (HR 1.47), psoriatic arthritis (HR 1.41), and osteoarthritis (HR 1.31), with a trend seen for ankylosing spondylitis (HR 1.24, 95% CI 0.93-1.65) as well.
"The study findings support more integrated cardiovascular prevention strategies for arthritis populations that target both reducing inflammation and enhancing management of traditional cardiovascular risk factors," the researchers concluded, suggesting that gout and osteoarthritis patients should be monitored and risk factors targeted as is already recommended in the other types of arthritis.
Source: http://www.medpagetoday.com/cardiology/prevention/63560
Sunday, May 10, 2026
Exelon: Brand Name Medication Guide For Alzheimer's Disease And Dementia Care
Exelon is the brand name for rivastigmine, a medication used in the management of conditions associated with Alzheimer's disease and dementia care. Brand name medications are pharmaceutical products marketed under a proprietary name by the company that originally developed them. Understanding the relationship between brand name and generic formulations, as well as the conditions for which the medication is approved, helps patients make informed choices about their treatment. Current Alzheimer's therapies focus on managing symptoms and slowing the progression of cognitive decline rather than reversing the disease. Cholinesterase inhibitors boost acetylcholine levels in the brain by blocking its breakdown enzyme, supporting the cholinergic neurotransmitter system that is depleted early in the disease. These medications are most commonly used in mild to moderate Alzheimer's disease. An NMDA receptor antagonist addresses a different pathway and is often used in moderate to severe disease. Newer disease-modifying therapies targeting amyloid accumulation have recently emerged as additional options. The brand name Exelon has built a clinical track record through use in a wide range of patients and healthcare settings. Brand versions and their generic equivalents contain the same active ingredient at the same strength, but may differ in inactive ingredients such as fillers, binders, and coatings. In most cases, generic formulations are therapeutically equivalent and offer cost savings, though some patients prefer to stay on a specific formulation for consistency. When prescribed Exelon, patients should follow the guidance of their prescribing physician regarding dose, frequency, and duration of therapy. The medication should be stored as directed on the label, typically at room temperature away from heat and moisture. Any unused medication should not be disposed of by flushing down the drain unless the label specifically says to do so, as this can harm the environment. Comprehensive details on Exelon and other medications used for Alzheimer's disease and dementia care are available through https://mednewwsstoday.com/alzheimer/. This resource provides evidence-based summaries to help patients and healthcare providers stay informed about treatment options in this therapeutic area.
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