Thread by @thecurbsiders

Currently watching the pre-recorded Update in Primary Care which reviews the 10 most impactful articles published in @AnnalsofIM, @NEJM, @TheLancet, ACP Journal Club, @JAMA_current, and @JAMAInternalMed from the past 2 years, as selected by a panel of SGIM physicians. #SGIM21

Study 1: 'Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction" by J.J. V. McMurray, et al. @NEJM pub. date Nov 21, 2019; nejm.org/doi/full/10.10… DAPA-HF trial bottom line: in pts with HFrEF, regardless of diabetes, dapagliflozin reduced HF and CV death.

Study 2: 'Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer' by Giancarlo Angelli, et al. @NEJM pub date March 29 2020 nejm.org/doi/full/10.10… Bottom line: in pts w/ cancer-associated VTE, apixaban is not inferior to dalteparin for preventing recurrence.

Study 3: 'Compression Therapy to Prevent Recurrent Cellulitis of the Leg' by Elizabeth Webb, et al. @NEJM pub Aug 13 2020; nejm.org/doi/full/10.10… Bottom line: for pts w/ chronic leg edema & recurrent cellulitis, consider compression stockings + education on cellulitis prevention

Study 4: 'Early Rhythm-Control Therapy in Patients with Atrial Fibrillation' by P. Kirchof et al @NEJM pub date Oct 1 2020; nejm.org/doi/full/10.10… Bottom line: for pts w/ AFib dx w/in past year, early referral to cardiology for consideration of rhythm control tx is reasonable.

Study 5: 'Controlled Trial of Budesonide-Formoterol as Needed for Mild Asthma' by Richard Beasley, et al. @NEJM pub date May 23, 2019; nejm.org/doi/full/10.10… Bottom line: for pts w/ mild asthma, use of LABA/ICS PRN⬇️ annual exacerbation rates compared to SABA alone or ICS+SABA.

Study 6: 'Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men with Overweight and Obesity' by Dylan Lowe et al @JAMAInternalMed Nov 1 2020 pubmed.ncbi.nlm.nih.gov/32986097/ Bottom line: TRE no more effective 4 weight loss than consistent meal⏲️

Study 7: 'C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations' by Christopher Butler et al. @NEJM pub date Jul 11 2019 nejm.org/doi/full/10.10… Bottom line: CRP-guided abx prescribing 4 COPD exacerbations in primary care pts may ⬇️unnecesssary abx use

Study 8: 'Bupropion and Naltrexone in Methamphetamine Use Disorder' by M.H. Trivedi et al. @NEJM pub date Jan 14 2021; nejm.org/doi/full/10.10… Bottom line: Naltrexone ER + Bupropion ER can be used to treat moderate to severe methamphetamine use disorder.

Study 9: 'Bedtime Hypertension Treatment Improves Cardiovascular Risk Reduction: The Hygia Chronotherapy Trial' by Ramón Hermida et al; European Heart Journal Dec 21 2020 pubmed.ncbi.nlm.nih.gov/31641769/ Bottom line: taking all BP-lowering meds at bedtime could improve BP ctrl,⬇️CVD risk

Study 10: 'Colchicine in Patients with Chronic Coronary Disease' by Stefan Nidorf et al. @NEJM pub date Nov 5 2020; nejm.org/doi/full/10.10… Bottom line: 4 pts w/ stable CAD on evidence-based tx for 2ndary prevention, low-dose colchicine may further⬇️risk of cardiovascular events.

The presenters for this session were:
Studies 1-2: Dr. Jeremy Smith, U. Wisconsin
Studies 3-5: Dr. Jason T. Alexander, U. Chicago
Studies 6-7: Dr. Simran Singh, Case Western Reserve University
Studies 8-10: Dr. David Williams, U. Washington, Boise VAMC