Consider The Evidence: Med/Peds Journal Roundup

April 13, 2006

B12 & Folic Acid, lower homocysteine but not cardiovascular risk

Filed under: CVD, homocysteine, NEJM, stroke — medblog @ 11:11 pm

NEJM 4/13 – After the correlation between high homocysteine levels and disease such as stroke and MI was discovered, there was a flurry of work looking at the connection. The hope was that the effect was causal, and the simple use of B vitamins would lower homocysteine levels and reduce mortality.

The HOPE-2 investigators published an article exploring whether folic acid and B12 supplementation would lower the risk of cardiovascular events via reduction of homocysteine levels. This was a large study including over 5000 patients. Although the treatment group had significantly lower homocysteinie levels, there were no significant differences between the groups in the rates of death from cardiovascular causes or myocardial infarction.

After the failure of HOPE-TOO to show improved outcomes with vitamin E, this is the second vitamin supplementation study that has not shown a benefit. I guess we will have to wait for the next one to come along….


February 15, 2006

will RIO make you less grande?

Filed under: CVD, JAMA, medicine, obesity — medblog @ 12:16 am

JAMA 2/15 – Do we finally have a drug to help combat obesity? Eagerly awaited results of the RIO trial are published in this weeks JAMA. Rimonabant (trade name: Accomplia) is a novel approach to reducing obesity and other CVD risk factors by targeting endocannabinoid receptors. This is the product of a hotbed of research targeting the signaling pathways that facilitate appetite and weight gain. RIO is the first large scale study of the safety and effectiveness of the drug, and it followed patients over 2 years. The results? Well I guess every little bit helps, but – keep looking for that magic pill.

Not to understate the success…Rimonabant definetly seems to help shed about 10lbs or so and there are significant positive effects on cholesterol levels and insulin sensitivity. (more…)

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