Intermittent fasting has become a popular diet because it has a simple structure and, according to a lot of "online experts," offers a plethora of benefits beyond weight loss. In case you weren't aware, fasting is the new fountain of youth, as it drops insulin levels, increases growth hormone, induces cellular repair, and reduces inflammation. No word yet on whether it improves your sex life, gives you energy, and makes you wealthy, but one can only assume. Anyway, several recently published studies compared the effects of intermittent fasting to usual eating; we break them down for you below. more
The American Heart Association (AHA) recently published an update to its heart failure guidelines. The new guidelines replace the previous 2013 recommendations and the "2017 focused update." The guidelines include changes to the heart failure classification system, medication recommendations, and guidance on non-drug therapies. more
A cholesterol drug with a novel mechanism of action was recently approved. Inclisiran (Leqvio) is a small interfering ribonucleic acid (siRNA) that inhibits the production of PCSK9 in hepatocytes. PCSK9 is an enzyme that binds to LDL receptors on liver cells and causes them to degrade. LDL receptor loss reduces hepatocyte uptake of LDL and leads to higher LDL blood levels. Two antibodies, alirocumab and evolocumab, are currently available that bind PCSK9 and inactivate it. more
HIV pre-exposure prophylaxis (PrEP) with Truvada, Descovy, and just recently, Apretude is becoming more common as access and awareness have increased. The CDC issues specific guidelines on whom to treat and how therapy should be managed. Our new HIV prophylaxis page covers all the details in a concise and easy-to-navigate format. Recommendations for nonoccupational post-exposure prophylaxis (NPEP) are also included, along with information on drug precautions, interactions, efficacy, and side effects. HIV prophylaxis page
The Wall Street Journal reported on 5/7/2022 that Cerebral Inc., the online mental-health company, has been subpoenaed by federal prosecutors to investigate possible violations of the Controlled Substances Act.
Cerebral Receives Subpoena From Federal Prosecutors, Wall Street Journal (5/7/2022)
It's no secret that biologics have transformed healthcare, with once difficult to treat diseases like rheumatoid arthritis, inflammatory bowel disease, and psoriasis now being quite manageable in many. Biologics that target inflammatory mediators (e.g. TNF inhibitors, IL inhibitors) are also very safe and well-tolerated, making them useful in a wide range of patients. Asthma, a condition driven by inflammatory pathways in the lungs, is a logical candidate for biologic therapy, and six biologics are now approved to treat it. more
Leqvio® (inclisiran) - small interfering ribonucleic acid (siRNA) for high cholesterol
Tezspire® (tezepelumab) - biologic to treat asthma
Adbry® (tralokinumab) - biologic to treat atopic dermatitis
Seglentis® (celecoxib + tramadol) - combination pain medication
Opzelura® (ruxolitinib) - topical janus kinase inhibitor for eczema
Qulipta® (atogepant) - CGRP receptor antagonist for migraine prevention
The FDA recently approved a new branded version of torsemide called Soaanz from Sarfez Pharmaceuticals. Torsemide is a loop diuretic that has been available since 1993. The original version of torsemide was marketed under the name Demadex, but it has been discontinued, and now only generic versions of the drug are available. Soaanz was approved as a reference listed drug, which means it is not considered bioequivalent to generic versions of torsemide. more
In the U.S., about 42% of adults are obese, which translates to around 108 million people. Severe obesity, defined as a BMI ≥ 40, affects 9.2% of adults or almost 24 million people. Given these sobering numbers, it goes without saying that effective weight loss therapies are hard to come by. This has led to a rise in bariatric surgery, an invasive treatment that carries many risks, but for a lot of people, offers the best chance of achieving meaningful weight loss. Bariatric surgery used to be considered an extreme, last-resort option for only the most desperate patients. more
GERD is boring, and many patients self-treat, but the American College of Gastroenterology (ACG) recently published GERD guidelines, so it's worth reviewing certain nuances of the disease. Our new GERD page covers ACG recommendations for diagnosis and treatment, along with a review of proton pump inhibitors, which are consumed every day by millions of people. See the Straight Healthcare GERD page for more.
Vitamin D has become all the rage over the last ten years. Many providers now routinely check levels, and in 2018, 37% of adults 60 years and over reported taking a daily vitamin D supplement. While people may feel like they're being healthy taking large doses of vitamins, there is little evidence from clinical trials that vitamin D supplements do anything. Not to mention, experts can't even agree on what a normal vitamin D level should be. more
A vast array of glucose meters are available to the general public today. Some devices make Bluetooth connections to phones and send readings to apps for charting and sharing. Some meters are thumbnail-sized devices that plug into smartphones for easy transport. The FreeStyle Libre measures glucose levels by waving a smartphone over a patch that is worn for 14 days. Bells and whistles are nice, but unless the meter delivers accurate readings, it is useless. more
Alcohol is a problem for a lot of people, with 10 - 15% of U.S. adults meeting criteria for alcohol use disorder (AUD). Despite these sobering numbers, only 8% of people with AUD report ever receiving any type of formal therapy. To help increase familiarity with treatment, we created a page that covers all aspects of AUD, including screening, diagnosis, acute withdrawal, professional recommendations, and chronic treatment with FDA-approved and non-approved therapies. See the Straight Healthcare AUD page for more.
When most providers think of varenicline, they think of smoking cessation, and when they think of dry eye treatment, they think of eye drops. A new product aims to change these perceptions. Tyrvaya is a nasal spray for dry eyes that contains varenicline, the active ingredient in the smoking cessation drug Chantix. Varenicline is a nicotine agonist/antagonist that binds nicotine acetylcholine receptors and stimulates a low level of nicotine activity (agonist effect) while simultaneously blocking nicotine from binding the receptor (antagonist effect). more
Most people have gotten their fill of vaccine news in the past year, but it didn't stop Pfizer and Merck from introducing two new pneumococcal vaccines. The Pfizer product is called Prevnar 20, and the Merck product is Vaxneuvance. The addition of these two vaccines now means that there are four pneumococcal vaccines available for adults. A breakdown of each vaccine is provided below, along with a review of their efficacy. more
A review of weight loss procedures is now available on Straight Healthcare. Procedures covered include gastric sleeve, gastric bypass, gastric banding, biliopancreatic diversion with duodenal switch, and intragastric balloon. Recommendations for chronic management pertinent to primary care are provided, along with indications for surgery, preprocedural evaluation, procedural benefits and risks, and average weight loss effects. See the Straight Healthcare weight loss procedure page for more.