Curbside Consult Volume 20, Issue 2 - Second Quarter 2022

Research Updates 

Comparison of Clopidogrel Monotherapy After One to Two Months of Dual Antiplatelet Therapy With 12 Months of Dual Antiplatelet Therapy in Patients with Acute Coronary Syndrome The STOPDAPT-2 ACS Randomized Clinical Trial
Sabrina Wolfe, PharmD, Essentia Health
Can one year really make a difference? Looking into the safety and efficacy of dual antiplatelet therapy for those with acute coronary syndrome - does duration matter when looking at one to two months vs a year?

Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction - The PACMAN-AMI Trial
Laurie Grund, PharmD, Geritom Medical, Inc.
Patients with acute myocardial infarction are characterized by an increased risk of recurrent atherothrombotic events, largely attributed to disease progression in non-culprit coronary lesions. The focus of the PACMAN-AIM trial was to provide evidence surrounding the potential benefits of early initiation of alirocumab, in addition to high-intensity statin, within this patient population.

Safety of Novel Asundexian Compared to Apixaban in Patients with Atrial Fibrillation (PACIFIC-AF Trial)
Rachel Wedemeyer, PharmD, M Health Fairview
Asundexian, a novel DOAC that inhibits factor XIa, has shown early evidence of reducing risk of stroke and minimizing bleeding risk in patients with atrial fibrillation. This medication has the potential to improve the safety risks of using DOACs, but how does it compare to currently available.

Therapeutic Thoughts

Growing Pains: Controversies of Levothyroxine
Madeleine Davies, PharmD, M Health Fairview Smiley’s Clinic
Levothyroxine products are too unreliable for pharmacists to be allowed to interchange them without notifying the prescriber - or are they?

Treatment of Chronic Hypertension during Pregnancy: Is it time to be more aggressive?
Sandra Leo, PharmD, Mille Lacs Health System
Chronic hypertension during pregnancy is associated with many negative outcomes. When should we recommend antihypertensive medications?

Social Determinants of Health: How is Your CMM Practice Screening for Them?
Ann Nagle, PharmD, MPH, Entira Family Clinics
Social determinants of health (SDoH) play a significant role in patient wellbeing and health outcomes. Pharmacists providing comprehensive medication management are positioned to play a major role in helping patients navigate these SDoH. The challenge is: are we asking the right questions to identify them?

From the Pharmacy Press  

Do PPIs Increase the Risk of Community-Acquired Pneumonia? Findings from an Updated Meta-Analysis
Riley Larson, PharmD, M Health Fairview Bethesda | Walgreens
Numerous small-scale studies have noted an association of community-acquired pneumonia with use of proton pump inhibitors. Does this association hold true under the lens of a meta-analysis of these small studies?

Retrospective Cohort Review of Pharmacists' Impact on Disparities in Care in the Management of Type 2 Diabetes with Glucagon-Like peptide -1 Agonists and Sodium-Glucose Co-transporter 2 Inhibitors
Debesai Hailemicael, PharmD, Minnesota Community Care
Are Black patients less likely to be prescribed newer agents for type 2 diabetes, such as GLP-1 agonists and SGLT-2 inhibitors? Can pharmacists, equipped with knowledge of insurance coverages, copay discounts, coupons, and medication formularies, increase the prescribing rates of agents for Black patients with diabetes?

Effects of Pharmacist Interventions on Pain Intensity: Systematic Review and Meta-Analysis of Randomized Controlled Trials
McKenzie Pfeffer, PharmD, St. Cloud VA
Pharmacists have been well-integrated into several ambulatory care/clinical settings. However, the role of pharmacists in enhancing outcomes in pain management is an area that has been less clear. This new systematic review and meta-analysis of recent randomized controlled trials attempts to fill this gap.

Miscellaneous News  

Shots, Shots, Shots! Updates for Hepatitis B, Pneumonia, and the Zoster Vaccines.
Makoto Hang, PharmD, Minnesota Community Care
New updates for hepatitis B, pneumonia, and shingles vaccines are now in place. These recommendations aim to lower the incidence of infection and provide more protection to all adult patients.

Male Birth Control Update
Deandra Lundeen, PharmD, Park Nicollet
Is a male birth control option finally on the horizon? Scientists from the University of Minnesota have discovered an encouraging compound.

Improving Statin Therapy Adherence: New Recommendations
Reid Larson, PharmD, Welia Health
Is your patient truly experiencing statin-induced myalgias or are the myalgias from another source? Are you wondering how you can improve statin therapy adherence in your patients? New recommendations from the International Lipid Expert Panel may help to answer these questions for you and your patients.

Switching to Over-the-Counter Availability of Rescue Inhalers for Asthma
Kristopher Nguyen, PharmD, New Ulm Medical Center
As it stands, epinephrine inhalation aerosol (Primatene MistⓇ) is the only over-the-counter (OTC) inhaler approved by the Food and Drug Administration to manage asthma symptoms. Guideline-recommended rescue inhalers are only available with a prescription and prices of these inhalers can make accessibility an issue for many patients with asthma. There have been recent changes in guidelines, availability, and precedence that suggest prescribed rescue inhalers could make the switch to OTC-status.