Questioning Medicine20 Joulu 2023

Episode 215: 215. Enteric coated or uncoated aspirin, which is better or safer?

Effectiveness and Safety of Enteric-Coated vs Uncoated Aspirin in Patients With Cardiovascular Disease: A Secondary Analysis of the ADAPTABLE Randomized Clinical Trial | Clinical Pharmacy and Pharmacology | JAMA Cardiology | JAMA Network

Enteric coating of aspirin delays the breakdown of the tablet until it is in the higher pH of the duodenum and has been shown to reduce gastric erosion5 but has not been shown to reduce gastrointestinal bleeding. We say take enteric coated but no study has shown that enteric coated formulation is safer then uncoated aspirin

post hoc secondary analysis of 10 678 participants with atherosclerotic cardiovascular disease from the ADAPTABLE randomized clinical trial—a reminder, (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness). In that trial they randomized 15,000 patients with coronary artery disease to take 81 mg or 325 mg of aspirin daily.

Roughly half of the pts using 81mg and half of the pts using 325mg were on enteric coated aspirin and half on regular uncoated aspirin. - Median follow-up was ≈2 years

primary outcomes were death, hospitalization for myocardial infarction, or hospitalization for stroke and the primary safety outcomes was major bleeding -- (hospitalization for a bleeding event with use of a blood product or intracranial hemorrhage).---between enteric-coated aspirin and uncoated aspirin among participants

and the answer was there was no difference so when your patient that needs aspirin for secondary prevention ask you should I take enteric-coated aspirin or uncoated aspirin

You can answer

Sound affect

At this time it appears the best available evidence that there likely is no difference between enteric-coated aspirin and uncoated aspirin just make sure you are taking your aspirin

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Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltextAntithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common si...

5 Kesä 20257min

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

https://jamanetwork.com/journals/jama/article-abstract/2834632SummaryThe article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination w...

4 Kesä 20258min

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

https://www.nejm.org/doi/full/10.1056/NEJMoa2405182?query=recirc_Semantic Key Takeaways Extended Predictive Value of Biomarkers: High-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipop...

29 Touko 20259min

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Desgagnés N et al. Use of albumin-adjusted calcium measurements in clinical practice. JAMA Netw Open 2025 Jan 21; 8:e2455251. (https://doi.org/10.1001/jamanetworkopen.2024.55251)Overall, total calcium...

27 Touko 20257min

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

https://www.nejm.org/doi/10.1056/NEJMoa2416394At 72 weeks, the mean percentage decrease in weight was significantly greater with tirzepatide than with semaglutide (20% vs. 14%). Gastrointestinal side ...

21 Touko 20258min

Episode 386: 397. What is the new drug for smoking cessation?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832701In this multisite trial, 800 adults who smoked 10 or more cigarettes daily (mean duration of smoking, ≈35 years) were randomize...

9 Touko 20255min

Episode 385: 396. Vitamin D and Kids (CME)

What does the evidence and the guidelines say about the use and testing of Vitamin D in kids

7 Touko 20258min

Episode 384: 395. How accurate is the BMI?

Aryee EK et al. Prevalence of obesity with and without confirmation of excess adiposity among US adults. JAMA 2025 Apr 17; [e-pub]. (https://doi.org/10.1001/jama.2025.2704)The rate of obesity was 39.7...

6 Touko 20255min

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