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Tiotropium an aid in COPD

Tiotropium reduces exacerbations and related hospitalisations in patients with COPD, a US study reports.

The systematic review pooled results from nine trials testing tiotropium for at least 12 weeks in 8,002 patients. The studies compared the drug with placebo, ipratropium bromide or long-acting ß-agonists.

Tiotropium reduced the risk of COPD exacerbations by 27 per cent and hospitalisation by 32 per cent.

Thorax 2006;61:854-62

Drug helps obese diabetics

Rimonabant can promote weight loss and improve control of blood glucose in patients with diabetes, Belgian researchers report.

Their study examined the effects of rimonabant in 1,047 overweight or obese patients with type 2 diabetes, whose disease was poorly controlled despite drug treatment.

After a year of treatment alongside a diet plan, patients on 5mg rimonabant lost an average of 2.3kg, and those on 20mg an average of 5.3kg, compared with 1.4kg with placebo.

The Lancet 2006; 27 October early online publication

Antipsychotic diabetes risk

A series of different atypical antipsychotics increase the risk of developing diabetes, a US study concludes.

The observational study examined the risk of diabetes in 15,767 patients on the US Veterans Health Administration database who were taking either an atypical antipsychotic or, as controls, haloperidol.

The risk of diabetes relative to controls was increased by 64 per cent with olanzapine, 60 per cent with risperidone and 67 per cent with quetiapine.

American Journal of Epidemiology 2006;164:672-81

Statins in pneumonia

Statins do not, after all, reduce mortality or admission to intensive care in patients with community-acquired pneumonia, a Canadian study reveals.

The researchers prospectively followed 3,415 patients with pneumonia admitted to hospital, 624 of whom died or were admitted to intensive care.

After an initial analysis, statins appeared to reduce the risk of death or intensive care by 20 per cent, but after more complete adjustment for confounders, the reduction disappeared completely.

BMJ 2006; 23 October early online publication

Traffic fumes stroke alert

Traffic fumes may trigger ischaemic stroke, according to Canadian researchers.

Their study assessed levels of six airborne pollutants at fixed-site monitoring stations.

After adjusting for temperature and humidity, the overall risk of stroke was not related to pollution. But each increase in the inter-quartile range of CO and NO2 raised the risk of ischaemic stroke – by 32 per cent and 26 per cent respectively.

European Journal of Epidemiology 2006; 18 October early online publication

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