The Intern At Work: Internal Medicine
264. The Rounds Table- Top 5 RCTs of 2024
Dec 28, 2024
Drs. Mike and John Fralick dive into the top randomized controlled trials of 2024. They highlight finerenone’s impact on heart failure outcomes and discuss innovative uses of tirzepatide for obstructive sleep apnea and liver conditions. Semaglutide’s positive effects on kidney health in diabetes patients also takes center stage. The hosts review findings on antibiotic durations for bloodstream infections, revealing shorter treatment might be just as effective. They wrap up with thoughts on the importance of credible data and community engagement.
24:51
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Quick takeaways
- Finerenone significantly reduces heart failure and cardiovascular deaths in patients with preserved ejection fraction, though its interaction with SGLT2 inhibitors remains uncertain.
- Terzepatide effectively treats obstructive sleep apnea and obesity by significantly improving the apnea-hypopnea index and promoting substantial weight loss, despite potential biases in the trial design.
Deep dives
Finerenone's Impact on Heart Failure Management
Research indicates that finerenone can effectively reduce morbidity and mortality in adults suffering from heart failure with preserved ejection fraction. In a double-blind placebo-controlled trial involving 6,000 participants, those taking finerenone experienced a 6% absolute risk reduction in worsening heart failure events and cardiovascular deaths, compared to those on a placebo. The trial highlighted that 36% of finerenone users faced adverse outcomes, contrasting with 42% in the placebo group, primarily driven by decreased heart failure events. However, the trial's limitation lies in the low concurrent use of SGLT2 inhibitors, leaving it uncertain if their combination would yield superior results.
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