10 1001@jama 2020 10338

News & Analysis
Clinical Trials Update
Physical Therapy Outperforms pedophilic disorder, a phase 2 trial in JAMA

Injections for Knee Osteoarthritis Psychiatry found.
Physical therapy reduced pain and func- The study involved 52 men in Sweden
tional disability more effectively than gluco- who were diagnosed with and seeking treat-
corticoid injections among patients with os- ment for pedophilic disorder. They were
teoarthritis of the knee, a trial in the New randomly assigned to receive either 2 sub-
England Journal of Medicine reported. cutaneous injections of degarelix acetate or
The study’s 156 patients in the US Mili- a placebo.
tary Health System were randomized to At 2 weeks, the composite risk score of
receive up to 3 glucocorticoid injections or 5 domains of child sexual abuse (range, 0-15
a maximum of 14 physical therapy sessions points) decreased from 7.4 to 4.4 among par-
over 12 months. The primary outcome was ticipants in the degarelix group and from 7.8
the total score on the Western Ontario and to 6.6 in the placebo group. A decrease in risk
McMaster Universities Osteoarthritis score was also seen at 10 weeks in the treat-
Index (WOMAC). The scores range from 0 ment group.
to 240, with higher scores indicating Degarelix is a gonadotropin-releasing Physical therapy relieved pain and disability from
worse symptoms. hormone antagonist that decreases testos- knee osteoarthritis more effectively than
In the glucocorticoid injection group, the terone to castration levels within 3 days glucocorticoid injections in a recent clinical trial.
average WOMAC score declined to 55.8 from without initial testosterone flare-ups seen
Clopidogrel Noninferior to Ticagrelor
a baseline of 108.8 and to 37.0 in the physi- with similar drugs. With further study, the With Less Bleeding
cal therapy group from a baseline of 107.1. fast-acting drug plus psychosocial support Among older patients with acute coronary
Both groups achieved the minimum clini- may be suitable for long-term treatment, syndrome, platelet inhibition with clopido-
cally important difference of 12% improve- the authors noted. grel significantly reduced bleeding risk with-
ment from baseline. out increasing thrombotic events com-
Plant Extracts May Relieve Hangover pared with ticagrelor, a noninferiority trial in
C-Reactive Protein Test Reduces Symptoms, Trial Suggests The Lancet reported.
Antibiotics for COPD Flare-ups A dietary supplement drink containing plant The trial involved 1002 patients in the
In a recent UK trial, use of a C-reactive pro- extracts improved hangover symptoms after Netherlands, aged 70 years and older, who
tein (CRP) point-of-care test to guide treat- moderate alcohol consumption in a trial pub- continuedtoreceivestandardcarefornon–ST-
ment decisions reduced antibiotic use lished in BMJ Nutrition, Prevention & Health. elevation acute coronary syndrome. They
among patients with acute exacerbations of The trial randomly assigned 214 partici- were randomly assigned to a loading dose of
chronic obstructive pulmonary disease pants in Germany to 3 groups. One group re- clopidogrel or ticagrelor followed by a main-
(AECOPD). Previous research suggests that ceived a flavored drink with plant extracts, tenance dose of 75 mg clopidogrel once daily
CRP levels correlate with antibiotic efficacy vitamins and minerals, and glucose. A sec- or90mgticagrelortwicedaily.(The5%ofpar-
among patients with AECOPD. ond group’s drink excluded the plant ex- ticipants who received prasugrel were in-
The study’s 649 patients with an tracts, and the placebo group’s drink had cluded in the ticagrelor analysis.)
AECOPD were randomly assigned to a CRP only glucose. Participants drank the solu- At 12 months, 18% of patients in the clopi-
test plus usual care or to usual care alone. tions before and immediately after they con- dogrel group experienced bleeding that re-
In the 4 weeks after randomization, 77.4% sumed beer or white wine. quired medical attention compared with 24%
of the usual-care group took antibiotics Only the drink with plant extracts signifi- in the ticagrelor group. The composite net
compared with 57% of the CRP test group. cantly lessened symptoms, reducing head- clinical benefit—a combination of all-cause
Clinicians said they valued the CRP test ache intensity by 34%, nausea by 42%, feel- death, myocardial infarction, stroke, and ma-
but that the time and costs associated ings of indifference by 27%, and restlessness jor or minor bleeding—was noninferior for
with it “needed careful consideration,” by 41% compared with placebo. In addi- clopidogrel(28%)vsticagrelor(32%).Among
the investigators wrote in Health Technol- tion, alcohol consumption did not cause sub- patients in the ticagrelor group, 47% prema-
ogy Assessment. stantial dehydration in the study, suggest- turely discontinued the study drug com-
ing that electrolyte and mineral loss may be pared with 22% in the clopidogrel group.
Prostate Cancer Drug Degarelix negligible hangover contributors. Bleeding, dyspnea, and need for oral antico-
Rapidly Treats Pedophilic Disorder Hangover symptoms are predomi- agulation were the primary reasons patients
Degarelix, an advanced prostate cancer nantly caused by alcohol and its metabo- left the study. − Anita Slomski, MA
drug, rapidly reduced the risk of commit- lites, and plant extracts may reduce their se- Note: Source references are available through
ting child sexual abuse among men with verity, the authors wrote. embedded hyperlinks in the article text online.
jama.com (Reprinted) JAMA June 23/30, 2020 Volume 323, Number 24 2453
© 2020 American Medical Association. All rights reserved.
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News & Analysis

Clinical Trials Update

Physical Therapy Outperforms pedophilic disorder, a phase 2 trial in JAMA

© 2020 American Medical Association. All rights reserved.

Downloaded From: https://jamanetwork.com/ by a Macquarie University User on 06/24/2020

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