Treatment of Metastatic Gastrointestinal Stromal Tumors (GIST): A Focus on Older Patients
AbstractGastrointestinal stromal tumors (GIST) originating in the Cajal cells are the most common mesenchymal neoplasms of the gastrointestinal tract. The median age of patients with this diagnosis is 65 years, and over 20% of cases affect people over the age of 70 years. The effectiveness and tolerability of systemic treatment with tyrosine kinase inhibitors in older patients with GIST seem to be similar to that in younger patients, but some studies have shown that treatment of older patients is suboptimal. Disability, frailty, comorbidities, and concomitant medications may influence treatment decisions, and toxicities al...
Source: Drugs and Aging - March 2, 2021 Category: Geriatrics Source Type: research
The Risk of Falling and Consequences of Falling in Patients with Atrial Fibrillation Receiving Different Types of Anticoagulant
ConclusionOlder patients who had comorbidities and were taking amiodarone, diuretics, or short- or medium-acting benzodiazepines had the highest risk of falls. The type and quality of anticoagulation did not seem to affect the risk of falling but did significantly affect survival after the first fall. (Source: Drugs and Aging)
Source: Drugs and Aging - March 2, 2021 Category: Geriatrics Source Type: research
Drug –Drug Interactions and Prescription Appropriateness at Hospital Discharge: Experience with COVID-19 Patients
ConclusionAn increased number of prescribed drugs was observed in COVID-19 patients discharged from our hospital. The addition of heparins is appropriate according to the current literature, while the use of proton pump inhibitors is more controversial. Particular attention should be paid to the risk of bleeding complications linked to heparin-based DDIs. (Source: Drugs and Aging)
Source: Drugs and Aging - March 1, 2021 Category: Geriatrics Source Type: research
Priority-Setting to Address the Geriatric Pharmacoparadox for Pain Management: A Nursing Home Stakeholder Delphi Study
ConclusionsStakeholder priorities for more evidence reflect concerns related to treating medically complex residents with complex drug regimens and included long-term adverse effects, coprescribing, and sedating medications. Carefully conducted observational studies are needed to address the vast evidence gap for nursing home residents. (Source: Drugs and Aging)
Source: Drugs and Aging - February 24, 2021 Category: Geriatrics Source Type: research
Therapeutic Recommendations for the Management of Older Adult Patients with Sj ögren’s Syndrome
AbstractPrimary Sj ögren’s syndrome (SjS) is a systemic autoimmune disease most commonly diagnosed in middle-aged women. Although the disease can occur at all ages, it is diagnosed between 30 and 60 years of age in two-thirds of patients. In more than 20% of cases, the people are older than 65 years. In this revi ew, we focus on the therapeutic management of primary SjS in older patients, following the recently published 2020 European League Against Rheumatism (EULAR) recommendations for the management of the disease with topical and systemic therapies. These recommendations are applicable to all patients wi th primar...
Source: Drugs and Aging - February 23, 2021 Category: Geriatrics Source Type: research
Seizures and Epilepsy After Stroke: Epidemiology, Biomarkers and Management
AbstractStroke is the leading cause of seizures and epilepsy in older adults. Patients who have larger and more severe strokes involving the cortex, are younger, and have acute symptomatic seizures and intracerebral haemorrhage are at highest risk of developing post-stroke epilepsy. Prognostic models, including the SeLECT and CAVE scores, help gauge the risk of epileptogenesis. Early electroencephalogram and blood-based biomarkers can provide information additional to the clinical risk factors of post-stroke epilepsy. The management of acute versus remote symptomatic seizures after stroke is markedly different. The choice ...
Source: Drugs and Aging - February 23, 2021 Category: Geriatrics Source Type: research
First-Line Biological Agents Plus Chemotherapy in Older Patients with Metastatic Colorectal Cancer: A Retrospective Pooled Analysis
ConclusionsBiologicals plus chemotherapy is an effective first-line treatment option for selected patients aged ≥ 65 years with mCRC and has a manageable safety profile and efficacy comparable to that observed in younger patients. (Source: Drugs and Aging)
Source: Drugs and Aging - February 22, 2021 Category: Geriatrics Source Type: research
Next-Generation Androgen Receptor-Signaling Inhibitors for Prostate Cancer: Considerations for Older Patients
AbstractProstate cancer is common, particularly in older patients, as the risk of getting prostate cancer increases with age. Cancer therapy brings unique challenges in older patients, as this population is vulnerable to many side effects and drug interactions, and they have varying degrees of frailty, which may limit the use of these therapies. The US FDA has recently approved several novel next-generation hormonal therapies for patients with various stages of prostate cancer, giving patients more treatment options. These therapies (e.g., apalutamide, enzalutamide, darolutamide, and abiraterone) have unique side effects t...
Source: Drugs and Aging - February 9, 2021 Category: Geriatrics Source Type: research
Interventions to Reduce Fall-Risk-Increasing Drug Use to Prevent Falls: A Narrative Review of Randomized Trials
ConclusionMost interventions did not reduce FRID use or change fall-related outcomes. Future studies should test “multi-pronged” intervention strategies that simultaneously target both patients and their providers and include more than a single intervention interaction to reduce this modifiable fall risk factor. (Source: Drugs and Aging)
Source: Drugs and Aging - February 5, 2021 Category: Geriatrics Source Type: research
Effect of Antihypertensive and Statin Medication Use on Muscle Performance in Community-Dwelling Older Adults Performing Strength Training
ConclusionOur study showed that statins and ARB usage might affect participant ’s response to strength training. Nevertheless, 6 weeks of training significantly improved muscle strength and performance irrespective of AHTD or statin use. (Source: Drugs and Aging)
Source: Drugs and Aging - February 5, 2021 Category: Geriatrics Source Type: research
Persistence of Effect of Medication Review on Potentially Inappropriate Prescriptions in Older Patients Following Hospital Discharge
ConclusionOur results highlighted a low PIP resumption rate at 6 months and showed that a collaborative medication review is associated with persistent medium-term medication changes. (Source: Drugs and Aging)
Source: Drugs and Aging - January 21, 2021 Category: Geriatrics Source Type: research
Efficacy and Safety of Once-Daily Vibegron for Treatment of Overactive Bladder in Patients Aged ≥65 and ≥75 Years: Subpopulation Analysis from the EMPOWUR Randomized, International, Phase III Study
ConclusionsIn this subpopulation analysis of patients with OAB aged ≥ 65 and ≥ 75 years from the EMPOWUR study, once-daily vibegron 75 mg showed rapid onset and robust efficacy versus placebo and was generally safe and well tolerated, consistent with results from the overall population.Trial RegistrationClinicalTrials.gov identifier NCT03492281; registered April 10, 2018. (Source: Drugs and Aging)
Source: Drugs and Aging - January 20, 2021 Category: Geriatrics Source Type: research
Clinical Considerations Regarding the Use of Thiopurines in Older Patients with Inflammatory Bowel Disease
AbstractThe number of older patients with inflammatory bowel disease (IBD) is increasing due to both improvements in the life expectancy of patients with long-lasting IBD and later onset of the disease. In spite of a less aggressive IBD phenotype, disease management in older patients is hampered by comorbidities and polypharmacy (which increase the risk of drug-related adverse events and errors in medication intake) and also by an increased risk of the infections and malignancies associated with the immunosuppressive drugs that are frequently used to treat IBD. Thiopurines are the most frequently used immunosuppressive dru...
Source: Drugs and Aging - January 13, 2021 Category: Geriatrics Source Type: research
Ethnic Variations in the Quality Use of Medicines in Older Adults: M āori and Non-Māori in Aotearoa New Zealand
AbstractIn Aotearoa New Zealand (NZ), ethnic inequities in health outcomes exist. Non-M āori experience better access to healthcare than Māori, including access to the quality use of medicines. Quality medicines use requires that medicines provide maximal therapeutic benefit with minimal harm. As older adults are more at risk of harm from medicines, and, because inequities are compou nded with age, Māori older adults may be at more risk of medicines-related harm than younger and non-Māori populations. This narrative review examined ethnic variation in the quality use of medicines, including medicines utilisation and as...
Source: Drugs and Aging - January 12, 2021 Category: Geriatrics Source Type: research
Anticholinergic Burden Does Not Influence Delirium Subtype or the Delirium –Mortality Association in Hospitalized Older Adults: Results from a Prospective Cohort Study
ConclusionsACB was not found to be associated with increased delirium of either subtype or to have a demonstrable impact on mortality in delirium. Prior suggestions of links between ACB and mortality in similar populations may be mediated by higher levels of functional dependence, greater levels of residential home residence, or an increased prevalence of dementia in this population. (Source: Drugs and Aging)
Source: Drugs and Aging - January 8, 2021 Category: Geriatrics Source Type: research
