Cardiovascular Research Technologies (CRT)

Is paclitaxel safe in drug-coated balloons and drug-eluting stents used for peripheral artery disease? The experts still don’t know. A panel at CRT on this issued agreed that there is a signal for an increased risk of mortality with paclitaxel-eluting DCBs and DES, but they aren’t sure if it is a real finding or not. They just can’t find the “smoking gun” or a mechanistic explanation. So, they called for more analysis and investigation – and for doctors to inform patients before procedures. Meanwhile, the issue is slowing down use of these devices.

North American Neuromodulation Society (NANS)

The outlook is for spinal cord stimulation implants to increase an average of 9% over the next year. Most use is on-label, but there is growing interest in expanding use for a variety of conditions beyond lower back pain. Among doctors at the meeting, devices from Boston Scientific and Nevro were most commonly used, with a smaller but significant role for Abbott devices. Other than their installed base, Medtronic and Nuvectra seemed to be the losers. Doctors generally agreed the explant rate with Nevro’s Senza is a non-issue. Saluda Medical’s closed-loop system was generating interest, but doctors were reserving their opinion until they see longer term data.

Society Of Critical Care Medicine (SCCM)

The meeting was a good opportunity to gauge the uptake of two new drugs as well as the use of high-flow non-invasive ventilation (HF-NIV), particularly for bronchiolitis. La Jolla Pharmaceutical’s Giapreza is a useful addition to treating distributive shock, but the price is holding back adoption, which should increase as hospitals establish protocols for use. Portola Pharmaceuticals’ Andexxa is also slowly getting on formularies. Again, price is the issue, and restrictive protocols are being established. More availability but not frequent use is expected. Vapotherm and Fisher & Paykel Healthcare are duking it out in the high-flow oxygenation/ventilation area. Both devices are a big improvement over BiPAP, and doctors and patients really like them, but generally they are viewed as interchangeable. Use is mainly in the ICU and should increase.

American Academy Of Cosmetic Surgery (AACS)

Business is booming for most cosmetic surgeons right now, and all procedures appear to be benefiting. As a California doctor explained, “Overall, business is up 13% across the board. There was a good economy last year, and a good economy floats all boats.” However, a Tennessee doctor said their volume is down year-over-year “because of nervousness over the stock market. Politicians are being ridiculous, so patients are reluctant to pay for elective procedures.”

Bulletin: Implications Of The FDA Warning About Mortality With Abiomed's Impella

The FDA issued a safety alert letter to healthcare providers, warning them that the interim results of a postmarketing study of Abiomed’s Impella RP, a temporary, percutaneously-placed right ventricular assist device, showed an increased rate of mortality. Here we look at what that means for use of the device.

Inflammatory Skin Disease Summit (ISDS): Atopic Dermatitis

Early data on three topical agents to treat mild-to-moderate eczema (atopic dermatitis) were presented at the meeting, each with a different method of action. It’s too early to compare them, but any agent that works would be appealing to patients.

Bulletin: American Society Of Hematology (ASH) – Preview

In a web briefing for reporters in advance of the American Society of Hematology (ASH) meeting in San Diego CA December 1-4, 2018, ASH officials highlighted three themes this year – sickle cell disease, CAR T therapies, and big trials with big results – as well as the late-breaking studies they predicted would be most important – and practice-changing. The big focus this year is chronic lymphocytic leukemia (CLL).

Bulletin: Ash Guidelines for VTE

The American Society of Hematology (ASH) has issued new guidelines for venous thromboembolism (VTE). Nearly a million Americans each year develop a deep vein thrombosis (DVT) or pulmonary embolism (PE). The guideline include nearly 150 recommendations. This report summarizes what ASH considers some of the key points from the guidelines.

American College Of Emergency Physicians (ACEP)

Novel oral anticoagulants (NOACs) are increasingly being prescribed, but until a few months ago there wasn’t a specific reversal agent for Factor Xa inhibitors. ACEP was a good opportunity to gauge the enthusiasm for – and uptake of – Portola Pharmaceuticals’ Andexxa. Emergency department physicians said they would like to have Andexxa in their pharmacy, but they are concerned about the cost. On average, doctors predicted they would use Andexxa 2-3 times a month – if it were available. Two new technologies were getting attention at ACEP: Butterfly Network’s iPhone-connected ultrasound, and Genetesis’ CardioFlux, a non-invasive magnetic imaging device to evaluate coronary stenosis in the ED.

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