Examining the News Affecting Pharmacy & Clinics
December 2015, Vol 3, No 12 - The Vitals

In This Article




Runners Prefer Cheap or MidRange Running Shoes Over Expensive Ones

Inexpensive running shoes are rated better by runners than expensive ones, according to a recent study by researchers at RunRepeat.com, an ad- and cost-free platform geared toward helping runners find running shoes by granting them access to aggregated information on reviews, rankings, and unique product comparisons.

“We did this study to spread the word that ‘the higher the list price the more [the] value’ does not apply to running shoes,” said Jens Jakob Andersen, BSc, lead researcher and Founder/Chief Executive Officer of RunRepeat.com. “Brands have strong incentives to promote high-end running shoes, but our study very clearly outlines that runners buying more expensive running shoes are less satisfied than runners buying mid-range or cheap running shoes.”

Using 134,867 reviews of 391 running shoes representing 24 brands, researchers compared the list price of the running shoes with how well they were rated. The results indicated that a higher list price corresponded with a lower rating, and that the 10 most expensive running shoes (average list price, $181) were rated 8.1% worse than the 10 cheapest running shoes (average list price, $61). Of note, Skechers, Saucony, and Vibram FiveFingers were the top 3 best-rated brands, whereas New Balance, Adidas, and Reebok were the 3 worst-rated brands.

“There is nothing wrong with a company selling premium running shoes, but…it is a problem when a running shoe brand spends massive amounts of money on marketing to promote products [consumers] dislike,” Mr Andersen stated.

These data may be useful to primary care providers when discussing health and wellness with their patients and to address financial concerns that may be associated with starting new exercise programs.

  1. RunRepeat. Expensive running shoes are not better than more affordable running shoes (study). http://runrepeat.com/expensive-running-shoes-are-not-better-than-more-affordable-running-shoes-study. Accessed November 30, 2015.

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Immunotherapy for Patients with Type 1 Diabetes Safe, Long-Lasting

Patients with type 1 diabetes are at risk for serious complications, including heart disease and kidney failure. In the autoimmune disease setting, regulatory T-cells (Tregs) have demonstrated inadequacy, resulting in efforts to reverse autoimmunity and protect insulin-producing β-cells that are remaining in patients with type 1 diabetes by repairing or replacing Tregs.

In a phase 1 trial recently published in Science Translational Medicine, researchers evaluated the safety of using Treg adoptive immunotherapy to replace or repair Tregs in patients with type 1 diabetes, and reported that the therapy was safe and long-lasting. The study included 14 adult patients with type 1 diabetes, who were placed in 4 dosing cohorts and given ex vivo–expanded autologous polyclonal Tregs.

In a subgroup of patients, the adoptively transferred Tregs was long-lasting, and up to 25% of the peak level remained in the circulation for 1 year after the transfer; immune studies revealed transient increases in Tregs in study participants, and a broad Treg phenotype was retained long-term. No cell therapy–related high-grade adverse events or infusion reactions were reported. C-peptide levels persisted ≥2 years after transfer in several patients.

“The ex vivo–expanded polyclonal Tregs were long-lived after transfer and retained a broad Treg phenotype long-term,” explained Jeffrey Bluestone, PhD, Diabetes Center, University of California San Francisco, and colleagues. “Moreover, the therapy was safe, supporting efficacy testing in further trials.” The development of a phase 2 trial to assess the efficacy of the Treg therapy is supported by these results.

Emerging therapies may be of interest to pharmacists and primary care providers to address patient questions as well as to be aware of other treatment options that may become available in the future.

  1. Bluestone JA, Buckner JH, Fitch M, et al. Type 1 diabetes immunotherapy using polyclonal regulatory T cells. Sci Transl Med. 2015;7:315ra189.

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Antibiotic Resistance Extensively Misunderstood, WHO Survey Reveals

Patients are confused about antibiotic resistance, and do not understand how to prevent the growth of this major threat to public health, according to a new survey by the World Health Organization (WHO). The survey included 14 questions on antibiotic use, knowledge of antibiotics, and antibiotic resistance, and was conducted online and in face-to-face interviews.

Of approximately 10,000 people who were surveyed across 12 countries, 64% revealed that although they know antibiotic resistance is an issue that could affect them, they do not understand how it affects them, or what they can do to address it. A total of 64% of respondents reported that antibiotics can treat colds and the flu, despite the fact that antibiotics have no impact on viruses, and roughly 32% thought they should stop taking antibiotics when they feel better, rather than finishing the prescribed treatment course.

Of note, 76% of respondents thought that antibiotic resistance—which occurs when bacteria become resistant to the antibiotics used to treat the infections they cause—occurs when the body becomes resistant to antibiotics.

“The rise of antibiotic resistance is a global health crisis, and governments now recognize it as one of the greatest challenges for public health today. It is reaching dangerously high levels in all parts of the world,” explained Dr Margaret Chan, WHO Director-General, in a statement released by WHO. “Antibiotic resistance is compromising our ability to treat infectious diseases and [is] undermining many advances in medicine.”

WHO asserts that this and other surveys will help WHO and its partners determine key gaps in the public’s understanding of, and misconceptions about how to use, antibiotics to be addressed through the new WHO campaign, “Antibiotics: Handle with care.”

Pharmacists and other primary care providers should take into account this information when they discuss antibiotic resistance with their patients and consider increasing awareness of this serious issue in their community.

  1. World Health Organization. WHO multi-country survey reveals widespread public misunderstanding about antibiotic resistance [news release]. http://who.int/mediacentre/news/releases/2015/antibiotic-resistance/en/#. Published November 16, 2015. Accessed November 17, 2015.

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LABA Combination Not Superior to Tiotropium plus ICS in Black Patients with Asthma

Adding long-acting β-agonists (LABAs) to inhaled corticosteroids (ICSs) did not improve time to asthma exacerbation compared with adding tiotropium to ICSs in black patients with asthma, according to a study published in JAMA.

The multisite, open-label, randomized clinical trial, which was conducted from March 2011 through July 2013 to compare the safety and efficacy of tiotropium versus LABAs when used with ICSs in black adults with asthma, included patients with moderate-to-severe asthma across the United States. The authors of the study also sought to determine whether allelic variation at the Arg16Gly locus of the β2-adrenergic receptor (ADRB2) gene is associated with treatment response.

Eligible patients received ICSs plus once-daily tiotropium (n = 532), or twice-daily LABAs (n = 538), and received follow-up for ≤18 months. The primary outcome measure was time to asthma exacerbation, defined as a deteriorating asthma event that required oral or parenteral corticosteroids, and secondary outcomes included patient-reported outcomes, rescue medication use, and adverse events.

In time to first exacerbation, there was no difference between the trial arms (mean number of exacerbations per person-year, 0.42 vs 0.37 [rate ratio, 0.90; 95% confidence interval {CI}, 0.73-1.11] log-rank; P = .31). Likewise, there were no differences in other patient-reported outcomes. Arg16Gly ADRB2 alleles were not associated with differences in the effect of either combination, tiotropium plus ICS or LABAs plus ICSs (hazard ratio for time to first exacerbation, 0.84 [95% CI, 0.47-1.51] for Arg/Arg vs 0.85 [95% CI, 0.63-1.15] for Arg/Gly or Gly/Gly; P = .97).

These data are important to primary care providers when making treatment decisions in patients with asthma.

  1. Wechsler ME, Yawn BP, Fuhlbrigge AL, et al. Anticholinergic vs long-acting β-agonist in combination with inhaled corticosteroids in black adults with asthma: The BELT randomized controlled trial. JAMA. 2015;314:1720-1730.

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Number of US Retail Clinics Will Exceed 2800 by 2017

By 2017, the number of retail clinics in the United States will exceed 2800, rising 47% since 2014, according to new research by Accenture. Walk-in retail clinics will add capacity for 25 million patient visits in 2017, increasing from 16 million in 2014.

“Retail clinics are shifting to a clinical focus with more sophisticated services for consumers who want walk-in convenience for their basic health needs,” said Kristin Ficery, Managing Director of Health Consulting at Accenture. “This shift provides a release valve for strained health systems, as they prioritize more critical patient cases, and will give consumers another option for addressing their healthcare needs on their own terms.”

Even with this projected growth, however, an Accenture survey of 1000 US physicians found that the clinics could meet some resistance. A total of 41% of respondents said they are comfortable with patients using a retail clinic for preventive care, but not services requiring a more clinical focus.

The number of retail clinics will reach 2150 by the end of 2015, and roughly 2400 in 2016, Accenture estimates.

  1. Accenture. Number of U.S. retail health clinics will surpass 2,800 by 2017, Accenture forecasts [news release]. https://newsroom.accenture.com/news/number-of-us-retail-health-clinics-will-surpass-2800-by-2017-accenture-forecasts.htm. Published November 12, 2015. Accessed November 30, 2015.

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Last modified: December 29, 2015
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