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Use of valproate in pregnancy and in women of childbearing age between 2014 and 2018 in Switzerland: a retrospective analysis of Swiss healthcare claims data

Original article
Spoendlin J, Blozik E, Graber S, Rauch M, Marxer C, Rüegg S, Meier C, Winterfeld U, Panchaud A
Swiss Med Wkly. 2021;151:w20386

As in most other European countries, the use of valproate in women of childbearing age in this study was higher than what the authors estimated to be indicated. This study demonstrates the value of electronic claims databases in the evaluation of drug exposure during pregnancy.

COVID-19 and cardiovascular disease: what have we learned?

Viewpoint
Tessitore E, Meyer P
Swiss Med Wkly. 2020;150:w20452

As of 10 December, 82,127 citations were found in PubMed on COVID-19 and 5285 when “COVID-19 and cardiovascular disease” were used as search words. Many cardiovascular societies have also released statements regarding COVID-19. What have we learned from this incredible scientific excitement?

Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs

Original article
Vernaz N, Agoritsas T, Calmy A, Gayet-Ageron A, Gold G, Perrier A, Picard F, Prendki V, Reny JL, Samer C, Stirnemann J, Vetter P, Zanella MC, Zekry D, Baggio S
Swiss Med Wkly. 2020;150:w20446

Prescribing experimental therapies for COVID-19 was not associated with a reduced length of hospital stay and might have increased the pressure put on healthcare systems.

The renin-angiotensin-aldosterone system inhibitors in COVID-19: from acidosis to ventilation and immunity

Viewpoint
Liao WH, Yang GG, Henneberg M
Swiss Med Wkly. 2020;150:w20444

The authors explain mechanisms by which inhibitors of the renin-angiotensin-aldosterone system may increase susceptibility to and the development of cytokine storm during SARS-CoV-2 infection.

Fluoropyrimidine chemotherapy: recommendations for DPYD genotyping and therapeutic drug monitoring of the Swiss Group of Pharmacogenomics and Personalised Therapy

Review article: Medical guidelines
Hamzic S, Aebi S, Joerger M, Montemurro M, Ansari M, Amstutz U, Largiadèr C
Swiss Med Wkly. 2020;150:w20375

The authors discuss current guidelines on genotype-guided fluoropyrimidine dosing and therapeutic drug monitoring, and propose recommendations tailored to the situation in Switzerland to facilitate their clinical uptake for the further individualisation of fluoropyrimidine chemotherapy.

Immune checkpoint inhibitor therapy-associated encephalitis: a case series and review of the literature

Original article
Stuby J, Herren T, Schwegler Naumburger G, Papet C, Rudiger A
Swiss Med Wkly. 2020;150:w20377

Encephalitis should be suspected in patients treated with immune checkpoint inhibitors who present with rapidly evolving confusion. Blood tests, CSF analysis, cerebral MRI and an EEG should be performed. Therapy with intravenous corticosteroids is recommended. Steroid unresponsiveness is rare and should lead to a review of the diagnosis. Alternative treatment options are IVIG, plasma exchange therapy and rituximab.

The prescription retroscope – tools for advocating critical and individualised therapy

Viewpoint
Cook S, Messerli FH
Swiss Med Wkly. 2020;150:w20342

Should we give beta-blockers to all patients after myocardial infarction? Beta-blockers have been clearly shown decrease mortality after myocardial infarction, but this was documented more than a quarter of a century ago, before the current revascularisation era, and has become uncertain at the present. Nowadays, the only ironclad indication for cardioprotection with beta-blockers remains heart failure with reduced ejection fraction, the very indication that half a century ago was the only contraindication for beta-blocker therapy.

Patiromer and medication optimisation in heart failure with reduced ejection fraction: a Swiss perspective

Review article: Biomedical intelligence
Meyer P, Lu H, Hullin R
Swiss Med Wkly. 2020;150:w20362

Despite medical advances, heart failure remains a major public health issue and is associated with considerable morbidity and mortality. Suboptimal use of evidence-based therapies and lack of medication up-titration play important roles in this regard. Hyperkalaemia is a frequent and potentially harmful finding which hinders treatment optimisation in patients with heart failure. In this review, heart failure experts from two Swiss academic hospitals discuss the principles of general pharmacological therapy in heart failure with reduced ejection fraction and the different treatment options for chronic hyperkalaemia, focusing on patiromer, a recently available potassium binder. 

Including adolescents of childbearing potential in clinical trials with possible exposure to teratogenic medication: a challenge for paediatricians and researchers

Review article: Medical guidelines
Michaud PA, Diezi M, Guihard L, Jacot-Guillarmod M, Kleist P, Sprumont D, Wenger P
Swiss Med Wkly. 2020;150:w20333

This article reviews how to address practical and ethical questions regarding minor adolescents of childbearing potential enrolled in a clinical trial that may involve teratogenic medication and offers a series of concrete advice and tools for dealing with problematic situations.

Use of SGLT2 inhibitors in cardiovascular diseases: why, when and how?

Review article: Biomedical intelligence
Lu H, Meyer P, Hullin R
Swiss Med Wkly. 2020;150:w20341

The authors present an up-to-date narrative literature review of the physiological mechanisms of action, current indications, therapeutic utility and side effects of SGLT2 inhibitors.

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