Here are the stories our MDedge editors across specialties think you need to know about today:
Migraine is often a deciding factor in pregnancy planning
Migraine can significantly influence a woman’s decision to have children, new research shows.
Results from a multicenter study of more than 600 women showed that, among participants with migraine, those who were younger, had menstrual migraine, or had chronic migraine were more likely to decide to not become pregnant.
“Women who avoided pregnancy due to migraine were most concerned that migraine would make raising a child difficult, that the migraine medications they take would have a negative impact on their child’s development, and that their migraine pattern would worsen during or just after pregnancy,” said study investigator Ryotaro Ishii, MD, PhD, a visiting scientist at Mayo Clinic in Phoenix.
The findings were presented at the virtual annual meeting of the American Headache Society. Read more.
FDA approves avelumab as maintenance for urothelial carcinoma
The Food and Drug Administration has approved avelumab (Bavencio) as a maintenance treatment for patients with locally advanced or metastatic urothelial carcinoma (UC) that has not progressed after first-line platinum-containing chemotherapy.
The new maintenance therapy indication for avelumab is based on efficacy demonstrated in the JAVELIN Bladder 100 trial. Results from this trial were presented as part of the American Society of Clinical Oncology virtual scientific program.
The new indication adds to avelumab use in other patient populations, including people with locally advanced or metastatic UC who experience disease progression during or following platinum-containing chemotherapy. The FDA also previously approved avelumab for patients who experienced UC progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. The FDA first approved marketing of avelumab in 2017. Other uses include treatment of metastatic Merkel cell carcinoma and first-line treatment of advanced renal cell carcinoma in combination with axitinib. Read more.
Lifestyle changes may explain skin lesions in pandemic-era patients
Two European prospective case series found no direct association between skin lesions on the hands and feet and SARS-CoV-2 in young people, which raises questions about other contributing factors, such as lockdown conditions, which may be clarified with additional research. The study appeared in JAMA Dermatology.
Meanwhile, data from the American Academy of Dermatology and a recent paper from the British Journal of Dermatology suggest a real association exists, at in least some patients.
“It’s going to be true that most patients with toe lesions are PCR [polymerase chain reaction]-negative because it tends to be a late phenomenon when patients are no longer shedding virus,” explained Lindy P. Fox, MD, professor of dermatology at the University of California, San Francisco, who was not an author of either study. Read more.
Take-home test strips allow drug users to detect fentanyl
Illicit drug users seem to overwhelmingly appreciate being able to use take-home test strips to detect the presence of dangerous fentanyl in opioids and other drugs, a new study finds.
More than 95% said they’d use the inexpensive strips again.
“These tests accurately detect fentanyl in the drug supply, and they can be a valuable addition to other drug prevention strategies,” the study’s lead author and addiction medicine specialist Sukhpreet Klaire, MD, of the British Columbia Center on Substance Use in Vancouver, said in an interview.
Dr. Klaire presented the study findings at the virtual annual meeting of the College on Problems of Drug Dependence. Read more.
New data back use of medical cannabis for epilepsy, pain, anxiety
Two new studies offer positive news about medical cannabis, suggesting that marijuana products improve physical and cognitive symptoms, boost quality of life, and rarely produce signs of problematic use.
In one study, patients with epilepsy who used medical cannabis were nearly half as likely to have needed an emergency department visit within the last 30 days as was a control group. In the other study, just 3 of 54 subjects who used medical cannabis showed signs of possible cannabis use disorder (CUD) over 12 months.
The findings show that “there is improvement in a range of outcome variables, and the adverse effects seem to be minimal, compared to what we might have hypothesized based on the bulk of the literature on the negative effects of cannabis on health outcomes,” cannabis researcher Ziva Cooper, PhD, of the University of California at Los Angeles, said in an interview. Dr. Cooper moderated a session about the studies at the virtual annual meeting of the College on Problems of Drug Dependence. Read more.
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