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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

MeReC Extra 40

The National Prescribing Centre has published MeReC Extra 40 (PDF) which covers the results of recent studies into the benefits of prostate cancer screening, the effect of rosuvastatin on venous thromboembolism (VTE) and the efficacy of clopidogrel in preventing major vascular events in patients with atrial fibrillation.

The first section reviews the results of two studies, one European and one America, that found systematic screening of prostate specific antigen (PSA) with our without a digital rectal examination results in greater detection of prostate cancer. What remains unclear is whether greater detection results in increased survival rates.

A review of results of a recent study of rosuvastatin found a reduced risk of VTE in patients at a low risk of cardiovascular disease when taking rosuvastatin compared to placebo. The interpretation of this study does not support the use of statins for prevention of VTE in the general population.

Lastly, a review of the ACTIVE A study found that the combination of aspirin and clopidogrel reduced major vascular event (stroke, non-central nervous system embolism, myocardial infarction, or death from vascular causes) in patients with atrial fibrillation who were unsuitable for treatment with warfarin. However, this reduction was balanced by an increased risk in major bleeds results in no overall net benefit.

Action: Clinicians who see patients in well man clinics or patients with a history of VTE or atrial fibrillation will find this information useful and informative.

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