Medical Bulletin 21/December/2023

Here are the top medical news of the day:

Childhood trauma increases risk of chronic pain in adulthood, research to-date highlights

Physical, sexual, or emotional abuse, or neglect, either alone or combined with other types of childhood trauma, increases the risk of chronic pain and related disability in adulthood, according to new research.

These new findings underscore the urgency of addressing adverse childhood experiences (ACEs) – potentially traumatic events that occur before 18 years of age – and taking steps to mitigate their long-term impact on people’s health.

Reference: Childhood trauma increases risk of chronic pain in adulthood, research to-date highlights; European Journal of Psychotraumatology, DOI: 10.1080/20008066.2023.2284025

Common drug for cardiac failure jams a debated blood test for Alzheimer’s disease

Alzheimer’s disease (AD) is associated with damaging protein aggregates in the brain, with β-amyloid (Aβ) aggregates called plaques being the key pathology. Entresto (sacubitril/valsartan) is a combined neprilysin inhibitor and angiotensin receptor blocker, approved for the treatment of heart failure.

Concerns were raised by the FDA that this neprilysin inhibition treatment may increase the risk of AD, since neprilysin is one of the main enzymes responsible for degrading Aβ in the brain. The PERSPECTIVE trial (NCT02884206) showed that 3-year neprilysin inhibition treatment was not associated with increased Aβ accumulation, determined by PET, or with cognitive deterioration, which was reassuring.

Reference: Common drug for cardiac failure jams a debated blood test for Alzheimer’s disease; JAMA Neurology; DOI: 10.1001/jamaneurol.2023.4719

How effective are opioid medications for cancer pain?

Researchers examining the data on opioids for pain caused by cancer have found surprisingly large gaps in evidence regarding the true benefits of these medicines for cancer pain. The review challenges the commonly held view that opioids are the most powerful pain relievers.

The University of Sydney-led review highlights there is no ‘one size fits all’ treatment approach for cancer pain, urging health professionals and patients to carefully weigh up the evidence when deciding on a suitable pain management plan.

Reference: How effective are opioid medications for cancer pain?; CA A Cancer Journal for Clinicians, DOI:10.3322/caac.21823