News briefs

Further evidence linking diabetes drug to heart problems

Research published by The BMJ adds to evidence that rosiglitazone, used to treat type 2 diabetes, is associated with increased risk of heart problems, especially heart failure. Rosiglitazone, a thiazolidinedione, helps control blood sugar levels in patients with type 2 diabetes, but can also increase the risk of serious heart problems, leading to suspension of its use in Europe and to earlier restrictions in the US. However, conflicting findings have been reported since 2007 of meta‐analyses of studies investigating whether rosiglitazone increases the risk of heart attack. The relevant studies did not have access to individual patient level data from clinical trials, instead relying on summary level data (ie, results reported in publications and clinical trial registries), which are not as reliable for assessing the safety profile of drugs. US researchers have now analysed the results of more than 130 trials, involving more than 48 000 adult patients, that compared rosiglitazone with any control for at least 24 weeks. Individual patient level data were available for 33 of the trials (21 156 patients), analysis of which indicated that rosiglitazone was associated with a 33% higher risk of a composite cardiovascular event (heart attack, heart failure, cardiovascular‐ and non‐cardiovascular‐related death) compared with controls (274 events among 11 837 patients taking rosiglitazone and 219 events among 9319 control patients). In particular, analysis of the 33 trials with individual patient level data yielded higher estimates of the risk of heart attacks than did those of trials reporting patient or summary level data. These findings highlight the potential for differing results to be derived from different types of data, and underline the need for greater clinical trial transparency and data sharing to accurately assess the safety of drugs, say the researchers.

https://www.bmj.com/content/368/bmj.l7078

Mental health‐related tweets associated with crisis referrals

Referrals for patients requiring urgent help to two mental health care providers in London were significantly more frequent on days with a higher than average number of tweets discussing mental health topics, according to an article published in Scientific Reports. Earlier studies had found that social media use, depiction of mental illness in the media, and public discussions about mental health may be associated with negative mental health outcomes. Research has primarily focused on high profile events reported by news media, while associations with references to mental health in social media are less well studied. The researchers compared the number of tweets including keywords associated with two important mental health disorders ― depression and schizophrenia ― with recorded referrals for “crisis episodes”. Between January 2010 and December 2014, 48 691 and 32 689 crisis episodes were respectively recorded by the two mental health providers. On days with a higher than average number of tweets mentioning depression or schizophrenia or showing support for people with either illness, the authors observed a 5–15% increase in the number of people referred with mental health‐related crisis episodes. The authors suggested that the factors underlying these associations should be further investigated, as should whether social media platforms could be monitored by health care services to identify vulnerable groups and predict times of higher risk.

https://www.nature.com/articles/s41598-020-57835-9