The prevalence of gout and hyperuricaemia increased in Italy from 2005 to 2009. A high recurrence rate for gout attack was observed during the first year following the first episode. Early management of hyperuricaemia in patients at higher risk of recurrent gout attack should be considered in primary care.

This multicentre, observational, cross-sectional study was conducted to determine migraine prevalence in a sample of population presenting to their GPs. The study covered all the patients who visited the GPs practice, for any reason, on 5 consecutive days of 2 different weeks. A total of 71,588 patients were interviewed by 902 GPs. The prevalence of migraine in this sample was 11.6%.

a b s t r a c tBackground and aims: Despite management guidelines advocating statin/ezetimibe use in very high cardiovascular risk (CV) conditions, adherence to this therapy is still suboptimal and LDL-C target attainment unsatisfactory. We aimed to investigate the level of adherence to statin/ezetimibe and LDL-C target achievement rates in an unselected very high CV risk population in primary care setting in Italy. Methods: We performed a retrospective population-based study using the Health Search IMS Health Longitudinal Patient Database (HSD), including adult patients at very high CV risk, newly treated with statin, ezetimibe or their combination, with 3 and 6 months of follow-up. Results: Although the large majority of patients had previous major CV events (99.9%), only 61% and 55.14% resulted adherent (Proportion of Days Covered, PDC 80%) after 3 and 6 months, respectively. High adherence entailed almost a three times higher probability to reach the therapeutic LDL-C target (3 months: OR ¼ 2.26 [95% [CI]: 1.88 to 2.72]; 6-months: OR ¼ 2.74 [95% CI: 2.27 to 3.31]). The odds to treat to LDL-C target was greater for simvastatin-ezetimibe fixed combination, simvastatin, atorvastatin and rosuvastatin, in decreasing order. Finally, poor adherence was slightly more prevalent among patients treated with less effective statins, and at both low and maximal dosage regimens.Conclusions: This population-based study showed that adherence to statin therapy is poor even among patients who have already experienced a CV event. Failure to achieve recommended LDL-C levels appears imputable to the use of moderate doses and low to standard efficacy statins.

Aims To investigate the effects of glucose‐lowering agents on all‐cause mortality, and cardiovascular and renal outcomes in adults with type 2 diabetes. Methods A MEDLINE and EMBASE search was performed to identify randomized controlled trials, published up to 28 February 2022, with a follow‐up ≥52 weeks, in which glucose‐lowering drugs were compared with either placebo or active comparators. We included only trials reporting formal external adjudication of events. All‐cause mortality, 3‐point MACE (major cardiovascular events), and hospitalization for heart failure (HHF) were considered as principal outcomes. Doubling of serum creatinine, worsening albuminuria, and renal death were considered as secondary endpoints. Results We included randomized controlled trials performed on metformin (n = 17), pioglitazone (n = 20), alpha‐glucosidase inhibitors (n = 9), insulin secretagogues (n = 42), dipeptidyl‐peptidase‐4 inhibitors (n = 67), glucagon‐like peptide‐1 receptor agonists (n = 45) or sodium‐glucose co‐transporter‐2 inhibitors (SGLT‐2i; n = 42) and insulin (n = 18). Glucagon‐like peptide‐1 receptor agonist and SGLT‐2i were associated with a significant reduction in all‐cause mortality [Mantel‐Haenszel odds ratio (MH‐OR), 95% confidence interval: 0.88 (0.83; 0.95) and 0.85 (0.79; 0.91), respectively] and MACE [MH‐OR, 95% confidence interval: 0.89 (0.84; 0.94) and 0.90 (0.84; 0.96), respectively]. SGLT‐2i was associated with a reduced risk of HHF [MH‐OR 0.68 (0.62; 0.75)], worsening albuminuria [MH‐OR 0.67 (0.55; 0.80)] and doubling of serum creatinine [MH‐OR 0.58 (0.44; 0.79)]. Metformin and pioglitazone were associated with a significantly lower risk of MACE [MH‐OR 0.60 (0.47; 0.80) and 0.85 (0.74; 0.97), respectively] and pioglitazone with a higher risk of HHF [MH‐OR 1.30 (1.04; 1.62)]. Insulin secretagogues were associated with increased risk of all‐cause mortality [MH‐OR 1.12 (1.01; 1.24)] and MACE [MH‐OR 1.19 (1.02; 1.39)]. Conclusions The results of this updated meta‐analysis need to be considered in the choice of drug treatment for type 2 diabetes mellitus, which cannot be merely based on the effect of glucose‐lowering drugs on long‐term glycaemic control.

No abstract