Notable Articles of 2018: Highlights from Editor-in-Chief Jeffrey Drazen
21
October

By Adem Lewis / in , , , , , , , , , /


Hi, everyone. I’m Jeff Drazen, editor of
the New England Journal of Medicine, and I wanted to talk to you about a special
package that we’ve put together of notable articles from the year 2018, and we’ve
picked these because we think they are articles that are really going to change
the practice of medicine. The first of them is about aspirin. Now if you’re like
me, you’ve been treating a lot of patients that are older, and although
they haven’t had a heart attack or a stroke you have them on low-dose aspirin
because the data on the secondary prevention of heart disease and vascular
disease with aspirin have been so compelling. But we really didn’t have
very good data on the primary prevention of heart disease with aspirin. In this
study, nearly 20,000 people who did not have heart disease were recruited from
Australia and the U.S. and were treated either with placebo or a low-dose aspirin.
The primary outcome of the study was all- cause mortality and changes in cognitive
function. At the end of the study period, there was no difference between the two
groups in these two outcomes. In a separate article taken from the same
data, we were also able to show that there was no benefit on cardiovascular
outcomes from this dose of aspirin. So even though it was something that we did, and we
thought had made sense based on the secondary prevention of disease, it didn’t
really work out for the primary prevention of disease. If some of those
patients come back in, you can tell them you know, it’s probably not helping and
it may even hurt you a little bit to be taking that aspirin every day. Those
patients were all quite old. What about the other end of the spectrum? A few
years ago, we published an article on how to prevent peanut allergy in infants, but
what do we do with the people that already have established peanut allergy?
In this study that we published, we were able to show that using a special
regimen of a defatted peanut flour that you could desensitize patients that had
established peanut allergy and that they could safely eat three or four peanuts.
And in this study, 67 percent of the people who had been allergic to peanuts
were able to pass a double-blind placebo-controlled food challenge at the
end, while only 4% of the placebo people were able to pass the study. These are
just two of the dozen articles that are in our collection. We think all of them
are going to change the way you think about patients and the way you practice
medicine, so please, be my guest and take a look at these articles as we explore
how medicine changes over time.


5 thoughts on “Notable Articles of 2018: Highlights from Editor-in-Chief Jeffrey Drazen

  1. My point: have you found any NEJM articles or positions, within the last 18 years, that either belittled oral immunotherapy, or advocated primary prevention with low dose aspirin?

  2. You’re very good in front of the camera. Very clear and a pleasure to listen to. Thank you and everyone involved for this video.

  3. Your videos have been progressive in the publishing world. I made recommendations for our scientific journal but we have yet to implement it because the other guys aren't doctors and don't know about this channel.

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