A bacterial lysate failed to prevent preschool wheeze in a five-year trial

The edition in brief

In the ORBEX trial, 822 children aged 6 to 18 months at high risk of asthma took the oral bacterial lysate OM-85 or placebo for 10 days a month for two years, then were followed for three years off treatment. Wheezing lower respiratory illness was no less common with OM-85 (21% vs 18%; HR 1.16, 95% CI 0.82–1.64). In TRIC-I-HF, 360 patients with symptomatic severe tricuspid regurgitation, mean age 80, did better with transcatheter repair plus medical therapy than with medical therapy alone: win ratio 2.42 at one year, and freedom from death or heart failure admission at three years of 52% versus 21% (HR 0.40). A BMJ individual participant data analysis of 35 randomised trials found escitalopram and amitriptyline lengthened QTc by about 9 and 5 ms over placebo in the first eight weeks, with wide variation between patients, while an aggregate analysis of 139 trials found no rise in early major cardiovascular events. In NOPARK, 52 weeks of nicotinamide riboside in early Parkinson disease left motor and non-motor scores slightly worse than placebo, a difference of 2.7 points on a scale where about 5 points is clinically meaningful.