Anticoagulation cut events in atrial fibrillation at intermediate stroke risk

The edition in brief

SINGLE-AF randomised 1,803 Korean patients with atrial fibrillation at intermediate stroke risk (CHA2DS2-VASc 1 in men, 2 in women) to a direct oral anticoagulant or none. At 24 months the composite of stroke, systemic embolism, major bleeding or cardiovascular death was 0.5% against 1.5% (hazard ratio 0.31, 95% CI 0.10 to 0.94), with strokes 3 against 10 and similar major bleeding. Event numbers were small and the trial open-label. In US Medicaid data on 21,923 people with epilepsy prescribed hormonal contraception vulnerable to enzyme induction, 32.6% also took an enzyme-inducing antiseizure drug for at least 14 days, with a median overlap of 218 days; intellectual disability, drug-resistant epilepsy and age over 35 raised the odds. In a cohort of 294 people with Parkinson's disease, the most physically active third had slower cognitive and motor decline over up to seven years than the least active, an association rather than proof. The FDA approved a supplement to a generic ethosuximide application in September, an administrative action. The pearl: oestrogen-containing contraception lowers lamotrigine levels, and the pill-free week raises them.