Cath Lab Digest

The use of medications intended for the treatment of attention-deficit/hyperactivity disorder (ADHD) by adults increased more rapidly than did use of those medications by children between 2001 and 2010. A US Food and Drug Administration advisory committee on ADHD medication safety stated that >1.5 million adults were taking stimulants in 2005, and nearly 32% of all prescriptions written were for adults. Adults diagnosed with ADHD are typically treated with the stimulant classes methylphenidate and amphetamine and, increasingly, with atomoxetine, a nonstimulant agent.

More open and transparent insurance markets is one goal of the Patient Protection and Affordable Care Act (ACA); by 2014, the act will require private insurers to provide coverage to individuals and small businesses by offering products with more comparable benefits and cost-sharing. The ACA also requires insurers to provide coverage regardless of preexisting health conditions. These and other changes included in the law will allow consumers to shop around for coverage.

After 15 months of therapy with etanercept, a tumor necrosis factor alpha antagonist, patients with juvenile idiopathic arthritis (JIA) who had had low baseline disability scores, prior disease-modifying antirheumatic drug (DMARD) use, and developed JIA at a young age were more likely to have achieved an excellent response, according to results of a recent study [JAMA. 2011;306(21):2340-2347].

Patients with suspected coronary artery disease (CAD) are increasingly being diagnosed using coronary computed tomography angiography (CCTA). This new technology provides anatomic information that differs from the functional information available through stress testing using electrocardiography (ECG). Among Medicare beneficiaries, the number of CCTA procedures has grown from 38,171 in 2006, when the procedure was first reimbursed, to 78,009 in 2008.

Results of a randomized, double-blind, double-dummy, phase 3 study [N Engl J Med. 2011;365(20):1886-1895] found that patients with active lupus who underwent 36 months of maintenance therapy with mycophenolate mofetil after successful treatment with induction therapy have superior maintenance of renal response to therapy and prevention of relapse compared with patients who undergo maintenance therapy with azathioprine.