Cardiac warning for donepezil

The TGA has issued an updated safety advisory for the dementia drug donepezil after receiving adverse event reports of cardiac conduction disorders.

In a statement released on 28 February it said Product Information (PI) documents for donepezil are being updated to advise caution in patients with known QTc prolongation or a family history of this condition. The updates also advise caution when donepezil is used in combination with other medicines known to prolong the QTc interval, including:

• class IA antiarrhythmics such as disopyramide
• class III antiarrhythmics such as amiodarone, sotalol
• certain antidepressants such as citalopram, escitalopram, amitriptyline
• other antipsychotics such as phenothiazine derivatives, pimozide, ziprasidone
• certain antibiotics such as clarithromycin, erythromycin, moxifloxacin.

“The cardiac conduction disorders caused by donepezil can be potentially life threatening, so monitoring of cardiac function may be required in at-risk individuals or where this adverse event is suspected,” the TGA statement said.

There have been 18 cases of atrioventricular block, atrioventricular block complete, atrioventricular block second degree, bundle branch block, bifascicular block or Torsades de Pointes associated with donepezil reported to the TGA up to 5 January 2022, it added.

Ketogenic diet shows promise in MS

A ketogenic diet may reduce fatigue and depression in multiple sclerosis, a small study involving 65 people with relapsing-remitting MS has shown.

In findings to be presented at the American Academy of Neurology’s 74th Annual Meeting, researchers from the University of Virginia will show that people who followed a ketogenic diet for six months had reduced body fat and improved quality of life.

In the study, which had no control group, 83% of participants adhered to the diet for the full six month period.

Participants showed improved average physical and mental health scores at the end of the six month period. Scores also improved on the EDSS progression test reducing from 2.3 at baseline to to 1.9 at the end. Improvements were also seen on a six-minute walking test, and participants showed a reduction in pro-inflammatory adipokines and an elevation in anti-inflammatory adipokines while on the diet.

“Our study provides evidence that a ketogenic diet may indeed be safe and beneficial, reducing some symptoms for people with MS, when used over a six-month period,” the study authors concluded.

Male researchers in denial about gender-bias in peer review

Gender disparities will continue in medical and scientific research funding so long as male medical researchers remain in denial about systemic bias in areas such as peer review, an immunologist says.

Dr Jessica Borger says there is clear evidence of gender bias against women in funding application processes such as the NHMRC,  and the problem increases with seniority.

Writing in Women’s Agenda she notes that funding rates for women in the recent 2021 Investigator Grants outcomes were 2–4% lower than those for men, enough to result in noticeable disparities in funding rates.

The bias is inherent in the peer review system and needs to be tackled with gender quotas, she says.

“With more men than women receiving funding in the top bracket, women on average received $500,000 less per grant than the men despite being at the same level of seniority. Ultimately, this means of the few successful senior women retained to do competitive research, are doing so with significantly reduced funds compared to their male counterparts, limiting their future research pathway and forcing women researchers to leave science at early stages of their career,” Dr Borger said.