Tom Nolan, clinical editor; sessional GP, Surrey
Tom Nolan reviews this week’s research
Bacterial vaginosis gets couples therapy
Is it time to treat male partners of women with bacterial vaginosis? A trial in the New England Journal of Medicine recruited women with confirmed bacterial vaginosis infection who also had a regular male partner, and randomised them to either receive treatment for the woman and partner or treatment of the woman only. At 12 weeks, 35% of the 69 women in the partner treatment group and 63% of the 68 in the control group had recurrence, causing the trial to be stopped early (absolute reduction in recurrences of −2.6 recurrences per person-year (95% confidence interval −4.0 to −1.2)). Important limitations of the study include that it was unblinded, and partner treatment, which consisted of oral and topical antibiotics, did not include a topical placebo in the control group.
N Engl J Med doi:10.1056/NEJMoa2405404
Multivitamin myocardial methods
TACT2 recently refuted the findings from the original 2013 TACT study, which had unexpectedly found that EDTA chelation and oral multivitamins and multiminerals (OMVM) after myocardial infarction (MI) improved cardiovascular outcomes. The findings from the OMVM versus placebo arm of TACT2 have now been published, with unsurprising findings. Despite containing thousands of times the recommended dietary allowance of compounds such as pantothenic acid and thiamin, the 28 vitamin and mineral cocktail didn’t reduce major cardiovascular events in people with diabetes and a previous MI compared with placebo.
JAMA Intern Med doi:10.1001/jamainternmed.2024.8408
Assessing antidepressant effects of GLP-1 receptor agonists
Glucagon-like peptide-1 (GLP-1) receptor agonists have been suggested as having antidepressant effects. If they do, you might expect that people prescribed a GLP-1 for diabetes would be less likely to subsequently receive a diagnosis of depression compared with those prescribed other, newer diabetes drugs, such as dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter-2 (SGLT2) inhibitors. A target trial emulation study in Annals of Internal Medicine examined US Medicare records to see if this is the case. The study found that those prescribed GLP-1 receptor agonists had a “modestly lower risk for depression” compared with use of DPP-4 inhibitors but not SGLT-2 inhibitors, which seems inconclusive.
Ann Intern Med doi:10.7326/ANNALS-24-01347
Weighting times update
In 2021 there were 1 billion men and 1.11 billion women with overweight or obesity, according to the global burden of disease study. Between 1990 and 2021, rates increased in all regions—and in all nations—and are likely to continue to rise. The study used body mass index (BMI) cut-offs of 25 and 30 for overweight and obesity respectively, rather than region-specific cut-offs, didn’t consider the recently proposed definition of clinical obesity, and didn’t incorporate in its modelling the potential impact (if any) of glucagon-like peptide-1 (GLP1) receptor agonists.
Lancet doi:10.1016/S0140-6736(25)00355-1
I can’t believe it’s not healthy to eat butter
The findings from a new cohort study exploring the association between butter consumption and mortality were enough to put me off my morning toast, not to mention my lunchtime sandwich, and dinner of butter chicken followed by bread and butter pudding. It found a 15% higher risk of mortality over more than 30 years with high butter intake compared with low butter consumption. The researchers modelled the effect of substituting butter with plant based oils and estimated a 17% reduction in mortality from substituting 10 g per day of butter. Hopefully, my preference for a certain leading brand of butter mixed with rapeseed oil will help to spread my risk, as well as the butter.
JAMA Intern Med doi:10.1001/jamainternmed.2025.0205