News in brief: TGA lifts ban on ‘mad cow disease’ blood donors; Bleeding risk particularly high in brain cancer patients; Pendulum swings away from aspirin for primary CVD prevention 

TGA lifts ban on ‘mad cow disease’ blood donors 

Citizens previously considered to be at risk of Creutzfeldt-Jakob disease can now donate blood in Australia following a relaxation of TGA rules.

Since December 2000 people who had spent six months or more in the UK between 1980 and 1996 were prevented from donating blood due to the risk of acquiring human variant Creutzfeldt-Jakob Disease (vCJD).

The TGA confirmed the ban had been lifted.

“This decision, which relates to both blood and plasma products, was based on a detailed evaluation of epidemiological data, the relevant scientific literature and was supported by expert advice,” a spokesperson told the ABC.

“Lifeblood is currently working with its stakeholders on the implementation of this decision.”

Bleeding risk particularly high in brain cancer patients 

Glioblastoma patients are at high risk of venous thromboembolism and major bleeding which in turn is linked to a poor prognosis, researchers report.

Of a cohort of almost 1,000 glioblastoma patients diagnosed between 2004-2020, 101 were diagnosed with venous thromboembolism (VTE), 50 with arterial thromboembolism (ATE)  and 126 with major bleeding during a median follow-up of 15 months. 

The adjusted one year cumulative incidence of venous thromboembolism was 7.5%, arterial thromboembolism 4.1% and major bleeding was 12%, the research team from The Netherlands reported. 

Both VTE and major bleeding was associated with mortality, conferring an adjusted Hazards Ratio of 1.3 and 1.7 respectively. 

Writing in the Journal of Thrombosis and Haemostasis the researchers acknowledged that their findings may not reflect contemporary anticoagulation treatment as the majority of patients in the cohort had received LMWH. 

Nevertheless, for now the  particularly  high  bleeding  incidence could  be  used  as  an  argument  to  “consider  a  limited  duration  of anticoagulant  treatment  (3-6  months,  as  VTE  recurrence  risk  is  highest  during  this  period in glioblastoma patients diagnosed with incident VTE, and to follow ISTH guidance suggesting against routine pharmacological thromboprophylaxis in ambulatory patients,” they argued. 

Pendulum swings away from aspirin for primary CVD prevention

The US Preventive Services Task Force (USPSTF) has tightened its recommendations on the use of aspirin to prevent cardiovascular disease.

It concludes that aspirin use has a small net benefit in the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk, based on a CVD risk calculator.

However aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit given the increasing risk of bleeding with older age.

It said for people who have initiated aspirin use, the net benefits continue to accrue overtime in the absence of a bleeding event.

“The net benefits, however, generally become progressively smaller with advancing age because of an increased risk for bleeding, and modeling data suggest that it may be reasonable to consider stopping aspirin use around age 75 years.”

Read more in JAMA

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