In this clinical trial, the appetite suppressant sibutramine as compared with placebo resulted in modest weight loss but also in an unexpected increase in the risk of nonfatal myocardial infarction and stroke (a finding limited to patients with preexisting cardiovascular disease). Sibutramine should not be used in patients with cardiovascular disease.

This trial tested whether intensive blood-pressure control retards the progression of chronic kidney disease in black patients with hypertension. Although there was an apparent benefit among patients with baseline proteinuria (urinary protein-to-creatinine ratio, >0.22), those with a normal protein-to-creatinine ratio had no benefit. Among all patients, intensive blood-pressure control had no effect on disease progression.

In a 2-by-2 factorial trial, patients presenting with an acute coronary syndrome and referred for an invasive strategy were randomly assigned to clopidogrel at either a double or a standard loading dose and to aspirin at either a higher or a lower dose. At 30 days, there was no difference for either the clopidogrel or the aspirin dose comparison with respect to the primary outcome of cardiovascular death, myocardial infarction, or stroke.

In this randomized trial, standard primary debulking surgery followed by chemotherapy was compared with neoadjuvant chemotherapy followed by debulking surgery in women with bulky stage IIIC or IV ovarian cancer. Starting treatment with chemotherapy allowed more patients to undergo optimal tumor debulking during the subsequent operation. However, the outcomes were the same regardless of the timing of the debulking operation. Primary chemotherapy is an option in the management of bulky ovarian cancer.