td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30516
[post_author] => 3387
[post_date] => 2025-09-15 12:20:04
[post_date_gmt] => 2025-09-15 02:20:04
[post_content] => Administered to the nasal mucosa, a spike-based formulation triggers rapid local defences that clear the COVID-19 virus where it enters.
In 2022, a year after Australia’s longest COVID-19 lockdowns, researchers from the Centenary Institute and the University of Sydney received a grant of almost $1 million from the NSW COVID-19 Vaccine Acceleration Research Grants Program to develop an intranasal COVID-19 vaccine.
Now, new research has been released by the team – finding that their formulation can stop infection in the nose before the virus spreads through the body, and to other people.
[caption id="attachment_30517" align="alignright" width="150"]
Dr Erica Stewart, Centenary Institute[/caption]
Australian Pharmacist sat down with Dr Erica Stewart, first author and researcher at the Centenary Institute when the work was undertaken, to discuss how the vaccine works, its applications and why it could be the key to stopping the spread.
What is the vaccine’s mechanism of action?
By acting where the virus first enters, the nasal vaccine prompts a rapid, effective immune response that eliminates the virus, Dr Stewart said.
‘The adjuvant we used was Pam2Cys, a Toll-like receptor 2 (TLR2), and we showed that it was able to stimulate the immune response in the nasal passages,’ she said.
‘We formulated the SARS-CoV-2 spike protein with this adjuvant, which emulates bacteria to alert the immune system that there is a danger and it should respond.’
When administered as a booster after a standard injection, the treatment also provided additional protection to vital organs, including the lungs and brain – pointing to the benefits of focusing immune responses within the upper airways.
Why target the nasal mucosa?
The nasal passage is an increasingly promising site for vaccine adjuvant formulation, Dr Stewart said.
‘It’s becoming more and more clear that the nasal passage is a very different immune environment to an injection in the muscle.’
Internationally, there are some other pre-clinical models of mucosal vaccines. ‘But most of those mucosal vaccines are viral vectors because there aren't a lot of vaccine adjuvants that have been found to be effective nasally, which is part of the novelty of this study,’ she said.
The team had previously looked at intranasal vaccination in mice, using a model where the vaccine entered both the lungs and the nose.
‘However, the main takeaway from this research was, when [administering] a very small volume to just the nose, we still got a really strong immune response in the blood,’ she said. ‘We also looked into the nose itself, and we could see that the immune cells were retained for long periods in the nasal passages, where they will be able to respond to infection quickly.’
There’s hope that these vaccines can potentially prevent infection and transmission by building immune defences directly in the upper airways where the virus first takes hold – a frontier that traditional vaccines have yet to reach.
‘We currently reduce disease severity really well, but we're still trying to block transmission,’ Dr Stewart said. ‘That's what nasal vaccines are aiming to address.’
Who would benefit most from a nasal COVID-19 vaccine?
Vulnerable populations who are more susceptible to severe disease, hospitalisations and death.
‘Sometimes you'll hear people say, “COVID-19 is over” – but people are still dying of it, including the elderly, immunocompromised people and those with other comorbidities,’ Dr Stewart said.
Similar to how younger, healthy patients are advised to get the flu vaccine to protect more vulnerable members of the community – this vaccine offers an additional layer of protection.
‘It would be the vulnerable people who are benefiting, but the vaccine would be for everyone to try to reduce the circulation of the virus in our community,’ she said.
How would the vaccine fit into the routine immunisation schedule?
With most people vaccinated against COVID-19 or exposed to the virus, the mucosal vaccines will likely be used as a booster.
‘In the mouse model, both the vaccine as a booster or as a primary vaccination induced nasal immunity,’ Dr Stewart said.
It’s assumed that the nasal vaccine will be used as an annual seasonal dose, similar to the flu vaccine or COVID-19 boosters for certain populations.
‘We do have some evidence that the vaccine can neutralise against other variants, but [we need to explore] how well it protects people and for how long, because that would indicate whether continuous boosters are needed,’ she said.
It’s also anticipated that the nasal vaccine will be self-administered.
‘There are studies looking into self-administration of nasal vaccines, which could really help with distribution and access to these vaccines in the community,’ she said.
This mode of administration could be particularly beneficial for those who are needlephobic, including children.
‘For people who cannot stand getting a needle, this is a less invasive method of vaccination,’ Dr Stewart said.
The researchers say that while more work is needed, the results show strong potential for nasal vaccines to complement existing COVID-19 vaccines and provide an extra layer of protection against the virus in the future.
[post_title] => Intranasal vaccine stops infection at the source
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => intranasal-vaccine-stops-infection-at-the-source
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-15 13:32:22
[post_modified_gmt] => 2025-09-15 03:32:22
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30516
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Intranasal vaccine stops infection at the source
[title] => Intranasal vaccine stops infection at the source
[href] => https://www.australianpharmacist.com.au/intranasal-vaccine-stops-infection-at-the-source/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30519
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30479
[post_author] => 3410
[post_date] => 2025-09-10 10:42:00
[post_date_gmt] => 2025-09-10 00:42:00
[post_content] => Women of reproductive age using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) could be at risk of unintended pregnancy, and may be unaware of associated risks to pregnancy and unborn babies.
A new study by Flinders University, which examined records from more than 1.6 million women aged 18–49 who attended general practice between 2011 and 2022, found that only one in five (21%) of those with first prescribing of GLP-1 RAs had documented contraceptive use.
The study also found that most prescriptions for GLP-1 RAs are now issued to women without diabetes. In 2022 alone, more than 6,000 women began treatment on GLP-1 RAs, and over 90% of those did not have a type 2 diabetes diagnosis.
[caption id="attachment_30483" align="alignright" width="300"]
Associate Professor Luke Grzeskowiak[/caption]
Participants were tracked at the initial stages of GLP-1 RA therapy, with the research team looking at documented evidence of pregnancies over a 6-month period, said lead author and pharmacist, Associate Professor Luke Grzeskowiak.
‘[While] limited to data from GP records, one in 25 women aged 18 to 34 years had a documented pregnancy at the time of prescribing,’ he said.
‘There will also be pregnancies that the GP might not be aware of, so if anything, what we're expecting is that this is an underestimate of what's truly happening.’
Those who were prescribed concurrent contraception were 50% less likely to have a documented pregnancy.
‘So we've got clear evidence that contraceptive use at the time of initiating these medicines reduces the risk of pregnancies occurring,’ A/Prof Grzeskowiak said.
Why does GLP-1 RA use increase pregnancy risk?
There are two key reasons: first, it is ‘well established’ that weight loss can improve fertility.
‘Because we know these medicines are very effective at promoting weight loss, it's highly plausible that they could improve fertility through that mechanism,’ A/Prof Grzeskowiak said.
There have also been concerns that GLP-1 RAs might impact absorption of the oral contraceptive pill.
In June 2025, the UK’s Medicines and Healthcare products Regulatory Agency issued a regulatory warning following case reports of unexpected pregnancies associated with GLP-1 RA use.
‘A detailed review [revealed] that the strongest evidence was around potential interaction between tirzepatide and reduced effectiveness of oral contraception,’ A/Prof Grzeskowiak said.
To date, evidence regarding interactions between GLP-1 RAs and the oral contraceptive pill is limited.
‘So the general recommendations around that regulatory warning were for those relying on oral contraceptive methods to also consider using a barrier method,’ he said.
What are the congenital risk factors?
The research also considered potential harms associated with GLP-1 RAs in pregnancy. Key concerns were taken from a University of Amsterdam review of animal studies, cited in the Flinders University study.
‘In animals, use of GLP-1 RAs [in pregnancy] led to reductions in foetal growth, impairments in bone development and impaired maternal weight gain,’ A/Prof Grzeskowiak said.
At this stage, the human data are more reassuring.
‘The studies that have been done have not shown an increased risk of birth defects,’ he said. ‘But they are still relatively limited in terms of numbers, and we don't have an examination of the full range of pregnancy outcomes yet,’ he said.
Due to this uncertainty, an abundance of caution is advised.
‘The recommendations are to not use these medicines during pregnancy, and to avoid the potential for them to be used during pregnancy accidentally,’ A/Prof Grzeskowiak said. ‘So it’s important to have a plan around concurrent contraception use, high-quality pre-conception care, and ensure that where pregnancies are planned, everything has been done to optimise pregnancy outcomes.’
What should pharmacists advise patients?
Dispensing GLP-1 RAs provides important opportunities for pharmacists to talk to patients about reproductive health.
For example, when dispensing tirzepatide, access to dispensing data on contraceptive methods enables pharmacists to raise awareness of the potential interaction by initiating an open and unassuming conversation, A/Prof Grzeskowiak said.
‘Having a conversation about how that might be addressed means patients can make an informed decision,’ he said. ‘It might mean changing contraceptive methods or [referring] them back to the GP for a conversation. Or it may be that they're using contraceptives for non-contraceptive purposes such as acne [management], so there’s a low risk of pregnancy.’
The initiation of therapy is the ideal time to discuss potential risks.
‘That way people know what to expect in terms of the medicines,’ he said.
When commencing GLP-1 RAs, patients may also experience profound gastrointestinal adverse effects, including vomiting or diarrhoea.
‘That in itself can reduce the effectiveness of oral contraception, regardless of any other interactions,’ A/Prof Grzeskowiak said. ‘So people should be aware of the side effects of what to expect when starting this and how it might impact on other treatments that they're using.’
Pharmacists have an important role in engaging patients in conversations about reproductive health, particularly contraception.
‘Not everyone feels comfortable asking those questions, but there are good training resources, particularly through PSA, around improving pharmacists’ comfort with having those conversations, including around the different types of contraceptive methods,’ he said.
‘It's one thing to start the conversation, but you also need to be armed with various information to be able to continue it, or at least identify when to refer patients back to their medical practitioner or another [healthcare practitioner] to provide that detailed advice.’
[post_title] => GLP-1 RAs found to pose pregnancy risks
[post_excerpt] => Women of reproductive age using GLP-1 RAs could be at risk of unintended pregnancy, and unaware of the risks to pregnancy and unborn babies.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => glp-1-ras-found-to-pose-pregnancy-risks
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:15:37
[post_modified_gmt] => 2025-09-10 05:15:37
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30479
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => GLP-1 RAs found to pose pregnancy risks
[title] => GLP-1 RAs found to pose pregnancy risks
[href] => https://www.australianpharmacist.com.au/glp-1-ras-found-to-pose-pregnancy-risks/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30482
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30421
[post_author] => 11005
[post_date] => 2025-09-09 14:18:51
[post_date_gmt] => 2025-09-09 04:18:51
[post_content] => In August 2025, I had the privilege of attending the International Pharmaceutical Students’ Federation (IPSF) World Congress in Nairobi, Kenya.
The theme of this year’s congress, Advancing Pharmacy Education and Practice for Global Health Impact, was reflected throughout the week in discussions, panels and workshops.
Thanks to the generous support of PSA and the National Australian Pharmacy Students’ Association (NAPSA), I was able to represent both Australia and New Zealand as the sole Official Delegate at the General Assembly. Without their support, our countries would not have had a voice.
Leaders in training
Before the official start of World Congress, I participated in the Leaders in Training (LiT) program, where I became an Alpha Trainer after reaching the required hours. I ran workshops focused on developing soft skills for future leaders, guiding students through sessions on motivation, feedback and evaluation.
This was a rewarding opportunity to share knowledge, strengthen my own skills, and witness the energy and passion of upcoming leaders.
Once the Congress began, much of my time was spent in the General Assembly, carrying the responsibility of casting votes and ensuring the perspectives of
students from both Australia and New Zealand were heard. Being the only delegate from our area made me realise just how vital the support of PSA and NAPSA was.
Technology and access
Among the many events I attended, one highlight was a panel discussion on the use of AI in healthcare. This session offered a fascinating look at both the opportunities and the challenges of integrating AI into healthcare delivery.
I also gained insight into the industrial pharmacy sector in Kenya, as well as the broader challenges faced by healthcare in Nairobi. These experiences expanded my understanding of the global landscape of pharmacy and reminded me of the inequities that continue to exist in access to medicines and resources.
The Congress also gave me the chance to reconnect with peers from around the world, including those I had previously worked with as NAPSA’s Contact Person. It was valuable to strengthen existing connections and build friendships with students who share the same interest in pharmacy.World Congress was a once-in-a-lifetime experience; one I hope more Australian pharmacy students will pursue in the future.
Start local, go global
IPSF represents over 500,000 pharmacy students worldwide, yet Australia’s presence remains small. I want to change that by encouraging more students to get involved and take advantage of the opportunities IPSF offers.
The first step is to become involved in your local student branch, which can then open doors to national opportunities through NAPSA and, eventually, to international representation.
I still remember attending my first IPSF conference alone and feeling nervous, only to be welcomed immediately by the IPSF Asia Pacific Regional Office (APRO), who embraced me as part of their community. The warmth and inclusivity I experienced then continues to inspire me, and I encourage others to take the same leap.
People want to connect with you, and IPSF provides a space where friendships, networks, and professional growth come naturally.
Looking ahead, the next IPSF events will be the Asia Pacific Pharmaceutical Symposium (APPS) in Indonesia and the World Congress in Thailand. I would strongly encourage pharmacy students to consider attending these future events, as they are transformative experiences that broaden horizons, deepen understanding and build lifelong networks.
Pathways Ahead
I am deeply grateful to PSA for their monumental support in making my attendance possible. With travel costs being high, it would have been impossible for me to attend without their sponsorship.
Because of their generosity, Australia and New Zealand were represented at the General Assembly, and our perspectives contributed to global discussions.
I also want to thank NAPSA for their support, which made it more feasible for me to attend in my role as Official Delegate. Their backing ensured that I was able to fulfil my duties and give our members a voice on the international stage.
Attending World Congress 2025 in Nairobi was an unforgettable experience that strengthened my leadership skills, broadened my understanding of global healthcare, and connected me with pharmacy students from across the world.
Most importantly, it reminded me of the importance of ensuring Australia and New Zealand are active participants in shaping the future of our profession.
To PSA and NAPSA, thank you once again for making this possible. To my fellow pharmacy students, I encourage you to take that first step, get involved, and see where it leads. You might just find yourself representing our country on the world stage one day.
[post_title] => A voice for Australia and New Zealand at IPSF 2025
[post_excerpt] => Australia and New Zealand had a voice at the IPSF World Congress, influencing discussions on education, practice and global health.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => a-voice-for-australia-and-new-zealand-at-ipsf-2025
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:14:40
[post_modified_gmt] => 2025-09-10 05:14:40
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30421
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => A voice for Australia and New Zealand at IPSF 2025
[title] => A voice for Australia and New Zealand at IPSF 2025
[href] => https://www.australianpharmacist.com.au/a-voice-for-australia-and-new-zealand-at-ipsf-2025/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30425
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30472
[post_author] => 250
[post_date] => 2025-09-08 11:03:51
[post_date_gmt] => 2025-09-08 01:03:51
[post_content] => A blistering opening plenary session at the FIP Congress last week has challenged policymakers and health professionals alike to act to slow the advance of antimicrobial resistance (AMR).
Mr Michele Cecchini, Head of Public Health, Organisation for Economic Co-operation and Development (OECD), worked through startling data showing the cost of AMR globally – in dollars, and in years of life lost.
The high price of insufficient action on AMR
The OECD has crunched the numbers, and the statistics are startling.
AMR is currently shortening life expectancy by an average of 1.8 years globally – 1.7 years for people in high-income countries, or 2.5 years for people in low-income countries.
This is represented in 79,000 people dying due to resistant infections across 34 OECD, European Union and European Economic Area counties – corresponding to 2.4 times the number of deaths due to tuberculosis, influenza and HIV/AIDS combined in 2020.
The financial burden on the health system is similarly staggering, with global annual costs totalling $US 412 billion.
Once lost productivity and loss of income costs are added in, this cost balloons to $US 850 billion annually – about the same size of Poland’s economy.
Bold action is required
Modelling by the OECD has shown that meaningful action is achievable – albeit with a substantial price tag.
To reduce AMR-related deaths by 10%, six actions are required:
- All countries need to have national AMR action plans and 60% of countries commit a budget
- 90% of countries should meet WHO’s minimum infection prevention and control programs at a national level
- All countries need to report surveillance data on AMR and antimicrobial use
- Meaningful reduction in antimicrobial use is taken in agrifood systems
- Strengthened actions to prevent and address the discharge of antimicrobials into the environment
- Mechanisms to support research and development to address AMR should be promoted.
The cost of these initiatives globally is estimated to be $US 52 billion annually – equivalent to 0.5% of the global health budget.
‘The World Bank told us this is a rounding error [in the context of health spending]. This is not an amount of money which cannot be mobilised,’ Mr Cecchini said.
These sentiments were echoed by the Danish Minister for the Interior and Health Sophie Løhde.
‘To tackle [AMR], we need to work much closer together, and your role as pharmacists and life science professionals is key,’ said Minister Løhde at the first plenary session of the 2025 FIP world congress last week. ‘We need your expertise to develop new antimicrobials in the most prudent and effective manner, and to inform and educate our citizens when you meet them in pharmacies all over the world.’
The FIP Copenhagen Declaration on Antimicrobial Resistance, signed by 79 organisations – including The Pharmaceutical Society of Australia – took place on 1 September 2025.
The FIP Declaration outlines clear priorities to address AMR, including global partnership building, promoting vaccination and rational antimicrobial use, protecting medicine supply chains, and advancing evidence on stewardship and outcomes.
[post_title] => OECD sounds the alarm on antimicrobial resistance
[post_excerpt] => A blistering session at the FIP Congress challenged policymakers and health professionals to slow the advance of antimicrobial resistance.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => oecd-sounds-the-alarm-on-antimicrobial-resistance
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:38:15
[post_modified_gmt] => 2025-09-08 05:38:15
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30472
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => OECD sounds the alarm on antimicrobial resistance
[title] => OECD sounds the alarm on antimicrobial resistance
[href] => https://www.australianpharmacist.com.au/oecd-sounds-the-alarm-on-antimicrobial-resistance/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30474
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30465
[post_author] => 3410
[post_date] => 2025-09-08 10:22:13
[post_date_gmt] => 2025-09-08 00:22:13
[post_content] => A study led by Flinders University and the Southern Adelaide Local Health Network shows that the anti-rheumatic medicine methotrexate significantly reduces blood pressure in some patients compared with sulfasalazine – the first clear evidence of this effect in patients newly diagnosed with rheumatoid arthritis (RA).
The common autoimmune disease occurs in around one in 100 people, leading to inflammation and pain in the connective tissue of the joints.
The inflammation caused by RA contributes to high blood pressure by damaging blood vessels, prompting rheumatologists to realise that people with RA don't typically die because of their condition, said lead researcher Professor Arduino Mangoni, Head of Pharmacology at Flinders University College of Medicine and Public Health.
[caption id="attachment_30469" align="alignright" width="216"]
Professor Arduino Mangoni[/caption]
‘The main reason people with RA die is because they have a cardiovascular event, such as a myocardial infarction or stroke,’ he said. ‘And this is often because of an excess prevalence of hypertension in these individuals.’
High blood pressure can significantly shorten the life expectancy of people with RA.
‘An epidemiological study quantifying the burden of cardiovascular disease in people with RA concluded that the increased risk imparted by rheumatoid arthritis was similar to diabetes,’ Prof Mangoni added.
What impact did methotrexate have on blood pressure?
Methotrexate is not the only anti-rheumatic medicine that can reduce hypertension, with hydroxychloroquine also being shown to be potentially protective against atherosclerosis, Prof Mangoni said.
‘So we wanted to use the comparator, sulfasalazine, that was still an anti-inflammatory drug [to test in] people with RA, but with very neutral effects on blood pressure,’ he said.
Among patients with RA, the blood pressure of those taking methotrexate differed by an average of 7.4 mmHg compared with people taking sulfasalazine.
‘Most tablets for blood pressure, when given at a moderate to high dose, will have an effect on blood pressure of between 5–10 mmHg – which is normally, at the population level, associated with the reduction in cardiovascular risk of around 10–15%,’ Prof Mangoni said. ‘So by extrapolation, methotrexate compares very well to a traditional antihypertensive medication.’
In patients with RA who don’t have hypertension, methotrexate could also have a preventative effect.
‘That was very well shown in our study, with only a proportion of [participants] having hypertension,’ Prof Mangoni said.
The medicine can also be assumed to lower cardiovascular risk.
‘If there is a positive effect on blood pressure, consequently, you should have a reduced risk of myocardial infarction and stroke, as well as potentially heart failure,’ he said.
Although the impacts of methotrexate on these indications were not specifically tested in the research, the observational results are promising.
‘They are in line with increasing clinical evidence from epidemiological studies that the use of methotrexate is associated with a reduced risk of heart failure, heart attacks and strokes in people with RA,’ Prof Mangoni said.
Is there potential for a new indication?
In people who have both hypertension and RA, there’s a possibility that medicine regimens could change, Prof Mangoni said.
‘The future should address whether the use of methotrexate in this population can allow modification of antihypertensive medications to have a different treatment regimen,’ he said.
‘Methotrexate could also be an adjuvant, but this can only be tested in adequately designed prospective studies.’
Beyond patients with RA, it’s possible that methotrexate might also be indicated for patients with hypertension in the not-too-distant future. But Prof Mangoni concedes this is an ‘increasingly debated topic’.
‘There has only been one study, published 5 years ago, that looks at the effects of low-dose methotrexate on cardiovascular risk in people without RA,’ he said.
‘The idea was that by giving methotrexate to this population that already has a high pro-inflammatory burden, you would actually reduce the risk of atherosclerosis.’
While this study didn’t yield positive results, there are a few reasons behind this that warrant further exploration. The participants in both the intervention and placebo groups did not have particularly high inflammatory markers, and both groups also received folic acid.
‘Folic acid is given together with methotrexate because it has been shown to reduce the toxicity of [the medicine],’ Prof Mangoni said. ‘However, folic acid can also be protective against atherosclerosis. So the fact that it was also given to the placebo arm might have somewhat diluted the protective effects of methotrexate in this trial.’
To best assess the effects in future research, he suggests a trial design comprising three arms: methotrexate plus folic acid, folic acid alone and the placebo group.
‘I suspect that in the future, methotrexate might have value in people without autoimmune diseases, but with a high inflammatory burden,’ he said.
What role does genetics play in the success of therapy?
Another key finding from the research is that methotrexate may not be the right fit for everyone. The medicine has a complex pharmacology, with several mechanisms facilitating its uptake and storage in cells, Prof Mangoni said.
‘Sometimes it is excreted by the cell, so it [reaches] different targets, with each of these targets potentially having genetic variations,’ he said.
Research has shown that there are several genetic polymorphisms that render people more or less responsive to methotrexate in terms of blood pressure reduction.
‘Interestingly, the polymorphisms that we observed [in our research] are different from the polymorphisms that have been previously described,’ Prof Mangoni said.
‘So future research should look for personalised treatment strategies to identify whether these polymorphisms are similar or different to other polymorphisms responsible for blood pressure reduction – and potentially the reduced risk of atherosclerosis.’
In further research, Prof Mangoni is keen to confirm the role of polymorphisms in lowering blood pressure after treatment with methotrexate, with pharmacogenomics determining who is a suitable candidate for the medicine.
‘The idea is to have a comprehensive genetic panel in people who are considered for treatment for methotrexate to determine from the very beginning who is more or less likely to respond,’ he said.
‘The next step is determining whether these polymorphisms could be translated into a non-RA population to see whether this can be tailored to the treatment of methotrexate in these [people].’
[post_title] => Blood pressure benefits seen with methotrexate treatment
[post_excerpt] => New research links methotrexate to a fall in blood pressure. This expert thinks it could lower cardiovascular risk in the general population.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => blood-pressure-benefits-seen-with-methotrexate-treatment
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:37:32
[post_modified_gmt] => 2025-09-08 05:37:32
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30465
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Blood pressure benefits seen with methotrexate treatment
[title] => Blood pressure benefits seen with methotrexate treatment
[href] => https://www.australianpharmacist.com.au/blood-pressure-benefits-seen-with-methotrexate-treatment/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30476
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30516
[post_author] => 3387
[post_date] => 2025-09-15 12:20:04
[post_date_gmt] => 2025-09-15 02:20:04
[post_content] => Administered to the nasal mucosa, a spike-based formulation triggers rapid local defences that clear the COVID-19 virus where it enters.
In 2022, a year after Australia’s longest COVID-19 lockdowns, researchers from the Centenary Institute and the University of Sydney received a grant of almost $1 million from the NSW COVID-19 Vaccine Acceleration Research Grants Program to develop an intranasal COVID-19 vaccine.
Now, new research has been released by the team – finding that their formulation can stop infection in the nose before the virus spreads through the body, and to other people.
[caption id="attachment_30517" align="alignright" width="150"] Dr Erica Stewart, Centenary Institute[/caption]
Australian Pharmacist sat down with Dr Erica Stewart, first author and researcher at the Centenary Institute when the work was undertaken, to discuss how the vaccine works, its applications and why it could be the key to stopping the spread.
What is the vaccine’s mechanism of action?
By acting where the virus first enters, the nasal vaccine prompts a rapid, effective immune response that eliminates the virus, Dr Stewart said.
‘The adjuvant we used was Pam2Cys, a Toll-like receptor 2 (TLR2), and we showed that it was able to stimulate the immune response in the nasal passages,’ she said.
‘We formulated the SARS-CoV-2 spike protein with this adjuvant, which emulates bacteria to alert the immune system that there is a danger and it should respond.’
When administered as a booster after a standard injection, the treatment also provided additional protection to vital organs, including the lungs and brain – pointing to the benefits of focusing immune responses within the upper airways.
Why target the nasal mucosa?
The nasal passage is an increasingly promising site for vaccine adjuvant formulation, Dr Stewart said.
‘It’s becoming more and more clear that the nasal passage is a very different immune environment to an injection in the muscle.’
Internationally, there are some other pre-clinical models of mucosal vaccines. ‘But most of those mucosal vaccines are viral vectors because there aren't a lot of vaccine adjuvants that have been found to be effective nasally, which is part of the novelty of this study,’ she said.
The team had previously looked at intranasal vaccination in mice, using a model where the vaccine entered both the lungs and the nose.
‘However, the main takeaway from this research was, when [administering] a very small volume to just the nose, we still got a really strong immune response in the blood,’ she said. ‘We also looked into the nose itself, and we could see that the immune cells were retained for long periods in the nasal passages, where they will be able to respond to infection quickly.’
There’s hope that these vaccines can potentially prevent infection and transmission by building immune defences directly in the upper airways where the virus first takes hold – a frontier that traditional vaccines have yet to reach.
‘We currently reduce disease severity really well, but we're still trying to block transmission,’ Dr Stewart said. ‘That's what nasal vaccines are aiming to address.’
Who would benefit most from a nasal COVID-19 vaccine?
Vulnerable populations who are more susceptible to severe disease, hospitalisations and death.
‘Sometimes you'll hear people say, “COVID-19 is over” – but people are still dying of it, including the elderly, immunocompromised people and those with other comorbidities,’ Dr Stewart said.
Similar to how younger, healthy patients are advised to get the flu vaccine to protect more vulnerable members of the community – this vaccine offers an additional layer of protection.
‘It would be the vulnerable people who are benefiting, but the vaccine would be for everyone to try to reduce the circulation of the virus in our community,’ she said.
How would the vaccine fit into the routine immunisation schedule?
With most people vaccinated against COVID-19 or exposed to the virus, the mucosal vaccines will likely be used as a booster.
‘In the mouse model, both the vaccine as a booster or as a primary vaccination induced nasal immunity,’ Dr Stewart said.
It’s assumed that the nasal vaccine will be used as an annual seasonal dose, similar to the flu vaccine or COVID-19 boosters for certain populations.
‘We do have some evidence that the vaccine can neutralise against other variants, but [we need to explore] how well it protects people and for how long, because that would indicate whether continuous boosters are needed,’ she said.
It’s also anticipated that the nasal vaccine will be self-administered.
‘There are studies looking into self-administration of nasal vaccines, which could really help with distribution and access to these vaccines in the community,’ she said.
This mode of administration could be particularly beneficial for those who are needlephobic, including children.
‘For people who cannot stand getting a needle, this is a less invasive method of vaccination,’ Dr Stewart said.
The researchers say that while more work is needed, the results show strong potential for nasal vaccines to complement existing COVID-19 vaccines and provide an extra layer of protection against the virus in the future.
[post_title] => Intranasal vaccine stops infection at the source
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => intranasal-vaccine-stops-infection-at-the-source
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-15 13:32:22
[post_modified_gmt] => 2025-09-15 03:32:22
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30516
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Intranasal vaccine stops infection at the source
[title] => Intranasal vaccine stops infection at the source
[href] => https://www.australianpharmacist.com.au/intranasal-vaccine-stops-infection-at-the-source/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30519
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30479
[post_author] => 3410
[post_date] => 2025-09-10 10:42:00
[post_date_gmt] => 2025-09-10 00:42:00
[post_content] => Women of reproductive age using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) could be at risk of unintended pregnancy, and may be unaware of associated risks to pregnancy and unborn babies.
A new study by Flinders University, which examined records from more than 1.6 million women aged 18–49 who attended general practice between 2011 and 2022, found that only one in five (21%) of those with first prescribing of GLP-1 RAs had documented contraceptive use.
The study also found that most prescriptions for GLP-1 RAs are now issued to women without diabetes. In 2022 alone, more than 6,000 women began treatment on GLP-1 RAs, and over 90% of those did not have a type 2 diabetes diagnosis.
[caption id="attachment_30483" align="alignright" width="300"] Associate Professor Luke Grzeskowiak[/caption]
Participants were tracked at the initial stages of GLP-1 RA therapy, with the research team looking at documented evidence of pregnancies over a 6-month period, said lead author and pharmacist, Associate Professor Luke Grzeskowiak.
‘[While] limited to data from GP records, one in 25 women aged 18 to 34 years had a documented pregnancy at the time of prescribing,’ he said.
‘There will also be pregnancies that the GP might not be aware of, so if anything, what we're expecting is that this is an underestimate of what's truly happening.’
Those who were prescribed concurrent contraception were 50% less likely to have a documented pregnancy.
‘So we've got clear evidence that contraceptive use at the time of initiating these medicines reduces the risk of pregnancies occurring,’ A/Prof Grzeskowiak said.
Why does GLP-1 RA use increase pregnancy risk?
There are two key reasons: first, it is ‘well established’ that weight loss can improve fertility.
‘Because we know these medicines are very effective at promoting weight loss, it's highly plausible that they could improve fertility through that mechanism,’ A/Prof Grzeskowiak said.
There have also been concerns that GLP-1 RAs might impact absorption of the oral contraceptive pill.
In June 2025, the UK’s Medicines and Healthcare products Regulatory Agency issued a regulatory warning following case reports of unexpected pregnancies associated with GLP-1 RA use.
‘A detailed review [revealed] that the strongest evidence was around potential interaction between tirzepatide and reduced effectiveness of oral contraception,’ A/Prof Grzeskowiak said.
To date, evidence regarding interactions between GLP-1 RAs and the oral contraceptive pill is limited.
‘So the general recommendations around that regulatory warning were for those relying on oral contraceptive methods to also consider using a barrier method,’ he said.
What are the congenital risk factors?
The research also considered potential harms associated with GLP-1 RAs in pregnancy. Key concerns were taken from a University of Amsterdam review of animal studies, cited in the Flinders University study.
‘In animals, use of GLP-1 RAs [in pregnancy] led to reductions in foetal growth, impairments in bone development and impaired maternal weight gain,’ A/Prof Grzeskowiak said.
At this stage, the human data are more reassuring.
‘The studies that have been done have not shown an increased risk of birth defects,’ he said. ‘But they are still relatively limited in terms of numbers, and we don't have an examination of the full range of pregnancy outcomes yet,’ he said.
Due to this uncertainty, an abundance of caution is advised.
‘The recommendations are to not use these medicines during pregnancy, and to avoid the potential for them to be used during pregnancy accidentally,’ A/Prof Grzeskowiak said. ‘So it’s important to have a plan around concurrent contraception use, high-quality pre-conception care, and ensure that where pregnancies are planned, everything has been done to optimise pregnancy outcomes.’
What should pharmacists advise patients?
Dispensing GLP-1 RAs provides important opportunities for pharmacists to talk to patients about reproductive health.
For example, when dispensing tirzepatide, access to dispensing data on contraceptive methods enables pharmacists to raise awareness of the potential interaction by initiating an open and unassuming conversation, A/Prof Grzeskowiak said.
‘Having a conversation about how that might be addressed means patients can make an informed decision,’ he said. ‘It might mean changing contraceptive methods or [referring] them back to the GP for a conversation. Or it may be that they're using contraceptives for non-contraceptive purposes such as acne [management], so there’s a low risk of pregnancy.’
The initiation of therapy is the ideal time to discuss potential risks.
‘That way people know what to expect in terms of the medicines,’ he said.
When commencing GLP-1 RAs, patients may also experience profound gastrointestinal adverse effects, including vomiting or diarrhoea.
‘That in itself can reduce the effectiveness of oral contraception, regardless of any other interactions,’ A/Prof Grzeskowiak said. ‘So people should be aware of the side effects of what to expect when starting this and how it might impact on other treatments that they're using.’
Pharmacists have an important role in engaging patients in conversations about reproductive health, particularly contraception.
‘Not everyone feels comfortable asking those questions, but there are good training resources, particularly through PSA, around improving pharmacists’ comfort with having those conversations, including around the different types of contraceptive methods,’ he said.
‘It's one thing to start the conversation, but you also need to be armed with various information to be able to continue it, or at least identify when to refer patients back to their medical practitioner or another [healthcare practitioner] to provide that detailed advice.’
[post_title] => GLP-1 RAs found to pose pregnancy risks
[post_excerpt] => Women of reproductive age using GLP-1 RAs could be at risk of unintended pregnancy, and unaware of the risks to pregnancy and unborn babies.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => glp-1-ras-found-to-pose-pregnancy-risks
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:15:37
[post_modified_gmt] => 2025-09-10 05:15:37
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30479
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => GLP-1 RAs found to pose pregnancy risks
[title] => GLP-1 RAs found to pose pregnancy risks
[href] => https://www.australianpharmacist.com.au/glp-1-ras-found-to-pose-pregnancy-risks/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30482
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30421
[post_author] => 11005
[post_date] => 2025-09-09 14:18:51
[post_date_gmt] => 2025-09-09 04:18:51
[post_content] => In August 2025, I had the privilege of attending the International Pharmaceutical Students’ Federation (IPSF) World Congress in Nairobi, Kenya.
The theme of this year’s congress, Advancing Pharmacy Education and Practice for Global Health Impact, was reflected throughout the week in discussions, panels and workshops.
Thanks to the generous support of PSA and the National Australian Pharmacy Students’ Association (NAPSA), I was able to represent both Australia and New Zealand as the sole Official Delegate at the General Assembly. Without their support, our countries would not have had a voice.
Leaders in training
Before the official start of World Congress, I participated in the Leaders in Training (LiT) program, where I became an Alpha Trainer after reaching the required hours. I ran workshops focused on developing soft skills for future leaders, guiding students through sessions on motivation, feedback and evaluation.
This was a rewarding opportunity to share knowledge, strengthen my own skills, and witness the energy and passion of upcoming leaders.
Once the Congress began, much of my time was spent in the General Assembly, carrying the responsibility of casting votes and ensuring the perspectives of
students from both Australia and New Zealand were heard. Being the only delegate from our area made me realise just how vital the support of PSA and NAPSA was.
Technology and access
Among the many events I attended, one highlight was a panel discussion on the use of AI in healthcare. This session offered a fascinating look at both the opportunities and the challenges of integrating AI into healthcare delivery.
I also gained insight into the industrial pharmacy sector in Kenya, as well as the broader challenges faced by healthcare in Nairobi. These experiences expanded my understanding of the global landscape of pharmacy and reminded me of the inequities that continue to exist in access to medicines and resources.
The Congress also gave me the chance to reconnect with peers from around the world, including those I had previously worked with as NAPSA’s Contact Person. It was valuable to strengthen existing connections and build friendships with students who share the same interest in pharmacy.World Congress was a once-in-a-lifetime experience; one I hope more Australian pharmacy students will pursue in the future.
Start local, go global
IPSF represents over 500,000 pharmacy students worldwide, yet Australia’s presence remains small. I want to change that by encouraging more students to get involved and take advantage of the opportunities IPSF offers.
The first step is to become involved in your local student branch, which can then open doors to national opportunities through NAPSA and, eventually, to international representation.
I still remember attending my first IPSF conference alone and feeling nervous, only to be welcomed immediately by the IPSF Asia Pacific Regional Office (APRO), who embraced me as part of their community. The warmth and inclusivity I experienced then continues to inspire me, and I encourage others to take the same leap.
People want to connect with you, and IPSF provides a space where friendships, networks, and professional growth come naturally.
Looking ahead, the next IPSF events will be the Asia Pacific Pharmaceutical Symposium (APPS) in Indonesia and the World Congress in Thailand. I would strongly encourage pharmacy students to consider attending these future events, as they are transformative experiences that broaden horizons, deepen understanding and build lifelong networks.
Pathways Ahead
I am deeply grateful to PSA for their monumental support in making my attendance possible. With travel costs being high, it would have been impossible for me to attend without their sponsorship.
Because of their generosity, Australia and New Zealand were represented at the General Assembly, and our perspectives contributed to global discussions.
I also want to thank NAPSA for their support, which made it more feasible for me to attend in my role as Official Delegate. Their backing ensured that I was able to fulfil my duties and give our members a voice on the international stage.
Attending World Congress 2025 in Nairobi was an unforgettable experience that strengthened my leadership skills, broadened my understanding of global healthcare, and connected me with pharmacy students from across the world.
Most importantly, it reminded me of the importance of ensuring Australia and New Zealand are active participants in shaping the future of our profession.
To PSA and NAPSA, thank you once again for making this possible. To my fellow pharmacy students, I encourage you to take that first step, get involved, and see where it leads. You might just find yourself representing our country on the world stage one day.
[post_title] => A voice for Australia and New Zealand at IPSF 2025
[post_excerpt] => Australia and New Zealand had a voice at the IPSF World Congress, influencing discussions on education, practice and global health.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => a-voice-for-australia-and-new-zealand-at-ipsf-2025
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:14:40
[post_modified_gmt] => 2025-09-10 05:14:40
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30421
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => A voice for Australia and New Zealand at IPSF 2025
[title] => A voice for Australia and New Zealand at IPSF 2025
[href] => https://www.australianpharmacist.com.au/a-voice-for-australia-and-new-zealand-at-ipsf-2025/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30425
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30472
[post_author] => 250
[post_date] => 2025-09-08 11:03:51
[post_date_gmt] => 2025-09-08 01:03:51
[post_content] => A blistering opening plenary session at the FIP Congress last week has challenged policymakers and health professionals alike to act to slow the advance of antimicrobial resistance (AMR).
Mr Michele Cecchini, Head of Public Health, Organisation for Economic Co-operation and Development (OECD), worked through startling data showing the cost of AMR globally – in dollars, and in years of life lost.
The high price of insufficient action on AMR
The OECD has crunched the numbers, and the statistics are startling.
AMR is currently shortening life expectancy by an average of 1.8 years globally – 1.7 years for people in high-income countries, or 2.5 years for people in low-income countries.
This is represented in 79,000 people dying due to resistant infections across 34 OECD, European Union and European Economic Area counties – corresponding to 2.4 times the number of deaths due to tuberculosis, influenza and HIV/AIDS combined in 2020.
The financial burden on the health system is similarly staggering, with global annual costs totalling $US 412 billion.
Once lost productivity and loss of income costs are added in, this cost balloons to $US 850 billion annually – about the same size of Poland’s economy.
Bold action is required
Modelling by the OECD has shown that meaningful action is achievable – albeit with a substantial price tag.
To reduce AMR-related deaths by 10%, six actions are required:
- All countries need to have national AMR action plans and 60% of countries commit a budget
- 90% of countries should meet WHO’s minimum infection prevention and control programs at a national level
- All countries need to report surveillance data on AMR and antimicrobial use
- Meaningful reduction in antimicrobial use is taken in agrifood systems
- Strengthened actions to prevent and address the discharge of antimicrobials into the environment
- Mechanisms to support research and development to address AMR should be promoted.
The cost of these initiatives globally is estimated to be $US 52 billion annually – equivalent to 0.5% of the global health budget.
‘The World Bank told us this is a rounding error [in the context of health spending]. This is not an amount of money which cannot be mobilised,’ Mr Cecchini said.
These sentiments were echoed by the Danish Minister for the Interior and Health Sophie Løhde.
‘To tackle [AMR], we need to work much closer together, and your role as pharmacists and life science professionals is key,’ said Minister Løhde at the first plenary session of the 2025 FIP world congress last week. ‘We need your expertise to develop new antimicrobials in the most prudent and effective manner, and to inform and educate our citizens when you meet them in pharmacies all over the world.’
The FIP Copenhagen Declaration on Antimicrobial Resistance, signed by 79 organisations – including The Pharmaceutical Society of Australia – took place on 1 September 2025.
The FIP Declaration outlines clear priorities to address AMR, including global partnership building, promoting vaccination and rational antimicrobial use, protecting medicine supply chains, and advancing evidence on stewardship and outcomes.
[post_title] => OECD sounds the alarm on antimicrobial resistance
[post_excerpt] => A blistering session at the FIP Congress challenged policymakers and health professionals to slow the advance of antimicrobial resistance.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => oecd-sounds-the-alarm-on-antimicrobial-resistance
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:38:15
[post_modified_gmt] => 2025-09-08 05:38:15
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30472
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => OECD sounds the alarm on antimicrobial resistance
[title] => OECD sounds the alarm on antimicrobial resistance
[href] => https://www.australianpharmacist.com.au/oecd-sounds-the-alarm-on-antimicrobial-resistance/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30474
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30465
[post_author] => 3410
[post_date] => 2025-09-08 10:22:13
[post_date_gmt] => 2025-09-08 00:22:13
[post_content] => A study led by Flinders University and the Southern Adelaide Local Health Network shows that the anti-rheumatic medicine methotrexate significantly reduces blood pressure in some patients compared with sulfasalazine – the first clear evidence of this effect in patients newly diagnosed with rheumatoid arthritis (RA).
The common autoimmune disease occurs in around one in 100 people, leading to inflammation and pain in the connective tissue of the joints.
The inflammation caused by RA contributes to high blood pressure by damaging blood vessels, prompting rheumatologists to realise that people with RA don't typically die because of their condition, said lead researcher Professor Arduino Mangoni, Head of Pharmacology at Flinders University College of Medicine and Public Health.
[caption id="attachment_30469" align="alignright" width="216"] Professor Arduino Mangoni[/caption]
‘The main reason people with RA die is because they have a cardiovascular event, such as a myocardial infarction or stroke,’ he said. ‘And this is often because of an excess prevalence of hypertension in these individuals.’
High blood pressure can significantly shorten the life expectancy of people with RA.
‘An epidemiological study quantifying the burden of cardiovascular disease in people with RA concluded that the increased risk imparted by rheumatoid arthritis was similar to diabetes,’ Prof Mangoni added.
What impact did methotrexate have on blood pressure?
Methotrexate is not the only anti-rheumatic medicine that can reduce hypertension, with hydroxychloroquine also being shown to be potentially protective against atherosclerosis, Prof Mangoni said.
‘So we wanted to use the comparator, sulfasalazine, that was still an anti-inflammatory drug [to test in] people with RA, but with very neutral effects on blood pressure,’ he said.
Among patients with RA, the blood pressure of those taking methotrexate differed by an average of 7.4 mmHg compared with people taking sulfasalazine.
‘Most tablets for blood pressure, when given at a moderate to high dose, will have an effect on blood pressure of between 5–10 mmHg – which is normally, at the population level, associated with the reduction in cardiovascular risk of around 10–15%,’ Prof Mangoni said. ‘So by extrapolation, methotrexate compares very well to a traditional antihypertensive medication.’
In patients with RA who don’t have hypertension, methotrexate could also have a preventative effect.
‘That was very well shown in our study, with only a proportion of [participants] having hypertension,’ Prof Mangoni said.
The medicine can also be assumed to lower cardiovascular risk.
‘If there is a positive effect on blood pressure, consequently, you should have a reduced risk of myocardial infarction and stroke, as well as potentially heart failure,’ he said.
Although the impacts of methotrexate on these indications were not specifically tested in the research, the observational results are promising.
‘They are in line with increasing clinical evidence from epidemiological studies that the use of methotrexate is associated with a reduced risk of heart failure, heart attacks and strokes in people with RA,’ Prof Mangoni said.
Is there potential for a new indication?
In people who have both hypertension and RA, there’s a possibility that medicine regimens could change, Prof Mangoni said.
‘The future should address whether the use of methotrexate in this population can allow modification of antihypertensive medications to have a different treatment regimen,’ he said.
‘Methotrexate could also be an adjuvant, but this can only be tested in adequately designed prospective studies.’
Beyond patients with RA, it’s possible that methotrexate might also be indicated for patients with hypertension in the not-too-distant future. But Prof Mangoni concedes this is an ‘increasingly debated topic’.
‘There has only been one study, published 5 years ago, that looks at the effects of low-dose methotrexate on cardiovascular risk in people without RA,’ he said.
‘The idea was that by giving methotrexate to this population that already has a high pro-inflammatory burden, you would actually reduce the risk of atherosclerosis.’
While this study didn’t yield positive results, there are a few reasons behind this that warrant further exploration. The participants in both the intervention and placebo groups did not have particularly high inflammatory markers, and both groups also received folic acid.
‘Folic acid is given together with methotrexate because it has been shown to reduce the toxicity of [the medicine],’ Prof Mangoni said. ‘However, folic acid can also be protective against atherosclerosis. So the fact that it was also given to the placebo arm might have somewhat diluted the protective effects of methotrexate in this trial.’
To best assess the effects in future research, he suggests a trial design comprising three arms: methotrexate plus folic acid, folic acid alone and the placebo group.
‘I suspect that in the future, methotrexate might have value in people without autoimmune diseases, but with a high inflammatory burden,’ he said.
What role does genetics play in the success of therapy?
Another key finding from the research is that methotrexate may not be the right fit for everyone. The medicine has a complex pharmacology, with several mechanisms facilitating its uptake and storage in cells, Prof Mangoni said.
‘Sometimes it is excreted by the cell, so it [reaches] different targets, with each of these targets potentially having genetic variations,’ he said.
Research has shown that there are several genetic polymorphisms that render people more or less responsive to methotrexate in terms of blood pressure reduction.
‘Interestingly, the polymorphisms that we observed [in our research] are different from the polymorphisms that have been previously described,’ Prof Mangoni said.
‘So future research should look for personalised treatment strategies to identify whether these polymorphisms are similar or different to other polymorphisms responsible for blood pressure reduction – and potentially the reduced risk of atherosclerosis.’
In further research, Prof Mangoni is keen to confirm the role of polymorphisms in lowering blood pressure after treatment with methotrexate, with pharmacogenomics determining who is a suitable candidate for the medicine.
‘The idea is to have a comprehensive genetic panel in people who are considered for treatment for methotrexate to determine from the very beginning who is more or less likely to respond,’ he said.
‘The next step is determining whether these polymorphisms could be translated into a non-RA population to see whether this can be tailored to the treatment of methotrexate in these [people].’
[post_title] => Blood pressure benefits seen with methotrexate treatment
[post_excerpt] => New research links methotrexate to a fall in blood pressure. This expert thinks it could lower cardiovascular risk in the general population.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => blood-pressure-benefits-seen-with-methotrexate-treatment
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:37:32
[post_modified_gmt] => 2025-09-08 05:37:32
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30465
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Blood pressure benefits seen with methotrexate treatment
[title] => Blood pressure benefits seen with methotrexate treatment
[href] => https://www.australianpharmacist.com.au/blood-pressure-benefits-seen-with-methotrexate-treatment/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30476
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30516
[post_author] => 3387
[post_date] => 2025-09-15 12:20:04
[post_date_gmt] => 2025-09-15 02:20:04
[post_content] => Administered to the nasal mucosa, a spike-based formulation triggers rapid local defences that clear the COVID-19 virus where it enters.
In 2022, a year after Australia’s longest COVID-19 lockdowns, researchers from the Centenary Institute and the University of Sydney received a grant of almost $1 million from the NSW COVID-19 Vaccine Acceleration Research Grants Program to develop an intranasal COVID-19 vaccine.
Now, new research has been released by the team – finding that their formulation can stop infection in the nose before the virus spreads through the body, and to other people.
[caption id="attachment_30517" align="alignright" width="150"] Dr Erica Stewart, Centenary Institute[/caption]
Australian Pharmacist sat down with Dr Erica Stewart, first author and researcher at the Centenary Institute when the work was undertaken, to discuss how the vaccine works, its applications and why it could be the key to stopping the spread.
What is the vaccine’s mechanism of action?
By acting where the virus first enters, the nasal vaccine prompts a rapid, effective immune response that eliminates the virus, Dr Stewart said.
‘The adjuvant we used was Pam2Cys, a Toll-like receptor 2 (TLR2), and we showed that it was able to stimulate the immune response in the nasal passages,’ she said.
‘We formulated the SARS-CoV-2 spike protein with this adjuvant, which emulates bacteria to alert the immune system that there is a danger and it should respond.’
When administered as a booster after a standard injection, the treatment also provided additional protection to vital organs, including the lungs and brain – pointing to the benefits of focusing immune responses within the upper airways.
Why target the nasal mucosa?
The nasal passage is an increasingly promising site for vaccine adjuvant formulation, Dr Stewart said.
‘It’s becoming more and more clear that the nasal passage is a very different immune environment to an injection in the muscle.’
Internationally, there are some other pre-clinical models of mucosal vaccines. ‘But most of those mucosal vaccines are viral vectors because there aren't a lot of vaccine adjuvants that have been found to be effective nasally, which is part of the novelty of this study,’ she said.
The team had previously looked at intranasal vaccination in mice, using a model where the vaccine entered both the lungs and the nose.
‘However, the main takeaway from this research was, when [administering] a very small volume to just the nose, we still got a really strong immune response in the blood,’ she said. ‘We also looked into the nose itself, and we could see that the immune cells were retained for long periods in the nasal passages, where they will be able to respond to infection quickly.’
There’s hope that these vaccines can potentially prevent infection and transmission by building immune defences directly in the upper airways where the virus first takes hold – a frontier that traditional vaccines have yet to reach.
‘We currently reduce disease severity really well, but we're still trying to block transmission,’ Dr Stewart said. ‘That's what nasal vaccines are aiming to address.’
Who would benefit most from a nasal COVID-19 vaccine?
Vulnerable populations who are more susceptible to severe disease, hospitalisations and death.
‘Sometimes you'll hear people say, “COVID-19 is over” – but people are still dying of it, including the elderly, immunocompromised people and those with other comorbidities,’ Dr Stewart said.
Similar to how younger, healthy patients are advised to get the flu vaccine to protect more vulnerable members of the community – this vaccine offers an additional layer of protection.
‘It would be the vulnerable people who are benefiting, but the vaccine would be for everyone to try to reduce the circulation of the virus in our community,’ she said.
How would the vaccine fit into the routine immunisation schedule?
With most people vaccinated against COVID-19 or exposed to the virus, the mucosal vaccines will likely be used as a booster.
‘In the mouse model, both the vaccine as a booster or as a primary vaccination induced nasal immunity,’ Dr Stewart said.
It’s assumed that the nasal vaccine will be used as an annual seasonal dose, similar to the flu vaccine or COVID-19 boosters for certain populations.
‘We do have some evidence that the vaccine can neutralise against other variants, but [we need to explore] how well it protects people and for how long, because that would indicate whether continuous boosters are needed,’ she said.
It’s also anticipated that the nasal vaccine will be self-administered.
‘There are studies looking into self-administration of nasal vaccines, which could really help with distribution and access to these vaccines in the community,’ she said.
This mode of administration could be particularly beneficial for those who are needlephobic, including children.
‘For people who cannot stand getting a needle, this is a less invasive method of vaccination,’ Dr Stewart said.
The researchers say that while more work is needed, the results show strong potential for nasal vaccines to complement existing COVID-19 vaccines and provide an extra layer of protection against the virus in the future.
[post_title] => Intranasal vaccine stops infection at the source
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => intranasal-vaccine-stops-infection-at-the-source
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-15 13:32:22
[post_modified_gmt] => 2025-09-15 03:32:22
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30516
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Intranasal vaccine stops infection at the source
[title] => Intranasal vaccine stops infection at the source
[href] => https://www.australianpharmacist.com.au/intranasal-vaccine-stops-infection-at-the-source/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30519
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30479
[post_author] => 3410
[post_date] => 2025-09-10 10:42:00
[post_date_gmt] => 2025-09-10 00:42:00
[post_content] => Women of reproductive age using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) could be at risk of unintended pregnancy, and may be unaware of associated risks to pregnancy and unborn babies.
A new study by Flinders University, which examined records from more than 1.6 million women aged 18–49 who attended general practice between 2011 and 2022, found that only one in five (21%) of those with first prescribing of GLP-1 RAs had documented contraceptive use.
The study also found that most prescriptions for GLP-1 RAs are now issued to women without diabetes. In 2022 alone, more than 6,000 women began treatment on GLP-1 RAs, and over 90% of those did not have a type 2 diabetes diagnosis.
[caption id="attachment_30483" align="alignright" width="300"] Associate Professor Luke Grzeskowiak[/caption]
Participants were tracked at the initial stages of GLP-1 RA therapy, with the research team looking at documented evidence of pregnancies over a 6-month period, said lead author and pharmacist, Associate Professor Luke Grzeskowiak.
‘[While] limited to data from GP records, one in 25 women aged 18 to 34 years had a documented pregnancy at the time of prescribing,’ he said.
‘There will also be pregnancies that the GP might not be aware of, so if anything, what we're expecting is that this is an underestimate of what's truly happening.’
Those who were prescribed concurrent contraception were 50% less likely to have a documented pregnancy.
‘So we've got clear evidence that contraceptive use at the time of initiating these medicines reduces the risk of pregnancies occurring,’ A/Prof Grzeskowiak said.
Why does GLP-1 RA use increase pregnancy risk?
There are two key reasons: first, it is ‘well established’ that weight loss can improve fertility.
‘Because we know these medicines are very effective at promoting weight loss, it's highly plausible that they could improve fertility through that mechanism,’ A/Prof Grzeskowiak said.
There have also been concerns that GLP-1 RAs might impact absorption of the oral contraceptive pill.
In June 2025, the UK’s Medicines and Healthcare products Regulatory Agency issued a regulatory warning following case reports of unexpected pregnancies associated with GLP-1 RA use.
‘A detailed review [revealed] that the strongest evidence was around potential interaction between tirzepatide and reduced effectiveness of oral contraception,’ A/Prof Grzeskowiak said.
To date, evidence regarding interactions between GLP-1 RAs and the oral contraceptive pill is limited.
‘So the general recommendations around that regulatory warning were for those relying on oral contraceptive methods to also consider using a barrier method,’ he said.
What are the congenital risk factors?
The research also considered potential harms associated with GLP-1 RAs in pregnancy. Key concerns were taken from a University of Amsterdam review of animal studies, cited in the Flinders University study.
‘In animals, use of GLP-1 RAs [in pregnancy] led to reductions in foetal growth, impairments in bone development and impaired maternal weight gain,’ A/Prof Grzeskowiak said.
At this stage, the human data are more reassuring.
‘The studies that have been done have not shown an increased risk of birth defects,’ he said. ‘But they are still relatively limited in terms of numbers, and we don't have an examination of the full range of pregnancy outcomes yet,’ he said.
Due to this uncertainty, an abundance of caution is advised.
‘The recommendations are to not use these medicines during pregnancy, and to avoid the potential for them to be used during pregnancy accidentally,’ A/Prof Grzeskowiak said. ‘So it’s important to have a plan around concurrent contraception use, high-quality pre-conception care, and ensure that where pregnancies are planned, everything has been done to optimise pregnancy outcomes.’
What should pharmacists advise patients?
Dispensing GLP-1 RAs provides important opportunities for pharmacists to talk to patients about reproductive health.
For example, when dispensing tirzepatide, access to dispensing data on contraceptive methods enables pharmacists to raise awareness of the potential interaction by initiating an open and unassuming conversation, A/Prof Grzeskowiak said.
‘Having a conversation about how that might be addressed means patients can make an informed decision,’ he said. ‘It might mean changing contraceptive methods or [referring] them back to the GP for a conversation. Or it may be that they're using contraceptives for non-contraceptive purposes such as acne [management], so there’s a low risk of pregnancy.’
The initiation of therapy is the ideal time to discuss potential risks.
‘That way people know what to expect in terms of the medicines,’ he said.
When commencing GLP-1 RAs, patients may also experience profound gastrointestinal adverse effects, including vomiting or diarrhoea.
‘That in itself can reduce the effectiveness of oral contraception, regardless of any other interactions,’ A/Prof Grzeskowiak said. ‘So people should be aware of the side effects of what to expect when starting this and how it might impact on other treatments that they're using.’
Pharmacists have an important role in engaging patients in conversations about reproductive health, particularly contraception.
‘Not everyone feels comfortable asking those questions, but there are good training resources, particularly through PSA, around improving pharmacists’ comfort with having those conversations, including around the different types of contraceptive methods,’ he said.
‘It's one thing to start the conversation, but you also need to be armed with various information to be able to continue it, or at least identify when to refer patients back to their medical practitioner or another [healthcare practitioner] to provide that detailed advice.’
[post_title] => GLP-1 RAs found to pose pregnancy risks
[post_excerpt] => Women of reproductive age using GLP-1 RAs could be at risk of unintended pregnancy, and unaware of the risks to pregnancy and unborn babies.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => glp-1-ras-found-to-pose-pregnancy-risks
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:15:37
[post_modified_gmt] => 2025-09-10 05:15:37
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30479
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => GLP-1 RAs found to pose pregnancy risks
[title] => GLP-1 RAs found to pose pregnancy risks
[href] => https://www.australianpharmacist.com.au/glp-1-ras-found-to-pose-pregnancy-risks/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30482
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30421
[post_author] => 11005
[post_date] => 2025-09-09 14:18:51
[post_date_gmt] => 2025-09-09 04:18:51
[post_content] => In August 2025, I had the privilege of attending the International Pharmaceutical Students’ Federation (IPSF) World Congress in Nairobi, Kenya.
The theme of this year’s congress, Advancing Pharmacy Education and Practice for Global Health Impact, was reflected throughout the week in discussions, panels and workshops.
Thanks to the generous support of PSA and the National Australian Pharmacy Students’ Association (NAPSA), I was able to represent both Australia and New Zealand as the sole Official Delegate at the General Assembly. Without their support, our countries would not have had a voice.
Leaders in training
Before the official start of World Congress, I participated in the Leaders in Training (LiT) program, where I became an Alpha Trainer after reaching the required hours. I ran workshops focused on developing soft skills for future leaders, guiding students through sessions on motivation, feedback and evaluation.
This was a rewarding opportunity to share knowledge, strengthen my own skills, and witness the energy and passion of upcoming leaders.
Once the Congress began, much of my time was spent in the General Assembly, carrying the responsibility of casting votes and ensuring the perspectives of
students from both Australia and New Zealand were heard. Being the only delegate from our area made me realise just how vital the support of PSA and NAPSA was.
Technology and access
Among the many events I attended, one highlight was a panel discussion on the use of AI in healthcare. This session offered a fascinating look at both the opportunities and the challenges of integrating AI into healthcare delivery.
I also gained insight into the industrial pharmacy sector in Kenya, as well as the broader challenges faced by healthcare in Nairobi. These experiences expanded my understanding of the global landscape of pharmacy and reminded me of the inequities that continue to exist in access to medicines and resources.
The Congress also gave me the chance to reconnect with peers from around the world, including those I had previously worked with as NAPSA’s Contact Person. It was valuable to strengthen existing connections and build friendships with students who share the same interest in pharmacy.World Congress was a once-in-a-lifetime experience; one I hope more Australian pharmacy students will pursue in the future.
Start local, go global
IPSF represents over 500,000 pharmacy students worldwide, yet Australia’s presence remains small. I want to change that by encouraging more students to get involved and take advantage of the opportunities IPSF offers.
The first step is to become involved in your local student branch, which can then open doors to national opportunities through NAPSA and, eventually, to international representation.
I still remember attending my first IPSF conference alone and feeling nervous, only to be welcomed immediately by the IPSF Asia Pacific Regional Office (APRO), who embraced me as part of their community. The warmth and inclusivity I experienced then continues to inspire me, and I encourage others to take the same leap.
People want to connect with you, and IPSF provides a space where friendships, networks, and professional growth come naturally.
Looking ahead, the next IPSF events will be the Asia Pacific Pharmaceutical Symposium (APPS) in Indonesia and the World Congress in Thailand. I would strongly encourage pharmacy students to consider attending these future events, as they are transformative experiences that broaden horizons, deepen understanding and build lifelong networks.
Pathways Ahead
I am deeply grateful to PSA for their monumental support in making my attendance possible. With travel costs being high, it would have been impossible for me to attend without their sponsorship.
Because of their generosity, Australia and New Zealand were represented at the General Assembly, and our perspectives contributed to global discussions.
I also want to thank NAPSA for their support, which made it more feasible for me to attend in my role as Official Delegate. Their backing ensured that I was able to fulfil my duties and give our members a voice on the international stage.
Attending World Congress 2025 in Nairobi was an unforgettable experience that strengthened my leadership skills, broadened my understanding of global healthcare, and connected me with pharmacy students from across the world.
Most importantly, it reminded me of the importance of ensuring Australia and New Zealand are active participants in shaping the future of our profession.
To PSA and NAPSA, thank you once again for making this possible. To my fellow pharmacy students, I encourage you to take that first step, get involved, and see where it leads. You might just find yourself representing our country on the world stage one day.
[post_title] => A voice for Australia and New Zealand at IPSF 2025
[post_excerpt] => Australia and New Zealand had a voice at the IPSF World Congress, influencing discussions on education, practice and global health.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => a-voice-for-australia-and-new-zealand-at-ipsf-2025
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:14:40
[post_modified_gmt] => 2025-09-10 05:14:40
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30421
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => A voice for Australia and New Zealand at IPSF 2025
[title] => A voice for Australia and New Zealand at IPSF 2025
[href] => https://www.australianpharmacist.com.au/a-voice-for-australia-and-new-zealand-at-ipsf-2025/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30425
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30472
[post_author] => 250
[post_date] => 2025-09-08 11:03:51
[post_date_gmt] => 2025-09-08 01:03:51
[post_content] => A blistering opening plenary session at the FIP Congress last week has challenged policymakers and health professionals alike to act to slow the advance of antimicrobial resistance (AMR).
Mr Michele Cecchini, Head of Public Health, Organisation for Economic Co-operation and Development (OECD), worked through startling data showing the cost of AMR globally – in dollars, and in years of life lost.
The high price of insufficient action on AMR
The OECD has crunched the numbers, and the statistics are startling.
AMR is currently shortening life expectancy by an average of 1.8 years globally – 1.7 years for people in high-income countries, or 2.5 years for people in low-income countries.
This is represented in 79,000 people dying due to resistant infections across 34 OECD, European Union and European Economic Area counties – corresponding to 2.4 times the number of deaths due to tuberculosis, influenza and HIV/AIDS combined in 2020.
The financial burden on the health system is similarly staggering, with global annual costs totalling $US 412 billion.
Once lost productivity and loss of income costs are added in, this cost balloons to $US 850 billion annually – about the same size of Poland’s economy.
Bold action is required
Modelling by the OECD has shown that meaningful action is achievable – albeit with a substantial price tag.
To reduce AMR-related deaths by 10%, six actions are required:
- All countries need to have national AMR action plans and 60% of countries commit a budget
- 90% of countries should meet WHO’s minimum infection prevention and control programs at a national level
- All countries need to report surveillance data on AMR and antimicrobial use
- Meaningful reduction in antimicrobial use is taken in agrifood systems
- Strengthened actions to prevent and address the discharge of antimicrobials into the environment
- Mechanisms to support research and development to address AMR should be promoted.
The cost of these initiatives globally is estimated to be $US 52 billion annually – equivalent to 0.5% of the global health budget.
‘The World Bank told us this is a rounding error [in the context of health spending]. This is not an amount of money which cannot be mobilised,’ Mr Cecchini said.
These sentiments were echoed by the Danish Minister for the Interior and Health Sophie Løhde.
‘To tackle [AMR], we need to work much closer together, and your role as pharmacists and life science professionals is key,’ said Minister Løhde at the first plenary session of the 2025 FIP world congress last week. ‘We need your expertise to develop new antimicrobials in the most prudent and effective manner, and to inform and educate our citizens when you meet them in pharmacies all over the world.’
The FIP Copenhagen Declaration on Antimicrobial Resistance, signed by 79 organisations – including The Pharmaceutical Society of Australia – took place on 1 September 2025.
The FIP Declaration outlines clear priorities to address AMR, including global partnership building, promoting vaccination and rational antimicrobial use, protecting medicine supply chains, and advancing evidence on stewardship and outcomes.
[post_title] => OECD sounds the alarm on antimicrobial resistance
[post_excerpt] => A blistering session at the FIP Congress challenged policymakers and health professionals to slow the advance of antimicrobial resistance.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => oecd-sounds-the-alarm-on-antimicrobial-resistance
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:38:15
[post_modified_gmt] => 2025-09-08 05:38:15
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30472
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => OECD sounds the alarm on antimicrobial resistance
[title] => OECD sounds the alarm on antimicrobial resistance
[href] => https://www.australianpharmacist.com.au/oecd-sounds-the-alarm-on-antimicrobial-resistance/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30474
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30465
[post_author] => 3410
[post_date] => 2025-09-08 10:22:13
[post_date_gmt] => 2025-09-08 00:22:13
[post_content] => A study led by Flinders University and the Southern Adelaide Local Health Network shows that the anti-rheumatic medicine methotrexate significantly reduces blood pressure in some patients compared with sulfasalazine – the first clear evidence of this effect in patients newly diagnosed with rheumatoid arthritis (RA).
The common autoimmune disease occurs in around one in 100 people, leading to inflammation and pain in the connective tissue of the joints.
The inflammation caused by RA contributes to high blood pressure by damaging blood vessels, prompting rheumatologists to realise that people with RA don't typically die because of their condition, said lead researcher Professor Arduino Mangoni, Head of Pharmacology at Flinders University College of Medicine and Public Health.
[caption id="attachment_30469" align="alignright" width="216"] Professor Arduino Mangoni[/caption]
‘The main reason people with RA die is because they have a cardiovascular event, such as a myocardial infarction or stroke,’ he said. ‘And this is often because of an excess prevalence of hypertension in these individuals.’
High blood pressure can significantly shorten the life expectancy of people with RA.
‘An epidemiological study quantifying the burden of cardiovascular disease in people with RA concluded that the increased risk imparted by rheumatoid arthritis was similar to diabetes,’ Prof Mangoni added.
What impact did methotrexate have on blood pressure?
Methotrexate is not the only anti-rheumatic medicine that can reduce hypertension, with hydroxychloroquine also being shown to be potentially protective against atherosclerosis, Prof Mangoni said.
‘So we wanted to use the comparator, sulfasalazine, that was still an anti-inflammatory drug [to test in] people with RA, but with very neutral effects on blood pressure,’ he said.
Among patients with RA, the blood pressure of those taking methotrexate differed by an average of 7.4 mmHg compared with people taking sulfasalazine.
‘Most tablets for blood pressure, when given at a moderate to high dose, will have an effect on blood pressure of between 5–10 mmHg – which is normally, at the population level, associated with the reduction in cardiovascular risk of around 10–15%,’ Prof Mangoni said. ‘So by extrapolation, methotrexate compares very well to a traditional antihypertensive medication.’
In patients with RA who don’t have hypertension, methotrexate could also have a preventative effect.
‘That was very well shown in our study, with only a proportion of [participants] having hypertension,’ Prof Mangoni said.
The medicine can also be assumed to lower cardiovascular risk.
‘If there is a positive effect on blood pressure, consequently, you should have a reduced risk of myocardial infarction and stroke, as well as potentially heart failure,’ he said.
Although the impacts of methotrexate on these indications were not specifically tested in the research, the observational results are promising.
‘They are in line with increasing clinical evidence from epidemiological studies that the use of methotrexate is associated with a reduced risk of heart failure, heart attacks and strokes in people with RA,’ Prof Mangoni said.
Is there potential for a new indication?
In people who have both hypertension and RA, there’s a possibility that medicine regimens could change, Prof Mangoni said.
‘The future should address whether the use of methotrexate in this population can allow modification of antihypertensive medications to have a different treatment regimen,’ he said.
‘Methotrexate could also be an adjuvant, but this can only be tested in adequately designed prospective studies.’
Beyond patients with RA, it’s possible that methotrexate might also be indicated for patients with hypertension in the not-too-distant future. But Prof Mangoni concedes this is an ‘increasingly debated topic’.
‘There has only been one study, published 5 years ago, that looks at the effects of low-dose methotrexate on cardiovascular risk in people without RA,’ he said.
‘The idea was that by giving methotrexate to this population that already has a high pro-inflammatory burden, you would actually reduce the risk of atherosclerosis.’
While this study didn’t yield positive results, there are a few reasons behind this that warrant further exploration. The participants in both the intervention and placebo groups did not have particularly high inflammatory markers, and both groups also received folic acid.
‘Folic acid is given together with methotrexate because it has been shown to reduce the toxicity of [the medicine],’ Prof Mangoni said. ‘However, folic acid can also be protective against atherosclerosis. So the fact that it was also given to the placebo arm might have somewhat diluted the protective effects of methotrexate in this trial.’
To best assess the effects in future research, he suggests a trial design comprising three arms: methotrexate plus folic acid, folic acid alone and the placebo group.
‘I suspect that in the future, methotrexate might have value in people without autoimmune diseases, but with a high inflammatory burden,’ he said.
What role does genetics play in the success of therapy?
Another key finding from the research is that methotrexate may not be the right fit for everyone. The medicine has a complex pharmacology, with several mechanisms facilitating its uptake and storage in cells, Prof Mangoni said.
‘Sometimes it is excreted by the cell, so it [reaches] different targets, with each of these targets potentially having genetic variations,’ he said.
Research has shown that there are several genetic polymorphisms that render people more or less responsive to methotrexate in terms of blood pressure reduction.
‘Interestingly, the polymorphisms that we observed [in our research] are different from the polymorphisms that have been previously described,’ Prof Mangoni said.
‘So future research should look for personalised treatment strategies to identify whether these polymorphisms are similar or different to other polymorphisms responsible for blood pressure reduction – and potentially the reduced risk of atherosclerosis.’
In further research, Prof Mangoni is keen to confirm the role of polymorphisms in lowering blood pressure after treatment with methotrexate, with pharmacogenomics determining who is a suitable candidate for the medicine.
‘The idea is to have a comprehensive genetic panel in people who are considered for treatment for methotrexate to determine from the very beginning who is more or less likely to respond,’ he said.
‘The next step is determining whether these polymorphisms could be translated into a non-RA population to see whether this can be tailored to the treatment of methotrexate in these [people].’
[post_title] => Blood pressure benefits seen with methotrexate treatment
[post_excerpt] => New research links methotrexate to a fall in blood pressure. This expert thinks it could lower cardiovascular risk in the general population.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => blood-pressure-benefits-seen-with-methotrexate-treatment
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:37:32
[post_modified_gmt] => 2025-09-08 05:37:32
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30465
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Blood pressure benefits seen with methotrexate treatment
[title] => Blood pressure benefits seen with methotrexate treatment
[href] => https://www.australianpharmacist.com.au/blood-pressure-benefits-seen-with-methotrexate-treatment/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30476
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30516
[post_author] => 3387
[post_date] => 2025-09-15 12:20:04
[post_date_gmt] => 2025-09-15 02:20:04
[post_content] => Administered to the nasal mucosa, a spike-based formulation triggers rapid local defences that clear the COVID-19 virus where it enters.
In 2022, a year after Australia’s longest COVID-19 lockdowns, researchers from the Centenary Institute and the University of Sydney received a grant of almost $1 million from the NSW COVID-19 Vaccine Acceleration Research Grants Program to develop an intranasal COVID-19 vaccine.
Now, new research has been released by the team – finding that their formulation can stop infection in the nose before the virus spreads through the body, and to other people.
[caption id="attachment_30517" align="alignright" width="150"] Dr Erica Stewart, Centenary Institute[/caption]
Australian Pharmacist sat down with Dr Erica Stewart, first author and researcher at the Centenary Institute when the work was undertaken, to discuss how the vaccine works, its applications and why it could be the key to stopping the spread.
What is the vaccine’s mechanism of action?
By acting where the virus first enters, the nasal vaccine prompts a rapid, effective immune response that eliminates the virus, Dr Stewart said.
‘The adjuvant we used was Pam2Cys, a Toll-like receptor 2 (TLR2), and we showed that it was able to stimulate the immune response in the nasal passages,’ she said.
‘We formulated the SARS-CoV-2 spike protein with this adjuvant, which emulates bacteria to alert the immune system that there is a danger and it should respond.’
When administered as a booster after a standard injection, the treatment also provided additional protection to vital organs, including the lungs and brain – pointing to the benefits of focusing immune responses within the upper airways.
Why target the nasal mucosa?
The nasal passage is an increasingly promising site for vaccine adjuvant formulation, Dr Stewart said.
‘It’s becoming more and more clear that the nasal passage is a very different immune environment to an injection in the muscle.’
Internationally, there are some other pre-clinical models of mucosal vaccines. ‘But most of those mucosal vaccines are viral vectors because there aren't a lot of vaccine adjuvants that have been found to be effective nasally, which is part of the novelty of this study,’ she said.
The team had previously looked at intranasal vaccination in mice, using a model where the vaccine entered both the lungs and the nose.
‘However, the main takeaway from this research was, when [administering] a very small volume to just the nose, we still got a really strong immune response in the blood,’ she said. ‘We also looked into the nose itself, and we could see that the immune cells were retained for long periods in the nasal passages, where they will be able to respond to infection quickly.’
There’s hope that these vaccines can potentially prevent infection and transmission by building immune defences directly in the upper airways where the virus first takes hold – a frontier that traditional vaccines have yet to reach.
‘We currently reduce disease severity really well, but we're still trying to block transmission,’ Dr Stewart said. ‘That's what nasal vaccines are aiming to address.’
Who would benefit most from a nasal COVID-19 vaccine?
Vulnerable populations who are more susceptible to severe disease, hospitalisations and death.
‘Sometimes you'll hear people say, “COVID-19 is over” – but people are still dying of it, including the elderly, immunocompromised people and those with other comorbidities,’ Dr Stewart said.
Similar to how younger, healthy patients are advised to get the flu vaccine to protect more vulnerable members of the community – this vaccine offers an additional layer of protection.
‘It would be the vulnerable people who are benefiting, but the vaccine would be for everyone to try to reduce the circulation of the virus in our community,’ she said.
How would the vaccine fit into the routine immunisation schedule?
With most people vaccinated against COVID-19 or exposed to the virus, the mucosal vaccines will likely be used as a booster.
‘In the mouse model, both the vaccine as a booster or as a primary vaccination induced nasal immunity,’ Dr Stewart said.
It’s assumed that the nasal vaccine will be used as an annual seasonal dose, similar to the flu vaccine or COVID-19 boosters for certain populations.
‘We do have some evidence that the vaccine can neutralise against other variants, but [we need to explore] how well it protects people and for how long, because that would indicate whether continuous boosters are needed,’ she said.
It’s also anticipated that the nasal vaccine will be self-administered.
‘There are studies looking into self-administration of nasal vaccines, which could really help with distribution and access to these vaccines in the community,’ she said.
This mode of administration could be particularly beneficial for those who are needlephobic, including children.
‘For people who cannot stand getting a needle, this is a less invasive method of vaccination,’ Dr Stewart said.
The researchers say that while more work is needed, the results show strong potential for nasal vaccines to complement existing COVID-19 vaccines and provide an extra layer of protection against the virus in the future.
[post_title] => Intranasal vaccine stops infection at the source
[post_excerpt] =>
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => intranasal-vaccine-stops-infection-at-the-source
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-15 13:32:22
[post_modified_gmt] => 2025-09-15 03:32:22
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30516
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Intranasal vaccine stops infection at the source
[title] => Intranasal vaccine stops infection at the source
[href] => https://www.australianpharmacist.com.au/intranasal-vaccine-stops-infection-at-the-source/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30519
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30479
[post_author] => 3410
[post_date] => 2025-09-10 10:42:00
[post_date_gmt] => 2025-09-10 00:42:00
[post_content] => Women of reproductive age using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) could be at risk of unintended pregnancy, and may be unaware of associated risks to pregnancy and unborn babies.
A new study by Flinders University, which examined records from more than 1.6 million women aged 18–49 who attended general practice between 2011 and 2022, found that only one in five (21%) of those with first prescribing of GLP-1 RAs had documented contraceptive use.
The study also found that most prescriptions for GLP-1 RAs are now issued to women without diabetes. In 2022 alone, more than 6,000 women began treatment on GLP-1 RAs, and over 90% of those did not have a type 2 diabetes diagnosis.
[caption id="attachment_30483" align="alignright" width="300"] Associate Professor Luke Grzeskowiak[/caption]
Participants were tracked at the initial stages of GLP-1 RA therapy, with the research team looking at documented evidence of pregnancies over a 6-month period, said lead author and pharmacist, Associate Professor Luke Grzeskowiak.
‘[While] limited to data from GP records, one in 25 women aged 18 to 34 years had a documented pregnancy at the time of prescribing,’ he said.
‘There will also be pregnancies that the GP might not be aware of, so if anything, what we're expecting is that this is an underestimate of what's truly happening.’
Those who were prescribed concurrent contraception were 50% less likely to have a documented pregnancy.
‘So we've got clear evidence that contraceptive use at the time of initiating these medicines reduces the risk of pregnancies occurring,’ A/Prof Grzeskowiak said.
Why does GLP-1 RA use increase pregnancy risk?
There are two key reasons: first, it is ‘well established’ that weight loss can improve fertility.
‘Because we know these medicines are very effective at promoting weight loss, it's highly plausible that they could improve fertility through that mechanism,’ A/Prof Grzeskowiak said.
There have also been concerns that GLP-1 RAs might impact absorption of the oral contraceptive pill.
In June 2025, the UK’s Medicines and Healthcare products Regulatory Agency issued a regulatory warning following case reports of unexpected pregnancies associated with GLP-1 RA use.
‘A detailed review [revealed] that the strongest evidence was around potential interaction between tirzepatide and reduced effectiveness of oral contraception,’ A/Prof Grzeskowiak said.
To date, evidence regarding interactions between GLP-1 RAs and the oral contraceptive pill is limited.
‘So the general recommendations around that regulatory warning were for those relying on oral contraceptive methods to also consider using a barrier method,’ he said.
What are the congenital risk factors?
The research also considered potential harms associated with GLP-1 RAs in pregnancy. Key concerns were taken from a University of Amsterdam review of animal studies, cited in the Flinders University study.
‘In animals, use of GLP-1 RAs [in pregnancy] led to reductions in foetal growth, impairments in bone development and impaired maternal weight gain,’ A/Prof Grzeskowiak said.
At this stage, the human data are more reassuring.
‘The studies that have been done have not shown an increased risk of birth defects,’ he said. ‘But they are still relatively limited in terms of numbers, and we don't have an examination of the full range of pregnancy outcomes yet,’ he said.
Due to this uncertainty, an abundance of caution is advised.
‘The recommendations are to not use these medicines during pregnancy, and to avoid the potential for them to be used during pregnancy accidentally,’ A/Prof Grzeskowiak said. ‘So it’s important to have a plan around concurrent contraception use, high-quality pre-conception care, and ensure that where pregnancies are planned, everything has been done to optimise pregnancy outcomes.’
What should pharmacists advise patients?
Dispensing GLP-1 RAs provides important opportunities for pharmacists to talk to patients about reproductive health.
For example, when dispensing tirzepatide, access to dispensing data on contraceptive methods enables pharmacists to raise awareness of the potential interaction by initiating an open and unassuming conversation, A/Prof Grzeskowiak said.
‘Having a conversation about how that might be addressed means patients can make an informed decision,’ he said. ‘It might mean changing contraceptive methods or [referring] them back to the GP for a conversation. Or it may be that they're using contraceptives for non-contraceptive purposes such as acne [management], so there’s a low risk of pregnancy.’
The initiation of therapy is the ideal time to discuss potential risks.
‘That way people know what to expect in terms of the medicines,’ he said.
When commencing GLP-1 RAs, patients may also experience profound gastrointestinal adverse effects, including vomiting or diarrhoea.
‘That in itself can reduce the effectiveness of oral contraception, regardless of any other interactions,’ A/Prof Grzeskowiak said. ‘So people should be aware of the side effects of what to expect when starting this and how it might impact on other treatments that they're using.’
Pharmacists have an important role in engaging patients in conversations about reproductive health, particularly contraception.
‘Not everyone feels comfortable asking those questions, but there are good training resources, particularly through PSA, around improving pharmacists’ comfort with having those conversations, including around the different types of contraceptive methods,’ he said.
‘It's one thing to start the conversation, but you also need to be armed with various information to be able to continue it, or at least identify when to refer patients back to their medical practitioner or another [healthcare practitioner] to provide that detailed advice.’
[post_title] => GLP-1 RAs found to pose pregnancy risks
[post_excerpt] => Women of reproductive age using GLP-1 RAs could be at risk of unintended pregnancy, and unaware of the risks to pregnancy and unborn babies.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => glp-1-ras-found-to-pose-pregnancy-risks
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:15:37
[post_modified_gmt] => 2025-09-10 05:15:37
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30479
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => GLP-1 RAs found to pose pregnancy risks
[title] => GLP-1 RAs found to pose pregnancy risks
[href] => https://www.australianpharmacist.com.au/glp-1-ras-found-to-pose-pregnancy-risks/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30482
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30421
[post_author] => 11005
[post_date] => 2025-09-09 14:18:51
[post_date_gmt] => 2025-09-09 04:18:51
[post_content] => In August 2025, I had the privilege of attending the International Pharmaceutical Students’ Federation (IPSF) World Congress in Nairobi, Kenya.
The theme of this year’s congress, Advancing Pharmacy Education and Practice for Global Health Impact, was reflected throughout the week in discussions, panels and workshops.
Thanks to the generous support of PSA and the National Australian Pharmacy Students’ Association (NAPSA), I was able to represent both Australia and New Zealand as the sole Official Delegate at the General Assembly. Without their support, our countries would not have had a voice.
Leaders in training
Before the official start of World Congress, I participated in the Leaders in Training (LiT) program, where I became an Alpha Trainer after reaching the required hours. I ran workshops focused on developing soft skills for future leaders, guiding students through sessions on motivation, feedback and evaluation.
This was a rewarding opportunity to share knowledge, strengthen my own skills, and witness the energy and passion of upcoming leaders.
Once the Congress began, much of my time was spent in the General Assembly, carrying the responsibility of casting votes and ensuring the perspectives of
students from both Australia and New Zealand were heard. Being the only delegate from our area made me realise just how vital the support of PSA and NAPSA was.
Technology and access
Among the many events I attended, one highlight was a panel discussion on the use of AI in healthcare. This session offered a fascinating look at both the opportunities and the challenges of integrating AI into healthcare delivery.
I also gained insight into the industrial pharmacy sector in Kenya, as well as the broader challenges faced by healthcare in Nairobi. These experiences expanded my understanding of the global landscape of pharmacy and reminded me of the inequities that continue to exist in access to medicines and resources.
The Congress also gave me the chance to reconnect with peers from around the world, including those I had previously worked with as NAPSA’s Contact Person. It was valuable to strengthen existing connections and build friendships with students who share the same interest in pharmacy.World Congress was a once-in-a-lifetime experience; one I hope more Australian pharmacy students will pursue in the future.
Start local, go global
IPSF represents over 500,000 pharmacy students worldwide, yet Australia’s presence remains small. I want to change that by encouraging more students to get involved and take advantage of the opportunities IPSF offers.
The first step is to become involved in your local student branch, which can then open doors to national opportunities through NAPSA and, eventually, to international representation.
I still remember attending my first IPSF conference alone and feeling nervous, only to be welcomed immediately by the IPSF Asia Pacific Regional Office (APRO), who embraced me as part of their community. The warmth and inclusivity I experienced then continues to inspire me, and I encourage others to take the same leap.
People want to connect with you, and IPSF provides a space where friendships, networks, and professional growth come naturally.
Looking ahead, the next IPSF events will be the Asia Pacific Pharmaceutical Symposium (APPS) in Indonesia and the World Congress in Thailand. I would strongly encourage pharmacy students to consider attending these future events, as they are transformative experiences that broaden horizons, deepen understanding and build lifelong networks.
Pathways Ahead
I am deeply grateful to PSA for their monumental support in making my attendance possible. With travel costs being high, it would have been impossible for me to attend without their sponsorship.
Because of their generosity, Australia and New Zealand were represented at the General Assembly, and our perspectives contributed to global discussions.
I also want to thank NAPSA for their support, which made it more feasible for me to attend in my role as Official Delegate. Their backing ensured that I was able to fulfil my duties and give our members a voice on the international stage.
Attending World Congress 2025 in Nairobi was an unforgettable experience that strengthened my leadership skills, broadened my understanding of global healthcare, and connected me with pharmacy students from across the world.
Most importantly, it reminded me of the importance of ensuring Australia and New Zealand are active participants in shaping the future of our profession.
To PSA and NAPSA, thank you once again for making this possible. To my fellow pharmacy students, I encourage you to take that first step, get involved, and see where it leads. You might just find yourself representing our country on the world stage one day.
[post_title] => A voice for Australia and New Zealand at IPSF 2025
[post_excerpt] => Australia and New Zealand had a voice at the IPSF World Congress, influencing discussions on education, practice and global health.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => a-voice-for-australia-and-new-zealand-at-ipsf-2025
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-10 15:14:40
[post_modified_gmt] => 2025-09-10 05:14:40
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30421
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => A voice for Australia and New Zealand at IPSF 2025
[title] => A voice for Australia and New Zealand at IPSF 2025
[href] => https://www.australianpharmacist.com.au/a-voice-for-australia-and-new-zealand-at-ipsf-2025/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30425
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30472
[post_author] => 250
[post_date] => 2025-09-08 11:03:51
[post_date_gmt] => 2025-09-08 01:03:51
[post_content] => A blistering opening plenary session at the FIP Congress last week has challenged policymakers and health professionals alike to act to slow the advance of antimicrobial resistance (AMR).
Mr Michele Cecchini, Head of Public Health, Organisation for Economic Co-operation and Development (OECD), worked through startling data showing the cost of AMR globally – in dollars, and in years of life lost.
The high price of insufficient action on AMR
The OECD has crunched the numbers, and the statistics are startling.
AMR is currently shortening life expectancy by an average of 1.8 years globally – 1.7 years for people in high-income countries, or 2.5 years for people in low-income countries.
This is represented in 79,000 people dying due to resistant infections across 34 OECD, European Union and European Economic Area counties – corresponding to 2.4 times the number of deaths due to tuberculosis, influenza and HIV/AIDS combined in 2020.
The financial burden on the health system is similarly staggering, with global annual costs totalling $US 412 billion.
Once lost productivity and loss of income costs are added in, this cost balloons to $US 850 billion annually – about the same size of Poland’s economy.
Bold action is required
Modelling by the OECD has shown that meaningful action is achievable – albeit with a substantial price tag.
To reduce AMR-related deaths by 10%, six actions are required:
- All countries need to have national AMR action plans and 60% of countries commit a budget
- 90% of countries should meet WHO’s minimum infection prevention and control programs at a national level
- All countries need to report surveillance data on AMR and antimicrobial use
- Meaningful reduction in antimicrobial use is taken in agrifood systems
- Strengthened actions to prevent and address the discharge of antimicrobials into the environment
- Mechanisms to support research and development to address AMR should be promoted.
The cost of these initiatives globally is estimated to be $US 52 billion annually – equivalent to 0.5% of the global health budget.
‘The World Bank told us this is a rounding error [in the context of health spending]. This is not an amount of money which cannot be mobilised,’ Mr Cecchini said.
These sentiments were echoed by the Danish Minister for the Interior and Health Sophie Løhde.
‘To tackle [AMR], we need to work much closer together, and your role as pharmacists and life science professionals is key,’ said Minister Løhde at the first plenary session of the 2025 FIP world congress last week. ‘We need your expertise to develop new antimicrobials in the most prudent and effective manner, and to inform and educate our citizens when you meet them in pharmacies all over the world.’
The FIP Copenhagen Declaration on Antimicrobial Resistance, signed by 79 organisations – including The Pharmaceutical Society of Australia – took place on 1 September 2025.
The FIP Declaration outlines clear priorities to address AMR, including global partnership building, promoting vaccination and rational antimicrobial use, protecting medicine supply chains, and advancing evidence on stewardship and outcomes.
[post_title] => OECD sounds the alarm on antimicrobial resistance
[post_excerpt] => A blistering session at the FIP Congress challenged policymakers and health professionals to slow the advance of antimicrobial resistance.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => oecd-sounds-the-alarm-on-antimicrobial-resistance
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:38:15
[post_modified_gmt] => 2025-09-08 05:38:15
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30472
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => OECD sounds the alarm on antimicrobial resistance
[title] => OECD sounds the alarm on antimicrobial resistance
[href] => https://www.australianpharmacist.com.au/oecd-sounds-the-alarm-on-antimicrobial-resistance/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30474
[authorType] =>
)
td_module_mega_menu Object
(
[post] => WP_Post Object
(
[ID] => 30465
[post_author] => 3410
[post_date] => 2025-09-08 10:22:13
[post_date_gmt] => 2025-09-08 00:22:13
[post_content] => A study led by Flinders University and the Southern Adelaide Local Health Network shows that the anti-rheumatic medicine methotrexate significantly reduces blood pressure in some patients compared with sulfasalazine – the first clear evidence of this effect in patients newly diagnosed with rheumatoid arthritis (RA).
The common autoimmune disease occurs in around one in 100 people, leading to inflammation and pain in the connective tissue of the joints.
The inflammation caused by RA contributes to high blood pressure by damaging blood vessels, prompting rheumatologists to realise that people with RA don't typically die because of their condition, said lead researcher Professor Arduino Mangoni, Head of Pharmacology at Flinders University College of Medicine and Public Health.
[caption id="attachment_30469" align="alignright" width="216"] Professor Arduino Mangoni[/caption]
‘The main reason people with RA die is because they have a cardiovascular event, such as a myocardial infarction or stroke,’ he said. ‘And this is often because of an excess prevalence of hypertension in these individuals.’
High blood pressure can significantly shorten the life expectancy of people with RA.
‘An epidemiological study quantifying the burden of cardiovascular disease in people with RA concluded that the increased risk imparted by rheumatoid arthritis was similar to diabetes,’ Prof Mangoni added.
What impact did methotrexate have on blood pressure?
Methotrexate is not the only anti-rheumatic medicine that can reduce hypertension, with hydroxychloroquine also being shown to be potentially protective against atherosclerosis, Prof Mangoni said.
‘So we wanted to use the comparator, sulfasalazine, that was still an anti-inflammatory drug [to test in] people with RA, but with very neutral effects on blood pressure,’ he said.
Among patients with RA, the blood pressure of those taking methotrexate differed by an average of 7.4 mmHg compared with people taking sulfasalazine.
‘Most tablets for blood pressure, when given at a moderate to high dose, will have an effect on blood pressure of between 5–10 mmHg – which is normally, at the population level, associated with the reduction in cardiovascular risk of around 10–15%,’ Prof Mangoni said. ‘So by extrapolation, methotrexate compares very well to a traditional antihypertensive medication.’
In patients with RA who don’t have hypertension, methotrexate could also have a preventative effect.
‘That was very well shown in our study, with only a proportion of [participants] having hypertension,’ Prof Mangoni said.
The medicine can also be assumed to lower cardiovascular risk.
‘If there is a positive effect on blood pressure, consequently, you should have a reduced risk of myocardial infarction and stroke, as well as potentially heart failure,’ he said.
Although the impacts of methotrexate on these indications were not specifically tested in the research, the observational results are promising.
‘They are in line with increasing clinical evidence from epidemiological studies that the use of methotrexate is associated with a reduced risk of heart failure, heart attacks and strokes in people with RA,’ Prof Mangoni said.
Is there potential for a new indication?
In people who have both hypertension and RA, there’s a possibility that medicine regimens could change, Prof Mangoni said.
‘The future should address whether the use of methotrexate in this population can allow modification of antihypertensive medications to have a different treatment regimen,’ he said.
‘Methotrexate could also be an adjuvant, but this can only be tested in adequately designed prospective studies.’
Beyond patients with RA, it’s possible that methotrexate might also be indicated for patients with hypertension in the not-too-distant future. But Prof Mangoni concedes this is an ‘increasingly debated topic’.
‘There has only been one study, published 5 years ago, that looks at the effects of low-dose methotrexate on cardiovascular risk in people without RA,’ he said.
‘The idea was that by giving methotrexate to this population that already has a high pro-inflammatory burden, you would actually reduce the risk of atherosclerosis.’
While this study didn’t yield positive results, there are a few reasons behind this that warrant further exploration. The participants in both the intervention and placebo groups did not have particularly high inflammatory markers, and both groups also received folic acid.
‘Folic acid is given together with methotrexate because it has been shown to reduce the toxicity of [the medicine],’ Prof Mangoni said. ‘However, folic acid can also be protective against atherosclerosis. So the fact that it was also given to the placebo arm might have somewhat diluted the protective effects of methotrexate in this trial.’
To best assess the effects in future research, he suggests a trial design comprising three arms: methotrexate plus folic acid, folic acid alone and the placebo group.
‘I suspect that in the future, methotrexate might have value in people without autoimmune diseases, but with a high inflammatory burden,’ he said.
What role does genetics play in the success of therapy?
Another key finding from the research is that methotrexate may not be the right fit for everyone. The medicine has a complex pharmacology, with several mechanisms facilitating its uptake and storage in cells, Prof Mangoni said.
‘Sometimes it is excreted by the cell, so it [reaches] different targets, with each of these targets potentially having genetic variations,’ he said.
Research has shown that there are several genetic polymorphisms that render people more or less responsive to methotrexate in terms of blood pressure reduction.
‘Interestingly, the polymorphisms that we observed [in our research] are different from the polymorphisms that have been previously described,’ Prof Mangoni said.
‘So future research should look for personalised treatment strategies to identify whether these polymorphisms are similar or different to other polymorphisms responsible for blood pressure reduction – and potentially the reduced risk of atherosclerosis.’
In further research, Prof Mangoni is keen to confirm the role of polymorphisms in lowering blood pressure after treatment with methotrexate, with pharmacogenomics determining who is a suitable candidate for the medicine.
‘The idea is to have a comprehensive genetic panel in people who are considered for treatment for methotrexate to determine from the very beginning who is more or less likely to respond,’ he said.
‘The next step is determining whether these polymorphisms could be translated into a non-RA population to see whether this can be tailored to the treatment of methotrexate in these [people].’
[post_title] => Blood pressure benefits seen with methotrexate treatment
[post_excerpt] => New research links methotrexate to a fall in blood pressure. This expert thinks it could lower cardiovascular risk in the general population.
[post_status] => publish
[comment_status] => open
[ping_status] => open
[post_password] =>
[post_name] => blood-pressure-benefits-seen-with-methotrexate-treatment
[to_ping] =>
[pinged] =>
[post_modified] => 2025-09-08 15:37:32
[post_modified_gmt] => 2025-09-08 05:37:32
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://www.australianpharmacist.com.au/?p=30465
[menu_order] => 0
[post_type] => post
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[title_attribute] => Blood pressure benefits seen with methotrexate treatment
[title] => Blood pressure benefits seen with methotrexate treatment
[href] => https://www.australianpharmacist.com.au/blood-pressure-benefits-seen-with-methotrexate-treatment/
[module_atts:td_module:private] => Array
(
)
[td_review:protected] => Array
(
)
[is_review:protected] =>
[post_thumb_id:protected] => 30476
[authorType] =>
)
Get your weekly dose of the news and research you need to help advance your practice.
Protected by Google reCAPTCHA v3.
Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
