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4 days ago
The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
Tristan Manalac, 3 days ago
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Amino bisphosphonates tied to glucocorticoid discontinuation in polymyalgia rheumatica

03 Apr 2019

Long-term treatment with glucocorticoids (GC) is necessary in polymyalgia rheumatica (PMR), but preliminary data of a study suggests that use of amino bisphosphonates (N-BP) correlates with GC discontinuation in the management of PMR.

The authors retrieved data for 385 patients (mean age, 71 years; 64 percent women; mean initial prednisone dose, 19 mg/day). Median follow-up period was 38 months (range, 9–57). Of the patients, >60 percent were exposed to N-BP.

After a median of 20 months (range, 14–27), 47 percent of patients discontinued use of GC, but 39 percent subsequently restarted. Of the 385 patients, 276 (72 percent) were actively treated at their last available evaluation (mean prednisone dose, 4.9 mg/day), while 123 of 205 (60 percent) patients still received GC after 24 months of follow-up.

An association existed between N-BP use and GC discontinuation (adjusted hazard ratio, 0.66; 95 percent CI, 0.50–0.88), independent of age, initial GC dose and osteoporosis.

“The duration of treatment with GC in PMR is often long-term,” the authors said. “N-BPs are used in PMR for the prevention of GC-induced osteoporosis, but they could also have immunomodulatory properties.”

This study sought to establish whether N-BP use in a PMR cohort might be associated with GC discontinuation. The authors retrospectively reviewed all patients diagnosed with PMR recorded in electronic medical notes. They used Cox regression analyses to examine the relationship between N-BP use and discontinuation of GC.

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Most Read Articles
4 days ago
The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
Tristan Manalac, 3 days ago
Minimally invasive pancreatectomy (MIP) offers a feasible alternative to open pancreatectomy (OP) for the treatment of pancreatic neuroendocrine neoplasms (PNEN), according to a recent Singapore study has found.
Dr. Wong Soon Tee, 17 hours ago
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
Yesterday
The perception that proton pump inhibitors (PPIs) cause multiple serious adverse effects (AEs) is supported by many internists, who then recommend treatment cessation even in patients at high risk for upper gastrointestinal bleeding (UGIB), reveals a study.