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Roshini Claire Anthony, 5 days ago

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
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No clear benefits with tight glycaemic control in critically ill children

Jairia Dela Cruz
01 Sep 2018

Tight glycaemic control (TGC) does not yield significant short-term survival gains and risk reductions for infections when compared with a conventional glucose-lowering strategy in critically ill patients in the paediatric intensive care unit, according to a meta-analysis.

Pooled data from five randomized controlled trials of TGC with insulin therapy vs conventional glucose monitoring (CGC) in a total of 3,933 critically ill children—including those who were severely burnt and who underwent cardiac surgery, among others—revealed that TGC had no significant effect on the primary outcome of 30-day mortality rates (odds ratio [OR], 0.99; 95 percent CI, 0.74–1.32; p=0.95). [Pediatr Res 2018;83:930-935]

Results were similar for the secondary outcome of healthcare-associated infections, with rates being slightly lower with TGC but not significantly different vs CGC (OR, 0.80; 0.64–1.00 p=0.05).

Additionally, hypoglycaemia occurred as a major complication of glucose control in all five trials. Children in the TGC group were six times as likely as those in the CGC group to develop the condition (OR, 6.37; 4.41–9.21; p<0.001).

No publication bias was detected among the studies.

The authors pointed out that although TGC may bring clinical benefits in theory, the strategy did not show obvious survival benefits compared with CGC in critically ill children. The null effect may be partially attributed to the heterogeneity of critical degrees of patients.

Meanwhile, the failure to reduce infection rates with TGC was probably due to the complicated condition of the children. “For example, insulin therapy may exert more obvious anti-inflammatory effect in obese or diabetic patients. Discrepancy [between] susceptibility to infection and different antibiotic regimens used in trials may also contribute to this result,” they added.

The results of the present meta-analysis should be interpreted with caution, given the heterogeneity of the included studies, the authors said. Additional investigations with long-term follow-up are also warranted to explore the association of TGC and hypoglycaemia with neurodevelopmental outcomes.

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Most Read Articles
Roshini Claire Anthony, 5 days ago

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
Elvira Manzano, 6 days ago
Treatment with two investigational, oral JAK inhibitors may be beneficial in individuals with moderate‐to‐severe alopecia areata (spot baldness), an autoimmune disease that can cause a lot of anxiety, according to an ongoing phase II study.
4 days ago
Discontinuing the use of tyrosine kinase inhibitors (TKIs) in the treatment of patients with chronic myeloid leukaemia appears to be feasible in real-life clinical practice in the context of close molecular monitoring, a study reports.