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06 Dec 2018
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First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
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Psoriasis carries increased risk of serious infection

11 Aug 2018

Patients with psoriasis are at risk of developing serious infection, with the severity of disease predicting greater infection risk, a study suggests.

The study used data from The Health Improvement Network (THIN) cohort and included 187,258 with mild disease, 12,442 with moderate-to-severe disease and 954,315 randomly selected controls (mean age 49.9 years; 44.3 percent male) without psoriasis. Disease severity was determined based on treatment patterns.

Patients with the skin condition (mild and moderate-to-severe disease groups: mean age 46.6 years; 48.4 percent male) were younger and more likely to be current or past smokers. Those more severe psoriasis also had higher body mass index (BMI) and were more likely to have received systemic corticosteroids.

Serious infections, such as those of the lower respiratory tract, skin and soft tissue, and upper respiratory tract, occurred more frequently in the two psoriasis vs control groups (5.4 percent vs 5.0 percent). The incidence was highest among patients with moderate-to-severe disease (7.5 percent vs 5.2 percent among those with mild disease).

Cox proportional hazards regression revealed psoriasis to be associated with an increased risk of serious infection (mild disease: hazard ratio [HR], 1.18; 95 percent CI, 1.16–1.21; moderate-to-severe disease: HR, 1.63; 1.52–1.75).

Similar results were obtained from a nested case–control analysis of 8,569 psoriasis patients in the iHOPE cohort, with disease severity classified by body surface area involvement. The HRs for serious infection were 1.21 (1.09–1.35) among psoriasis patients overall, 1.16 (0.99-1.35) in the mild disease group and 1.27 (1.10-1.47) in the moderate-to-severe disease group.

Overall, the risks of opportunistic infection and herpes zoster were significantly increased only in the moderate-to-severe disease group vs controls and were associated with immunosuppressive therapy.

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Most Read Articles
06 Dec 2018
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
Pearl Toh, Yesterday
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
6 days ago
Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
4 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.