Most Read Articles
24 Jun 2015
Persistent sleepless nights can take their toll on sufferers, and leave some insomniacs gasping for a caffeine hit just to get them through the morning slog.
01 Sep 2013
Centella asiatica methanol extract is a promising agent in skin care, a study shows.
14 Jan 2018
Patients with a first episode of Clostridium difficile infection (CDI) are likely to respond to treatment with fidaxomicin with no recurrences, a recent study has shown. On the other hand, those with prior CDI episodes are less likely to respond, especially with >1 prior episode, and more likely to recur, which suggests a greater clinical benefit of fidaxomicin earlier in the course of CDI.
01 Aug 2012

Proper use of family planning methods is the key to preventing unplanned preg­nancies. Despite the great effort spent in the research and development of contra­ceptive methods resulting in many new advances, none of the current methods is 100% effective. Emergency contraception (EC), also called ‘postcoital contraception’, is a back-up contraception adminis­tered to a woman after unprotected sexual intercourse (UPSI) or contraceptive failure, so as to prevent unplanned pregnancy. This may be indicated when unexpected intercourse has occurred without the use of any contraception, when there is a sus­pected potential failure of one’s regular contraceptive method (eg, condom break­age or slippage, missed dose of hormonal contraceptive, or potential failure of an intrauterine contraceptive device), or after sexual assault.

TNFi effectiveness: nonradiographic axial spondyloarthritis vs ankylosing spondylitis

27 Jan 2017

Subjective disease activity is higher in patients with nonradiographic axial spondyloarthritis (nr-axSpA) at start of tumour necrosis factor inhibitor (TNFi) treatment, but outcomes are similar to patients with ankylosing spondylitis (AS) after adjusting for confounders, according to a nationwide cohort study.

In addition, HLA-B27 positivity is associated with better outcomes regardless of axSpA subdiagnosis.

Researchers conducted an observational cohort study based on data from the nationwide DANBIO registry to compare baseline disease activity and treatment effectiveness in biologic-naïve patients with nr-axSpA and AS who started TNFi treatment, as well as to analyse the role of potential confounders (sex/age/start yr/HLA-B27/disease duration/TNFi-type/smoking/baseline disease activity).

Kaplan-Meier plots, Cox and logistic regression analyses were used to assess the effect of diagnosis (nr-axSpA vs AS) and potential confounders on TNFi adherence and response (eg, Bath Ankylosing Spondylitis Activity Index [BASDAI] 50 percent/20 mm).

At TNFi initiation, nr-axSpA patients had higher visual analogue scale scores, compared with AS patients, for pain (median 72 vs 65 mm), global (76 vs 68 mm), fatigue (74 vs 67 mm) and BASDAI (64 vs 59; p<0.01 for all). Patients with nr-axSpA, however, had lower C-reactive protein (7 vs 11 mg) and BAS Metrology Index (20 vs 40; p<0.01 for all).

Median treatment adherence was poorer in nr-axSpA than in AS patients (1.59 years; 95 percent CI, 1.15 to 2.02 vs 3.67 years; 2.86 to 4.49; p<0.0001) in univariate analysis, but not in confounder-adjusted analysis (p>0.05). Both nr-axSpA and AS groups had similar response rates (p>0.05).

HLA-B27 negativity correlated with poorer treatment adherence (HLA-B27 negative/positive, nr-axSpA: hazard ratio [HR], 1.74; 1.29 to 2.36; AS: HR, 2.04; 1.53 to 2.71; p<0.0001 for both) and lower response rates (nr-axSpA: 30 vs 55 percent; AS: 29 vs 54 percent; both p<0.05).

A total of 1,250 TNFi-naïve patients with axSpA were included in the study. Patients with nr-axSpA were more frequently women (50/27 percent) and HLA-B27–negative (25 percent), compared to AS (17 percent; p<0.01).

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Most Read Articles
24 Jun 2015
Persistent sleepless nights can take their toll on sufferers, and leave some insomniacs gasping for a caffeine hit just to get them through the morning slog.
01 Sep 2013
Centella asiatica methanol extract is a promising agent in skin care, a study shows.
14 Jan 2018
Patients with a first episode of Clostridium difficile infection (CDI) are likely to respond to treatment with fidaxomicin with no recurrences, a recent study has shown. On the other hand, those with prior CDI episodes are less likely to respond, especially with >1 prior episode, and more likely to recur, which suggests a greater clinical benefit of fidaxomicin earlier in the course of CDI.
01 Aug 2012

Proper use of family planning methods is the key to preventing unplanned preg­nancies. Despite the great effort spent in the research and development of contra­ceptive methods resulting in many new advances, none of the current methods is 100% effective. Emergency contraception (EC), also called ‘postcoital contraception’, is a back-up contraception adminis­tered to a woman after unprotected sexual intercourse (UPSI) or contraceptive failure, so as to prevent unplanned pregnancy. This may be indicated when unexpected intercourse has occurred without the use of any contraception, when there is a sus­pected potential failure of one’s regular contraceptive method (eg, condom break­age or slippage, missed dose of hormonal contraceptive, or potential failure of an intrauterine contraceptive device), or after sexual assault.