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01 Dec 2020
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Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
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Valproic acid may be protective against melanoma

26 Nov 2020

Exposure to valproic acid seems to reduce the risk of melanoma, a recent study has found. That this may be due to residual confounding cannot be ruled out, however.

Researchers conducted a retrospective cohort study of 2,213,845 adults, of whom 22,355 had a history of exposure to valproic acid. The incidence rate of melanoma was significantly higher in the unexposed vs exposed participants (92.6 vs 64.0 cases per 100,000 person-years; p<0.001). Incidence was observed over a mean follow-up of 6.9±5.4 years.

Unadjusted Cox proportional hazards regression analysis found a 36-percent decrease in the risk of melanoma among valproic acid-exposed participants (hazard ratio [HR], 0.64, 95 percent confidence interval [CI], 0.51–0.79). Adjusting for covariates such as age, sex, and ambulatory healthcare use slightly attenuated the magnitude of the effect but not its significance (HR, 0.72, 95 percent CI, 0.58–0.90).

There were also slight differences between exposed and unexposed participants in terms of tumour characteristics upon presentation. Those exposed to VPA, for instance, did not show thick tumours, and were more likely to have local malignancies, though statistical significance over their exposed comparators was not achieved. Tumour behaviour did not differ between exposure subgroups.

The researchers then looked at the number of filled valproic acid prescriptions as a time-varying factor as a surrogate for exposure duration. They found that filling 1–3 prescriptions almost halved the risk of melanoma (HR, 0.48, 95 percent CI, 0.29–0.79), but at greater cumulative durations, no such effect was observed (≥12 fills: HR, 0.82, 95 percent CI, 0.59–1.16).

“[L]ack of a dose-effect necessitates interpreting these results with caution. Future studies validating our findings using additional large administrative databases will help to better elucidate the role of valproic acid in melanoma prevention,” the researchers said.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
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