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Rheumatoid Arthritis May Raise Lung Cancer Risk, Particularly in Those With ILD
TOPLINE:
Rheumatoid arthritis (RA) is linked with over a 50% increased risk for lung cancer, with those having RA-associated interstitial lung disease (RA-ILD) being particularly vulnerable, facing nearly a threefold higher risk.
METHODOLOGY:
- Researchers conducted a retrospective matched cohort study to evaluate the risk for lung cancer in participants with RA, including those with RA-ILD, within Veterans Affairs (VA) from 2000 to 2019.
- A total of 72,795 participants with RA were matched with 633,937 participants without RA on the basis of birth year, sex, and VA enrollment year.
- Among those with RA, 757 had prevalent RA-ILD and were matched with 5931 participants without RA-ILD.
- The primary outcome was incident lung cancer, assessed using the VA Oncology Raw Domain and the National Death Index.
TAKEAWAY:
- Over a mean follow-up of 6.3 years, 2974 incidences of lung cancer were reported in patients with RA, and 34 were reported in those with RA-ILD.
- The risk for lung cancer was 58% higher in patients with RA than in those without RA (adjusted hazard ratio [aHR], 1.58; 95% CI, 1.52-1.64), with this association persisting even when only never-smokers were considered (aHR, 1.65; 95% CI, 1.22-2.24).
- Participants with prevalent RA-ILD had 3.25-fold higher risk for lung cancer than those without RA (aHR, 3.25; 95% CI, 2.13-4.95).
- Both patients with prevalent and those with incident RA-ILD showed a similar increase in risk for lung cancer (aHR, 2.88; 95% CI, 2.45-3.40).
IN PRACTICE:
“Our results highlight RA and RA-ILD as high-risk populations that may benefit from enhanced lung cancer screening,” the authors wrote.
SOURCE:
The study was led by Rebecca T. Brooks, MD, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. It was published online on July 28, 2024, in Arthritis & Rheumatology.
LIMITATIONS:
The study included a predominantly male population, which may have affected the generalizability of the study. Although the study considered smoking status, data on the duration and intensity of smoking were not available. Restriction to never-smokers could not be completed for comparisons between patients with RA-ILD and those without RA because of insufficient sample sizes.
DISCLOSURES:
This study did not receive funding from any source. Some authors reported receiving research funding or having ties with various pharmaceutical companies and other sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
Rheumatoid arthritis (RA) is linked with over a 50% increased risk for lung cancer, with those having RA-associated interstitial lung disease (RA-ILD) being particularly vulnerable, facing nearly a threefold higher risk.
METHODOLOGY:
- Researchers conducted a retrospective matched cohort study to evaluate the risk for lung cancer in participants with RA, including those with RA-ILD, within Veterans Affairs (VA) from 2000 to 2019.
- A total of 72,795 participants with RA were matched with 633,937 participants without RA on the basis of birth year, sex, and VA enrollment year.
- Among those with RA, 757 had prevalent RA-ILD and were matched with 5931 participants without RA-ILD.
- The primary outcome was incident lung cancer, assessed using the VA Oncology Raw Domain and the National Death Index.
TAKEAWAY:
- Over a mean follow-up of 6.3 years, 2974 incidences of lung cancer were reported in patients with RA, and 34 were reported in those with RA-ILD.
- The risk for lung cancer was 58% higher in patients with RA than in those without RA (adjusted hazard ratio [aHR], 1.58; 95% CI, 1.52-1.64), with this association persisting even when only never-smokers were considered (aHR, 1.65; 95% CI, 1.22-2.24).
- Participants with prevalent RA-ILD had 3.25-fold higher risk for lung cancer than those without RA (aHR, 3.25; 95% CI, 2.13-4.95).
- Both patients with prevalent and those with incident RA-ILD showed a similar increase in risk for lung cancer (aHR, 2.88; 95% CI, 2.45-3.40).
IN PRACTICE:
“Our results highlight RA and RA-ILD as high-risk populations that may benefit from enhanced lung cancer screening,” the authors wrote.
SOURCE:
The study was led by Rebecca T. Brooks, MD, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. It was published online on July 28, 2024, in Arthritis & Rheumatology.
LIMITATIONS:
The study included a predominantly male population, which may have affected the generalizability of the study. Although the study considered smoking status, data on the duration and intensity of smoking were not available. Restriction to never-smokers could not be completed for comparisons between patients with RA-ILD and those without RA because of insufficient sample sizes.
DISCLOSURES:
This study did not receive funding from any source. Some authors reported receiving research funding or having ties with various pharmaceutical companies and other sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
Rheumatoid arthritis (RA) is linked with over a 50% increased risk for lung cancer, with those having RA-associated interstitial lung disease (RA-ILD) being particularly vulnerable, facing nearly a threefold higher risk.
METHODOLOGY:
- Researchers conducted a retrospective matched cohort study to evaluate the risk for lung cancer in participants with RA, including those with RA-ILD, within Veterans Affairs (VA) from 2000 to 2019.
- A total of 72,795 participants with RA were matched with 633,937 participants without RA on the basis of birth year, sex, and VA enrollment year.
- Among those with RA, 757 had prevalent RA-ILD and were matched with 5931 participants without RA-ILD.
- The primary outcome was incident lung cancer, assessed using the VA Oncology Raw Domain and the National Death Index.
TAKEAWAY:
- Over a mean follow-up of 6.3 years, 2974 incidences of lung cancer were reported in patients with RA, and 34 were reported in those with RA-ILD.
- The risk for lung cancer was 58% higher in patients with RA than in those without RA (adjusted hazard ratio [aHR], 1.58; 95% CI, 1.52-1.64), with this association persisting even when only never-smokers were considered (aHR, 1.65; 95% CI, 1.22-2.24).
- Participants with prevalent RA-ILD had 3.25-fold higher risk for lung cancer than those without RA (aHR, 3.25; 95% CI, 2.13-4.95).
- Both patients with prevalent and those with incident RA-ILD showed a similar increase in risk for lung cancer (aHR, 2.88; 95% CI, 2.45-3.40).
IN PRACTICE:
“Our results highlight RA and RA-ILD as high-risk populations that may benefit from enhanced lung cancer screening,” the authors wrote.
SOURCE:
The study was led by Rebecca T. Brooks, MD, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. It was published online on July 28, 2024, in Arthritis & Rheumatology.
LIMITATIONS:
The study included a predominantly male population, which may have affected the generalizability of the study. Although the study considered smoking status, data on the duration and intensity of smoking were not available. Restriction to never-smokers could not be completed for comparisons between patients with RA-ILD and those without RA because of insufficient sample sizes.
DISCLOSURES:
This study did not receive funding from any source. Some authors reported receiving research funding or having ties with various pharmaceutical companies and other sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
Low Vitamin D Levels May Worsen Gastroparesis Symptoms
TOPLINE:
Over half of patients with symptoms of gastroparesis have low vitamin D levels, which is linked to heightened nausea, vomiting, and gastric neuromuscular dysfunction.
METHODOLOGY:
- In this observational study, researchers evaluated 513 patients, aged 18 years or older, with symptoms of gastroparesis who are included in the registry of the Gastroparesis Clinical Research Consortium. Patients were enrolled across seven tertiary clinical centers in the United States.
- Patients’ vitamin D levels were measured at enrollment in the registry. Gastroparesis Cardinal Symptom Index, gastric emptying scintigraphy, and electrogastrography before and after a water load satiety test (WLST) were measured.
- Low vitamin D levels were defined as 25-hydroxy vitamin D levels < 30 ng/mL, with 20 to < 30 ng/mL considered insufficient and < 20 ng/mL considered deficient.
- The aims of the study were to determine the prevalence of low vitamin D levels in patients with gastroparesis and to examine the relationships among vitamin D levels, symptoms, gastric emptying rate, and gastric myoelectric activity in response to WLST in patients with gastroparesis and those with symptoms but normal gastric emptying.
TAKEAWAY:
- Of the 513 patients with gastroparesis symptoms, 288 patients (56.1%) had low vitamin D levels, with levels being insufficient in 156 patients and deficient in 132 patients. The prevalence of low vitamin D levels was similar in patients with gastroparesis (54.8%) and with normal gastric emptying (59.9%).
- Low vitamin D levels were associated with significantly higher nausea subscores and individual retching scores in patients with gastroparesis and with normal gastric emptying and with higher individual vomiting scores in patients with gastroparesis. It was not associated with increased fullness or bloating in either group.
- Patients with gastroparesis and low vitamin D levels showed higher gastric retention of a solid, low-fat meal at 4 hours than those with normal vitamin D levels (36% retention vs 31% retention; P = .05) but not at 1 or 2 hours.
- Patients with normal gastric emptying and insufficient and deficient vitamin D levels had increased bradygastria and decreased three-cycles-per-minute gastric myoelectrical activity before ingesting a water load compared with those with normal vitamin D levels (P = .004 for both). After ingesting a water load, they had increased tachygastria (P = .01).
IN PRACTICE:
“This study lays the framework for the next level of investigation, replenishment of vitamin D in patients with symptoms of gastroparesis who have low vitamin D levels and see if this improves their gastric neuromuscular dysfunction and symptoms of gastroparesis. Until this study is performed, we advocate assessing vitamin D levels in patients with symptoms of gastroparesis and treatment with exogenous vitamin D if the patient is deficient in vitamin D,” the authors wrote.
SOURCE:
The study, led by Kenneth L. Koch, MD, from the Section of Gastroenterology, Wake Forest University, Winston-Salem, North Carolina, was published online (2024 Jun 14. doi: 10.1007/s10620-024-08520-8) in Digestive Diseases and Sciences.
LIMITATIONS:
The performance of gastric emptying tests and vitamin D level measurements only at registry enrollment could influence the associations observed. Researchers did not compare vitamin D levels with actual dietary intake or explore the correlation between vitamin D levels and symptoms over time. Limitations also included the study’s exploratory nature in which multiple comparisons were made.
DISCLOSURES:
The Gastroparesis Clinical Research Consortium is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Advancing Translational Sciences. Dr. Koch declared being a shareholder of 3CPM, a diagnostic gastroenterology device company.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
Over half of patients with symptoms of gastroparesis have low vitamin D levels, which is linked to heightened nausea, vomiting, and gastric neuromuscular dysfunction.
METHODOLOGY:
- In this observational study, researchers evaluated 513 patients, aged 18 years or older, with symptoms of gastroparesis who are included in the registry of the Gastroparesis Clinical Research Consortium. Patients were enrolled across seven tertiary clinical centers in the United States.
- Patients’ vitamin D levels were measured at enrollment in the registry. Gastroparesis Cardinal Symptom Index, gastric emptying scintigraphy, and electrogastrography before and after a water load satiety test (WLST) were measured.
- Low vitamin D levels were defined as 25-hydroxy vitamin D levels < 30 ng/mL, with 20 to < 30 ng/mL considered insufficient and < 20 ng/mL considered deficient.
- The aims of the study were to determine the prevalence of low vitamin D levels in patients with gastroparesis and to examine the relationships among vitamin D levels, symptoms, gastric emptying rate, and gastric myoelectric activity in response to WLST in patients with gastroparesis and those with symptoms but normal gastric emptying.
TAKEAWAY:
- Of the 513 patients with gastroparesis symptoms, 288 patients (56.1%) had low vitamin D levels, with levels being insufficient in 156 patients and deficient in 132 patients. The prevalence of low vitamin D levels was similar in patients with gastroparesis (54.8%) and with normal gastric emptying (59.9%).
- Low vitamin D levels were associated with significantly higher nausea subscores and individual retching scores in patients with gastroparesis and with normal gastric emptying and with higher individual vomiting scores in patients with gastroparesis. It was not associated with increased fullness or bloating in either group.
- Patients with gastroparesis and low vitamin D levels showed higher gastric retention of a solid, low-fat meal at 4 hours than those with normal vitamin D levels (36% retention vs 31% retention; P = .05) but not at 1 or 2 hours.
- Patients with normal gastric emptying and insufficient and deficient vitamin D levels had increased bradygastria and decreased three-cycles-per-minute gastric myoelectrical activity before ingesting a water load compared with those with normal vitamin D levels (P = .004 for both). After ingesting a water load, they had increased tachygastria (P = .01).
IN PRACTICE:
“This study lays the framework for the next level of investigation, replenishment of vitamin D in patients with symptoms of gastroparesis who have low vitamin D levels and see if this improves their gastric neuromuscular dysfunction and symptoms of gastroparesis. Until this study is performed, we advocate assessing vitamin D levels in patients with symptoms of gastroparesis and treatment with exogenous vitamin D if the patient is deficient in vitamin D,” the authors wrote.
SOURCE:
The study, led by Kenneth L. Koch, MD, from the Section of Gastroenterology, Wake Forest University, Winston-Salem, North Carolina, was published online (2024 Jun 14. doi: 10.1007/s10620-024-08520-8) in Digestive Diseases and Sciences.
LIMITATIONS:
The performance of gastric emptying tests and vitamin D level measurements only at registry enrollment could influence the associations observed. Researchers did not compare vitamin D levels with actual dietary intake or explore the correlation between vitamin D levels and symptoms over time. Limitations also included the study’s exploratory nature in which multiple comparisons were made.
DISCLOSURES:
The Gastroparesis Clinical Research Consortium is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Advancing Translational Sciences. Dr. Koch declared being a shareholder of 3CPM, a diagnostic gastroenterology device company.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
Over half of patients with symptoms of gastroparesis have low vitamin D levels, which is linked to heightened nausea, vomiting, and gastric neuromuscular dysfunction.
METHODOLOGY:
- In this observational study, researchers evaluated 513 patients, aged 18 years or older, with symptoms of gastroparesis who are included in the registry of the Gastroparesis Clinical Research Consortium. Patients were enrolled across seven tertiary clinical centers in the United States.
- Patients’ vitamin D levels were measured at enrollment in the registry. Gastroparesis Cardinal Symptom Index, gastric emptying scintigraphy, and electrogastrography before and after a water load satiety test (WLST) were measured.
- Low vitamin D levels were defined as 25-hydroxy vitamin D levels < 30 ng/mL, with 20 to < 30 ng/mL considered insufficient and < 20 ng/mL considered deficient.
- The aims of the study were to determine the prevalence of low vitamin D levels in patients with gastroparesis and to examine the relationships among vitamin D levels, symptoms, gastric emptying rate, and gastric myoelectric activity in response to WLST in patients with gastroparesis and those with symptoms but normal gastric emptying.
TAKEAWAY:
- Of the 513 patients with gastroparesis symptoms, 288 patients (56.1%) had low vitamin D levels, with levels being insufficient in 156 patients and deficient in 132 patients. The prevalence of low vitamin D levels was similar in patients with gastroparesis (54.8%) and with normal gastric emptying (59.9%).
- Low vitamin D levels were associated with significantly higher nausea subscores and individual retching scores in patients with gastroparesis and with normal gastric emptying and with higher individual vomiting scores in patients with gastroparesis. It was not associated with increased fullness or bloating in either group.
- Patients with gastroparesis and low vitamin D levels showed higher gastric retention of a solid, low-fat meal at 4 hours than those with normal vitamin D levels (36% retention vs 31% retention; P = .05) but not at 1 or 2 hours.
- Patients with normal gastric emptying and insufficient and deficient vitamin D levels had increased bradygastria and decreased three-cycles-per-minute gastric myoelectrical activity before ingesting a water load compared with those with normal vitamin D levels (P = .004 for both). After ingesting a water load, they had increased tachygastria (P = .01).
IN PRACTICE:
“This study lays the framework for the next level of investigation, replenishment of vitamin D in patients with symptoms of gastroparesis who have low vitamin D levels and see if this improves their gastric neuromuscular dysfunction and symptoms of gastroparesis. Until this study is performed, we advocate assessing vitamin D levels in patients with symptoms of gastroparesis and treatment with exogenous vitamin D if the patient is deficient in vitamin D,” the authors wrote.
SOURCE:
The study, led by Kenneth L. Koch, MD, from the Section of Gastroenterology, Wake Forest University, Winston-Salem, North Carolina, was published online (2024 Jun 14. doi: 10.1007/s10620-024-08520-8) in Digestive Diseases and Sciences.
LIMITATIONS:
The performance of gastric emptying tests and vitamin D level measurements only at registry enrollment could influence the associations observed. Researchers did not compare vitamin D levels with actual dietary intake or explore the correlation between vitamin D levels and symptoms over time. Limitations also included the study’s exploratory nature in which multiple comparisons were made.
DISCLOSURES:
The Gastroparesis Clinical Research Consortium is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Advancing Translational Sciences. Dr. Koch declared being a shareholder of 3CPM, a diagnostic gastroenterology device company.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
Air Pollution and Genetics May Raise Risk for Lupus
TOPLINE:
Chronic exposure to air pollutants such as fine particulate matter ≤ 2.5 μm in diameter (PM2.5), particulate matter ≤ 10 μm in diameter (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOX) increased the risk for systemic lupus erythematosus (SLE) onset. The risk was highest among those with high genetic risk and high air-pollution exposure.
METHODOLOGY:
- Researchers prospectively investigated the association between long-term exposure to air pollutants and incident SLE in 459,815 participants from the UK Biobank.
- A land-use regression model was used to quantify the annual average air pollution concentrations, including PM2.5, PM10, NO2, and NOX.
- The genetic susceptibility to lupus was assessed using polygenic risk scores (PRS), and the participants were classified into low–, intermediate–, or high–genetic-risk groups based on the tertiles of PRS.
- The joint effect of air pollutants and genetic susceptibility to lupus on the risk for incident SLE was evaluated, with the reference group consisting of participants with a low genetic risk and low exposure to air pollution.
TAKEAWAY:
- Over a median follow-up period of 11.77 years, 399 new cases of SLE were identified.
- The odds of developing SLE were higher among participants with high genetic risk than among those with low genetic risk (hazard ratio [HR], 3.45; P < .001 for trend).
- The risk for developing SLE was even higher among participants with a high genetic risk and high exposure to PM2.5 (adjusted HR [aHR], 4.16; 95% CI, 2.67-6.49), PM10 (aHR, 5.31; 95% CI, 3.30-8.55), NO2 (aHR, 5.61; 95% CI, 3.45-9.13), and NOX (aHR, 4.80; 95% CI, 3.00-7.66) than among with those with a low genetic risk and low exposure to air pollutants.
IN PRACTICE:
“Findings can inform the development of stricter air quality regulations to mitigate exposure to harmful pollutants, thereby reducing the risk of SLE,” the authors wrote.
SOURCE:
The study was led by Meiqi Xing, MASc, Huazhong University of Science and Technology, Wuhan, China. It was published online in Arthritis & Rheumatology.
LIMITATIONS:
The study participants were enrolled voluntarily, which may have led to selection bias because they might have been healthier or more health conscious. The study did not consider the specific components of air pollutants, particularly particulate matter, which may have varying effects on the incidence of SLE. Other air pollutants such as ozone, sulfur dioxide, and carbon monoxide were not included in the analysis.
DISCLOSURES:
This study did not disclose any funding source. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
Chronic exposure to air pollutants such as fine particulate matter ≤ 2.5 μm in diameter (PM2.5), particulate matter ≤ 10 μm in diameter (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOX) increased the risk for systemic lupus erythematosus (SLE) onset. The risk was highest among those with high genetic risk and high air-pollution exposure.
METHODOLOGY:
- Researchers prospectively investigated the association between long-term exposure to air pollutants and incident SLE in 459,815 participants from the UK Biobank.
- A land-use regression model was used to quantify the annual average air pollution concentrations, including PM2.5, PM10, NO2, and NOX.
- The genetic susceptibility to lupus was assessed using polygenic risk scores (PRS), and the participants were classified into low–, intermediate–, or high–genetic-risk groups based on the tertiles of PRS.
- The joint effect of air pollutants and genetic susceptibility to lupus on the risk for incident SLE was evaluated, with the reference group consisting of participants with a low genetic risk and low exposure to air pollution.
TAKEAWAY:
- Over a median follow-up period of 11.77 years, 399 new cases of SLE were identified.
- The odds of developing SLE were higher among participants with high genetic risk than among those with low genetic risk (hazard ratio [HR], 3.45; P < .001 for trend).
- The risk for developing SLE was even higher among participants with a high genetic risk and high exposure to PM2.5 (adjusted HR [aHR], 4.16; 95% CI, 2.67-6.49), PM10 (aHR, 5.31; 95% CI, 3.30-8.55), NO2 (aHR, 5.61; 95% CI, 3.45-9.13), and NOX (aHR, 4.80; 95% CI, 3.00-7.66) than among with those with a low genetic risk and low exposure to air pollutants.
IN PRACTICE:
“Findings can inform the development of stricter air quality regulations to mitigate exposure to harmful pollutants, thereby reducing the risk of SLE,” the authors wrote.
SOURCE:
The study was led by Meiqi Xing, MASc, Huazhong University of Science and Technology, Wuhan, China. It was published online in Arthritis & Rheumatology.
LIMITATIONS:
The study participants were enrolled voluntarily, which may have led to selection bias because they might have been healthier or more health conscious. The study did not consider the specific components of air pollutants, particularly particulate matter, which may have varying effects on the incidence of SLE. Other air pollutants such as ozone, sulfur dioxide, and carbon monoxide were not included in the analysis.
DISCLOSURES:
This study did not disclose any funding source. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
Chronic exposure to air pollutants such as fine particulate matter ≤ 2.5 μm in diameter (PM2.5), particulate matter ≤ 10 μm in diameter (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOX) increased the risk for systemic lupus erythematosus (SLE) onset. The risk was highest among those with high genetic risk and high air-pollution exposure.
METHODOLOGY:
- Researchers prospectively investigated the association between long-term exposure to air pollutants and incident SLE in 459,815 participants from the UK Biobank.
- A land-use regression model was used to quantify the annual average air pollution concentrations, including PM2.5, PM10, NO2, and NOX.
- The genetic susceptibility to lupus was assessed using polygenic risk scores (PRS), and the participants were classified into low–, intermediate–, or high–genetic-risk groups based on the tertiles of PRS.
- The joint effect of air pollutants and genetic susceptibility to lupus on the risk for incident SLE was evaluated, with the reference group consisting of participants with a low genetic risk and low exposure to air pollution.
TAKEAWAY:
- Over a median follow-up period of 11.77 years, 399 new cases of SLE were identified.
- The odds of developing SLE were higher among participants with high genetic risk than among those with low genetic risk (hazard ratio [HR], 3.45; P < .001 for trend).
- The risk for developing SLE was even higher among participants with a high genetic risk and high exposure to PM2.5 (adjusted HR [aHR], 4.16; 95% CI, 2.67-6.49), PM10 (aHR, 5.31; 95% CI, 3.30-8.55), NO2 (aHR, 5.61; 95% CI, 3.45-9.13), and NOX (aHR, 4.80; 95% CI, 3.00-7.66) than among with those with a low genetic risk and low exposure to air pollutants.
IN PRACTICE:
“Findings can inform the development of stricter air quality regulations to mitigate exposure to harmful pollutants, thereby reducing the risk of SLE,” the authors wrote.
SOURCE:
The study was led by Meiqi Xing, MASc, Huazhong University of Science and Technology, Wuhan, China. It was published online in Arthritis & Rheumatology.
LIMITATIONS:
The study participants were enrolled voluntarily, which may have led to selection bias because they might have been healthier or more health conscious. The study did not consider the specific components of air pollutants, particularly particulate matter, which may have varying effects on the incidence of SLE. Other air pollutants such as ozone, sulfur dioxide, and carbon monoxide were not included in the analysis.
DISCLOSURES:
This study did not disclose any funding source. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
New Study Says Your Sedentary Lifestyle Is Killing You
TOPLINE:
METHODOLOGY:
- Researchers evaluated the association between PA and ST with the risk for mortality in 5836 middle-aged and older Australian adults (mean age, 56.4 years; 45% men) from the Australian Diabetes, Obesity and Lifestyle Study.
- The Physical Activity and Sitting Time Balance Index (PASTBI) was calculated by dividing the total duration of daily PA by the duration of daily ST.
- Participants were categorized into quartiles on the basis of their PASTBI score, ranging from low PA/high ST to high PA/low ST.
- The primary outcome was all-cause mortality.
TAKEAWAY:
- During a median follow-up time of 14.3 years, 885 (15%) all-cause deaths were reported.
- The risk for all-cause mortality was 47% higher in participants with lower engagement in PA and higher ST (low PASTBI) than those with higher engagement in PA and lower ST (high PASTBI; adjusted hazard ratio, 1.47; 95% confidence interval, 1.21-1.79).
IN PRACTICE:
“The utility of the PASTBI in identifying relationships with mortality risk further highlights the importance of achieving a healthier balance in the dual health behaviors of PA [physical activity] and ST [sitting time],” the authors wrote.
SOURCE:
The study was led by Roslin Botlero, MBBS, MPH, PhD, of the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia. It was published online in the American Journal of Preventive Medicine.
LIMITATIONS:
The study relied on self-reported data for PA and ST, which may have introduced recall or reporting bias. The generalizability of the findings is restricted to a specific set of self-reported questionnaires. Even after adjustment for several potential confounders, other unmeasured or unknown confounders may have influenced the association between PASTBI and all-cause mortality.
DISCLOSURES:
The Australian Diabetes, Obesity and Lifestyle Study was sponsored by the National Health and Medical Research Council, the Australian Government Department of Health and Aged Care, and others. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- Researchers evaluated the association between PA and ST with the risk for mortality in 5836 middle-aged and older Australian adults (mean age, 56.4 years; 45% men) from the Australian Diabetes, Obesity and Lifestyle Study.
- The Physical Activity and Sitting Time Balance Index (PASTBI) was calculated by dividing the total duration of daily PA by the duration of daily ST.
- Participants were categorized into quartiles on the basis of their PASTBI score, ranging from low PA/high ST to high PA/low ST.
- The primary outcome was all-cause mortality.
TAKEAWAY:
- During a median follow-up time of 14.3 years, 885 (15%) all-cause deaths were reported.
- The risk for all-cause mortality was 47% higher in participants with lower engagement in PA and higher ST (low PASTBI) than those with higher engagement in PA and lower ST (high PASTBI; adjusted hazard ratio, 1.47; 95% confidence interval, 1.21-1.79).
IN PRACTICE:
“The utility of the PASTBI in identifying relationships with mortality risk further highlights the importance of achieving a healthier balance in the dual health behaviors of PA [physical activity] and ST [sitting time],” the authors wrote.
SOURCE:
The study was led by Roslin Botlero, MBBS, MPH, PhD, of the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia. It was published online in the American Journal of Preventive Medicine.
LIMITATIONS:
The study relied on self-reported data for PA and ST, which may have introduced recall or reporting bias. The generalizability of the findings is restricted to a specific set of self-reported questionnaires. Even after adjustment for several potential confounders, other unmeasured or unknown confounders may have influenced the association between PASTBI and all-cause mortality.
DISCLOSURES:
The Australian Diabetes, Obesity and Lifestyle Study was sponsored by the National Health and Medical Research Council, the Australian Government Department of Health and Aged Care, and others. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- Researchers evaluated the association between PA and ST with the risk for mortality in 5836 middle-aged and older Australian adults (mean age, 56.4 years; 45% men) from the Australian Diabetes, Obesity and Lifestyle Study.
- The Physical Activity and Sitting Time Balance Index (PASTBI) was calculated by dividing the total duration of daily PA by the duration of daily ST.
- Participants were categorized into quartiles on the basis of their PASTBI score, ranging from low PA/high ST to high PA/low ST.
- The primary outcome was all-cause mortality.
TAKEAWAY:
- During a median follow-up time of 14.3 years, 885 (15%) all-cause deaths were reported.
- The risk for all-cause mortality was 47% higher in participants with lower engagement in PA and higher ST (low PASTBI) than those with higher engagement in PA and lower ST (high PASTBI; adjusted hazard ratio, 1.47; 95% confidence interval, 1.21-1.79).
IN PRACTICE:
“The utility of the PASTBI in identifying relationships with mortality risk further highlights the importance of achieving a healthier balance in the dual health behaviors of PA [physical activity] and ST [sitting time],” the authors wrote.
SOURCE:
The study was led by Roslin Botlero, MBBS, MPH, PhD, of the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia. It was published online in the American Journal of Preventive Medicine.
LIMITATIONS:
The study relied on self-reported data for PA and ST, which may have introduced recall or reporting bias. The generalizability of the findings is restricted to a specific set of self-reported questionnaires. Even after adjustment for several potential confounders, other unmeasured or unknown confounders may have influenced the association between PASTBI and all-cause mortality.
DISCLOSURES:
The Australian Diabetes, Obesity and Lifestyle Study was sponsored by the National Health and Medical Research Council, the Australian Government Department of Health and Aged Care, and others. The authors declared no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.
Dupilumab Safe, Effective Over 5 Years in Moderate to Severe Atopic Dermatitis
TOPLINE:
Over 5 years, dupilumab demonstrated acceptable safety and sustained efficacy, with significant improvements in the signs and symptoms of AD, in the treatment of moderate to severe atopic dermatitis (AD).
METHODOLOGY:
- The phase 3 multinational LIBERTY AD open-label extension study evaluated the safety and efficacy of dupilumab in 2677 adults with moderate to severe AD who had previously participated in dupilumab trials over 5 years; 334 patients (12.5%) completed treatment up to 5 years.
- Patients started with subcutaneous dupilumab, initially dosed weekly after a loading dose, then every 2 weeks in 2019.
- The primary outcomes were the incidence and rate of treatment-emergent adverse events (TEAEs).
TAKEAWAY:
- Overall, 14,717 TEAEs were reported over 5 years. The exposure-adjusted incidence rate decreased over time and was 252.48 events per 100 patient-years.
- The most common TEAEs were nasopharyngitis (28.9%), worsening AD (16.7%), upper respiratory tract infection (13.6%), conjunctivitis (10.3%), allergic conjunctivitis (9%), headache (8.1%), oral herpes (7.5%), and injection-site reactions (5.2%).
- Serious and severe TEAE rates were 10.6% and 10.0%, respectively. Exposure-adjusted incidence rates were 6.66 and 6.71 events per 100 patient-years, respectively.
- At week 260, 67.5% of patients had achieved clear or almost clear skin according to the Investigator’s Global Assessment, and 88.9% experienced a 75% or greater improvement in the Eczema Area and Severity Index.
IN PRACTICE:
“Safety and efficacy results from up to 5 years of dupilumab treatment in the LIBERTY AD open-label extension study support dupilumab as a continuous long-term treatment for adults with moderate to severe AD,” the authors concluded.
SOURCE:
The study was led by Lisa A. Beck, MD, University of Rochester, Rochester, New York, and was published online in JAMA Dermatology.
LIMITATIONS:
Study limitations included the absence of a placebo arm and treatment interruptions stemming from protocol changes. The number of patients who received biweekly doses was small. The early conclusion of the trial by the sponsor because of regulatory approval also resulted in a lower number of patients at later stages.
DISCLOSURES:
This study was funded by dupilumab manufacturers Sanofi and Regeneron Pharmaceuticals. Several authors declared ties with various pharmaceutical companies including Sanofi and Regeneron, and several authors were employees of Sanofi or Regeneron. No disclosures were reported by other authors.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
Over 5 years, dupilumab demonstrated acceptable safety and sustained efficacy, with significant improvements in the signs and symptoms of AD, in the treatment of moderate to severe atopic dermatitis (AD).
METHODOLOGY:
- The phase 3 multinational LIBERTY AD open-label extension study evaluated the safety and efficacy of dupilumab in 2677 adults with moderate to severe AD who had previously participated in dupilumab trials over 5 years; 334 patients (12.5%) completed treatment up to 5 years.
- Patients started with subcutaneous dupilumab, initially dosed weekly after a loading dose, then every 2 weeks in 2019.
- The primary outcomes were the incidence and rate of treatment-emergent adverse events (TEAEs).
TAKEAWAY:
- Overall, 14,717 TEAEs were reported over 5 years. The exposure-adjusted incidence rate decreased over time and was 252.48 events per 100 patient-years.
- The most common TEAEs were nasopharyngitis (28.9%), worsening AD (16.7%), upper respiratory tract infection (13.6%), conjunctivitis (10.3%), allergic conjunctivitis (9%), headache (8.1%), oral herpes (7.5%), and injection-site reactions (5.2%).
- Serious and severe TEAE rates were 10.6% and 10.0%, respectively. Exposure-adjusted incidence rates were 6.66 and 6.71 events per 100 patient-years, respectively.
- At week 260, 67.5% of patients had achieved clear or almost clear skin according to the Investigator’s Global Assessment, and 88.9% experienced a 75% or greater improvement in the Eczema Area and Severity Index.
IN PRACTICE:
“Safety and efficacy results from up to 5 years of dupilumab treatment in the LIBERTY AD open-label extension study support dupilumab as a continuous long-term treatment for adults with moderate to severe AD,” the authors concluded.
SOURCE:
The study was led by Lisa A. Beck, MD, University of Rochester, Rochester, New York, and was published online in JAMA Dermatology.
LIMITATIONS:
Study limitations included the absence of a placebo arm and treatment interruptions stemming from protocol changes. The number of patients who received biweekly doses was small. The early conclusion of the trial by the sponsor because of regulatory approval also resulted in a lower number of patients at later stages.
DISCLOSURES:
This study was funded by dupilumab manufacturers Sanofi and Regeneron Pharmaceuticals. Several authors declared ties with various pharmaceutical companies including Sanofi and Regeneron, and several authors were employees of Sanofi or Regeneron. No disclosures were reported by other authors.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.
TOPLINE:
Over 5 years, dupilumab demonstrated acceptable safety and sustained efficacy, with significant improvements in the signs and symptoms of AD, in the treatment of moderate to severe atopic dermatitis (AD).
METHODOLOGY:
- The phase 3 multinational LIBERTY AD open-label extension study evaluated the safety and efficacy of dupilumab in 2677 adults with moderate to severe AD who had previously participated in dupilumab trials over 5 years; 334 patients (12.5%) completed treatment up to 5 years.
- Patients started with subcutaneous dupilumab, initially dosed weekly after a loading dose, then every 2 weeks in 2019.
- The primary outcomes were the incidence and rate of treatment-emergent adverse events (TEAEs).
TAKEAWAY:
- Overall, 14,717 TEAEs were reported over 5 years. The exposure-adjusted incidence rate decreased over time and was 252.48 events per 100 patient-years.
- The most common TEAEs were nasopharyngitis (28.9%), worsening AD (16.7%), upper respiratory tract infection (13.6%), conjunctivitis (10.3%), allergic conjunctivitis (9%), headache (8.1%), oral herpes (7.5%), and injection-site reactions (5.2%).
- Serious and severe TEAE rates were 10.6% and 10.0%, respectively. Exposure-adjusted incidence rates were 6.66 and 6.71 events per 100 patient-years, respectively.
- At week 260, 67.5% of patients had achieved clear or almost clear skin according to the Investigator’s Global Assessment, and 88.9% experienced a 75% or greater improvement in the Eczema Area and Severity Index.
IN PRACTICE:
“Safety and efficacy results from up to 5 years of dupilumab treatment in the LIBERTY AD open-label extension study support dupilumab as a continuous long-term treatment for adults with moderate to severe AD,” the authors concluded.
SOURCE:
The study was led by Lisa A. Beck, MD, University of Rochester, Rochester, New York, and was published online in JAMA Dermatology.
LIMITATIONS:
Study limitations included the absence of a placebo arm and treatment interruptions stemming from protocol changes. The number of patients who received biweekly doses was small. The early conclusion of the trial by the sponsor because of regulatory approval also resulted in a lower number of patients at later stages.
DISCLOSURES:
This study was funded by dupilumab manufacturers Sanofi and Regeneron Pharmaceuticals. Several authors declared ties with various pharmaceutical companies including Sanofi and Regeneron, and several authors were employees of Sanofi or Regeneron. No disclosures were reported by other authors.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.