Bianca Nogrady

Lower respiratory illness in childhood is associated with later development of asthma and wheezing that can persist into adulthood, and may be a risk factor for adult chronic obstructive pulmonary disease (COPD), a prospective study has found.

Researchers assessed the lung function of 646 children – 338 of whom had experienced lower respiratory illness before age 3 years, and 308 controls – and found those who had early pneumonia had a nearly twofold increase in the risk of asthma and wheeze up to age 26 years.

They also had the most severe subsequent deficits in lung function, while those with early non-pneumonia lower respiratory illness had smaller but still significant impairments in lung function and increased risk of wheezing, according to a paper published online in Pediatrics (2015;135:607-15 [10.1542/peds.2014-3060]).

“Because there is considerable evidence that asthma associated with airflow limitation is a strong risk factor for subsequent chronic obstructive pulmonary disease, the prevention of early-life pneumonia and of the factors that determine low lung function in infancy may contribute significantly to decrease the public health burden of chronic obstructive pulmonary disease,” wrote Dr. Johnny Y.C. Chan of the Kwong Wah Hospital, Hong Kong, and his associates.

The study was funded by the National Institutes of Health, and no conflicts of interest were declared.

Lower respiratory illness in childhood is associated with later development of asthma and wheezing that can persist into adulthood, and may be a risk factor for adult chronic obstructive pulmonary disease (COPD), a prospective study has found.

Researchers assessed the lung function of 646 children – 338 of whom had experienced lower respiratory illness before age 3 years, and 308 controls – and found those who had early pneumonia had a nearly twofold increase in the risk of asthma and wheeze up to age 26 years.

They also had the most severe subsequent deficits in lung function, while those with early non-pneumonia lower respiratory illness had smaller but still significant impairments in lung function and increased risk of wheezing, according to a paper published online in Pediatrics (2015;135:607-15 [10.1542/peds.2014-3060]).

“Because there is considerable evidence that asthma associated with airflow limitation is a strong risk factor for subsequent chronic obstructive pulmonary disease, the prevention of early-life pneumonia and of the factors that determine low lung function in infancy may contribute significantly to decrease the public health burden of chronic obstructive pulmonary disease,” wrote Dr. Johnny Y.C. Chan of the Kwong Wah Hospital, Hong Kong, and his associates.

The study was funded by the National Institutes of Health, and no conflicts of interest were declared.

Lower respiratory illness in childhood is associated with later development of asthma and wheezing that can persist into adulthood, and may be a risk factor for adult chronic obstructive pulmonary disease (COPD), a prospective study has found.

Researchers assessed the lung function of 646 children – 338 of whom had experienced lower respiratory illness before age 3 years, and 308 controls – and found those who had early pneumonia had a nearly twofold increase in the risk of asthma and wheeze up to age 26 years.

They also had the most severe subsequent deficits in lung function, while those with early non-pneumonia lower respiratory illness had smaller but still significant impairments in lung function and increased risk of wheezing, according to a paper published online in Pediatrics (2015;135:607-15 [10.1542/peds.2014-3060]).

“Because there is considerable evidence that asthma associated with airflow limitation is a strong risk factor for subsequent chronic obstructive pulmonary disease, the prevention of early-life pneumonia and of the factors that determine low lung function in infancy may contribute significantly to decrease the public health burden of chronic obstructive pulmonary disease,” wrote Dr. Johnny Y.C. Chan of the Kwong Wah Hospital, Hong Kong, and his associates.

The study was funded by the National Institutes of Health, and no conflicts of interest were declared.

Models predicting the likelihood of a successful VBAC are as accurate for women who have undergone two previous cesarean deliveries as they are for women who have had only one previous cesarean, an analysis of registry data shows.

The Maternal–Fetal Medicine Units Network vaginal birth after cesarean delivery (VBAC) prediction model was created for and validated in women with one prior cesarean delivery.

Analysis of data from 369 women with two prior cesarean deliveries undergoing trial of labor after cesarean (TOLAC) delivery showed the area under the receiver operating characteristic curve was 0.74, compared to 0.75 in the original model for women with one prior cesarean delivery (Obstet. Gynecol. 2015;125:948-52).

“When compared with women who had a failed TOLAC, women with a successful TOLAC had a lower mean BMI, were more likely to have a history of vaginal delivery or VBAC, and were less likely to have a history of recurring indication for cesarean delivery or diabetes,” wrote Dr. Torri D. Metz of the University of Colorado, Aurora, and coauthors. Recurring indication for cesarean delivery was defined as arrest of dilation or descent.

The study was supported grants by the Agency for Healthcare Research and Quality and the National Institutes of Health/National Center for Research Resources Colorado. There were no conflicts of interest declared.

Models predicting the likelihood of a successful VBAC are as accurate for women who have undergone two previous cesarean deliveries as they are for women who have had only one previous cesarean, an analysis of registry data shows.

The Maternal–Fetal Medicine Units Network vaginal birth after cesarean delivery (VBAC) prediction model was created for and validated in women with one prior cesarean delivery.

Analysis of data from 369 women with two prior cesarean deliveries undergoing trial of labor after cesarean (TOLAC) delivery showed the area under the receiver operating characteristic curve was 0.74, compared to 0.75 in the original model for women with one prior cesarean delivery (Obstet. Gynecol. 2015;125:948-52).

“When compared with women who had a failed TOLAC, women with a successful TOLAC had a lower mean BMI, were more likely to have a history of vaginal delivery or VBAC, and were less likely to have a history of recurring indication for cesarean delivery or diabetes,” wrote Dr. Torri D. Metz of the University of Colorado, Aurora, and coauthors. Recurring indication for cesarean delivery was defined as arrest of dilation or descent.

The study was supported grants by the Agency for Healthcare Research and Quality and the National Institutes of Health/National Center for Research Resources Colorado. There were no conflicts of interest declared.

Models predicting the likelihood of a successful VBAC are as accurate for women who have undergone two previous cesarean deliveries as they are for women who have had only one previous cesarean, an analysis of registry data shows.

The Maternal–Fetal Medicine Units Network vaginal birth after cesarean delivery (VBAC) prediction model was created for and validated in women with one prior cesarean delivery.

Analysis of data from 369 women with two prior cesarean deliveries undergoing trial of labor after cesarean (TOLAC) delivery showed the area under the receiver operating characteristic curve was 0.74, compared to 0.75 in the original model for women with one prior cesarean delivery (Obstet. Gynecol. 2015;125:948-52).

“When compared with women who had a failed TOLAC, women with a successful TOLAC had a lower mean BMI, were more likely to have a history of vaginal delivery or VBAC, and were less likely to have a history of recurring indication for cesarean delivery or diabetes,” wrote Dr. Torri D. Metz of the University of Colorado, Aurora, and coauthors. Recurring indication for cesarean delivery was defined as arrest of dilation or descent.

The study was supported grants by the Agency for Healthcare Research and Quality and the National Institutes of Health/National Center for Research Resources Colorado. There were no conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk for CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk for CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk for CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk of CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk of CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.

However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.

Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.

The study’s authors said their findings supported previous suggestions that the increased risk of CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).

“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.

The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.

Methotrexate is not associated with an increased risk for pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk for total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk for pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

Methotrexate is not associated with an increased risk for pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk for total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk for pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

Methotrexate is not associated with an increased risk for pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk for total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk for pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

Methotrexate is not associated with an increased risk of pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk of total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk of pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

Methotrexate is not associated with an increased risk of pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk of total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk of pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

Methotrexate is not associated with an increased risk of pulmonary disease in patients taking it for the treatment of psoriatic arthritis, psoriasis, or inflammatory bowel disease, a meta-analysis has found.

The analysis of results from seven double-blind, randomized, controlled studies, involving a total of 1,640 participants, showed no increased risk of total adverse respiratory events – infectious or noninfectious – or pulmonary deaths in patients taking methotrexate, compared with controls, according to Dr. Richard Conway of the department of rheumatology at Galway (Ireland) University Hospitals and his coauthors.

Methotrexate has previously been implicated as a cause of lung toxicity, and the prevalence of methotrexate-related interstitial lung disease has been reported as high as 11.6% in rheumatoid arthritis, but studies of methotrexate-induced lung disease are confounded by the higher risk of pulmonary infections among patients with rheumatoid arthritis, the authors said (BMJ 2015 [doi:10.1136/bmj.h1269]).

“These findings, coupled with those of a previous study in rheumatoid arthritis, suggest that methotrexate-related lung disease is rare, if it exists at all,” the investigators wrote.

The investigators had no specific source of funding for the study and had no conflicts of interest to declare.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

The combination of methotrexate and biologics for the treatment of psoriasis may increase the risk of herpes zoster infection, according to a large, database cohort study published in JAMA Dermatology.

Analysis of medical records for 95,941 patients with psoriasis showed treatment with both biologic medications and methotrexate was associated with a significant 66% increase in the incidence of herpes zoster, compared with a control group, during more than 11 years of follow-up. Episodes of herpes zoster (HZ) occurring in a patient following at least 6 consecutive treatment-free months or in a patient who did not receive any of the listed medications at any time during follow-up were counted as HZ episodes in the control group. The multivariate regression analysis was adjusted for age, sex, psoriasis severity, Charlson comorbidity index, steroid administration per year, and socioeconomic status.

The study found phototherapy, methotrexate alone, cyclosporine, or biologic medications as single agents did not significantly increase the risk, while acitretin therapy was associated with a significant 31% decrease in the incidence of herpes zoster (JAMA Dermatol. 2015 March 22 [doi:10.1001/jamadermatol.2014.4956]).

“Our study results might suggest the need for prophylactic vaccination against VZV [varicella zoster virus] in patients with psoriasis and multiple risk factors for HZ (eg, age, female sex) as part of the preparation for biologic medication treatments in the appropriate clinical setting,” wrote Dr. Guy Shalom of Soroka Medical Center, Beer-Sheva, Israel, and his coauthors.

One author reported consultancies and research grants from a range of pharmaceutical companies. There were no other disclosures.

Young women taking spironolactone for hormonally mediated acne do not need to be monitored for hyperkalemia, say the authors of a study that showed no significant increase in the risk of the condition.

The retrospective study in 974 otherwise healthy women taking spironolactone found the rate of hyperkalemia was 0.72%, compared with 0.76% in women not taking spironolactone, according to data published online March 22 in JAMA Dermatology.

A subset of 13 patients were found to have elevated serum potassium but upon repeat testing in 6, these measurements had all returned to normal, suggesting either incorrect first measurements or that the mild hyperkalemia was transient (JAMA Dermatology 2015 [doi:10.1001/jamadermatol.2015.34].

“The low rate of hyperkalemia may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice,” wrote Dr. Molly Plovanich and her coauthors from Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

Young women taking spironolactone for hormonally mediated acne do not need to be monitored for hyperkalemia, say the authors of a study that showed no significant increase in the risk of the condition.

The retrospective study in 974 otherwise healthy women taking spironolactone found the rate of hyperkalemia was 0.72%, compared with 0.76% in women not taking spironolactone, according to data published online March 22 in JAMA Dermatology.

A subset of 13 patients were found to have elevated serum potassium but upon repeat testing in 6, these measurements had all returned to normal, suggesting either incorrect first measurements or that the mild hyperkalemia was transient (JAMA Dermatology 2015 [doi:10.1001/jamadermatol.2015.34].

“The low rate of hyperkalemia may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice,” wrote Dr. Molly Plovanich and her coauthors from Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

Young women taking spironolactone for hormonally mediated acne do not need to be monitored for hyperkalemia, say the authors of a study that showed no significant increase in the risk of the condition.

The retrospective study in 974 otherwise healthy women taking spironolactone found the rate of hyperkalemia was 0.72%, compared with 0.76% in women not taking spironolactone, according to data published online March 22 in JAMA Dermatology.

A subset of 13 patients were found to have elevated serum potassium but upon repeat testing in 6, these measurements had all returned to normal, suggesting either incorrect first measurements or that the mild hyperkalemia was transient (JAMA Dermatology 2015 [doi:10.1001/jamadermatol.2015.34].

“The low rate of hyperkalemia may encourage more health care professionals to consider the use of this highly effective drug in their clinical practice,” wrote Dr. Molly Plovanich and her coauthors from Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

More than one-quarter of patients prescribed treatments for acne do not fill all their prescriptions, particularly those prescribed more than one treatment, research suggests.

A telephone survey of 143 individuals prescribed treatments for acne showed that 27% of patients did not fill all their prescriptions, and primary nonadherence was higher in those prescribed topical retinoid or over-the-counter products, according to data published online March 20 in JAMA Dermatology.

Nine percent of patients who were prescribed one medication did not fill all their prescriptions, 40% of those prescribed two treatments and 31% of those prescribed three treatments did not fill all their prescriptions (JAMA Dermatol. 2015, March 20 [doi:10.1001/jamadermatol.2014.5254]).

“Common justifications [for not filling prescriptions] included cost, forgetfulness, similar treatments already on hand, not agreeing with the prescribed regimen, and improvement of skin condition before obtaining the prescriptions,” wrote Kathryn L. Anderson and colleagues of Wake Forest University, Winston-Salem, N.C.

The study center is supported by a grant from Galderma Laboratories. One author reported speaker fees, grants, advisory board positions, and stock ownership for a range of pharmaceutical companies.

More than one-quarter of patients prescribed treatments for acne do not fill all their prescriptions, particularly those prescribed more than one treatment, research suggests.

A telephone survey of 143 individuals prescribed treatments for acne showed that 27% of patients did not fill all their prescriptions, and primary nonadherence was higher in those prescribed topical retinoid or over-the-counter products, according to data published online March 20 in JAMA Dermatology.

Nine percent of patients who were prescribed one medication did not fill all their prescriptions, 40% of those prescribed two treatments and 31% of those prescribed three treatments did not fill all their prescriptions (JAMA Dermatol. 2015, March 20 [doi:10.1001/jamadermatol.2014.5254]).

“Common justifications [for not filling prescriptions] included cost, forgetfulness, similar treatments already on hand, not agreeing with the prescribed regimen, and improvement of skin condition before obtaining the prescriptions,” wrote Kathryn L. Anderson and colleagues of Wake Forest University, Winston-Salem, N.C.

The study center is supported by a grant from Galderma Laboratories. One author reported speaker fees, grants, advisory board positions, and stock ownership for a range of pharmaceutical companies.

More than one-quarter of patients prescribed treatments for acne do not fill all their prescriptions, particularly those prescribed more than one treatment, research suggests.

A telephone survey of 143 individuals prescribed treatments for acne showed that 27% of patients did not fill all their prescriptions, and primary nonadherence was higher in those prescribed topical retinoid or over-the-counter products, according to data published online March 20 in JAMA Dermatology.

Nine percent of patients who were prescribed one medication did not fill all their prescriptions, 40% of those prescribed two treatments and 31% of those prescribed three treatments did not fill all their prescriptions (JAMA Dermatol. 2015, March 20 [doi:10.1001/jamadermatol.2014.5254]).

“Common justifications [for not filling prescriptions] included cost, forgetfulness, similar treatments already on hand, not agreeing with the prescribed regimen, and improvement of skin condition before obtaining the prescriptions,” wrote Kathryn L. Anderson and colleagues of Wake Forest University, Winston-Salem, N.C.

The study center is supported by a grant from Galderma Laboratories. One author reported speaker fees, grants, advisory board positions, and stock ownership for a range of pharmaceutical companies.