Rosacea is a common chronic skin condition that manifests as recurrent inflammatory lesions. Long-term treatment is required to control symptoms and disease progression, with topical treatments being the first-line choice. Ivermectin 1 % cream is a new once-daily (QD) topical treatment for the inflammatory lesions of rosacea, and it is important to compare the efficacy, safety, and tolerability of ivermectin with other currently available topical treatments.A systematic literature review was performed from January 2011 to June 2015, with articles published prior to 2011 retrieved from a Cochrane review on rosacea. Randomized controlled trials of the topical treatment of adult patients with moderate-to-severe papulopustular rosacea were identified from electronic databases and trial registers, and supplemented with data from clinical study reports. Mixed treatment comparisons (MTCs) were conducted to compare different treatments according to Bayesian methodology.57 studies were identified, with 19 providing data suitable for MTC. Ivermectin 1 % cream QD led to a significantly greater likelihood of success compared with azelaic acid 15 % gel twice-daily (BID) [relative risk (95 % credible interval): 1.25 (1.14-1.37)], and metronidazole 0.75 % cream BID [1.17 (1.08-1.29)] at 12 weeks. Ivermectin 1 % cream QD also demonstrated a significant reduction in inflammatory lesion count compared with azelaic acid 15 % gel BID [-8.04 (-12.69 to -3.43)] and metronidazole 0.75 % cream BID [-9.92 (-13.58 to -6.35)] at 12 weeks. Ivermectin 1 % cream QD led to a significantly lower risk of developing any AE or TRAE compared with azelaic acid 15 % gel BID [0.83 (0.71-0.97) and 0.47 (0.32-0.67), respectively].Ivermectin 1 % cream QD appears to be a more effective topical treatment than other current options for the inflammatory lesions of rosacea, with at least an equivalent safety and tolerability profile, and could provide physicians and dermatologists with an alternative first-line treatment option.
Prostate cancer mortality usually occurs as a result of castrate resistant disease. Many approaches are currently being evaluated to improve the treatment of this condition. These include drugs that induce androgen deprivation, that is, LHRH antagonists; more active or less toxic chemotherapy agents; immunologic approaches, including passive and active immunization; drugs that target the androgen receptor and/or androgen synthesis; drugs that target specific pathways, including tyrosine kinase inhibitors, angiogenesis inhibitors, endothelin antagonists and matrix metalloproteinase inhibitors; and antioxidants and cell cycle inhibitors. Many of these agents seem promising. The rationale, biologic activity and therapeutic results of these emerging drugs are reviewed.
OBJECTIVE: Compare the efficacy, safety, and tolerability of delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) with other disease-modifying therapies (DMTs) in treatment-naïve patients with relapsing-remitting multiple sclerosis (RRMS). BACKGROUND: In the absence of head-to-head comparisons between DMF and other approved DMTs, a systematic review and mixed treatment comparison (MTC) was performed. DESIGN/METHODS: Systematic searches were conducted in MEDLINE®, Embase®, and Cochrane Library to identify randomized controlled trials evaluating DMF, interferon (IFN) beta, glatiramer acetate (GA), or teriflunomide. Conference proceedings from relevant annual symposia were hand-searched. Based on a pre-specified protocol, studies were included and extracted independently by professional reviewers. Quality of included trials was assessed using criteria recommended by the National Institute for Health and Care Excellence and the Institute for Quality and Efficiency in Healthcare. Treatment-naïve population was selected based on the trial population or subgroup data publications. The MTC was conducted to derive relative effect sizes for included treatments using SAS® analytical software version 9.3. RESULTS: Annualized relapse rate (ARR) was considered the primary efficacy outcome. DMF 240 mg bid demonstrated significantly greater reduction in ARR compared to all evaluated comparators: placebo (rate ratio [RR]: 0.52; 95[percnt] CI: 0.45-0.62), IFN beta-1a 30 mcg qw (RR: 0.71; 95[percnt] CI: 0.58-0.88), IFN beta-1b 250 mcg EOD (RR: 0.79; 95[percnt] CI: 0.66-0.96), IFN beta 1a 22 mcg tiw (RR: 0.74; 95[percnt] CI: 0.60-0.91), IFN beta-1a 44 mcg tiw (RR: 0.80; 95[percnt] CI: 0.67-0.97), GA 20 mg od (RR: 0.82; 95[percnt] CI: 0.68-0.97), teriflunomide 7 mg od (RR: 0.77; 95[percnt] CI: 0.61-0.97), and teriflunomide 14 mg od (RR: 0.77; 95[percnt] CI: 0.61-0.97). MTC results on safety and tolerability will be presented. CONCLUSIONS: DMF offers a valuable treatment option and promising overall efficacy profile in treatment-naïve patients with RRMS. Study Supported by: Biogen Idec
Abstract A 44 year old man previously in good health presented to the accident and emergency department with a 3-day history of gradually worsening abdominal pain. The pain started as a dull ache in the periumbilical region and later became diffuse and more severe. He developed diarrhoea 24 hours after the pain started, opening his bowels up to 10 times a day. This was initially brown watery motion but later became mixed with dark blood. There was associated vomiting and anuria.
Background: Intradetrusor botulinum toxin (BTX) therapy has been shown to be effective in treating neurogenic detrusor overactivity. Recently, BTX has been extended to patients with
'/%3e%3cpath fill='%23fff' d='m8.751-17.959 10.11 11.373L3.997-9.844l13.94-6.1-7.692 13.129z'/%3e%3c/svg%3e)
'/%3e%3cpath d='M200 752.362h200v300H200z' style='fill:%23fff;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3cpath d='M400 752.362h200v300H400z' style='fill:%23ff883e;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3c/svg%3e)