Sitagliptin and Narrow-Band Ultraviolet-B for Moderate Psoriasis (DINUP): A Randomised Controlled Clinical Trial

Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Maeve Lynch ◽  
Anna Malara ◽  
Irene Timoney ◽  
Sebastian Vencken ◽  
Tomas Ahern ◽  
...  
Keyword(s):  
Narrow Band ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Depression Scale ◽  
Ultraviolet B ◽  
Controlled Clinical Trial ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Uvb Phototherapy ◽  
Psoriasis Severity

<b><i>Background:</i></b> Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor licensed for the treatment of type 2 diabetes mellitus (T2DM), has been reported to improve psoriasis. <b><i>Objective:</i></b> We compared the effects of sitagliptin treatment, a DPP-4 inhibitor, in combination with narrow-band ultraviolet-B (NB-UVB) phototherapy compared to NB-UVB alone on psoriasis severity, quality of life, cardiovascular disease risk factors and immune parameters in people with moderate psoriasis without T2DM. <b><i>Methods:</i></b> In this 39-week, single-centre, randomised controlled trial, people were allocated randomly to receive sitagliptin for 24 weeks with NB-UVB or NB-UVB alone. The primary endpoint was the change in Psoriasis Area and Severity Index (PASI) from baseline to 24 weeks. We estimated that 120 participants would be needed to have 80% power to find a significant difference between the groups. <b><i>Results:</i></b> A total of 118 patients were randomised. The median (IQR) baseline PASI was 8.8 (7.5–11.6). At 24 weeks, the mean difference from baseline in PASI (–1.0 [95% CI –2.0 to 0.0]) was significantly larger in the sitagliptin/NB-UVB arm than in the NB-UVB-alone arm (<i>p</i> = 0.044). There were significant differences in the change in Hospital Anxiety and Depression Scale (–2.5 [95% CI –4.0 to –1.0]; <i>p</i> = 0.002) and EuroQol 5-item questionnaire (0.1 [95% CI 0.0–0.1]; <i>p</i> = 0.036) values from baseline to 24 weeks between the sitagliptin/NB-UVB and the NB-UVB-alone arm. There were no treatment-related serious adverse events. <b><i>Conclusion:</i></b> Sitagliptin therapy combined with NB-UVB phototherapy significantly improved psoriasis severity, albeit modestly, compared to NB-UVB phototherapy alone in patients with moderate psoriasis without T2DM.

scholarly journals Standard versus Endocuff versus cap-assisted colonoscopy for adenoma detection: A randomised controlled clinical trial

2020 ◽  
pp. 205064062098295
Author(s):  
Martin Floer ◽  
Laura Tschaikowski ◽  
Michael Schepke ◽  
Radoslaw Kempinski ◽  
Katarzyna Neubauer ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cancer Screening ◽  
Controlled Clinical Trial ◽  
Polyp Detection ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Randomised Controlled Clinical Trial ◽  
Randomised Controlled ◽  
Standard Colonoscopy

Background and aims Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three-armed randomised controlled clinical trial aimed at comparing a head-to-head setting standard colonoscopy (SC) with Endocuff-assisted colonoscopy (EC) and cap-assisted colonoscopy (CAC) for improvement of ADR. Methods Patients from Poland and Germany with independent indication for colonoscopy were randomised into three arms of this trial: EC, CAC and SC. Exclusion criteria were age <18 years, active Crohn’s disease or ulcerative colitis, known stenosis and post-colonic resection status. Results A total of 585 patients (195 SC, 189 EC and 186 CAC) were enrolled in this study. Indications were not different between the groups (colorectal cancer screening 51%, diagnostic colonoscopy in 31% and post polypectomy follow-up in 18%; p=0.94). Withdrawal time was a mean of seven minutes in all groups ( p=0.658), and bowel preparation did not differ between the groups. The time to reach the caecum was significantly reduced when using the cap (a mean of six minutes for CAC vs. seven minutes for SC; p=0.0001). There was no significant difference in the primary outcome of the ADR between the groups (EC 32%, CAC 30%, SC 30%; p=0.815). EC proved to be superior (EC vs. SC) in the sigmoid colon and transverse colon for polyp detection. Conclusion The use of EC increased the total number of polyps seen during colonoscopy. In contrast to recent studies, no significant improvement of the ADR was detected.

scholarly journals A randomised controlled clinical trial comparing the effectiveness of bandaging compared to the JuxtaCures™ device in the management of people with venous ulceration: Feasibility study

2021 ◽  
pp. 026835552098822
Author(s):  
Philip Stather ◽  
Carroll Petty ◽  
Helen Langthorne ◽  
Emma Rayner ◽  
Jufen Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Feasibility Study ◽  
Multicentre Trial ◽  
Compression Therapy ◽  
Controlled Clinical Trial ◽  
Venous Ulceration ◽  
Significant Difference ◽  
Potential Benefits ◽  
Randomised Controlled

Introduction The mainstay of treatment for venous ulceration remains compression therapy. Velcro Wrap devices are being increasingly used in these patients despite limited evidence. This feasibility study aimed to compare standard bandaging to the JuxtaCures™ Velcro wrap device. Methods A single centre, unblinded RCT compared participants with venous ulceration randomised to either the JuxtaCures™ device or short stretch bandaging. Participants were followed up for 26 weeks. Results 160 participants were screened with 40 randomised. 3 participants in bandaging and 1 in JuxtaCures™ didn’t complete the study. 60% in JuxtaCures™ healed v 55% in bandaging despite larger ulcers in the JuxtaCures™ arm (9.33 cm2 v 6.97 cm2). There was no significant difference in time to healing (12.17 v 13.64 weeks). JuxtaCures™ showed improved ulcer reduction for those that didn’t heal (14.91–5.00 cm2 v 14.20–8.62 cm2; P = 0.06). JuxtaCures™ had more consistent sub-bandage pressure dropping from 39–36 mmHg versus 41–25 mmHg in bandaging between application and removal (P < 0.001). Quality of life (EQ5D) was improved in JuxtaCures at 3 months (mean difference 0.14, p = 0.04), but not at 1 and 6 months, or in disease specific quality of life. Cost was lower in JuxtaCures™ £842.47 v £1064.68. Duration of appointment was significantly shorter in JuxtaCures™ (41 minutes v 53 minutes; P = 0.003). Conclusion This study has shown the feasibility and necessity of running a multicentre trial to evaluate the use of Velcro wrap devices for venous ulceration. It highlights the potential benefits of more consistent pressure, increased self-care, and potential with regards to ulcer healing, cost, nursing resource and quality of life.

Effects of diets rich in ghee or olive oil on cardiometabolic risk factors in healthy adults: A 2-period, crossover, randomized trial

2021 ◽  
pp. 1-30
Author(s):  
Susan Mohammadi Hosseinabadi ◽  
Javad Nasrollahzadeh
Keyword(s):  
Olive Oil ◽  
Dietary Intervention ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Dietary Fats ◽  
Lipoprotein Cholesterol ◽  
Apo B ◽  
Blood Samples ◽  
Significant Difference

Abstract This study aimed to evaluate the cardiovascular health-related effects of consuming ghee in the usual diet. Thirty healthy men and women were studied in a free-living outpatient regimen. The participants were instructed for the isocaloric inclusion of ghee or olive oil in their diets for 4 weeks using a randomized crossover design. At the end of run-in (baseline), 2-week wash-out, and interventions, fasting blood samples were drawn. In addition, 2-h postprandial blood samples were collected after ingestion of a meal containing olive oil or ghee at week 4 of each dietary intervention. Body weight was not different between the two interventions. Compared to the olive oil, the diet with ghee increased fasting plasma apolipoprotein-B (apo B) (0.09, 95% CI 0.02 to 0.17 g/L, p= 0.018) and non-high-density lipoprotein cholesterol (non-HDL-C) (0.53, 95% CI 0.01 to 1.05 mmol/L, p= 0.046) and low-density lipoprotein cholesterol did not differ significantly between diet groups (0.29, 95% CI –0.05 to 0.63 mmol/L, p= 0.092), but had no significant effect on total cholesterol/HDL-C ratio (0.75, 95% CI −0.24 to 1.74 mmol/L, p= 0.118). No significant difference was observed in fasting as well as 2-h postprandial plasma triacylglycerol, glucose, insulin, and plasminogen activator inhibitor-1 concentrations. This study showed that ghee which is predominantly saturated fats had an increasing effect on plasma apo B and non-HDL-C compared to olive oil, adding further evidence to the existing recommendations to replace dietary fats high in SFA with dietary fats high in unsaturated fats to reduce cardiovascular disease risk.

Eruption of bullae within psoriatic plaques: A rare adverse effect of narrow-band ultraviolet B (NB-UVB) phototherapy

2012 ◽  
Vol 18 (6) ◽  
Author(s):  
Kristen Corey ◽  
Nikki A Levin ◽  
Michelle Hure ◽  
April Deng ◽  
Jeffrey Mailhot
Keyword(s):  
Adverse Effect ◽  
Narrow Band ◽  
Ultraviolet B ◽  
Uvb Phototherapy

Abstract TMP56: Prediction of Primary Stroke: A Secondary Analysis of the SPRINT Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Eric Goldstein ◽  
Stephanie Lyden ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Blood Pressure Control ◽  
Primary Outcome ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Significant Difference ◽  
History Of

Background: The Systolic Blood Pressure Intervention Trial enrolled patients aged 50 or older with at least one cardiovascular disease risk factor, but free of prior symptomatic stroke. Patients were assigned to two blood pressure reduction goals (<140 versus 120 mm Hg). There was not a significant difference in the rate of stroke, making this an ideal cohort to refine risk prediction of primary stroke, which is understudied in patients with adequate blood pressure control and a rigorously adjudicated outcome of stroke. Methods: The primary outcome is ischemic stroke. We fit Cox models to the primary outcome and evaluated all baseline demographic variables to determine which would be most predictive of stroke, which we then used to create a prediction score. Results: We included 9,361 patients with a mean (SD) age of 67.9 (9.4) years and 171 (1.8%) patients met the primary outcome of stroke. For our prediction model, we gave one point each for history of TIA, atrial fibrillation, congestive heart failure, or diabetes. Patients with 2 or more points were collapsed, making three possible scores of 0, 1, and 2, which had rates of stroke of 1.5% (117/8042), 3.2% (30/933), and 6.2% (24/386) (p<0.001). Compared to a score of 0, the hazard ratios for stroke of score 1 and 2 were 2.3 (95% CI, 1.6-3.5) and 4.6 (95% CI, 2.9-7.1) (both p<0.001) (Figure 1). Conclusion: A simple scoring system can improve prediction of ischemic stroke from 1.8% to 6.2% in patients with no prior history of stroke and excellent blood pressure control. This information could be used to improve patient selection for clinical trials or for identifying patients for more aggressive primary prevention strategies.

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