- Safety & Recalls
- Regulatory Updates
- Drug Coverage
- COPD
- Cardiovascular
- Obstetrics-Gynecology & Women's Health
- Ophthalmology
- Clinical Pharmacology
- Pediatrics
- Urology
- Pharmacy
- Idiopathic Pulmonary Fibrosis
- Diabetes and Endocrinology
- Allergy, Immunology, and ENT
- Musculoskeletal/Rheumatology
- Respiratory
- Psychiatry and Behavioral Health
- Dermatology
- Oncology
Meta-analysis: anti-IL-12/23 agents or anti-tumor necrosis factor-alpha treatments have no effect on the cardiovascular risk of chronic plaque psoriasis patients
Biologic agents have no effect on the rate of major adverse cardiovascular events in patients suffering from chronic plaque psoriasis.
Key Points
Biologic agents (anti-IL-12/IL-23 antibodies or anti-tumor necrosis factor (TNF)-alpha treatments) have no effect on the rate of major adverse cardiovascular events (MACEs) in patients suffering from chronic plaque psoriasis, according to a meta-analysis in the August 24/31, 2011 edition of JAMA.
However, according to the researchers, "... a cardioprotective effect has been suggested with systemic agents such as methotrexate and TNF-alpha agents in rheumatoid arthritis and psoriasis populations." They continued, "Preliminary reports of MACEs in psoriasis patients receiving anti-IL-12/23 agents have prompted concern."
To evaluate the effect of these different biologic agents on the incidence of MACE, researchers conducted a meta-analysis of randomized controlled trials (RCTs). Following a systematic search of the medical literature, they identified 22 RCTs randomly assigning a total of 10,183 patients to a biologic agent or placebo. In the anti-IL-12/23 studies, 10 of 3,179 patients receiving an anti-IL-12/23 therapy experienced MACE compared with 0 of 1,474 patients receiving placebo (pooled risk difference, 0.012 events/person-year; 95% CI, -0.001 to 0.026; P=.12). In the anti–TNF-alpha blocker trials, 1 of 3,858 patients receiving an anti-TNF-alpha blocker and 1 of 1,812 patients receiving placebo experienced a MACE (pooled risk difference, -0.0005 events/person-year; 95% CI, -0.010 to 0.009; P=.94). Thus, the meta-analysis was unable to demonstrate an effect of either class of biologic agent on the occurrence of MACE, although the researchers themselves caution that the small number of MACEs and the limited duration of follow-up of included studies likely reduced their statistical power to detect a change in risk.
SOURCE
Ryan C, Leonardi CL, Krueger JG, et al. Association between biologic therapies for chronic plaque psoriasis and cardiovascular events: a meta-analysis of randomized controlled trials. JAMA. 2011;306(8):864–871.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
