Secukinumab treatment of plaque psoriasis shows early improvement in DLQI response - results of a phase II regimen-finding trial.

BACKGROUND: The social stigma and chronicity of psoriasis significantly affect health-related quality of life (HRQoL). OBJECTIVE: We examined the effect of three regimens of secukinumab on HRQoL in moderate to severe psoriasis patients. METHODS: Twelve-week data from a phase II, randomized, double-blind, placebo-controlled, regimen-finding study evaluated HRQoL, measured by the Dermatology Life Quality Index (DLQI). Secukinumab or placebo was administered subcutaneously in three treatment regimens: single (baseline only), monthly (baseline, weeks 4, 8) and early (baseline, weeks 1, 2, 4). Differences among regimens were assessed with logistic regression models and Fisher's exact test. RESULTS: Patients (n = 404) were randomized to single (baseline) treatment regimen, n = 66; monthly, (baseline, weeks 4 and 8), n = 138; early, (baseline, weeks 1, 2, 4), n = 133; and placebo, n = 67. DLQI response was significantly higher in early, monthly and single regimens than in placebo regimen (40.8%, 33.6% and 13.1% vs. 1.6%, respectively; P < 0.001 for all). CONCLUSION: Moderate to severe psoriasis patients receiving monthly and early treatment with secukinumab demonstrated improved HRQoL compared with placebo.

Cemented metal-on-metal total hip replacement with 28-mm head: prospective, long-term, clinical, radiological and metal ions data.

PURPOSE: The aim of this study was to evaluate the long-term clinical, radiological and metal ion blood concentration results following 28-mm metal-on-metal cemented total hip replacement using Metasul(®) acetabular component and polished, cannulated Allopro CF-30 (Sulzer-Medica, subsequently Centerpulse-Zimmer, Winterthur, Switzerland) femoral component. METHODS: Prospective follow-up of patients operated between 1997 and 2000 at a district general hospital. RESULTS: Seventy-nine patients (89 implants) with female predominance and median age of 66 years (IQR 45-87 years) were prospectively followed up for mean 13 years (11-14 years). There was significant improvement in Harris hip score (paired Student's t test p = 0.0001). The mean plasma cobalt and chromium levels were 1.3 µg/L (IQR 0.5-23.9) and 3.6 µg/L (IQR 1.0-22), respectively. Elevated plasma metal ions >7 µg/L were noted in four asymptomatic patients with negative ultrasound examination. Radiolucent lines were present in various zones but majority were stable. One femoral component was revised due to aseptic femoral loosening. Three acetabular and one femoral component have radiologically failed but not revised yet. The Kaplan-Meier survival at 14 years was 92 % for failure as endpoint. CONCLUSION: The long-term survival of Metasul(®) cemented total hip replacements using 28-mm metal-on-metal head is comparable with metal on polyethylene bearing devices.

Therapy service use among individuals with fragile X syndrome: findings from a US parent survey.

BACKGROUND: Fragile X syndrome (FXS) is known to be associated with a range of developmental challenges, yet the occurrence and intensity of therapy services along with associated factors have not been determined. METHOD: In a US national survey, caregivers provided information regarding the therapy services received by their sons (n = 1013) and daughters (n = 283) with FXS (from birth to 63 years; mean = 15.6 years, SD = 10.6). Caregivers reported (1) type, (2) amount, (3) location, and (4) overall satisfaction with services. Associations with other child variables and family income were also examined. RESULTS: Key findings included that 72% of males and 47% of females were currently receiving at least one type of therapy service; the most common services for both males and females were speech-language therapy (ST) and occupational therapy (OT). Overall, males were more likely to receive therapy services as well as a greater number of services than females. Autism status was significantly associated with both males and females receiving ST and males receiving OT and behaviour management therapy. Therapies were provided in a variety of locations, and parents were generally satisfied with the amount and quality of therapy services. Age-related declines were evident in the use of services for both males and females, with very few individuals receiving any therapy services after 20 years of age. CONCLUSIONS: This study provides a baseline description of the current state of therapy services for children with FXS, laying a foundation for future research and recommendations for service provision and policy.