ObjectiveTo examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6–10 years.DesignPooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s.Exposure definitionOwnership of only cats, dogs, birds, rodents, or cats/dogs combined during the first 2 years of life.Outcome definitionCurrent asthma (primary outcome), allergic asthma, allergic rhinitis and allergic sensitization during 6–10 years of age.Data synthesisThree-step approach: (i) Common definition of outcome and exposure variables across cohorts; (ii) calculation of adjusted effect estimates for each cohort; (iii) pooling of effect estimates by using random effects meta-analysis models.ResultsWe found no association between furry and feathered pet keeping early in life and asthma in school age. For example, the odds ratio for asthma comparing cat ownership with “no pets” (10 studies, 11489 participants) was 1.00 (95% confidence interval 0.78 to 1.28) (I2 = 9%; p = 0.36). The odds ratio for asthma comparing dog ownership with “no pets” (9 studies, 11433 participants) was 0.77 (0.58 to 1.03) (I2 = 0%, p = 0.89). Owning both cat(s) and dog(s) compared to “no pets” resulted in an odds ratio of 1.04 (0.59 to 1.84) (I2 = 33%, p = 0.18). Similarly, for allergic asthma and for allergic rhinitis we did not find associations regarding any type of pet ownership early in life. However, we found some evidence for an association between ownership of furry pets during the first 2 years of life and reduced likelihood of becoming sensitized to aero-allergens.ConclusionsPet ownership in early life did not appear to either increase or reduce the risk of asthma or allergic rhinitis symptoms in children aged 6–10. Advice from health care practitioners to avoid or to specifically acquire pets for primary prevention of asthma or allergic rhinitis in children should not be given.

RESUMENFundamento: El objetivo de este estudio es analizar la evolución del consumo de hormona de crecimiento (Somatropina) en la Comunidad Valenciana, durante el periodo 2003 a 2007, determinando el impacto que ha tenido en el mismo el cambio de las condiciones de dispensación de diagnóstico hospitalario a uso hospitalario (mayo 2005), así como la aprobación de una nueva indicación en 2004. Se han estudiado también el número de pacientes tratados y el ahorro económico estimado por los tratamientos denegados por el Comité Asesor.Métodos: Estudio descriptivo. Los datos sobre pacientes se han obtenido de la base de datos propia sobre protocolos de solicitud de tratamiento y los de consumo de hormona de crecimiento de las bases de datos de la Conselleria de Sanidad: Gestor de la prestación farmacéutica Gaia y de consumos de medicamentos en el hospital. Se expresan en número de pacientes tratados, miligramos dispensados y coste. Resultados

Background: More than 3,000 multiple sclerosis (MS) patients were treated with disease-modifying drugs (DMDs) in the Region of Valencia during 2005-2014. We aimed at describing the demographic and clinical characteristics of MS patients who requested treatment with DMDs, variations in their use, and the factors associated with change to second-line therapies during this decade. Methods: A retrospective cohort study with information from Subcomité Especializado de Medicamentos de Alto Impacto Sanitario y/o Económico registers. A statistical analysis was run in 2 phases: descriptive analysis of the sample using classical statistical methods, and of DMD trend by a chi-square test for linear trends; analytic analysis to examine the factors associated with change to second-line treatment (logistic regression model). Results: We selected 2,205 patients (mean age 32.12, SD 9.64; 70% females, and 86.6% remising-remitting MS (RRMS)); 1,012 patients were attended to in highly specialized MS units (45.8%); 525 in monographic units (23.8%); and 668 in general units (30.2%). DMD prescriptions increased, and glatiramer acetate was more widespread at the end of the period (35.4%). Conclusion: Variability in access to different treatments was slight. The younger the patient, the higher the risk of first-line RRMS treatment failing in female gender and first treatment with interferon.