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Component-resolved sensitization profiles in HBV allergy suggest predominant IgE sensitization to Api m 10 as a risk factor for treatment failure in HBV immunotherapy.

BackgroundWe set out a systemic review to evaluate whether off-label bevacizumab is as safe as licensed ranibizumab, and whether bevacizumab can be justifiably offered to patients as a treatment for age-related macular degeneration with robust evidence of no differential risk.Methods and FindingsMedline, Embase and the Cochrane Library were searched with no limitations of language and year of publication. We included RCTs with a minimum follow-up of one year which investigated bevacizumab or ranibizumab in direct comparison or against any other control group (indirect comparison). Direct comparison (3 trials, 1333 patients): The one year data show a significantly higher rate of ocular adverse effects (AE) with bevacizumab compared to ranibizumab (RR = 2.8; 95% CI 1.2–6.5). The proportion of patients with serious infections and gastrointestinal disorders was also higher with bevacizumab than with ranibizumab (RR = 1.3; 95% CI 1.0–1.7). Arterial thromboembolic events were equally distributed among the groups. Indirect comparison: Ranibizumab versus any control (5 trials, 4054 patients): The two year results of three landmark trials showed that while absolute rates of serious ocular AE were low (≤2.1%), relative harm was significantly raised (RR = 3.1; 95% CI 1.1–8.9). A significant increase in nonocular haemorrhage was also observed with ranibizumab (RR = 1.7; 95% CI 1.1–2.7). Bevacizumab versus any control (3 trials, 244 patients): We were unable to judge the safety profile of bevacizumab due to the poor quality of AE monitoring and reporting in the trials.ConclusionsEvidence from head-to-head trials raises concern about an increased risk of ocular and multiple systemic AE with bevacizumab. Therefore, clinicians and patients should continue to carefully weight up the benefits and harms when choosing between the two treatment options. We also emphasize the need for studies that are powered not just for efficacy, but for defined safety outcomes based on the signals detected in this systematic review.

The development of peak performances is a main research focus in sports science. It is unclear how many former top junior athletes achieve success in the elite class later. The aim of the present study was to examine the careers of athletes who participated in major junior or adult/elite cycling events using prospective and retrospective analysis of competition results. The official results of major junior (age < or = 18 years) and elite (age > 18 years) cycling races from 1980 to 2004 were analysed. Age-related aspects, career lengths, and success were compared between riders who presented results in both junior and elite races (JUNIOR ELITE) and riders who had no junior race results (ELITE ONLY). Altogether, 27,454 results of 8004 athletes from 108 countries were collected. We found that 29.4% of the elite athletes had participated in junior World Championships, and that 34% of the participants in junior World Championships later participated in major elite competitions. JUNIOR ELITE athletes are significantly more successful in several cycling disciplines and have their first and last elite result at a younger age than ELITE ONLY athletes. No difference was found in career lengths. The data presented here emphasize the importance of long-term training programmes in the development of peak performance in cycling.