No abstract

The prevalence of hyperuricemia and gout has been increasing, but the comparative effectiveness and safety of different treatments remain uncertain. We aimed to compare the effectiveness and safety of different treatments for hyperuricemia using network meta-analysis methodology. We systematically reviewed fifteen randomized controlled trials (involving 7,246 patients through January 2016) that compared the effects of different urate-lowering drugs (allopurinol, benzbromarone, febuxostat, pegloticase and probenecid) on hyperuricemia. Drug efficacy and safety, as outcomes, were measured by whether the target level of serum urate acid was achieved and whether any adverse events occurred, respectively. We derived pooled effect sizes expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The efficacy and safety of the drugs were ranked by cumulative ranking probabilities. Our findings show that febuxostat, benzbromarone, probenecid, pegloticase, and allopurinol were all highly effective at reducing the risk of hyperuricemia compared to placebo. Febuxostat had the best efficacy and safety compared to the other drugs. Furthermore, febuxostat 120 mg QD was more effective at achieving urate-lowering targets (OR: 0.17, 95% CI: 0.12–0.24) and safer (OR: 0.72, 95% CI: 0.56–0.91) than allopurinol.

Background Obesity and metabolic syndrome (MetS) appear in clusters and are both associated with an increased risk of cancer. However, it remains unknown whether obesity status with or without MetS increases the risk of site-specific cancers. Methods We used data derived from 390,575 individuals (37–73 years old) from the UK Biobank who were enrolled from 2006–2016 with a median of 7.8 years of follow-up. Obesity was defined by BMI ≥ 30 kg/m2 and MetS was defined by the criteria of the Adult Treatment Panel-III (ATP-III). Cox proportional hazards models were used to investigate the associations of BMI and MetS with 22 cancers. Results Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) phenotypes represented 6.7% and 17.9% of the total analytic samples and 27.1% and 72.9% of the included subpopulation with obesity, respectively. Obesity was independently associated with higher risks of 10 of 22 cancers. Stratified by metabolic status, the MUO phenotype was consistently associated with 10 obesity-related cancers. In contrast, the MHO phenotype was only associated with increased risks of five cancers: endometrium, oesophagus, kidney, pancreas and postmenopausal breast cancers. Conclusion Even in metabolically healthy individuals, obesity was associated with increased risks of five cancers, whereas we did not find that these individuals were associated with increased risks of several other obesity-related cancers.

Background Cancer poses a serious threat to the health of Chinese people, resulting in a major challenge for public health work. Today, people can obtain relevant information from not only medical workers in hospitals, but also the internet in any place in real-time. Search behaviors can reflect a population’s awareness of cancer from a completely new perspective, which could be driven by the underlying cancer epidemiology. However, such Web-retrieved data are not yet well validated or understood. Objective This study aimed to explore whether a correlation exists between the incidence and mortality of cancers and normalized internet search volumes on the big data platform, Baidu. We also assessed whether the distribution of people who searched for specific types of cancer differed by gender. Finally, we determined whether there were regional disparities among people who searched the Web for cancer-related information. Methods Standard Boolean operators were used to choose search terms for each type of cancer. Spearman’s correlation analysis was used to explore correlations among monthly search index values for each cancer type and their monthly incidence and mortality rates. We conducted cointegration analysis between search index data and incidence rates to examine whether a stable equilibrium existed between them. We also conducted cointegration analysis between search index data and mortality data. Results The monthly Baidu index was significantly correlated with cancer incidence rates for 26 of 28 cancers in China (lung cancer: r =.80, P <.001; liver cancer: r =.28, P =.016; stomach cancer: r =.50, P <.001; esophageal cancer: r =.50, P <.001; colorectal cancer: r =.81, P <.001; pancreatic cancer: r =.86, P <.001; breast cancer: r =.56, P <.001; brain and nervous system cancer: r =.63, P <.001; leukemia: r =.75, P <.001; Non-Hodgkin lymphoma: r =.88, P <.001; Hodgkin lymphoma: r =.91, P <.001; cervical cancer: r =.64, P <.001; prostate cancer: r =.67, P <.001; bladder cancer: r =.62, P <.001; gallbladder and biliary tract cancer: r =.88, P <.001; lip and oral cavity cancer: r =.88, ...