Background-Voriconazole is a broad spectrum antifungal agent associated with photosensitivity and accelerated photoaging. A possible link with aggressive squamous cell carcinoma (SCC) has also been reported.
Background
There is a need to better understand the safety of TNF inhibitors in patients with psoriatic disease in whom TNF inhibitors are frequently used as monotherapy.
Objective
Examine the risks of infection and malignancy with the use of TNF antagonists in adult patients with psoriatic disease.
Methods
Systematic search for trials of TNF antagonists for adults with plaque psoriasis (PsO) and psoriatic arthritis (PsA). We included randomized, placebo-controlled trials of etanercept, infliximab, adalimumab, golimumab, and certolizumab for the treatment of PsO and PsA. 20 out of 820 identified studies with a total of 6,810 patients were included. Results were calculated using fixed effects models and reported as pooled odds ratios (OR).
Results
ORs for overall infection and serious infection over a mean of 17.8 weeks were 1.18 (95% CI: 1.05, 1.33) and 0.70 (95% CI: 0.40, 1.21), respectively. When adjusting for patient-years, the incidence rate ratio for overall infection was 1.01 (95% CI: 0.92, 1.11). The OR for malignancy was 1.48 (95% CI: 0.71, 3.09), and 1.26 (95% CI: 0.39, 4.15) when non-melanoma skin cancer was excluded.
Limitations
Short duration of follow-up and rarity of malignancies and serious infections.
Conclusions
There is a small increased risk of overall infection with the short-term use of TNF antagonists for psoriasis that may be attributable to differences in follow-up time between treatment and placebo groups. There was no evidence of an increased risk of serious infection and a statistically significant increased risk in cancer was not observed with short-term use of TNF inhibitors.
Background: The increased proportion of female physicians over the last 30 years may have important implications for future physician workforce needs. Objective: To assess the roles of gender, marital status, and parenting in employment choices. Design, Setting, and Participants: Anonymous surveys were distributed to recent dermatology residency graduates taking a board examination review course from 1999 through 2002. Main Outcome Measures: The number of hours respondents saw patients per week and the number of hours they spent in each field of dermatology per week. Results: There were 191 respondents to the survey in 2002, which represented 54% of the 2002 residency graduates. For clarity, this article focuses on the 2002 results except where trends over time become apparent. Of the (REPRINTED) ARCH DERMATOL / VOL 140, FEB 2004 WWW.ARCHDERMATOL.COM 191
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.