OT: about subscribing to the

[Guest guest]

Ooops. Please disregard the previous message. I should have continued reading

before I responded!

Glad to have you back ... and welcome, to your friend .

We are well. Josh is not on the mainland. He's going to school right here in

Maui, as is Kayla. He also has a part time job at the college, so he isn't

planning on leaving anytime soon. He does have a friend who in recent months

moved to the mainland (Vegas) but he's missing the local island flavor and I

wouldn't be surprised if he comes back home, soon. I think there's just

something magical about this place. Once it becomes your home, nothing else

quite compares and often, you yearn to return.

Still doing it island style : )

Georgina

Meta-analysis Reveals Low Infection Rates With Methotrexate in

Psoriasis

Meta-analysis Reveals Low Infection Rates With Methotrexate in

Psoriasis:

Presented at AAD

www.docguide.com/news/content.nsf/news/852576140048867C852576E200692541

March 10, 2010 -- A meta-analysis of more than a score of randomised

clinical trials of the administration of methotrexate in psoriasis and

rheumatoid arthritis indicated the rate of serious infectious events to be

about 2 per 100 patient-year exposures, researchers said here at the 68th

Annual Meeting of the American Academy of Dermatology (AAD).

" This rate is consistent with past large observational studies, " said

Gloeckner Powers, MD, Grand Rapids Medical Research Center, Grand

Rapids, Michigan, who explained on March 8 that data on serious infectious

events from methotrexate in psoriasis and psoriatic arthritis are limited

and cannot provide meaningful conclusions, unless researchers can use

meta-analysis to put the data into perspective.

Dr. Powers examined literature from EMBASE, MEDLINE, CINAHL, and the

Cochrane Library from January 2005 until May 2009 to estimate serious

infectious events occurring in randomised, placebo-controlled trials of oral

methotrexate 7.5-30.0 mg weekly for psoriasis, psoriatic arthritis, and

rheumatoid arthritis. To be included in the meta-analysis the trials were

conducted for a minimum of 12 weeks with dropout rates of <=20%.

Of 79 potential articles examined, the meta-analysis included 27 studies on

the use of methotrexate. Researchers used 5 relevant psoriasis studies to

determine 2.2 serious infectious events per 100 patient-years (P = .220).

Five studies on psoriatic arthritis revealed 0.9 serious infectious events

per 100 patient-years (P = .263).

After review of 17 related rheumatoid arthritis studies, researchers found

2.3 serious infectious events per 100 patient-years. Although the infection

rate was marginally different from the psoriasis and psoriatic arthritis

groups, the larger number of studies and patients produced a statistically

significant value for the rheumatoid arthritis group (P < .001).

" There are a lot of interesting case reports about opportunistic

infections, " said Dr. Powers. " I think these data at least give us an idea

of the inherent risk with methotrexate. "

She said the study was spurred by the decision in 2009 by the US Food and

Drug Administration to phase withdrawal of efalizumab from the US market

because of increasing concerns of a link to progressive multifocal

leucoencephalopathy.

" Biologic agents have transformed psoriasis treatment, but they are

associated with increased serious infectious events and significant expense,

which revives interest in the comparative efficacy of standard versus new

therapies, " she said.

The feasibility of standard therapies like methotrexate as psoriasis

treatment hinges on a more accurate measurement of serious adverse events

such as serious infectious events.

_________________________________________________________________

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