Archita Rai

TOPLINE:

Women with a new diagnosis of irritable bowel syndrome (IBS) have a significantly higher risk for ovarian cancer at 3 months and 6 months post-diagnosis, but this risk is no longer elevated beyond 8 months.

METHODOLOGY:

• Ovarian cancer often presents with nonspecific symptoms overlapping those of IBS. The frequency of misdiagnosis remains unknown, and not all IBS guidelines recommend screening for ovarian cancer.
• Researchers conducted a retrospective cohort study using US administrative claims data to compare ovarian cancer incidence in adult women with and without a new IBS diagnosis.
• Diagnostic codes were used to identify cases of IBS and ovarian cancer.

TAKEAWAY:

• The cohort comprised 9804 women with IBS and 79,804 women without IBS, identified between January 2017 and December 2020.
• Women with IBS had a significantly higher risk for ovarian cancer at 3 months (hazard ratio [HR], 1.71; P = .02) and 6 months (HR, 1.43; P = .02), but not beyond 8 months post-diagnosis.
• Women with both IBS and endometriosis had an even greater risk for ovarian cancer at 3 months (HR, 4.20; P = .01), 6 months (HR, 3.52; P = .01), and after 1 year (HR, 2.67; P = .04).
• Increasing age was significantly associated with higher ovarian cancer incidence only in women younger than 50 years (HR, 1.07; P < .01), regardless of IBS status.

IN PRACTICE:

“Identifying patient-specific risk factors, such as chronic pelvic pain or endometriosis, could help develop tailored risk profiles and improve the approach to personalized care in women with IBS-type symptoms,” the authors wrote.

SOURCE:

This study was led by Andrea Shin, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles. It was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS:

The use of diagnostic codes for identifying IBS may have led to misclassification or reflected symptoms rather than confirmed and validated diagnosis.

DISCLOSURES:

This study received support from the National Institutes of Health. Some authors reported serving as consultants, advisors, and/or receiving research support from pharmaceutical and healthcare companies; one author reported having stock options.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

Women with a new diagnosis of irritable bowel syndrome (IBS) have a significantly higher risk for ovarian cancer at 3 months and 6 months post-diagnosis, but this risk is no longer elevated beyond 8 months.

METHODOLOGY:

• Ovarian cancer often presents with nonspecific symptoms overlapping those of IBS. The frequency of misdiagnosis remains unknown, and not all IBS guidelines recommend screening for ovarian cancer.
• Researchers conducted a retrospective cohort study using US administrative claims data to compare ovarian cancer incidence in adult women with and without a new IBS diagnosis.
• Diagnostic codes were used to identify cases of IBS and ovarian cancer.

TAKEAWAY:

• The cohort comprised 9804 women with IBS and 79,804 women without IBS, identified between January 2017 and December 2020.
• Women with IBS had a significantly higher risk for ovarian cancer at 3 months (hazard ratio [HR], 1.71; P = .02) and 6 months (HR, 1.43; P = .02), but not beyond 8 months post-diagnosis.
• Women with both IBS and endometriosis had an even greater risk for ovarian cancer at 3 months (HR, 4.20; P = .01), 6 months (HR, 3.52; P = .01), and after 1 year (HR, 2.67; P = .04).
• Increasing age was significantly associated with higher ovarian cancer incidence only in women younger than 50 years (HR, 1.07; P < .01), regardless of IBS status.

IN PRACTICE:

“Identifying patient-specific risk factors, such as chronic pelvic pain or endometriosis, could help develop tailored risk profiles and improve the approach to personalized care in women with IBS-type symptoms,” the authors wrote.

SOURCE:

This study was led by Andrea Shin, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles. It was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS:

The use of diagnostic codes for identifying IBS may have led to misclassification or reflected symptoms rather than confirmed and validated diagnosis.

DISCLOSURES:

This study received support from the National Institutes of Health. Some authors reported serving as consultants, advisors, and/or receiving research support from pharmaceutical and healthcare companies; one author reported having stock options.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

Women with a new diagnosis of irritable bowel syndrome (IBS) have a significantly higher risk for ovarian cancer at 3 months and 6 months post-diagnosis, but this risk is no longer elevated beyond 8 months.

METHODOLOGY:

• Ovarian cancer often presents with nonspecific symptoms overlapping those of IBS. The frequency of misdiagnosis remains unknown, and not all IBS guidelines recommend screening for ovarian cancer.
• Researchers conducted a retrospective cohort study using US administrative claims data to compare ovarian cancer incidence in adult women with and without a new IBS diagnosis.
• Diagnostic codes were used to identify cases of IBS and ovarian cancer.

TAKEAWAY:

• The cohort comprised 9804 women with IBS and 79,804 women without IBS, identified between January 2017 and December 2020.
• Women with IBS had a significantly higher risk for ovarian cancer at 3 months (hazard ratio [HR], 1.71; P = .02) and 6 months (HR, 1.43; P = .02), but not beyond 8 months post-diagnosis.
• Women with both IBS and endometriosis had an even greater risk for ovarian cancer at 3 months (HR, 4.20; P = .01), 6 months (HR, 3.52; P = .01), and after 1 year (HR, 2.67; P = .04).
• Increasing age was significantly associated with higher ovarian cancer incidence only in women younger than 50 years (HR, 1.07; P < .01), regardless of IBS status.

IN PRACTICE:

“Identifying patient-specific risk factors, such as chronic pelvic pain or endometriosis, could help develop tailored risk profiles and improve the approach to personalized care in women with IBS-type symptoms,” the authors wrote.

SOURCE:

This study was led by Andrea Shin, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles. It was published online in Alimentary Pharmacology & Therapeutics.

LIMITATIONS:

The use of diagnostic codes for identifying IBS may have led to misclassification or reflected symptoms rather than confirmed and validated diagnosis.

DISCLOSURES:

This study received support from the National Institutes of Health. Some authors reported serving as consultants, advisors, and/or receiving research support from pharmaceutical and healthcare companies; one author reported having stock options.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

Better lung function, expressed as higher forced vital capacity (FVC), is associated with a reduced risk for the onset of heart disease, diabetes, and stroke over a follow-up period of approximately 10 years, according to a cross-sectional analysis of a population-based study.

METHODOLOGY:

• Researchers conducted a cross-sectional analysis of a population-based study (the BOLD study) between 2003 and 2016 to investigate the association between lung function and the onset of cardiometabolic diseases by using data from participants across 15 countries.
• Overall, 5916 participants (mean age, 54 years; 55% women) were included, and the mean follow-up duration was 9.5 years.
• Lung function was evaluated as forced expiratory volume in 1 second (FEV1), FVC, and FEV1/FVC ratio, measured using spirometry at baseline, and postbronchodilator values of these measures were expressed as the percent of the predicted values at baseline.
• The onset of cardiometabolic diseases was identified through participant-reported doctor diagnoses of hypertension, heart disease, diabetes, and stroke at follow-up but not at baseline.

TAKEAWAY:

• Each 10% predicted FVC was associated with a 9% reduced risk for the onset of diabetes (adjusted odds ratio [aOR], 0.91; 95% CI, 0.84-0.99), a 14% reduced risk for the onset of heart disease (aOR, 0.86; 95% CI, 0.80-0.92), and a 19% reduced risk for the onset of stroke (aOR, 0.81; 95% CI, 0.73-0.89).
• Each 10% predicted FEV1 was associated with a reduced risk for the onset of heart disease (aOR, 0.88; 95% CI, 0.83-0.94) and stroke (aOR, 0.83; 95% CI, 0.76-0.90).
• A high FEV1/FVC ratio was associated with an increased risk for the onset of diabetes (aOR per 10%, 1.21; 95% CI, 1.08-1.35) but not associated with other cardiometabolic diseases.
• Moderate heterogeneity was observed across study sites regarding the association between high lung function and the risk for the onset of diabetes and stroke.

IN PRACTICE:

“FVC is not included in any risk score for predicting the risk of cardiometabolic events, although data also suggests that FVC predicted mortality more strongly than systolic blood pressure or BMI [body mass index]. Our results and several previous studies suggest that including FVC will improve the precision of risk scores used to predict the onset of diabetes and cardiovascular diseases,” the authors wrote.

SOURCE:

This study was led by Christer Janson, Department of Medical Sciences Respiratory Medicine, Uppsala Universitet, Uppsala, Sweden. It was published online on January 19, 2025, in BMJ Open Respiratory Research.

LIMITATIONS:

The primary limitation of this study was the reliance on the self-reported onset of cardiometabolic diseases, which is particularly challenging in low- and middle-income countries with underdeveloped healthcare systems. The observed outcomes could be the result of an undiagnosed condition. The data did not allow differentiation between various types of heart diseases or strokes.

DISCLOSURES:

The BOLD study received support through grants from the Wellcome Trust and Medical Research Council, and the follow-up study at some centers was supported by an unrestricted grant from AstraZeneca. Four authors reported receiving support from various sources related or unrelated to this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

TOPLINE:

Better lung function, expressed as higher forced vital capacity (FVC), is associated with a reduced risk for the onset of heart disease, diabetes, and stroke over a follow-up period of approximately 10 years, according to a cross-sectional analysis of a population-based study.

METHODOLOGY:

• Researchers conducted a cross-sectional analysis of a population-based study (the BOLD study) between 2003 and 2016 to investigate the association between lung function and the onset of cardiometabolic diseases by using data from participants across 15 countries.
• Overall, 5916 participants (mean age, 54 years; 55% women) were included, and the mean follow-up duration was 9.5 years.
• Lung function was evaluated as forced expiratory volume in 1 second (FEV1), FVC, and FEV1/FVC ratio, measured using spirometry at baseline, and postbronchodilator values of these measures were expressed as the percent of the predicted values at baseline.
• The onset of cardiometabolic diseases was identified through participant-reported doctor diagnoses of hypertension, heart disease, diabetes, and stroke at follow-up but not at baseline.

TAKEAWAY:

• Each 10% predicted FVC was associated with a 9% reduced risk for the onset of diabetes (adjusted odds ratio [aOR], 0.91; 95% CI, 0.84-0.99), a 14% reduced risk for the onset of heart disease (aOR, 0.86; 95% CI, 0.80-0.92), and a 19% reduced risk for the onset of stroke (aOR, 0.81; 95% CI, 0.73-0.89).
• Each 10% predicted FEV1 was associated with a reduced risk for the onset of heart disease (aOR, 0.88; 95% CI, 0.83-0.94) and stroke (aOR, 0.83; 95% CI, 0.76-0.90).
• A high FEV1/FVC ratio was associated with an increased risk for the onset of diabetes (aOR per 10%, 1.21; 95% CI, 1.08-1.35) but not associated with other cardiometabolic diseases.
• Moderate heterogeneity was observed across study sites regarding the association between high lung function and the risk for the onset of diabetes and stroke.

IN PRACTICE:

“FVC is not included in any risk score for predicting the risk of cardiometabolic events, although data also suggests that FVC predicted mortality more strongly than systolic blood pressure or BMI [body mass index]. Our results and several previous studies suggest that including FVC will improve the precision of risk scores used to predict the onset of diabetes and cardiovascular diseases,” the authors wrote.

SOURCE:

This study was led by Christer Janson, Department of Medical Sciences Respiratory Medicine, Uppsala Universitet, Uppsala, Sweden. It was published online on January 19, 2025, in BMJ Open Respiratory Research.

LIMITATIONS:

The primary limitation of this study was the reliance on the self-reported onset of cardiometabolic diseases, which is particularly challenging in low- and middle-income countries with underdeveloped healthcare systems. The observed outcomes could be the result of an undiagnosed condition. The data did not allow differentiation between various types of heart diseases or strokes.

DISCLOSURES:

The BOLD study received support through grants from the Wellcome Trust and Medical Research Council, and the follow-up study at some centers was supported by an unrestricted grant from AstraZeneca. Four authors reported receiving support from various sources related or unrelated to this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

TOPLINE:

Better lung function, expressed as higher forced vital capacity (FVC), is associated with a reduced risk for the onset of heart disease, diabetes, and stroke over a follow-up period of approximately 10 years, according to a cross-sectional analysis of a population-based study.

METHODOLOGY:

• Researchers conducted a cross-sectional analysis of a population-based study (the BOLD study) between 2003 and 2016 to investigate the association between lung function and the onset of cardiometabolic diseases by using data from participants across 15 countries.
• Overall, 5916 participants (mean age, 54 years; 55% women) were included, and the mean follow-up duration was 9.5 years.
• Lung function was evaluated as forced expiratory volume in 1 second (FEV1), FVC, and FEV1/FVC ratio, measured using spirometry at baseline, and postbronchodilator values of these measures were expressed as the percent of the predicted values at baseline.
• The onset of cardiometabolic diseases was identified through participant-reported doctor diagnoses of hypertension, heart disease, diabetes, and stroke at follow-up but not at baseline.

TAKEAWAY:

• Each 10% predicted FVC was associated with a 9% reduced risk for the onset of diabetes (adjusted odds ratio [aOR], 0.91; 95% CI, 0.84-0.99), a 14% reduced risk for the onset of heart disease (aOR, 0.86; 95% CI, 0.80-0.92), and a 19% reduced risk for the onset of stroke (aOR, 0.81; 95% CI, 0.73-0.89).
• Each 10% predicted FEV1 was associated with a reduced risk for the onset of heart disease (aOR, 0.88; 95% CI, 0.83-0.94) and stroke (aOR, 0.83; 95% CI, 0.76-0.90).
• A high FEV1/FVC ratio was associated with an increased risk for the onset of diabetes (aOR per 10%, 1.21; 95% CI, 1.08-1.35) but not associated with other cardiometabolic diseases.
• Moderate heterogeneity was observed across study sites regarding the association between high lung function and the risk for the onset of diabetes and stroke.

IN PRACTICE:

“FVC is not included in any risk score for predicting the risk of cardiometabolic events, although data also suggests that FVC predicted mortality more strongly than systolic blood pressure or BMI [body mass index]. Our results and several previous studies suggest that including FVC will improve the precision of risk scores used to predict the onset of diabetes and cardiovascular diseases,” the authors wrote.

SOURCE:

This study was led by Christer Janson, Department of Medical Sciences Respiratory Medicine, Uppsala Universitet, Uppsala, Sweden. It was published online on January 19, 2025, in BMJ Open Respiratory Research.

LIMITATIONS:

The primary limitation of this study was the reliance on the self-reported onset of cardiometabolic diseases, which is particularly challenging in low- and middle-income countries with underdeveloped healthcare systems. The observed outcomes could be the result of an undiagnosed condition. The data did not allow differentiation between various types of heart diseases or strokes.

DISCLOSURES:

The BOLD study received support through grants from the Wellcome Trust and Medical Research Council, and the follow-up study at some centers was supported by an unrestricted grant from AstraZeneca. Four authors reported receiving support from various sources related or unrelated to this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

TOPLINE:

Changes in Krebs von den Lungen 6 (KL-6) levels after 12 months of treatment with mycophenolate mofetil (MMF) or cyclophosphamide (CYC) are associated with the development of progressive pulmonary fibrosis (PPF) in patients with systemic sclerosis–associated interstitial lung disease (SSc-ILD) in the following year.

METHODOLOGY:

• Despite available treatments, about 25% of patients with SSc-ILD develop PPF, highlighting the need for reliable early treatment response indicators, such as blood biomarkers, which may help predict the risk for PPF.
• Researchers conducted post hoc analyses of a randomized control trial that compared treatment responses to MMF with those to CYC in patients with SSc-ILD. Patients received either oral CYC for 12 months followed by placebo for 12 months or MMF for 24 months.
• A total of 92 patients with complete biomarker measurements at baseline and 12 months were included in the analysis (mean age, 52.2 years; 73.9% women; 68.5% White).
• The analysis included measurement of multiple blood biomarker levels, including C-reactive protein (CRP), interleukin-6, chemokine ligand 4 (CXCL4), CXCL18, and KL-6. Changes in these levels were evaluated from baseline to 12 months.
• The primary outcome was the development of PPF between 12 and 24 months, defined by meeting at least two of these following conditions: Worsening respiratory symptoms, a decline in forced vital capacity ≥ 5% and/or a decline in diffusing capacity for carbon monoxide ≥ 10%, or radiological disease progression.

TAKEAWAY:

• Among 92 patients, 19 developed PPF between 12 and 24 months, with 10 patients in the MMF arm and 9 patients in the CYC arm.
• KL-6 levels increased from baseline to 12 months in patients who developed PPF and decreased in those who did not (mean change, 365.68 vs –207.45 u/mL; P < .001).
• A 0.10-unit increase in KL-6 levels was associated with a 40% increase in the odds of developing PPF in an adjusted analysis (P = .0002).
• In the MMF group, levels of KL-6, CRP, and CXCL4 differed significantly between patients who developed PPF and those who did not (P = .004, P = .04, and P = .038, respectively).

IN PRACTICE:

“Reliable response biomarkers detectable early in the course of SSc-ILD treatment could minimize exposure to toxic therapies that are not conferring benefit and maximize exposure to alternative therapies that do confer benefit,” the authors wrote.

SOURCE:

The study was led by Elizabeth R. Volkmann, MD, MS, University of California, Los Angeles David Geffen School of Medicine. It was published online in Arthritis Care & Research.

LIMITATIONS:

The study population consisted of patients who were treatment-naive to MMF and CYC and had a relatively early disease course, potentially limiting generalizability to patients at later disease stages or with different treatment histories. Additionally, biomarker measurements were conducted at 12 months, when treatment response may be detectable through currently available methods, rather than at earlier timepoints.

DISCLOSURES:

The study was funded by grants from the National Institutes of Health/National Heart, Lung, and Blood Institute and the Department of Defense. MMF was supplied by Hoffmann–La Roche. Some authors reported having financial relationships with pharmaceutical companies, including Hoffmann–La Roche.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Changes in Krebs von den Lungen 6 (KL-6) levels after 12 months of treatment with mycophenolate mofetil (MMF) or cyclophosphamide (CYC) are associated with the development of progressive pulmonary fibrosis (PPF) in patients with systemic sclerosis–associated interstitial lung disease (SSc-ILD) in the following year.

METHODOLOGY:

• Despite available treatments, about 25% of patients with SSc-ILD develop PPF, highlighting the need for reliable early treatment response indicators, such as blood biomarkers, which may help predict the risk for PPF.
• Researchers conducted post hoc analyses of a randomized control trial that compared treatment responses to MMF with those to CYC in patients with SSc-ILD. Patients received either oral CYC for 12 months followed by placebo for 12 months or MMF for 24 months.
• A total of 92 patients with complete biomarker measurements at baseline and 12 months were included in the analysis (mean age, 52.2 years; 73.9% women; 68.5% White).
• The analysis included measurement of multiple blood biomarker levels, including C-reactive protein (CRP), interleukin-6, chemokine ligand 4 (CXCL4), CXCL18, and KL-6. Changes in these levels were evaluated from baseline to 12 months.
• The primary outcome was the development of PPF between 12 and 24 months, defined by meeting at least two of these following conditions: Worsening respiratory symptoms, a decline in forced vital capacity ≥ 5% and/or a decline in diffusing capacity for carbon monoxide ≥ 10%, or radiological disease progression.

TAKEAWAY:

• Among 92 patients, 19 developed PPF between 12 and 24 months, with 10 patients in the MMF arm and 9 patients in the CYC arm.
• KL-6 levels increased from baseline to 12 months in patients who developed PPF and decreased in those who did not (mean change, 365.68 vs –207.45 u/mL; P < .001).
• A 0.10-unit increase in KL-6 levels was associated with a 40% increase in the odds of developing PPF in an adjusted analysis (P = .0002).
• In the MMF group, levels of KL-6, CRP, and CXCL4 differed significantly between patients who developed PPF and those who did not (P = .004, P = .04, and P = .038, respectively).

IN PRACTICE:

“Reliable response biomarkers detectable early in the course of SSc-ILD treatment could minimize exposure to toxic therapies that are not conferring benefit and maximize exposure to alternative therapies that do confer benefit,” the authors wrote.

SOURCE:

The study was led by Elizabeth R. Volkmann, MD, MS, University of California, Los Angeles David Geffen School of Medicine. It was published online in Arthritis Care & Research.

LIMITATIONS:

The study population consisted of patients who were treatment-naive to MMF and CYC and had a relatively early disease course, potentially limiting generalizability to patients at later disease stages or with different treatment histories. Additionally, biomarker measurements were conducted at 12 months, when treatment response may be detectable through currently available methods, rather than at earlier timepoints.

DISCLOSURES:

The study was funded by grants from the National Institutes of Health/National Heart, Lung, and Blood Institute and the Department of Defense. MMF was supplied by Hoffmann–La Roche. Some authors reported having financial relationships with pharmaceutical companies, including Hoffmann–La Roche.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Changes in Krebs von den Lungen 6 (KL-6) levels after 12 months of treatment with mycophenolate mofetil (MMF) or cyclophosphamide (CYC) are associated with the development of progressive pulmonary fibrosis (PPF) in patients with systemic sclerosis–associated interstitial lung disease (SSc-ILD) in the following year.

METHODOLOGY:

• Despite available treatments, about 25% of patients with SSc-ILD develop PPF, highlighting the need for reliable early treatment response indicators, such as blood biomarkers, which may help predict the risk for PPF.
• Researchers conducted post hoc analyses of a randomized control trial that compared treatment responses to MMF with those to CYC in patients with SSc-ILD. Patients received either oral CYC for 12 months followed by placebo for 12 months or MMF for 24 months.
• A total of 92 patients with complete biomarker measurements at baseline and 12 months were included in the analysis (mean age, 52.2 years; 73.9% women; 68.5% White).
• The analysis included measurement of multiple blood biomarker levels, including C-reactive protein (CRP), interleukin-6, chemokine ligand 4 (CXCL4), CXCL18, and KL-6. Changes in these levels were evaluated from baseline to 12 months.
• The primary outcome was the development of PPF between 12 and 24 months, defined by meeting at least two of these following conditions: Worsening respiratory symptoms, a decline in forced vital capacity ≥ 5% and/or a decline in diffusing capacity for carbon monoxide ≥ 10%, or radiological disease progression.

TAKEAWAY:

• Among 92 patients, 19 developed PPF between 12 and 24 months, with 10 patients in the MMF arm and 9 patients in the CYC arm.
• KL-6 levels increased from baseline to 12 months in patients who developed PPF and decreased in those who did not (mean change, 365.68 vs –207.45 u/mL; P < .001).
• A 0.10-unit increase in KL-6 levels was associated with a 40% increase in the odds of developing PPF in an adjusted analysis (P = .0002).
• In the MMF group, levels of KL-6, CRP, and CXCL4 differed significantly between patients who developed PPF and those who did not (P = .004, P = .04, and P = .038, respectively).

IN PRACTICE:

“Reliable response biomarkers detectable early in the course of SSc-ILD treatment could minimize exposure to toxic therapies that are not conferring benefit and maximize exposure to alternative therapies that do confer benefit,” the authors wrote.

SOURCE:

The study was led by Elizabeth R. Volkmann, MD, MS, University of California, Los Angeles David Geffen School of Medicine. It was published online in Arthritis Care & Research.

LIMITATIONS:

The study population consisted of patients who were treatment-naive to MMF and CYC and had a relatively early disease course, potentially limiting generalizability to patients at later disease stages or with different treatment histories. Additionally, biomarker measurements were conducted at 12 months, when treatment response may be detectable through currently available methods, rather than at earlier timepoints.

DISCLOSURES:

The study was funded by grants from the National Institutes of Health/National Heart, Lung, and Blood Institute and the Department of Defense. MMF was supplied by Hoffmann–La Roche. Some authors reported having financial relationships with pharmaceutical companies, including Hoffmann–La Roche.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

The use of valaciclovir as prophylaxis prevents herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE) receiving anifrolumab treatment, with no cases of zoster reported during the follow-up period in patients receiving valaciclovir.

METHODOLOGY:

• Anifrolumab, a human monoclonal antibody binding to type I interferon receptor subunit 1, increases the risk for HZ in patients with SLE; however, specific recommendations to prevent HZ are currently nonexistent for patients with SLE receiving anifrolumab.
• Researchers conducted a multicenter observational study in France from November 2021 to July 2024 to evaluate the prophylactic benefits of valaciclovir in 132 patients with SLE (mean age, 42 years; 92% women) treated with anifrolumab for ≥ 3 months.
• Among these patients, 87 received either 500 mg/d valaciclovir (n = 69) or 1000 mg/d valaciclovir (n = 18) as prophylaxis, whereas 45 did not receive valaciclovir.
• The patients were followed up for a median duration of 234 days under anifrolumab treatment, with monitoring for the development of herpes zoster.

TAKEAWAY:

• The risk for HZ was significantly lower in patients who received valaciclovir than in those who did not (hazard ratio, 0.08; P = .01).
• None of the patients treated with valaciclovir developed HZ during the survey period.
• The frequency of HZ in patients who did not receive valaciclovir increased progressively from 2.2% at 3 months to 6.2% at 6 months, reaching 23% at 12 months.
• None of the reported cases of HZ required hospitalization or led to anifrolumab discontinuation, although one patient developed neuralgia.

IN PRACTICE:

“Prophylactic treatment with valaciclovir is effective for preventing HZ [herpes zoster] infection in SLE patients treated with anifrolumab,” the authors wrote. “This finding is particularly relevant for SLE patients who cannot receive the recombinant HZ vaccine or for whom it is unavailable,” they added.

SOURCE:

The study was led by Ludovic Trefond, MD, PhD, Centre Hospitalier Universitaire de Clermont-Ferrand in France. It was published online on January 4, 2025, in RMD Open.

LIMITATIONS:

The observational design of the study and the low number of herpes zoster events during the follow-up period may have affected the robustness of the findings.

DISCLOSURES:

The authors did not receive any specific grants. Some authors reported having financial relationships with various pharmaceutical companies.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

The use of valaciclovir as prophylaxis prevents herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE) receiving anifrolumab treatment, with no cases of zoster reported during the follow-up period in patients receiving valaciclovir.

METHODOLOGY:

• Anifrolumab, a human monoclonal antibody binding to type I interferon receptor subunit 1, increases the risk for HZ in patients with SLE; however, specific recommendations to prevent HZ are currently nonexistent for patients with SLE receiving anifrolumab.
• Researchers conducted a multicenter observational study in France from November 2021 to July 2024 to evaluate the prophylactic benefits of valaciclovir in 132 patients with SLE (mean age, 42 years; 92% women) treated with anifrolumab for ≥ 3 months.
• Among these patients, 87 received either 500 mg/d valaciclovir (n = 69) or 1000 mg/d valaciclovir (n = 18) as prophylaxis, whereas 45 did not receive valaciclovir.
• The patients were followed up for a median duration of 234 days under anifrolumab treatment, with monitoring for the development of herpes zoster.

TAKEAWAY:

• The risk for HZ was significantly lower in patients who received valaciclovir than in those who did not (hazard ratio, 0.08; P = .01).
• None of the patients treated with valaciclovir developed HZ during the survey period.
• The frequency of HZ in patients who did not receive valaciclovir increased progressively from 2.2% at 3 months to 6.2% at 6 months, reaching 23% at 12 months.
• None of the reported cases of HZ required hospitalization or led to anifrolumab discontinuation, although one patient developed neuralgia.

IN PRACTICE:

“Prophylactic treatment with valaciclovir is effective for preventing HZ [herpes zoster] infection in SLE patients treated with anifrolumab,” the authors wrote. “This finding is particularly relevant for SLE patients who cannot receive the recombinant HZ vaccine or for whom it is unavailable,” they added.

SOURCE:

The study was led by Ludovic Trefond, MD, PhD, Centre Hospitalier Universitaire de Clermont-Ferrand in France. It was published online on January 4, 2025, in RMD Open.

LIMITATIONS:

The observational design of the study and the low number of herpes zoster events during the follow-up period may have affected the robustness of the findings.

DISCLOSURES:

The authors did not receive any specific grants. Some authors reported having financial relationships with various pharmaceutical companies.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

The use of valaciclovir as prophylaxis prevents herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE) receiving anifrolumab treatment, with no cases of zoster reported during the follow-up period in patients receiving valaciclovir.

METHODOLOGY:

• Anifrolumab, a human monoclonal antibody binding to type I interferon receptor subunit 1, increases the risk for HZ in patients with SLE; however, specific recommendations to prevent HZ are currently nonexistent for patients with SLE receiving anifrolumab.
• Researchers conducted a multicenter observational study in France from November 2021 to July 2024 to evaluate the prophylactic benefits of valaciclovir in 132 patients with SLE (mean age, 42 years; 92% women) treated with anifrolumab for ≥ 3 months.
• Among these patients, 87 received either 500 mg/d valaciclovir (n = 69) or 1000 mg/d valaciclovir (n = 18) as prophylaxis, whereas 45 did not receive valaciclovir.
• The patients were followed up for a median duration of 234 days under anifrolumab treatment, with monitoring for the development of herpes zoster.

TAKEAWAY:

• The risk for HZ was significantly lower in patients who received valaciclovir than in those who did not (hazard ratio, 0.08; P = .01).
• None of the patients treated with valaciclovir developed HZ during the survey period.
• The frequency of HZ in patients who did not receive valaciclovir increased progressively from 2.2% at 3 months to 6.2% at 6 months, reaching 23% at 12 months.
• None of the reported cases of HZ required hospitalization or led to anifrolumab discontinuation, although one patient developed neuralgia.

IN PRACTICE:

“Prophylactic treatment with valaciclovir is effective for preventing HZ [herpes zoster] infection in SLE patients treated with anifrolumab,” the authors wrote. “This finding is particularly relevant for SLE patients who cannot receive the recombinant HZ vaccine or for whom it is unavailable,” they added.

SOURCE:

The study was led by Ludovic Trefond, MD, PhD, Centre Hospitalier Universitaire de Clermont-Ferrand in France. It was published online on January 4, 2025, in RMD Open.

LIMITATIONS:

The observational design of the study and the low number of herpes zoster events during the follow-up period may have affected the robustness of the findings.

DISCLOSURES:

The authors did not receive any specific grants. Some authors reported having financial relationships with various pharmaceutical companies.

This article was created using several editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Both low and high levels of high-density lipoprotein (HDL) are associated with an increased risk for age-related macular degeneration (AMD). This study also identified a potential novel single-nucleotide polymorphism linked to an elevated risk for the retina condition.

METHODOLOGY:

• Researchers conducted a cross-sectional retrospective analysis using data from the All of Us research program to assess the association between lipoprotein and the risk for AMD.
• They analyzed data from 2328 patients with AMD (mean age, 75.5 years; 46.7% women; 84.2% White individuals) and 5028 matched controls (mean age, 75.6 years; 52.5% women; 82.9% White individuals).
• Data were extracted for smoking status, history of hyperlipidemia, use of statins (categorized as hepatically and non-hepatically metabolized), and laboratory values for total triglyceride, low-density lipoprotein (LDL), and HDL levels.
• Data for single-nucleotide polymorphisms associated with the dysregulation of LDL and HDL metabolism were extracted using the PLINK toolkit.

TAKEAWAY:

• Both high and low HDL levels were associated with an increased risk for AMD (adjusted odds ratio [aOR], 1.28 for both; both P < .001), whereas low and high levels of triglyceride and LDL did not demonstrate a statistically significant association with the risk for AMD.
• A history of smoking and statin use showed significant associations with an increased risk for AMD (aOR, 1.30 and 1.36, respectively; both P < .001).
• Single-nucleotide polymorphisms in the genes associated with HDL metabolism, ABCA1 and LIPC, were negatively associated with the risk for AMD (aOR, 0.88; P = .04 and aOR, 0.86; P = .001, respectively).
• Lipoprotein(a) or Lp(a) was identified as a novel single nucleotide polymorphism linked to an increased risk for AMD (aOR, 1.37; P = .007).

IN PRACTICE:

“Despite conflicting evidence regarding the relationship with elevated HDL and AMD risk, this is to our knowledge the first time a U-shaped relationship with low and high HDL and AMD has been described. In fact, the presence of a U-shaped relationship may explain inconsistency in prior analyses comparing mean HDL levels in AMD and control populations,” the study authors wrote. 

SOURCE:

The study was led by Jimmy S. Chen, MD, of the Viterbi Family Department of Ophthalmology and Shiley Eye Institute at the University of California, San Diego. It was published online on January 3, 2025, in Ophthalmology.

LIMITATIONS:

The study was limited by the retrospective collection and analysis of data. The use of billing codes for diagnosis extraction may have introduced documentation inaccuracies. The subgroup analysis by severity of AMD was not performed.

DISCLOSURES:

One of the authors was funded by grants from the National Eye Institute (NEI), Research to Prevent Blindness Career Development Award, Robert Machemer MD and International Retinal Research Foundation, and the UC San Diego Academic Senate. Another author reported receiving a grant from the National Heart, Lung, and Blood Institute, while a third author received funding from the National Institutes of Health (NIH), NEI, and Research to Prevent Blindness. The All of Us Research Program was supported by grants from the NIH and other sources. The authors reported no conflicts of interest.
 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Both low and high levels of high-density lipoprotein (HDL) are associated with an increased risk for age-related macular degeneration (AMD). This study also identified a potential novel single-nucleotide polymorphism linked to an elevated risk for the retina condition.

METHODOLOGY:

• Researchers conducted a cross-sectional retrospective analysis using data from the All of Us research program to assess the association between lipoprotein and the risk for AMD.
• They analyzed data from 2328 patients with AMD (mean age, 75.5 years; 46.7% women; 84.2% White individuals) and 5028 matched controls (mean age, 75.6 years; 52.5% women; 82.9% White individuals).
• Data were extracted for smoking status, history of hyperlipidemia, use of statins (categorized as hepatically and non-hepatically metabolized), and laboratory values for total triglyceride, low-density lipoprotein (LDL), and HDL levels.
• Data for single-nucleotide polymorphisms associated with the dysregulation of LDL and HDL metabolism were extracted using the PLINK toolkit.

TAKEAWAY:

• Both high and low HDL levels were associated with an increased risk for AMD (adjusted odds ratio [aOR], 1.28 for both; both P < .001), whereas low and high levels of triglyceride and LDL did not demonstrate a statistically significant association with the risk for AMD.
• A history of smoking and statin use showed significant associations with an increased risk for AMD (aOR, 1.30 and 1.36, respectively; both P < .001).
• Single-nucleotide polymorphisms in the genes associated with HDL metabolism, ABCA1 and LIPC, were negatively associated with the risk for AMD (aOR, 0.88; P = .04 and aOR, 0.86; P = .001, respectively).
• Lipoprotein(a) or Lp(a) was identified as a novel single nucleotide polymorphism linked to an increased risk for AMD (aOR, 1.37; P = .007).

IN PRACTICE:

“Despite conflicting evidence regarding the relationship with elevated HDL and AMD risk, this is to our knowledge the first time a U-shaped relationship with low and high HDL and AMD has been described. In fact, the presence of a U-shaped relationship may explain inconsistency in prior analyses comparing mean HDL levels in AMD and control populations,” the study authors wrote. 

SOURCE:

The study was led by Jimmy S. Chen, MD, of the Viterbi Family Department of Ophthalmology and Shiley Eye Institute at the University of California, San Diego. It was published online on January 3, 2025, in Ophthalmology.

LIMITATIONS:

The study was limited by the retrospective collection and analysis of data. The use of billing codes for diagnosis extraction may have introduced documentation inaccuracies. The subgroup analysis by severity of AMD was not performed.

DISCLOSURES:

One of the authors was funded by grants from the National Eye Institute (NEI), Research to Prevent Blindness Career Development Award, Robert Machemer MD and International Retinal Research Foundation, and the UC San Diego Academic Senate. Another author reported receiving a grant from the National Heart, Lung, and Blood Institute, while a third author received funding from the National Institutes of Health (NIH), NEI, and Research to Prevent Blindness. The All of Us Research Program was supported by grants from the NIH and other sources. The authors reported no conflicts of interest.
 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Both low and high levels of high-density lipoprotein (HDL) are associated with an increased risk for age-related macular degeneration (AMD). This study also identified a potential novel single-nucleotide polymorphism linked to an elevated risk for the retina condition.

METHODOLOGY:

• Researchers conducted a cross-sectional retrospective analysis using data from the All of Us research program to assess the association between lipoprotein and the risk for AMD.
• They analyzed data from 2328 patients with AMD (mean age, 75.5 years; 46.7% women; 84.2% White individuals) and 5028 matched controls (mean age, 75.6 years; 52.5% women; 82.9% White individuals).
• Data were extracted for smoking status, history of hyperlipidemia, use of statins (categorized as hepatically and non-hepatically metabolized), and laboratory values for total triglyceride, low-density lipoprotein (LDL), and HDL levels.
• Data for single-nucleotide polymorphisms associated with the dysregulation of LDL and HDL metabolism were extracted using the PLINK toolkit.

TAKEAWAY:

• Both high and low HDL levels were associated with an increased risk for AMD (adjusted odds ratio [aOR], 1.28 for both; both P < .001), whereas low and high levels of triglyceride and LDL did not demonstrate a statistically significant association with the risk for AMD.
• A history of smoking and statin use showed significant associations with an increased risk for AMD (aOR, 1.30 and 1.36, respectively; both P < .001).
• Single-nucleotide polymorphisms in the genes associated with HDL metabolism, ABCA1 and LIPC, were negatively associated with the risk for AMD (aOR, 0.88; P = .04 and aOR, 0.86; P = .001, respectively).
• Lipoprotein(a) or Lp(a) was identified as a novel single nucleotide polymorphism linked to an increased risk for AMD (aOR, 1.37; P = .007).

IN PRACTICE:

“Despite conflicting evidence regarding the relationship with elevated HDL and AMD risk, this is to our knowledge the first time a U-shaped relationship with low and high HDL and AMD has been described. In fact, the presence of a U-shaped relationship may explain inconsistency in prior analyses comparing mean HDL levels in AMD and control populations,” the study authors wrote. 

SOURCE:

The study was led by Jimmy S. Chen, MD, of the Viterbi Family Department of Ophthalmology and Shiley Eye Institute at the University of California, San Diego. It was published online on January 3, 2025, in Ophthalmology.

LIMITATIONS:

The study was limited by the retrospective collection and analysis of data. The use of billing codes for diagnosis extraction may have introduced documentation inaccuracies. The subgroup analysis by severity of AMD was not performed.

DISCLOSURES:

One of the authors was funded by grants from the National Eye Institute (NEI), Research to Prevent Blindness Career Development Award, Robert Machemer MD and International Retinal Research Foundation, and the UC San Diego Academic Senate. Another author reported receiving a grant from the National Heart, Lung, and Blood Institute, while a third author received funding from the National Institutes of Health (NIH), NEI, and Research to Prevent Blindness. The All of Us Research Program was supported by grants from the NIH and other sources. The authors reported no conflicts of interest.
 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Healthcare utilization after immediate and delayed intrauterine device (IUD) placement postpartum was comparable, with the immediate placement group making slightly fewer visits to obstetricians or gynecologists (ob/gyns). While immediate placement was associated with increased rates of imaging, it showed lower rates of laparoscopic surgery for IUD-related complications.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from Kaiser Permanente Northern California electronic health records to compare healthcare utilization after immediate (within 24 hours of placental delivery) and delayed (after 24 hours up to 6 weeks later) IUD placement.
• They included 11,875 patients who delivered a live neonate and had an IUD placed between 0 and 63 days postpartum from 2016 to 2020, of whom 1543 received immediate IUD placement.
• The primary outcome measures focused on the number of outpatient visits to ob/gyns for any indication within 1 year after delivery.
• The secondary outcomes included pelvic or abdominal ultrasonograms performed in radiology departments, surgical interventions, hospitalizations related to IUD placement, and rates of pregnancy within 1 year.

TAKEAWAY:

• Immediate placement of an IUD was associated with a modest decrease in the number of overall visits to ob/gyns compared with delayed placement (mean visits, 2.30 vs 2.47; adjusted risk ratio [aRR], 0.91; 95% CI, 0.87-0.94; P < .001).
• Immediate placement of an IUD was associated with more imaging studies not within an ob/gyn visit (aRR, 2.26; P < .001); however, the rates of laparoscopic surgeries for complications related to IUD were lower in the immediate than in the delayed group (0.0% vs 0.4%; P = .005).
• Hospitalizations related to IUD insertion were rare and increased in the immediate group (0.4% immediate; 0.02% delayed; P < .001).
• No significant differences in repeat pregnancies were observed between the groups at 1 year (P = .342), and immediate placement of an IUD was not associated with an increased risk for ectopic pregnancies.

IN PRACTICE:

“Because one of the main goals of immediate IUD is preventing short-interval unintended pregnancies, it is of critical importance to highlight that there was no difference in the pregnancy rate between groups in the study,” the authors wrote. “This study can guide patient counseling and consent for immediate IUD,” they further added.

SOURCE:

This study was led by Talis M. Swisher, MD, of the Department of Obstetrics and Gynecology at the San Leandro Medical Center of Kaiser Permanente in San Leandro, California. It was published online on December 12, 2024, in Obstetrics & Gynecology.

LIMITATIONS:

Data on patient satisfaction were not included in this study. No analysis of cost-benefit was carried out due to challenges in comparing differences in insurance plans and regional disparities in costs across the United States. The study setting was unique to Kaiser Permanente Northern California, in which all patients in the hospital had access to IUDs and multiple settings of ultrasonography were readily available. Visits carried out virtually were not included in the analysis.

DISCLOSURES:

This study was supported by the Kaiser Permanente Northern California Graduate Medical Education Program, Kaiser Foundation Hospitals. The authors reported no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Healthcare utilization after immediate and delayed intrauterine device (IUD) placement postpartum was comparable, with the immediate placement group making slightly fewer visits to obstetricians or gynecologists (ob/gyns). While immediate placement was associated with increased rates of imaging, it showed lower rates of laparoscopic surgery for IUD-related complications.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from Kaiser Permanente Northern California electronic health records to compare healthcare utilization after immediate (within 24 hours of placental delivery) and delayed (after 24 hours up to 6 weeks later) IUD placement.
• They included 11,875 patients who delivered a live neonate and had an IUD placed between 0 and 63 days postpartum from 2016 to 2020, of whom 1543 received immediate IUD placement.
• The primary outcome measures focused on the number of outpatient visits to ob/gyns for any indication within 1 year after delivery.
• The secondary outcomes included pelvic or abdominal ultrasonograms performed in radiology departments, surgical interventions, hospitalizations related to IUD placement, and rates of pregnancy within 1 year.

TAKEAWAY:

• Immediate placement of an IUD was associated with a modest decrease in the number of overall visits to ob/gyns compared with delayed placement (mean visits, 2.30 vs 2.47; adjusted risk ratio [aRR], 0.91; 95% CI, 0.87-0.94; P < .001).
• Immediate placement of an IUD was associated with more imaging studies not within an ob/gyn visit (aRR, 2.26; P < .001); however, the rates of laparoscopic surgeries for complications related to IUD were lower in the immediate than in the delayed group (0.0% vs 0.4%; P = .005).
• Hospitalizations related to IUD insertion were rare and increased in the immediate group (0.4% immediate; 0.02% delayed; P < .001).
• No significant differences in repeat pregnancies were observed between the groups at 1 year (P = .342), and immediate placement of an IUD was not associated with an increased risk for ectopic pregnancies.

IN PRACTICE:

“Because one of the main goals of immediate IUD is preventing short-interval unintended pregnancies, it is of critical importance to highlight that there was no difference in the pregnancy rate between groups in the study,” the authors wrote. “This study can guide patient counseling and consent for immediate IUD,” they further added.

SOURCE:

This study was led by Talis M. Swisher, MD, of the Department of Obstetrics and Gynecology at the San Leandro Medical Center of Kaiser Permanente in San Leandro, California. It was published online on December 12, 2024, in Obstetrics & Gynecology.

LIMITATIONS:

Data on patient satisfaction were not included in this study. No analysis of cost-benefit was carried out due to challenges in comparing differences in insurance plans and regional disparities in costs across the United States. The study setting was unique to Kaiser Permanente Northern California, in which all patients in the hospital had access to IUDs and multiple settings of ultrasonography were readily available. Visits carried out virtually were not included in the analysis.

DISCLOSURES:

This study was supported by the Kaiser Permanente Northern California Graduate Medical Education Program, Kaiser Foundation Hospitals. The authors reported no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Healthcare utilization after immediate and delayed intrauterine device (IUD) placement postpartum was comparable, with the immediate placement group making slightly fewer visits to obstetricians or gynecologists (ob/gyns). While immediate placement was associated with increased rates of imaging, it showed lower rates of laparoscopic surgery for IUD-related complications.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from Kaiser Permanente Northern California electronic health records to compare healthcare utilization after immediate (within 24 hours of placental delivery) and delayed (after 24 hours up to 6 weeks later) IUD placement.
• They included 11,875 patients who delivered a live neonate and had an IUD placed between 0 and 63 days postpartum from 2016 to 2020, of whom 1543 received immediate IUD placement.
• The primary outcome measures focused on the number of outpatient visits to ob/gyns for any indication within 1 year after delivery.
• The secondary outcomes included pelvic or abdominal ultrasonograms performed in radiology departments, surgical interventions, hospitalizations related to IUD placement, and rates of pregnancy within 1 year.

TAKEAWAY:

• Immediate placement of an IUD was associated with a modest decrease in the number of overall visits to ob/gyns compared with delayed placement (mean visits, 2.30 vs 2.47; adjusted risk ratio [aRR], 0.91; 95% CI, 0.87-0.94; P < .001).
• Immediate placement of an IUD was associated with more imaging studies not within an ob/gyn visit (aRR, 2.26; P < .001); however, the rates of laparoscopic surgeries for complications related to IUD were lower in the immediate than in the delayed group (0.0% vs 0.4%; P = .005).
• Hospitalizations related to IUD insertion were rare and increased in the immediate group (0.4% immediate; 0.02% delayed; P < .001).
• No significant differences in repeat pregnancies were observed between the groups at 1 year (P = .342), and immediate placement of an IUD was not associated with an increased risk for ectopic pregnancies.

IN PRACTICE:

“Because one of the main goals of immediate IUD is preventing short-interval unintended pregnancies, it is of critical importance to highlight that there was no difference in the pregnancy rate between groups in the study,” the authors wrote. “This study can guide patient counseling and consent for immediate IUD,” they further added.

SOURCE:

This study was led by Talis M. Swisher, MD, of the Department of Obstetrics and Gynecology at the San Leandro Medical Center of Kaiser Permanente in San Leandro, California. It was published online on December 12, 2024, in Obstetrics & Gynecology.

LIMITATIONS:

Data on patient satisfaction were not included in this study. No analysis of cost-benefit was carried out due to challenges in comparing differences in insurance plans and regional disparities in costs across the United States. The study setting was unique to Kaiser Permanente Northern California, in which all patients in the hospital had access to IUDs and multiple settings of ultrasonography were readily available. Visits carried out virtually were not included in the analysis.

DISCLOSURES:

This study was supported by the Kaiser Permanente Northern California Graduate Medical Education Program, Kaiser Foundation Hospitals. The authors reported no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Adults aged 50 years who were born preterm have a higher risk for hypertension but lower risk for cardiovascular events than those born at term, with similar risks for diabetes, prediabetes, and dyslipidemia between groups.

METHODOLOGY:

• The researchers conducted a prospective cohort study of the Auckland Steroid Trial — the first randomized trial of antenatal corticosteroids (betamethasone) for women who were at risk for preterm birth, conducted in Auckland, New Zealand, between December 1969 and February 1974.
• They analyzed 470 participants, including 424 survivors recruited between January 2020 and May 2022 and 46 participants who died after infancy.
• The outcomes for 326 participants born preterm (mean age, 49.4 years) and 144 participants born at term (mean age, 49.2 years) were assessed using either a questionnaire, administrative datasets, or both.
• The primary outcome was a composite of cardiovascular events or risk factors, defined as a history of a major adverse cardiovascular event or the presence of at least one cardiovascular risk factor, including diabetes mellitus, prediabetes, treated dyslipidemia, and treated hypertension.
• The secondary outcomes included respiratory, mental health, educational, and other health outcomes, as well as components of the primary outcomes.

TAKEAWAY:

• The composite of cardiovascular events or risk factors occurred in 34.5% of participants born preterm and 29.9% of participants born at term, with no differences in the risk factor components.
• The risk for cardiovascular events was lower in participants born preterm than in those born at term (adjusted relative risk [aRR], 0.33; P = .013).
• The participants born preterm had a higher risk for high blood pressure (aRR, 1.74; P = .007) and the composite of treated hypertension or self-reported diagnosis of high blood pressure (aRR, 1.63; P = .010) than those born at term.
• From randomization to the 50-year follow-up, death from any cause was more common in those born preterm than in those born at term (aRR, 2.29; P < .0001), whereas the diagnosis or treatment of a mental health disorder was less common (P = .007); no differences were observed between the groups for other outcomes.

IN PRACTICE:

“Those aware of being born preterm also may be more likely to seek preventive treatments, potentially resulting in a reduced risk of cardiovascular disease but a greater prevalence of risk factors if defined by a treatment such as treated dyslipidemia or treated hypertension,” the authors wrote.

“In this cohort, the survival advantage of the term-born control group abated after infancy, with a higher all-cause mortality rate, compared with that of the group born preterm,” wrote Jonathan S. Litt, MD, MPH, ScD, and Henning Tiemeier, MD, PhD, in a related commentary published in Pediatrics.

SOURCE:

The study was led by Anthony G. B. Walters, MBChB, Liggins Institute, Auckland, New Zealand. It was published online on December 16, 2024, in Pediatrics .

LIMITATIONS:

The small sample size limited the ability to detect subtle differences between groups and the validity of subgroup analyses. Attrition bias may have occurred because of low follow-up rates among presumed survivors. Bias could have been introduced because of lack of consent for access to the administrative dataset or from missing data from the participants in the questionnaire. The lack of in-person assessments for blood pressure and blood tests, resulting from geographical dispersion over 50 years, may have led to underestimation of some outcomes. Additionally, as most participants were born moderately or late preterm, with a median gestational age of 34.1 weeks, findings may not be generalizable to those born preterm at earlier gestational ages.

DISCLOSURES:

The study was supported in part by the Aotearoa Foundation, the Auckland Medical Research Foundation, Cure Kids New Zealand, and the Health Research Council of New Zealand. The authors of both the study and the commentary reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Adults aged 50 years who were born preterm have a higher risk for hypertension but lower risk for cardiovascular events than those born at term, with similar risks for diabetes, prediabetes, and dyslipidemia between groups.

METHODOLOGY:

• The researchers conducted a prospective cohort study of the Auckland Steroid Trial — the first randomized trial of antenatal corticosteroids (betamethasone) for women who were at risk for preterm birth, conducted in Auckland, New Zealand, between December 1969 and February 1974.
• They analyzed 470 participants, including 424 survivors recruited between January 2020 and May 2022 and 46 participants who died after infancy.
• The outcomes for 326 participants born preterm (mean age, 49.4 years) and 144 participants born at term (mean age, 49.2 years) were assessed using either a questionnaire, administrative datasets, or both.
• The primary outcome was a composite of cardiovascular events or risk factors, defined as a history of a major adverse cardiovascular event or the presence of at least one cardiovascular risk factor, including diabetes mellitus, prediabetes, treated dyslipidemia, and treated hypertension.
• The secondary outcomes included respiratory, mental health, educational, and other health outcomes, as well as components of the primary outcomes.

TAKEAWAY:

• The composite of cardiovascular events or risk factors occurred in 34.5% of participants born preterm and 29.9% of participants born at term, with no differences in the risk factor components.
• The risk for cardiovascular events was lower in participants born preterm than in those born at term (adjusted relative risk [aRR], 0.33; P = .013).
• The participants born preterm had a higher risk for high blood pressure (aRR, 1.74; P = .007) and the composite of treated hypertension or self-reported diagnosis of high blood pressure (aRR, 1.63; P = .010) than those born at term.
• From randomization to the 50-year follow-up, death from any cause was more common in those born preterm than in those born at term (aRR, 2.29; P < .0001), whereas the diagnosis or treatment of a mental health disorder was less common (P = .007); no differences were observed between the groups for other outcomes.

IN PRACTICE:

“Those aware of being born preterm also may be more likely to seek preventive treatments, potentially resulting in a reduced risk of cardiovascular disease but a greater prevalence of risk factors if defined by a treatment such as treated dyslipidemia or treated hypertension,” the authors wrote.

“In this cohort, the survival advantage of the term-born control group abated after infancy, with a higher all-cause mortality rate, compared with that of the group born preterm,” wrote Jonathan S. Litt, MD, MPH, ScD, and Henning Tiemeier, MD, PhD, in a related commentary published in Pediatrics.

SOURCE:

The study was led by Anthony G. B. Walters, MBChB, Liggins Institute, Auckland, New Zealand. It was published online on December 16, 2024, in Pediatrics .

LIMITATIONS:

The small sample size limited the ability to detect subtle differences between groups and the validity of subgroup analyses. Attrition bias may have occurred because of low follow-up rates among presumed survivors. Bias could have been introduced because of lack of consent for access to the administrative dataset or from missing data from the participants in the questionnaire. The lack of in-person assessments for blood pressure and blood tests, resulting from geographical dispersion over 50 years, may have led to underestimation of some outcomes. Additionally, as most participants were born moderately or late preterm, with a median gestational age of 34.1 weeks, findings may not be generalizable to those born preterm at earlier gestational ages.

DISCLOSURES:

The study was supported in part by the Aotearoa Foundation, the Auckland Medical Research Foundation, Cure Kids New Zealand, and the Health Research Council of New Zealand. The authors of both the study and the commentary reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Adults aged 50 years who were born preterm have a higher risk for hypertension but lower risk for cardiovascular events than those born at term, with similar risks for diabetes, prediabetes, and dyslipidemia between groups.

METHODOLOGY:

• The researchers conducted a prospective cohort study of the Auckland Steroid Trial — the first randomized trial of antenatal corticosteroids (betamethasone) for women who were at risk for preterm birth, conducted in Auckland, New Zealand, between December 1969 and February 1974.
• They analyzed 470 participants, including 424 survivors recruited between January 2020 and May 2022 and 46 participants who died after infancy.
• The outcomes for 326 participants born preterm (mean age, 49.4 years) and 144 participants born at term (mean age, 49.2 years) were assessed using either a questionnaire, administrative datasets, or both.
• The primary outcome was a composite of cardiovascular events or risk factors, defined as a history of a major adverse cardiovascular event or the presence of at least one cardiovascular risk factor, including diabetes mellitus, prediabetes, treated dyslipidemia, and treated hypertension.
• The secondary outcomes included respiratory, mental health, educational, and other health outcomes, as well as components of the primary outcomes.

TAKEAWAY:

• The composite of cardiovascular events or risk factors occurred in 34.5% of participants born preterm and 29.9% of participants born at term, with no differences in the risk factor components.
• The risk for cardiovascular events was lower in participants born preterm than in those born at term (adjusted relative risk [aRR], 0.33; P = .013).
• The participants born preterm had a higher risk for high blood pressure (aRR, 1.74; P = .007) and the composite of treated hypertension or self-reported diagnosis of high blood pressure (aRR, 1.63; P = .010) than those born at term.
• From randomization to the 50-year follow-up, death from any cause was more common in those born preterm than in those born at term (aRR, 2.29; P < .0001), whereas the diagnosis or treatment of a mental health disorder was less common (P = .007); no differences were observed between the groups for other outcomes.

IN PRACTICE:

“Those aware of being born preterm also may be more likely to seek preventive treatments, potentially resulting in a reduced risk of cardiovascular disease but a greater prevalence of risk factors if defined by a treatment such as treated dyslipidemia or treated hypertension,” the authors wrote.

“In this cohort, the survival advantage of the term-born control group abated after infancy, with a higher all-cause mortality rate, compared with that of the group born preterm,” wrote Jonathan S. Litt, MD, MPH, ScD, and Henning Tiemeier, MD, PhD, in a related commentary published in Pediatrics.

SOURCE:

The study was led by Anthony G. B. Walters, MBChB, Liggins Institute, Auckland, New Zealand. It was published online on December 16, 2024, in Pediatrics .

LIMITATIONS:

The small sample size limited the ability to detect subtle differences between groups and the validity of subgroup analyses. Attrition bias may have occurred because of low follow-up rates among presumed survivors. Bias could have been introduced because of lack of consent for access to the administrative dataset or from missing data from the participants in the questionnaire. The lack of in-person assessments for blood pressure and blood tests, resulting from geographical dispersion over 50 years, may have led to underestimation of some outcomes. Additionally, as most participants were born moderately or late preterm, with a median gestational age of 34.1 weeks, findings may not be generalizable to those born preterm at earlier gestational ages.

DISCLOSURES:

The study was supported in part by the Aotearoa Foundation, the Auckland Medical Research Foundation, Cure Kids New Zealand, and the Health Research Council of New Zealand. The authors of both the study and the commentary reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Patients with anorexia nervosa are at significantly increased risk for cardiovascular conditions such as heart failure and cardiac arrest, compared with people without an eating disorder, researchers found. The risk for many of these conditions declines after 5 years of follow-up, whereas the risk for ischemic heart disease rises only after that period.

METHODOLOGY:

• Researchers conducted a longitudinal cohort study by analyzing the data from Taiwan’s National Health Insurance database to investigate the incidences and risk for cardiovascular conditions in patients with anorexia.
• They included 22,891 participants (mean age, 24.9 years; 91.3% women), of whom 2081 were diagnosed with anorexia between January 2010 and December 2021 and 20,810 were matched control participants without any eating disorder.
• The mean follow-up duration of this study was 5 years; investigators also assessed the risk for individual cardiovascular conditions during three periods after the diagnosis of anorexia: 0-24 months, between 24 and 60 months, and greater than 60 months.
• The primary outcomes were the occurrence of major adverse cardiovascular events (MACE) and any cardiovascular condition, including heart failure, stroke, ischemic heart diseases, conduction disorder, inflammatory heart disease, valve disease, cardiomyopathy, atherosclerosis, and cardiac arrest.

TAKEAWAY:

• At the 5-year follow-up, the incidence and risk for MACE were higher in patients with anorexia than in those without (4.82% vs 0.85% and adjusted hazard ratio [aHR], 3.78; 95% CI, 2.83-5.05, respectively).
• Similarly, the incidence of any cardiovascular condition was higher in patients with anorexia than in those without (6.19% vs 2.27%), which translated to a nearly twofold increased risk (aHR, 1.93; 95% CI, 1.54-2.41).
• Patients with anorexia showed elevated risks for individual cardiovascular conditions such as cardiac arrest, structural heart disease, conduction disorder, and heart failure, but not stroke, atherosclerosis, ischemic heart disease, or inflammatory heart disease.
• The risks for congestive heart failure, structural heart disease, and conduction disorder increased in the first 24 months after the diagnosis of anorexia and disappeared after 5 years of follow-up, whereas the risk for ischemic heart disease increased only after 5 years of follow-up.

IN PRACTICE:

“Clinicians should monitor comorbid cardiovascular conditions among patients with [anorexia] at initial presentation, during treatment, and at follow-up,” the authors of the study wrote.

“In this study, most cardiovascular conditions were in remission after 5 years except ischemic heart disease,” the researchers noted. “This finding is corroborated by the recovery rate of 50%-70% in patients with [anorexia] after 4 years of follow-up in a recent meta-analysis, and in previous studies, most of the cardiac complications improved with weight restoration. Similarly, genome-wide association studies did not support elevated cardiovascular risk in patients with [anorexia] due to shared genetic mechanisms between [anorexia] and cardiovascular diseases, but they suggested that cardiovascular diseases were a downstream consequence” of the eating disorder.
 

SOURCE:

The study was led by Mei-Chih Meg Tseng, MD, PhD, of the Department of Psychiatry at Taipei Medical University in Taipei, Taiwan. It was published online on December 19, 2024, in JAMA Network Open.

LIMITATIONS:

The cardiovascular outcomes relied on the clinical diagnoses, and the validity of anorexia or its subtype was not confirmed. The study population was limited to patients seeking medical treatment, which may have led to the inclusion of patients with more severe symptoms. Key potential confounders such as body weight, nutritional status, lifestyle, drug use, and family history were unavailable in the claims dataset and could not be adjusted. The generalizability of the study may be limited as it involved only participants from a single ethnic group.

DISCLOSURES:

This study was supported by grants from the National Science and Technology Council, Taiwan, and Taipei Medical University. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Patients with anorexia nervosa are at significantly increased risk for cardiovascular conditions such as heart failure and cardiac arrest, compared with people without an eating disorder, researchers found. The risk for many of these conditions declines after 5 years of follow-up, whereas the risk for ischemic heart disease rises only after that period.

METHODOLOGY:

• Researchers conducted a longitudinal cohort study by analyzing the data from Taiwan’s National Health Insurance database to investigate the incidences and risk for cardiovascular conditions in patients with anorexia.
• They included 22,891 participants (mean age, 24.9 years; 91.3% women), of whom 2081 were diagnosed with anorexia between January 2010 and December 2021 and 20,810 were matched control participants without any eating disorder.
• The mean follow-up duration of this study was 5 years; investigators also assessed the risk for individual cardiovascular conditions during three periods after the diagnosis of anorexia: 0-24 months, between 24 and 60 months, and greater than 60 months.
• The primary outcomes were the occurrence of major adverse cardiovascular events (MACE) and any cardiovascular condition, including heart failure, stroke, ischemic heart diseases, conduction disorder, inflammatory heart disease, valve disease, cardiomyopathy, atherosclerosis, and cardiac arrest.

TAKEAWAY:

• At the 5-year follow-up, the incidence and risk for MACE were higher in patients with anorexia than in those without (4.82% vs 0.85% and adjusted hazard ratio [aHR], 3.78; 95% CI, 2.83-5.05, respectively).
• Similarly, the incidence of any cardiovascular condition was higher in patients with anorexia than in those without (6.19% vs 2.27%), which translated to a nearly twofold increased risk (aHR, 1.93; 95% CI, 1.54-2.41).
• Patients with anorexia showed elevated risks for individual cardiovascular conditions such as cardiac arrest, structural heart disease, conduction disorder, and heart failure, but not stroke, atherosclerosis, ischemic heart disease, or inflammatory heart disease.
• The risks for congestive heart failure, structural heart disease, and conduction disorder increased in the first 24 months after the diagnosis of anorexia and disappeared after 5 years of follow-up, whereas the risk for ischemic heart disease increased only after 5 years of follow-up.

IN PRACTICE:

“Clinicians should monitor comorbid cardiovascular conditions among patients with [anorexia] at initial presentation, during treatment, and at follow-up,” the authors of the study wrote.

“In this study, most cardiovascular conditions were in remission after 5 years except ischemic heart disease,” the researchers noted. “This finding is corroborated by the recovery rate of 50%-70% in patients with [anorexia] after 4 years of follow-up in a recent meta-analysis, and in previous studies, most of the cardiac complications improved with weight restoration. Similarly, genome-wide association studies did not support elevated cardiovascular risk in patients with [anorexia] due to shared genetic mechanisms between [anorexia] and cardiovascular diseases, but they suggested that cardiovascular diseases were a downstream consequence” of the eating disorder.
 

SOURCE:

The study was led by Mei-Chih Meg Tseng, MD, PhD, of the Department of Psychiatry at Taipei Medical University in Taipei, Taiwan. It was published online on December 19, 2024, in JAMA Network Open.

LIMITATIONS:

The cardiovascular outcomes relied on the clinical diagnoses, and the validity of anorexia or its subtype was not confirmed. The study population was limited to patients seeking medical treatment, which may have led to the inclusion of patients with more severe symptoms. Key potential confounders such as body weight, nutritional status, lifestyle, drug use, and family history were unavailable in the claims dataset and could not be adjusted. The generalizability of the study may be limited as it involved only participants from a single ethnic group.

DISCLOSURES:

This study was supported by grants from the National Science and Technology Council, Taiwan, and Taipei Medical University. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Patients with anorexia nervosa are at significantly increased risk for cardiovascular conditions such as heart failure and cardiac arrest, compared with people without an eating disorder, researchers found. The risk for many of these conditions declines after 5 years of follow-up, whereas the risk for ischemic heart disease rises only after that period.

METHODOLOGY:

• Researchers conducted a longitudinal cohort study by analyzing the data from Taiwan’s National Health Insurance database to investigate the incidences and risk for cardiovascular conditions in patients with anorexia.
• They included 22,891 participants (mean age, 24.9 years; 91.3% women), of whom 2081 were diagnosed with anorexia between January 2010 and December 2021 and 20,810 were matched control participants without any eating disorder.
• The mean follow-up duration of this study was 5 years; investigators also assessed the risk for individual cardiovascular conditions during three periods after the diagnosis of anorexia: 0-24 months, between 24 and 60 months, and greater than 60 months.
• The primary outcomes were the occurrence of major adverse cardiovascular events (MACE) and any cardiovascular condition, including heart failure, stroke, ischemic heart diseases, conduction disorder, inflammatory heart disease, valve disease, cardiomyopathy, atherosclerosis, and cardiac arrest.

TAKEAWAY:

• At the 5-year follow-up, the incidence and risk for MACE were higher in patients with anorexia than in those without (4.82% vs 0.85% and adjusted hazard ratio [aHR], 3.78; 95% CI, 2.83-5.05, respectively).
• Similarly, the incidence of any cardiovascular condition was higher in patients with anorexia than in those without (6.19% vs 2.27%), which translated to a nearly twofold increased risk (aHR, 1.93; 95% CI, 1.54-2.41).
• Patients with anorexia showed elevated risks for individual cardiovascular conditions such as cardiac arrest, structural heart disease, conduction disorder, and heart failure, but not stroke, atherosclerosis, ischemic heart disease, or inflammatory heart disease.
• The risks for congestive heart failure, structural heart disease, and conduction disorder increased in the first 24 months after the diagnosis of anorexia and disappeared after 5 years of follow-up, whereas the risk for ischemic heart disease increased only after 5 years of follow-up.

IN PRACTICE:

“Clinicians should monitor comorbid cardiovascular conditions among patients with [anorexia] at initial presentation, during treatment, and at follow-up,” the authors of the study wrote.

“In this study, most cardiovascular conditions were in remission after 5 years except ischemic heart disease,” the researchers noted. “This finding is corroborated by the recovery rate of 50%-70% in patients with [anorexia] after 4 years of follow-up in a recent meta-analysis, and in previous studies, most of the cardiac complications improved with weight restoration. Similarly, genome-wide association studies did not support elevated cardiovascular risk in patients with [anorexia] due to shared genetic mechanisms between [anorexia] and cardiovascular diseases, but they suggested that cardiovascular diseases were a downstream consequence” of the eating disorder.
 

SOURCE:

The study was led by Mei-Chih Meg Tseng, MD, PhD, of the Department of Psychiatry at Taipei Medical University in Taipei, Taiwan. It was published online on December 19, 2024, in JAMA Network Open.

LIMITATIONS:

The cardiovascular outcomes relied on the clinical diagnoses, and the validity of anorexia or its subtype was not confirmed. The study population was limited to patients seeking medical treatment, which may have led to the inclusion of patients with more severe symptoms. Key potential confounders such as body weight, nutritional status, lifestyle, drug use, and family history were unavailable in the claims dataset and could not be adjusted. The generalizability of the study may be limited as it involved only participants from a single ethnic group.

DISCLOSURES:

This study was supported by grants from the National Science and Technology Council, Taiwan, and Taipei Medical University. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.