News

Ofatumumab (Arzerra), a monoclonal antibody treatment for chronic lymphocytic leukemia, will soon be available outside the United States through compassionate use programs only. The drug will continue to be widely available in the United States.

Novartis announced in January that it would begin limiting the availability of the drug outside of the United States and would work with regulatory authorities to set up compassionate use programs for patients who are currently being treated with the drug. Patients who use these programs will receive the drug for free.

The decision was driven by the surge in CLL drugs that have become available over the last 5 years, according to Novartis.

The decision to pull the drug from international markets will not affect its use in ongoing clinical trials, particularly two phase 3 studies in relapsing multiple sclerosis and indolent non-Hodgkin lymphoma.

mschneider@frontlinemedcom.com

Ofatumumab (Arzerra), a monoclonal antibody treatment for chronic lymphocytic leukemia, will soon be available outside the United States through compassionate use programs only. The drug will continue to be widely available in the United States.

Novartis announced in January that it would begin limiting the availability of the drug outside of the United States and would work with regulatory authorities to set up compassionate use programs for patients who are currently being treated with the drug. Patients who use these programs will receive the drug for free.

The decision was driven by the surge in CLL drugs that have become available over the last 5 years, according to Novartis.

The decision to pull the drug from international markets will not affect its use in ongoing clinical trials, particularly two phase 3 studies in relapsing multiple sclerosis and indolent non-Hodgkin lymphoma.

mschneider@frontlinemedcom.com

Ofatumumab (Arzerra), a monoclonal antibody treatment for chronic lymphocytic leukemia, will soon be available outside the United States through compassionate use programs only. The drug will continue to be widely available in the United States.

Novartis announced in January that it would begin limiting the availability of the drug outside of the United States and would work with regulatory authorities to set up compassionate use programs for patients who are currently being treated with the drug. Patients who use these programs will receive the drug for free.

The decision was driven by the surge in CLL drugs that have become available over the last 5 years, according to Novartis.

The decision to pull the drug from international markets will not affect its use in ongoing clinical trials, particularly two phase 3 studies in relapsing multiple sclerosis and indolent non-Hodgkin lymphoma.

mschneider@frontlinemedcom.com

The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

czardases/Thinkstock

The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

czardases/Thinkstock

The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

czardases/Thinkstock

Social media communication around lung cancer is focused primarily on cancer treatment and use of pharmaceutical and research interventions, followed closely by awareness, prevention, and risk topics, according to an analysis of Twitter conversation over a 10-day period.

Although awareness and risk prevention tweets were likely to contain cues toward action, “messages focused on treatment, end of life ... were significantly less likely to integrate cues for personal activity,” the investigators wrote. The report was published in Journal of the American College of Radiology.

©Huntstock/thinkstockphotos.com

SOURCE: Sutton J. et al., J Am Coll Radiol. 2018 Jan. doi: 10.1016/j.jacr.2017.09.043

Social media communication around lung cancer is focused primarily on cancer treatment and use of pharmaceutical and research interventions, followed closely by awareness, prevention, and risk topics, according to an analysis of Twitter conversation over a 10-day period.

Although awareness and risk prevention tweets were likely to contain cues toward action, “messages focused on treatment, end of life ... were significantly less likely to integrate cues for personal activity,” the investigators wrote. The report was published in Journal of the American College of Radiology.

©Huntstock/thinkstockphotos.com

SOURCE: Sutton J. et al., J Am Coll Radiol. 2018 Jan. doi: 10.1016/j.jacr.2017.09.043

Social media communication around lung cancer is focused primarily on cancer treatment and use of pharmaceutical and research interventions, followed closely by awareness, prevention, and risk topics, according to an analysis of Twitter conversation over a 10-day period.

Although awareness and risk prevention tweets were likely to contain cues toward action, “messages focused on treatment, end of life ... were significantly less likely to integrate cues for personal activity,” the investigators wrote. The report was published in Journal of the American College of Radiology.

©Huntstock/thinkstockphotos.com

SOURCE: Sutton J. et al., J Am Coll Radiol. 2018 Jan. doi: 10.1016/j.jacr.2017.09.043

Myocardial infarction admissions were six times more likely to occur in the week after a positive test for influenza than in the year before or the 51 weeks after the infection, according to analysis of a Canadian cohort that links laboratories with administrative databases.

The investigators used this cohort data to define definitions of “risk interval” – the first 7 days after flu detection – and a combined “control interval” – 52 weeks before the flu detection and 51 weeks after the end of the risk interval.

Among the total of 364 hospital admissions for MI in patients with confirmed influenza, 20 occurred during the defined 1-week risk interval (20 admissions/week) and 344 occurred during the control interval (3.3 admissions/week), giving an incidence ratio (IR) of 6.05, Jeffrey C. Kwong, MD, of the University of Toronto and his associates reported in the New England Journal of Medicine.

There was little difference between days 1 and 3 after flu confirmation (IR, 6.3) and days 4-7 (IR, 5.8), but risk dropped off quickly after that, with IRs of 0.6 at days 8-14 and 0.75 at days 15-28. Risk was increased for older adults, those with influenza B infection, and those who had their first MI, the investigators said.

MI incidence also was elevated after infection with noninfluenza respiratory viruses, although to a lesser extent than with influenza, which suggests that “influenza is illustrative of the role that acute respiratory infections have in precipitating acute myocardial infarction,” Dr. Kwong and his associates wrote.

The study was supported by the Canadian Institutes of Health Research, by Public Health Ontario, and by the Institute for Clinical Evaluative Sciences. Dr. Kwong reported grants from Canadian Institutes of Health Research during the conduct of the study, as well as grants from Canadian Institutes of Health Research and University of Toronto.

rfranki@frontlinemedcom.com

SOURCE: Kwong JC et al. N Engl J Med. 2018. 378(4):345-53. doi: 10.1056/NEJMoa1702090.

Myocardial infarction admissions were six times more likely to occur in the week after a positive test for influenza than in the year before or the 51 weeks after the infection, according to analysis of a Canadian cohort that links laboratories with administrative databases.

The investigators used this cohort data to define definitions of “risk interval” – the first 7 days after flu detection – and a combined “control interval” – 52 weeks before the flu detection and 51 weeks after the end of the risk interval.

Among the total of 364 hospital admissions for MI in patients with confirmed influenza, 20 occurred during the defined 1-week risk interval (20 admissions/week) and 344 occurred during the control interval (3.3 admissions/week), giving an incidence ratio (IR) of 6.05, Jeffrey C. Kwong, MD, of the University of Toronto and his associates reported in the New England Journal of Medicine.

There was little difference between days 1 and 3 after flu confirmation (IR, 6.3) and days 4-7 (IR, 5.8), but risk dropped off quickly after that, with IRs of 0.6 at days 8-14 and 0.75 at days 15-28. Risk was increased for older adults, those with influenza B infection, and those who had their first MI, the investigators said.

MI incidence also was elevated after infection with noninfluenza respiratory viruses, although to a lesser extent than with influenza, which suggests that “influenza is illustrative of the role that acute respiratory infections have in precipitating acute myocardial infarction,” Dr. Kwong and his associates wrote.

The study was supported by the Canadian Institutes of Health Research, by Public Health Ontario, and by the Institute for Clinical Evaluative Sciences. Dr. Kwong reported grants from Canadian Institutes of Health Research during the conduct of the study, as well as grants from Canadian Institutes of Health Research and University of Toronto.

rfranki@frontlinemedcom.com

SOURCE: Kwong JC et al. N Engl J Med. 2018. 378(4):345-53. doi: 10.1056/NEJMoa1702090.

Myocardial infarction admissions were six times more likely to occur in the week after a positive test for influenza than in the year before or the 51 weeks after the infection, according to analysis of a Canadian cohort that links laboratories with administrative databases.

The investigators used this cohort data to define definitions of “risk interval” – the first 7 days after flu detection – and a combined “control interval” – 52 weeks before the flu detection and 51 weeks after the end of the risk interval.

Among the total of 364 hospital admissions for MI in patients with confirmed influenza, 20 occurred during the defined 1-week risk interval (20 admissions/week) and 344 occurred during the control interval (3.3 admissions/week), giving an incidence ratio (IR) of 6.05, Jeffrey C. Kwong, MD, of the University of Toronto and his associates reported in the New England Journal of Medicine.

There was little difference between days 1 and 3 after flu confirmation (IR, 6.3) and days 4-7 (IR, 5.8), but risk dropped off quickly after that, with IRs of 0.6 at days 8-14 and 0.75 at days 15-28. Risk was increased for older adults, those with influenza B infection, and those who had their first MI, the investigators said.

MI incidence also was elevated after infection with noninfluenza respiratory viruses, although to a lesser extent than with influenza, which suggests that “influenza is illustrative of the role that acute respiratory infections have in precipitating acute myocardial infarction,” Dr. Kwong and his associates wrote.

The study was supported by the Canadian Institutes of Health Research, by Public Health Ontario, and by the Institute for Clinical Evaluative Sciences. Dr. Kwong reported grants from Canadian Institutes of Health Research during the conduct of the study, as well as grants from Canadian Institutes of Health Research and University of Toronto.

rfranki@frontlinemedcom.com

SOURCE: Kwong JC et al. N Engl J Med. 2018. 378(4):345-53. doi: 10.1056/NEJMoa1702090.

The FDA is launching a new website to get critical updates about antibiotics and antifungals out faster to health care professionals to help them make more informed prescribing decisions. The site will provide “direct and timely access” to information about when bacterial or fungal infections are likely to respond to a specific drug.

“When you are treating critically ill patients, you want as much information as possible about the pathogen…and the susceptibility of that pathogen to various treatment,” said FDA Commissioner Scott Gottlieb, MD. Under the old approach, he said, updating each drug’s individual labeling took too long. Only after the revised drug labeling was approved could a drug or device manufacturer update testing criteria and labeling for the latest antimicrobial susceptibility test results. Each drug and device labeling had to be updated whenever criteria changed.

The new tool will allow the FDA to simultaneously provide updates multiple drugs that have the same active ingredient and share that information transparently via a dedicated web page.

The FDA is launching a new website to get critical updates about antibiotics and antifungals out faster to health care professionals to help them make more informed prescribing decisions. The site will provide “direct and timely access” to information about when bacterial or fungal infections are likely to respond to a specific drug.

“When you are treating critically ill patients, you want as much information as possible about the pathogen…and the susceptibility of that pathogen to various treatment,” said FDA Commissioner Scott Gottlieb, MD. Under the old approach, he said, updating each drug’s individual labeling took too long. Only after the revised drug labeling was approved could a drug or device manufacturer update testing criteria and labeling for the latest antimicrobial susceptibility test results. Each drug and device labeling had to be updated whenever criteria changed.

The new tool will allow the FDA to simultaneously provide updates multiple drugs that have the same active ingredient and share that information transparently via a dedicated web page.

The FDA is launching a new website to get critical updates about antibiotics and antifungals out faster to health care professionals to help them make more informed prescribing decisions. The site will provide “direct and timely access” to information about when bacterial or fungal infections are likely to respond to a specific drug.

“When you are treating critically ill patients, you want as much information as possible about the pathogen…and the susceptibility of that pathogen to various treatment,” said FDA Commissioner Scott Gottlieb, MD. Under the old approach, he said, updating each drug’s individual labeling took too long. Only after the revised drug labeling was approved could a drug or device manufacturer update testing criteria and labeling for the latest antimicrobial susceptibility test results. Each drug and device labeling had to be updated whenever criteria changed.

The new tool will allow the FDA to simultaneously provide updates multiple drugs that have the same active ingredient and share that information transparently via a dedicated web page.

People with rheumatologic diseases and cancer appear to be at no higher risk of having an adverse event or disease flare if they receive checkpoint inhibitor therapy, compared with the general population, experience from the Mayo Clinic suggests.

In a brief report published in Arthritis and Rheumatology, a team from the Mayo Clinic in Rochester, Minn., reported on 16 patients with rheumatologic diseases who received cancer immunotherapy. They found that only a minority experienced a flare of their disease or another immune-related event.

The rate of severe immune-related adverse effects (IRAEs) with a single immune checkpoint inhibitor (ICI) has been reported to be less than 2% among the average population. However, less is known about patients with underlying rheumatologic disease, largely because initial trials of ICIs had excluded patients with autoimmune diseases for fear the treatment would induce a disease flare, the researchers noted.

Small studies have suggested that people with inflammatory arthritis or connective tissue diseases have higher rates of IRAEs with immunotherapy, but it is unclear how often these events represented flares of their disease or new autoimmune events, and whether the events had any predictive significance for cancer survival.

In this study, researchers performed a retrospective review of medical records and identified 16 patients with rheumatologic diseases who had received checkpoint inhibitor therapy at the Mayo Clinic between 2011 and 2016.

The most common rheumatologic diseases among the 16 patients were rheumatoid arthritis, polymyalgia rheumatica, Sjögren’s syndrome, and systemic lupus erythematosus, and the most common cancers were malignant melanoma, pulmonary malignancies, and non-Hodgkin lymphoma. Seven of the patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatologic disease upon initiation of a checkpoint inhibitor.

Ten patients had received a prior disease-modifying antirheumatic drug, but only two patients were still taking this at the time of ICI initiation.

Results showed that six of the patients (38%) had an IRAE or flare of their rheumatologic disease, two were graded as mild. All of the patients responded well to glucocorticoids and discontinuation of therapy. The most common event was colitis and just one patient had a flare of rheumatologic disease.

“This is consistent with what is currently known about the management of IRAEs,” the research team wrote. “This study adds further support to the emerging notion that the rate of IRAEs is not necessarily higher in this group compared to the general population.”

The type and severity of rheumatologic disease may play an important role in both the risk of disease flare and IRAEs, a factor that they were unable to assess in the current study, the researchers wrote.

“Further large, prospective studies are needed to address the link between the type, severity, and concurrent rheumatologic disease activity on the risk of flare and IRAE. It is possible that patients with more severe or active disease are at higher risk for these complications,” they wrote.

While patients in the study did not appear to have significantly increased incidence or severity of adverse effects, the research team advised that “treatment decisions must factor in clinical judgement.”

They noted that some studies had proposed predictive biomarkers, pretreatment workup, and monitoring, but this advice was based on a small body of evidence.

“Larger, prospective studies will be necessary to validate these findings and establish evidence-based guidelines for appropriate identification and rating of the rheumatologic IRAEs as well as their treatment, such that patients can continue to receive potentially life-saving cancer treatments,” they wrote.

One of the researchers reported advisory board membership with Bristol-Myers Squibb.

rhnews@frontlinemedcom.com

SOURCE: Richter M et al. Arthritis Rheumatol. 2018 Jan 24. doi: 10.1002/art.40397.

People with rheumatologic diseases and cancer appear to be at no higher risk of having an adverse event or disease flare if they receive checkpoint inhibitor therapy, compared with the general population, experience from the Mayo Clinic suggests.

In a brief report published in Arthritis and Rheumatology, a team from the Mayo Clinic in Rochester, Minn., reported on 16 patients with rheumatologic diseases who received cancer immunotherapy. They found that only a minority experienced a flare of their disease or another immune-related event.

The rate of severe immune-related adverse effects (IRAEs) with a single immune checkpoint inhibitor (ICI) has been reported to be less than 2% among the average population. However, less is known about patients with underlying rheumatologic disease, largely because initial trials of ICIs had excluded patients with autoimmune diseases for fear the treatment would induce a disease flare, the researchers noted.

Small studies have suggested that people with inflammatory arthritis or connective tissue diseases have higher rates of IRAEs with immunotherapy, but it is unclear how often these events represented flares of their disease or new autoimmune events, and whether the events had any predictive significance for cancer survival.

In this study, researchers performed a retrospective review of medical records and identified 16 patients with rheumatologic diseases who had received checkpoint inhibitor therapy at the Mayo Clinic between 2011 and 2016.

The most common rheumatologic diseases among the 16 patients were rheumatoid arthritis, polymyalgia rheumatica, Sjögren’s syndrome, and systemic lupus erythematosus, and the most common cancers were malignant melanoma, pulmonary malignancies, and non-Hodgkin lymphoma. Seven of the patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatologic disease upon initiation of a checkpoint inhibitor.

Ten patients had received a prior disease-modifying antirheumatic drug, but only two patients were still taking this at the time of ICI initiation.

Results showed that six of the patients (38%) had an IRAE or flare of their rheumatologic disease, two were graded as mild. All of the patients responded well to glucocorticoids and discontinuation of therapy. The most common event was colitis and just one patient had a flare of rheumatologic disease.

“This is consistent with what is currently known about the management of IRAEs,” the research team wrote. “This study adds further support to the emerging notion that the rate of IRAEs is not necessarily higher in this group compared to the general population.”

The type and severity of rheumatologic disease may play an important role in both the risk of disease flare and IRAEs, a factor that they were unable to assess in the current study, the researchers wrote.

“Further large, prospective studies are needed to address the link between the type, severity, and concurrent rheumatologic disease activity on the risk of flare and IRAE. It is possible that patients with more severe or active disease are at higher risk for these complications,” they wrote.

While patients in the study did not appear to have significantly increased incidence or severity of adverse effects, the research team advised that “treatment decisions must factor in clinical judgement.”

They noted that some studies had proposed predictive biomarkers, pretreatment workup, and monitoring, but this advice was based on a small body of evidence.

“Larger, prospective studies will be necessary to validate these findings and establish evidence-based guidelines for appropriate identification and rating of the rheumatologic IRAEs as well as their treatment, such that patients can continue to receive potentially life-saving cancer treatments,” they wrote.

One of the researchers reported advisory board membership with Bristol-Myers Squibb.

rhnews@frontlinemedcom.com

SOURCE: Richter M et al. Arthritis Rheumatol. 2018 Jan 24. doi: 10.1002/art.40397.

People with rheumatologic diseases and cancer appear to be at no higher risk of having an adverse event or disease flare if they receive checkpoint inhibitor therapy, compared with the general population, experience from the Mayo Clinic suggests.

In a brief report published in Arthritis and Rheumatology, a team from the Mayo Clinic in Rochester, Minn., reported on 16 patients with rheumatologic diseases who received cancer immunotherapy. They found that only a minority experienced a flare of their disease or another immune-related event.

The rate of severe immune-related adverse effects (IRAEs) with a single immune checkpoint inhibitor (ICI) has been reported to be less than 2% among the average population. However, less is known about patients with underlying rheumatologic disease, largely because initial trials of ICIs had excluded patients with autoimmune diseases for fear the treatment would induce a disease flare, the researchers noted.

Small studies have suggested that people with inflammatory arthritis or connective tissue diseases have higher rates of IRAEs with immunotherapy, but it is unclear how often these events represented flares of their disease or new autoimmune events, and whether the events had any predictive significance for cancer survival.

In this study, researchers performed a retrospective review of medical records and identified 16 patients with rheumatologic diseases who had received checkpoint inhibitor therapy at the Mayo Clinic between 2011 and 2016.

The most common rheumatologic diseases among the 16 patients were rheumatoid arthritis, polymyalgia rheumatica, Sjögren’s syndrome, and systemic lupus erythematosus, and the most common cancers were malignant melanoma, pulmonary malignancies, and non-Hodgkin lymphoma. Seven of the patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatologic disease upon initiation of a checkpoint inhibitor.

Ten patients had received a prior disease-modifying antirheumatic drug, but only two patients were still taking this at the time of ICI initiation.

Results showed that six of the patients (38%) had an IRAE or flare of their rheumatologic disease, two were graded as mild. All of the patients responded well to glucocorticoids and discontinuation of therapy. The most common event was colitis and just one patient had a flare of rheumatologic disease.

“This is consistent with what is currently known about the management of IRAEs,” the research team wrote. “This study adds further support to the emerging notion that the rate of IRAEs is not necessarily higher in this group compared to the general population.”

The type and severity of rheumatologic disease may play an important role in both the risk of disease flare and IRAEs, a factor that they were unable to assess in the current study, the researchers wrote.

“Further large, prospective studies are needed to address the link between the type, severity, and concurrent rheumatologic disease activity on the risk of flare and IRAE. It is possible that patients with more severe or active disease are at higher risk for these complications,” they wrote.

While patients in the study did not appear to have significantly increased incidence or severity of adverse effects, the research team advised that “treatment decisions must factor in clinical judgement.”

They noted that some studies had proposed predictive biomarkers, pretreatment workup, and monitoring, but this advice was based on a small body of evidence.

“Larger, prospective studies will be necessary to validate these findings and establish evidence-based guidelines for appropriate identification and rating of the rheumatologic IRAEs as well as their treatment, such that patients can continue to receive potentially life-saving cancer treatments,” they wrote.

One of the researchers reported advisory board membership with Bristol-Myers Squibb.

rhnews@frontlinemedcom.com

SOURCE: Richter M et al. Arthritis Rheumatol. 2018 Jan 24. doi: 10.1002/art.40397.

No shocker here: > 90% of American homes have ≥ 3 detectable allergens, and 73% have at least 1 allergen at elevated levels, acceding to the largest U.S. indoor allergen study to date.

Using data from National Institute of Environmental Health Sciences  (NHANES) 2005-2006, researchers studied levels of 8 common allergens (cat, dog, cockroach, mouse, rat, mold, and 2 types of dust mite allergens) in nearly 7,000 homes.

Mobile homes, older homes, rental homes, and rural homes were more likely to have higher amounts of indoor allergens, as were homes with pets and pests.

Elevated levels of dust mites were more common in the South and Northeast and humid regions. Cat and dust mite allergens were more common in rural settings compared with urban.

The NHANES 2005-2006 data allowed national comparisons for the first time of exposure and sensitization. Men and non-Hispanic blacks were less likely to be exposed to multiple allergens, and sensitization was more common in those groups compared with women and other racial groups, respectively. Exposure to several elevated allergens was most prevalent in rural areas. Sensitization rates were higher in urban areas.

The researchers emphasize that the relationships between allergen exposures, allergic sensitization, and disease are complex. They also note that studies are still investigating how allergen exposures interact with other environmental and genetic factors in asthma and allergies. However, among the tips they offer: vacuum every week, wash sheets and blankets in hot water every week, and lower indoor humidity levels below 50%.

No shocker here: > 90% of American homes have ≥ 3 detectable allergens, and 73% have at least 1 allergen at elevated levels, acceding to the largest U.S. indoor allergen study to date.

Using data from National Institute of Environmental Health Sciences  (NHANES) 2005-2006, researchers studied levels of 8 common allergens (cat, dog, cockroach, mouse, rat, mold, and 2 types of dust mite allergens) in nearly 7,000 homes.

Mobile homes, older homes, rental homes, and rural homes were more likely to have higher amounts of indoor allergens, as were homes with pets and pests.

Elevated levels of dust mites were more common in the South and Northeast and humid regions. Cat and dust mite allergens were more common in rural settings compared with urban.

The NHANES 2005-2006 data allowed national comparisons for the first time of exposure and sensitization. Men and non-Hispanic blacks were less likely to be exposed to multiple allergens, and sensitization was more common in those groups compared with women and other racial groups, respectively. Exposure to several elevated allergens was most prevalent in rural areas. Sensitization rates were higher in urban areas.

The researchers emphasize that the relationships between allergen exposures, allergic sensitization, and disease are complex. They also note that studies are still investigating how allergen exposures interact with other environmental and genetic factors in asthma and allergies. However, among the tips they offer: vacuum every week, wash sheets and blankets in hot water every week, and lower indoor humidity levels below 50%.

No shocker here: > 90% of American homes have ≥ 3 detectable allergens, and 73% have at least 1 allergen at elevated levels, acceding to the largest U.S. indoor allergen study to date.

Using data from National Institute of Environmental Health Sciences  (NHANES) 2005-2006, researchers studied levels of 8 common allergens (cat, dog, cockroach, mouse, rat, mold, and 2 types of dust mite allergens) in nearly 7,000 homes.

Mobile homes, older homes, rental homes, and rural homes were more likely to have higher amounts of indoor allergens, as were homes with pets and pests.

Elevated levels of dust mites were more common in the South and Northeast and humid regions. Cat and dust mite allergens were more common in rural settings compared with urban.

The NHANES 2005-2006 data allowed national comparisons for the first time of exposure and sensitization. Men and non-Hispanic blacks were less likely to be exposed to multiple allergens, and sensitization was more common in those groups compared with women and other racial groups, respectively. Exposure to several elevated allergens was most prevalent in rural areas. Sensitization rates were higher in urban areas.

The researchers emphasize that the relationships between allergen exposures, allergic sensitization, and disease are complex. They also note that studies are still investigating how allergen exposures interact with other environmental and genetic factors in asthma and allergies. However, among the tips they offer: vacuum every week, wash sheets and blankets in hot water every week, and lower indoor humidity levels below 50%.

Patients taking disease-modifying antirheumatic medications for systemic sclerosis appear to have a decreased response to pneumococcal vaccines, a Swedish study has determined.

Those not taking disease-modifying antirheumatic medications (DMARDs), however, had a normal immune response, suggesting that it’s the immunomodulating medications, not the disease itself, that is affecting antibody levels, Roger Hesselstrand, MD, of Lund (Sweden) University and his colleagues reported online in Rheumatology.

“The currently recommended prime-boost vaccination strategy using a dose of PCV13 [13-valent pneumococcal conjugate vaccine] followed by a dose of PPV23 [23-valent pneumococcal polysaccharide vaccine] might be a possible way of enhancing the vaccine immunogenicity in immunosuppressed patients,” Dr. Hesselstrand and his coauthors wrote.

The study comprised 44 subjects with systemic sclerosis, 12 of whom were taking a DMARD (mycophenolate mofetil, azathioprine, or hydroxychloroquine), and 49 healthy controls; all underwent pneumococcal vaccination. The first 13 got a single dose of PPV23 intramuscularly. PCV13 was then licensed for adults in Sweden, and the remaining 31 patients received this vaccine. The primary outcome was 6-week change from baseline in the level of pneumococcal IgG to Streptococcus pneumoniae serotypes 23F and 6B.

Both vaccines were safe and well-tolerated by all patients, including those taking a DMARD.

Before vaccination, antibody levels to both serotypes were similar between the groups. After vaccination, antibody levels for both serotypes increased significantly in systemic sclerosis patients not taking a DMARD and in controls. However, patients taking a DMARD mounted only an adequate response to serotype 6B.

msullivan@frontlinemedcom.com

SOURCE: Hesselstrand R et al. Rheumatology [Oxford]. 2018 Jan 8. doi: 10.1093/rheumatology/kex471.

Patients taking disease-modifying antirheumatic medications for systemic sclerosis appear to have a decreased response to pneumococcal vaccines, a Swedish study has determined.

Those not taking disease-modifying antirheumatic medications (DMARDs), however, had a normal immune response, suggesting that it’s the immunomodulating medications, not the disease itself, that is affecting antibody levels, Roger Hesselstrand, MD, of Lund (Sweden) University and his colleagues reported online in Rheumatology.

“The currently recommended prime-boost vaccination strategy using a dose of PCV13 [13-valent pneumococcal conjugate vaccine] followed by a dose of PPV23 [23-valent pneumococcal polysaccharide vaccine] might be a possible way of enhancing the vaccine immunogenicity in immunosuppressed patients,” Dr. Hesselstrand and his coauthors wrote.

The study comprised 44 subjects with systemic sclerosis, 12 of whom were taking a DMARD (mycophenolate mofetil, azathioprine, or hydroxychloroquine), and 49 healthy controls; all underwent pneumococcal vaccination. The first 13 got a single dose of PPV23 intramuscularly. PCV13 was then licensed for adults in Sweden, and the remaining 31 patients received this vaccine. The primary outcome was 6-week change from baseline in the level of pneumococcal IgG to Streptococcus pneumoniae serotypes 23F and 6B.

Both vaccines were safe and well-tolerated by all patients, including those taking a DMARD.

Before vaccination, antibody levels to both serotypes were similar between the groups. After vaccination, antibody levels for both serotypes increased significantly in systemic sclerosis patients not taking a DMARD and in controls. However, patients taking a DMARD mounted only an adequate response to serotype 6B.

msullivan@frontlinemedcom.com

SOURCE: Hesselstrand R et al. Rheumatology [Oxford]. 2018 Jan 8. doi: 10.1093/rheumatology/kex471.

Patients taking disease-modifying antirheumatic medications for systemic sclerosis appear to have a decreased response to pneumococcal vaccines, a Swedish study has determined.

Those not taking disease-modifying antirheumatic medications (DMARDs), however, had a normal immune response, suggesting that it’s the immunomodulating medications, not the disease itself, that is affecting antibody levels, Roger Hesselstrand, MD, of Lund (Sweden) University and his colleagues reported online in Rheumatology.

“The currently recommended prime-boost vaccination strategy using a dose of PCV13 [13-valent pneumococcal conjugate vaccine] followed by a dose of PPV23 [23-valent pneumococcal polysaccharide vaccine] might be a possible way of enhancing the vaccine immunogenicity in immunosuppressed patients,” Dr. Hesselstrand and his coauthors wrote.

The study comprised 44 subjects with systemic sclerosis, 12 of whom were taking a DMARD (mycophenolate mofetil, azathioprine, or hydroxychloroquine), and 49 healthy controls; all underwent pneumococcal vaccination. The first 13 got a single dose of PPV23 intramuscularly. PCV13 was then licensed for adults in Sweden, and the remaining 31 patients received this vaccine. The primary outcome was 6-week change from baseline in the level of pneumococcal IgG to Streptococcus pneumoniae serotypes 23F and 6B.

Both vaccines were safe and well-tolerated by all patients, including those taking a DMARD.

Before vaccination, antibody levels to both serotypes were similar between the groups. After vaccination, antibody levels for both serotypes increased significantly in systemic sclerosis patients not taking a DMARD and in controls. However, patients taking a DMARD mounted only an adequate response to serotype 6B.

msullivan@frontlinemedcom.com

SOURCE: Hesselstrand R et al. Rheumatology [Oxford]. 2018 Jan 8. doi: 10.1093/rheumatology/kex471.

The health care industry sees more nonfatal occupational injury and illness than other industry sectors. One reason may be that employers and employees are not adhering to health and safety best practices, according to a recent National Institute for Occupational Safety and Health (NIOSH) survey of nearly 11,000 workers in a wide range of professional, technical, and support occupations.

The survey—the largest federally sponsored survey addressing chemical hazards in health care—found lapses everywhere. For instance, when administering aerosolized pentamidine, 69% of health care workers did not always wear protective gowns, 49% did not always wear respiratory protection, and 22% did not always wear protective gloves.

When NIOSH compared responses from respondents who administered pentamidine versus those who administered antibiotics, it found that those who administered pentamidine were more likely to be trained, familiar with employer standard procedures, and use eye/face protection and respirators. The major barrier to using personal protective equipment for those who administered either pentamidine or antibiotics include “the perception that aerosolized medications are not as dangerous as other chemicals.” Moreover, NIOSH concluded that there was “a belief” that employers do not fully appreciate the potential adverse health effects associated with exposure to the drugs, and thus do not prioritize adherence.

The survey also revealed that best practices to minimize exposure to high-level disinfectants are not universally implemented: 17% of respondents said they never received training. Of those who received training, 42% said it was > 12 months before, and 19% said employer safe handling procedures were unavailable. Nearly half of respondents did not always wear a protective gown when handling the products; 9% did not always wear protective gloves.

Among other findings: use of anesthesia machines with scavenging systems was “nearly universal.” However, adherence to other best practices was lacking. For instance, one third of health care workers who administered anesthetic gases to children and 14% of those with adult patients started the anesthetic gas flow before the delivery mask or airway mask was applied to the patient. And, 18% of respondents said they never received training. Of those who did receive training, 81% said it had been > 12 months before. Not surprisingly, NIOSH concludes that findings from the survey show that best practices have not been implemented and adherence is “not universal.”

The health care industry sees more nonfatal occupational injury and illness than other industry sectors. One reason may be that employers and employees are not adhering to health and safety best practices, according to a recent National Institute for Occupational Safety and Health (NIOSH) survey of nearly 11,000 workers in a wide range of professional, technical, and support occupations.

The survey—the largest federally sponsored survey addressing chemical hazards in health care—found lapses everywhere. For instance, when administering aerosolized pentamidine, 69% of health care workers did not always wear protective gowns, 49% did not always wear respiratory protection, and 22% did not always wear protective gloves.

When NIOSH compared responses from respondents who administered pentamidine versus those who administered antibiotics, it found that those who administered pentamidine were more likely to be trained, familiar with employer standard procedures, and use eye/face protection and respirators. The major barrier to using personal protective equipment for those who administered either pentamidine or antibiotics include “the perception that aerosolized medications are not as dangerous as other chemicals.” Moreover, NIOSH concluded that there was “a belief” that employers do not fully appreciate the potential adverse health effects associated with exposure to the drugs, and thus do not prioritize adherence.

The survey also revealed that best practices to minimize exposure to high-level disinfectants are not universally implemented: 17% of respondents said they never received training. Of those who received training, 42% said it was > 12 months before, and 19% said employer safe handling procedures were unavailable. Nearly half of respondents did not always wear a protective gown when handling the products; 9% did not always wear protective gloves.

Among other findings: use of anesthesia machines with scavenging systems was “nearly universal.” However, adherence to other best practices was lacking. For instance, one third of health care workers who administered anesthetic gases to children and 14% of those with adult patients started the anesthetic gas flow before the delivery mask or airway mask was applied to the patient. And, 18% of respondents said they never received training. Of those who did receive training, 81% said it had been > 12 months before. Not surprisingly, NIOSH concludes that findings from the survey show that best practices have not been implemented and adherence is “not universal.”

The health care industry sees more nonfatal occupational injury and illness than other industry sectors. One reason may be that employers and employees are not adhering to health and safety best practices, according to a recent National Institute for Occupational Safety and Health (NIOSH) survey of nearly 11,000 workers in a wide range of professional, technical, and support occupations.

The survey—the largest federally sponsored survey addressing chemical hazards in health care—found lapses everywhere. For instance, when administering aerosolized pentamidine, 69% of health care workers did not always wear protective gowns, 49% did not always wear respiratory protection, and 22% did not always wear protective gloves.

When NIOSH compared responses from respondents who administered pentamidine versus those who administered antibiotics, it found that those who administered pentamidine were more likely to be trained, familiar with employer standard procedures, and use eye/face protection and respirators. The major barrier to using personal protective equipment for those who administered either pentamidine or antibiotics include “the perception that aerosolized medications are not as dangerous as other chemicals.” Moreover, NIOSH concluded that there was “a belief” that employers do not fully appreciate the potential adverse health effects associated with exposure to the drugs, and thus do not prioritize adherence.

The survey also revealed that best practices to minimize exposure to high-level disinfectants are not universally implemented: 17% of respondents said they never received training. Of those who received training, 42% said it was > 12 months before, and 19% said employer safe handling procedures were unavailable. Nearly half of respondents did not always wear a protective gown when handling the products; 9% did not always wear protective gloves.

Among other findings: use of anesthesia machines with scavenging systems was “nearly universal.” However, adherence to other best practices was lacking. For instance, one third of health care workers who administered anesthetic gases to children and 14% of those with adult patients started the anesthetic gas flow before the delivery mask or airway mask was applied to the patient. And, 18% of respondents said they never received training. Of those who did receive training, 81% said it had been > 12 months before. Not surprisingly, NIOSH concludes that findings from the survey show that best practices have not been implemented and adherence is “not universal.”

The Food and Drug Administration has granted a priority review for the CAR T-cell therapy tisagenlecleucel suspension, formerly CTL019, for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma who are ineligible for or relapsed after autologous stem cell transplant.

lnikolaides@frontlinemedcom.com

The Food and Drug Administration has granted a priority review for the CAR T-cell therapy tisagenlecleucel suspension, formerly CTL019, for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma who are ineligible for or relapsed after autologous stem cell transplant.

lnikolaides@frontlinemedcom.com

The Food and Drug Administration has granted a priority review for the CAR T-cell therapy tisagenlecleucel suspension, formerly CTL019, for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma who are ineligible for or relapsed after autologous stem cell transplant.

lnikolaides@frontlinemedcom.com