9th March 2018, Volume 131 Number 1471

Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia

Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia.

In this multicentre, double-blind, placebo-controlled trial, 1,620 women with singleton pregnancies who were at high risk for preterm preeclampsia were assigned to receive aspirin, at a dose of 150mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. Preterm preeclampsia occurred in 13 participants (1.6%) in the aspirin group, as compared with 35 (4.3%) in the placebo group (odds ratio in the aspirin group, 0.38; P=0.004). There was no difference in the incidence of adverse neonatal events between the two groups.

Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a lower incidence of this diagnosis than placebo.

N Engl J Med 2017; 377:613–22

Association between coffee consumption and risk of renal cell carcinoma?

Apparently, several studies have raised the possibility that regular consumption of coffee may increase the risk for the development of renal cell carcinoma (RCC).

This report concerns a meta-analysis relevant to this issue. The researchers review data from 22 appropriate studies. Comparison is made on the incidence of RCC in those subjects who have consumed at least one cup of coffee per day and those who have not drunk coffee.

The results of the meta-analysis were that the relative risk of RCC in individuals consuming coffee was 0.99. It was concluded that there is no significant association between coffee consumption and RCC.

Internal Medicine Journal 2017; 47:1422–1432

Efficacy and safety of adalimumab every other week versus methotrexate once weekly in children and adolescents with severe chronic plaque psoriasis

Adalimumab is indicated for the treatment of moderate to severe psoriasis in adults. This report concerns a randomised trial which reviews the efficacy and safety of adalimumab in children and adolescents with severe plaque psoriasis.

One hundred and fourteen patients were randomly assigned to receive subcutaneous injections of adalimumab at week 0, then every other week starting at week 1, or oral methotrexate once weekly for 16 weeks. The primary endpoint was a 75% improvement in the lesions at 16 weeks. This was achieved in 58% of the adalimumab group and 32% of the methotrexate group. Adverse events were similar between the groups with infections being the most common.

It was concluded that adalimumab seems to be efficacious and well tolerated for the treatment of severe plaque psoriasis in children and adolescents.

Lancet 2017; 390:40–49