Prevalence of dementia in Nigeria: a systematic review of the evidence

Background The burden of dementia is poorly understood in Nigeria. We sought to gather available epidemiologic evidence on dementia in Nigeria to provide country-wide estimates of its prevalence and associated risks. Methods We searched MEDLINE, EMBASE, Global Health, Africa Journals Online (AJOL) and Google Scholar for epidemiologic studies on dementia in Nigeria from 1990 to 2018. We pooled crude estimates using random effects meta-analysis. A meta-regression epidemiologic model, using the United Nations demographics for Nigeria, was used to estimate the absolute number of people living with dementia in Nigeria in 1995 and 2015. Results Our searches returned 835 studies, of which nine were selected. These included 10,820 individuals with a median age of 74.4 years. Heterogeneity ( I2 =98.8%, P<0.001) was high across studies. Five studies were conducted in the South-west, and four studies were rated as high quality. The pooled crude prevalence of dementia in Nigeria was 4.9% (95% confidence interval (CI) 3.0-6.9) with prevalence significantly higher in women (6.7%, 3.6-9.9) compared to men (3.1%, 1.2-5.0). Age 80+ (odds ratio (OR) 1.6, 1.3-1.9), female sex (OR 2.2, 1.4-3.4) and BMI ≤18.5 (OR 3.5, 1.2-10.1) were significant risks for dementia in Nigeria. Using our epidemiologic model, we estimated that the number of dementia cases increased by over 400% over a 20-year period, increasing from 63,512 in 1995 to 318,011 in 2015 among persons aged ≥60 years. Conclusion Our findings suggest the prevalence and cases of dementia have increased in Nigeria over the last two decades. Population-wide response to dementia is lacking

British Association of dermatologists guidelines for biologic therapy for psoriasis 2020 – a rapid update

The overall aim of the guideline is to provide up‐to‐date, evidence‐based recommendations on the use of biologic therapies targeting TNF (adalimumab, etanercept, certolizumab pegol, infliximab), IL12/23p40 (ustekinumab), IL17A (ixekizumab, secukinumab), IL17RA (brodalumab) and IL23p19 (guselkumab, risankizumab, tildrakizumab) in adults, children and young people for the treatment of psoriasis; consideration is given to the specific needs of people with psoriasis and psoriatic arthritis

Comparing the efficacy and tolerability of biologic therapies in psoriasis: an updated network meta-analysis

Background The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development. Objectives To update a 2017 meta‐analysis on the comparative efficacy and tolerability of biologic treatments for psoriasis. Methods We searched the MEDLINE, PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs), published up to 7 September 2018, of 11 licensed, NICE‐approved biologics targeting tumour necrosis factor (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)‐12/IL‐23p40 (ustekinumab), IL‐17A (secukinumab, ixekizumab), IL‐17RA (brodalumab) and IL‐23p19 (guselkumab, tildrakizumab, risankizumab). A frequentist network meta‐analysis ascertained direct or indirect evidence comparing biologics with one another, methotrexate or placebo. This was combined with hierarchical cluster analyses to consider efficacy (≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) or Physician’s Global Assessment 0 or 1; PASI 75; Dermatology Life Quality Index improvement) and tolerability (drug withdrawal due to adverse events) outcomes at 10–16 weeks, followed by assessments of study quality, heterogeneity and inconsistency. Results We identified 62 RCTs presenting data on direct comparisons (31 899 participants). All biologics were efficacious compared with placebo or methotrexate at 10–16 weeks. Hierarchical cluster analyses revealed that adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab and ustekinumab were comparable with respect to high short‐term efficacy and tolerability. Infliximab and ixekizumab clustered together, with high short‐term efficacy but relatively lower tolerability than the other agents, although the number of drug withdrawal events across the network was low, so these findings should be treated with caution. Conclusions Using our methodology we found that most biologics cluster together with respect to short‐term efficacy and tolerability, and we did not identify any single agent as ‘best’. These data need to be interpreted in the context of longer‐term efficacy, effectiveness data, safety, posology and drug acquisition costs when making treatment decisions.</p

Comparing the efficacy and tolerability of biologic therapies in psoriasis: an updated network meta‐analysis

Background: The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development. Objectives: To update a 2017 meta-analysis on the comparative efficacy and tolerability of biologic treatments for psoriasis. Methods: We searched the MEDLINE, PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs), published up to 7 September 2018, of 11 licensed, NICE-approved biologics targeting tumour necrosis factor (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)-12/IL-23p40 (ustekinumab), IL-17A (secukinumab, ixekizumab), IL-17RA (brodalumab) and IL-23p19 (guselkumab, tildrakizumab, risankizumab). A frequentist network meta-analysis ascertained direct or indirect evidence comparing biologics with one another, methotrexate or placebo. This was combined with hierarchical cluster analyses to consider efficacy (≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) or Physician’s Global Assessment 0 or 1; PASI 75; Dermatology Life Quality Index improvement) and tolerability (drug withdrawal due to adverse events) outcomes at 10–16 weeks, followed by assessments of study quality, heterogeneity and inconsistency. Results: We identified 62 RCTs presenting data on direct comparisons (31 899 participants). All biologics were efficacious compared with placebo or methotrexate at 10–16 weeks. Hierarchical cluster analyses revealed that adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab and ustekinumab were comparable with respect to high short-term efficacy and tolerability. Infliximab and ixekizumab clustered together, with high short-term efficacy but relatively lower tolerability than the other agents, although the number of drug withdrawal events across the network was low, so these findings should be treated with caution. Conclusions: Using our methodology we found that most biologics cluster together with respect to short-term efficacy and tolerability, and we did not identify any single agent as ‘best’. These data need to be interpreted in the context of longer-term efficacy, effectiveness data, safety, posology and drug acquisition costs when making treatment decisions

Comparing the efficacy and tolerability of biologic therapies in psoriasis: an updated network meta-analysis

Background The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development. Objectives To update a 2017 meta‐analysis on the comparative efficacy and tolerability of biologic treatments for psoriasis. Methods We searched the MEDLINE, PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs), published up to 7 September 2018, of 11 licensed, NICE‐approved biologics targeting tumour necrosis factor (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)‐12/IL‐23p40 (ustekinumab), IL‐17A (secukinumab, ixekizumab), IL‐17RA (brodalumab) and IL‐23p19 (guselkumab, tildrakizumab, risankizumab). A frequentist network meta‐analysis ascertained direct or indirect evidence comparing biologics with one another, methotrexate or placebo. This was combined with hierarchical cluster analyses to consider efficacy (≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) or Physician’s Global Assessment 0 or 1; PASI 75; Dermatology Life Quality Index improvement) and tolerability (drug withdrawal due to adverse events) outcomes at 10–16 weeks, followed by assessments of study quality, heterogeneity and inconsistency. Results We identified 62 RCTs presenting data on direct comparisons (31 899 participants). All biologics were efficacious compared with placebo or methotrexate at 10–16 weeks. Hierarchical cluster analyses revealed that adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab and ustekinumab were comparable with respect to high short‐term efficacy and tolerability. Infliximab and ixekizumab clustered together, with high short‐term efficacy but relatively lower tolerability than the other agents, although the number of drug withdrawal events across the network was low, so these findings should be treated with caution. Conclusions Using our methodology we found that most biologics cluster together with respect to short‐term efficacy and tolerability, and we did not identify any single agent as ‘best’. These data need to be interpreted in the context of longer‐term efficacy, effectiveness data, safety, posology and drug acquisition costs when making treatment decisions.</p

Comparing the efficacy and tolerability of biologic therapies in psoriasis:an updated network meta-analysis

Background The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development. Objectives To update a 2017 meta‐analysis on the comparative efficacy and tolerability of biologic treatments for psoriasis. Methods We searched the MEDLINE, PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs), published up to 7 September 2018, of 11 licensed, NICE‐approved biologics targeting tumour necrosis factor (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)‐12/IL‐23p40 (ustekinumab), IL‐17A (secukinumab, ixekizumab), IL‐17RA (brodalumab) and IL‐23p19 (guselkumab, tildrakizumab, risankizumab). A frequentist network meta‐analysis ascertained direct or indirect evidence comparing biologics with one another, methotrexate or placebo. This was combined with hierarchical cluster analyses to consider efficacy (≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) or Physician’s Global Assessment 0 or 1; PASI 75; Dermatology Life Quality Index improvement) and tolerability (drug withdrawal due to adverse events) outcomes at 10–16 weeks, followed by assessments of study quality, heterogeneity and inconsistency. Results We identified 62 RCTs presenting data on direct comparisons (31 899 participants). All biologics were efficacious compared with placebo or methotrexate at 10–16 weeks. Hierarchical cluster analyses revealed that adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab and ustekinumab were comparable with respect to high short‐term efficacy and tolerability. Infliximab and ixekizumab clustered together, with high short‐term efficacy but relatively lower tolerability than the other agents, although the number of drug withdrawal events across the network was low, so these findings should be treated with caution. Conclusions Using our methodology we found that most biologics cluster together with respect to short‐term efficacy and tolerability, and we did not identify any single agent as ‘best’. These data need to be interpreted in the context of longer‐term efficacy, effectiveness data, safety, posology and drug acquisition costs when making treatment decisions.</p

British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: A rapid update

The overall aim of the guideline is to provide up‐to‐date, evidence‐based recommendations on the use of biologic therapies targeting TNF (adalimumab, etanercept, certolizumab pegol, infliximab), IL12/23p40 (ustekinumab), IL17A (ixekizumab, secukinumab), IL17RA (brodalumab) and IL23p19 (guselkumab, risankizumab, tildrakizumab) in adults, children and young people for the treatment of psoriasis; consideration is given to the specific needs of people with psoriasis and psoriatic arthritis

Quantitative Evaluation of Biologic Therapy Options for Psoriasis:A Systematic Review and Network Meta-Analysis-Correction

No abstract available

British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of basal cell carcinoma (BCC). The document aims to: offer an appraisal of all relevant literature up to 24(th) January 2020 focusing on any key developments address important, practical clinical questions relating to the primary guideline objective provide guideline recommendations and if appropriate research recommendations.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.Published version, accepted version (12 month embargo), submitted versio