Post-licensure observational safety study after meningococcal B vaccine 4CMenB (Bexsero) vaccination within the routine UK immunisation program.

The study investigated the safety of 4-component meningococcal serogroup B vaccination (4CMenB) in routine care. 4CMenB exposure and seizures, febrile seizures and Kawasaki disease were identified from The Health Improvement Network (THIN) database of UK electronic primary healthcare records, 2015-2018. A self-controlled case series analysis was completed. Anaphylaxis, Guillain-Barré syndrome and acute disseminated encephalomyelitis were secondary outcomes. A total of 107,231 children aged 1-18 months received ≥1 doses of 4CMenB vaccination. Most 4CMenB exposure (93%) was on the same day as other vaccines within a complete national immunisation program stage. With day 0 as day of vaccination, 43 seizures occurred in days 0-6 after 239,505 doses, and 23 febrile seizures occurred in days 0-6, and 4 Kawasaki disease cases in days 1-28 after 194,929 4CMenB doses. Adjusted incidence rate ratios including all 4CMenB exposures were 1.43 (95%CI: 1.02-2.02) for seizures and 1.72 (95%CI: 1.08-2.75) for febrile seizures. There were insufficient cases to model Kawasaki disease, and no cases of the secondary outcomes in risk periods when they may be associated with the vaccination. This study shows few cases of the outcomes after vaccination including 4CMenB with an increased risk of seizures and febrile seizures. It is not possible to attribute the finding to one specific vaccination as the majority of 4CMenB was given with other vaccinations. Trial registration: NA

Primary care incidence and treatment of four neuropathic pain conditions: A descriptive study, 2002–2005

<p>Abstract</p> <p>Background</p> <p>Between 1992 and 2001 the UK general practice incidence of post-herpetic neuralgia and trigeminal neuralgia declined, whilst the incidence of painful diabetic neuropathy increased. The most common first line treatments were compound analgesics. As therapeutic options have subsequently changed, this study presents updated data on incidence and prescribing patterns in neuropathic pain.</p> <p>Methods</p> <p>A descriptive analysis of the epidemiology and prescription treatment at diagnosis of incident post-herpetic neuralgia (n = 1,923); trigeminal neuralgia (1,862); phantom limb pain (57) and painful diabetic neuropathy (1,444) using computerised UK general practice records (THIN): May 2002 to July 2005.</p> <p>Results</p> <p>Primary care incidences per 100,000 person years observation of 28 (95% confidence interval (CI) 27–30) for post-herpetic neuralgia, 27 (95%CI 26–29) for trigeminal neuralgia, 0.8 (95%CI 0.6–1.1) for phantom limb pain and 21 (95%CI 20–22) for painful diabetic neuropathy are reported. The most common initial treatments were tricyclic antidepressants (post-herpetic neuralgia) or antiepileptics (trigeminal neuralgia and painful diabetic neuropathy) and opioid analgesics (phantom limb pain). The mean number of changes before a stable drug regimen was 1.2 to 1.5 for trigeminal neuralgia, painful diabetic neuropathy and post-herpetic neuralgia, and 2.4 for phantom limb pain.</p> <p>Conclusion</p> <p>The incidence of phantom limb pain and post-herpetic neuralgia are decreasing whilst painful diabetic neuropathy plateaued and trigeminal neuralgia remained constant. Despite more frequent use of antidepressants and antiepileptics for first line treatment, as opposed to conventional non-opioid analgesics, changes to therapy are common before a stable regimen is reached.</p

Introducing a common language of health (the read codes) across health care organisations

Version 1.1Available from British Library Document Supply Centre- DSC:GPC/07675 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Read mapping validation Project initiation document; new projects

IMG ref:F6057/ICD/202Available from British Library Document Supply Centre- DSC:GPC/07418 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Joint training project Supplementary classifications

SIGLEAvailable from British Library Document Supply Centre- DSC:GPC/07048 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The read codes Version 3

SIGLEAvailable from British Library Document Supply Centre- DSC:GPD/0678 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A proposed new file structure for qualifiers

Terms projects: TP/121Available from British Library Document Supply Centre- DSC:GPC/04808 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Integrated Clinical Workstation Project investment appraisal (version 2)

IMG reference: F6039/ICWS/180Available from British Library Document Supply Centre- DSC:GPC/06603 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

A guide to the use of tables of equivalence between ICD-9 and ICD-10 Document version 3.0

SIGLEAvailable from British Library Document Supply Centre- DSC:GPC/07054 / BLDSC - British Library Document Supply CentreGBUnited Kingdo