11 October 2017

Journal round up: Support for HPV screening

Clinical

Here’s the latest from the medical journals:

Support for HPV screening

Primary HPV screening is as much as 10 times more effective than cytology for detecting high-grade precancerous cervical lesions in women aged 33 years or under, Australian research has found.

The research comes ahead of the new cervical cancer screening program being introduced in December and is the first study undertaken in a population where there has been high HPV vaccine uptake.

Approximately 5000 women aged between 25 and 64, some of whom were vaccinated and some whom were not, were screened using either liquid-based cytology or HPV testing.

Researchers assessed colposcopy referral and CIN2+  detection rates between the two groups.

These findings provided support for the implementation of HPV screening in vaccinated populations, the study authors said.

PLOS Medicine; 20 September

Inflammation and CVD link

A biologic used to treat juvenile rheumatoid arthritis, canakinumab, has been found to reduce the risk of CVD in people with previous myocardial infarction and high levels of the inflammatory protein, interleukin-1.

The randomised, double-blind trial of more than 10,000 participants, was split into four arms. Each arm received regular injections of either 50mg, 150mg of 300mg of canakinumab, or placebo, for up to four years.

The participants receiving the highest dose of the drug had 14% fewer cardiovascular events compared with the placebo arm, over and above the effect of statins.

Novartis, maker of canakinumab, funded the study.

NEJM; Online 27 August

Corticosteroids as adjunct

Corticosteroids can be used safely as an adjunct treatment to relieve pain for sore throats, a review of and meta-analysis of randomised trials has found.

The review focused on 10 RCTs, involving more than 1400 participants aged over five years, where corticosteroids were added to standard clinical care for presentations of acute tonsillitis, pharyngitis or the clinical syndrome of sore throat.

The most common corticosteroid used was a single dose of oral dexamethasone at a maximum dosage of 10mg.

Those receiving corticosteroids were twice as likely to experience pain relief after 24 hours than the placebo arms, with no increase in serious adverse effects.

BMJ; 20 September

STI check for LARCs

Special vigilance may be needed for STIs among women starting long-acting reversible contraceptives (LARCs), with research showing they are twice as likely to acquire an STI as women on other contraception.

US researchers analysed data from a study of 9,300 women offered a choice of contraceptives. Choosing the LARC didn’t appear to change condom-use behaviour as these women were already less likely to use a condom, saying they always used a condom only 5% of the time, compared with 11% for women who didn’t start on LARC.

During the study period, 4% of LARC users contracted a STI, compared with 2% of those using other contraceptive methods.

Am J Obstet Gynecol; online 14 September

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