Debbie Rigby rounds up the latest in research news
Findings from a large Danish case-control study suggests that neonatal vitamin D deficiency is associated with an increased risk for schizophrenia in later life. Compared to the reference (fourth) quintile, those in the lowest quintile (<20.4 nmol/L) had a significantly increased risk of schizophrenia (IRR = 1.44). The authors conclude that optimization of maternal vitamin D status may result in the primary prevention of schizophrenia in a manner comparable to the role of folate supplementation in the prevention of spina bifida.
Scientific Reports 2018;8:17692.
Triple therapy decreases the risk of exacerbations and improved lung function and health status compared to LAMA, ICS/LABA, or LAMA/LABA, with a favorable benefit-to-harm ratio. Triple therapy shows a promising signal in terms of improved survival. The evidence suggests that triple therapy is the most effective treatment in moderate/severe symptomatic patients with COPD at risk of exacerbations, with marginal if any risk of side effects including pneumonia.
International Journal of COPD 2018:13 3971–3981.
A systematic review and meta-analysis of 96 RCTs including over 26,000 patients with chronic noncancer pain has concluded that opioids may provide a statistically significant benefit for chronic noncancer pain, but the magnitude is likely to be small and not clinically significant. Overall pain severity was reduced by -0.69cm on a 10cm visual analogue scale and physical functioning improved by 2.04 on a 100 point scale. Improvements in pain and physical functioning were similar to NSAIDs, TCAs and anticonvulsants.
In this systematic review and network meta-analysis of 33 pharmacological interventions that included 22 037 patients with knee osteoarthritis in 47 randomized clinical trials lasting at least 12 months, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo, including the 2 medications that were associated with improved pain (celecoxib and glucosamine sulfate).