6
HIGHLIGHTS
Gun ban
left nothing
to chance
NEXT-GEN:
Researchers
hope their
study will give
prescribers
comfort
Biologics pose no
preterm birth risk
Women with autoimmune diseases can safely take
new-generation drugs during pregnancy
TAKING biologics shortly before conception or during preg-
nancy does not confer any extra risk of preterm delivery or a
small-for-gestational-age baby (SGA), Canadian researchers say.
They conducted a 10-year retrospective study of 109 women
(120 pregnancies) in British Columbia who were exposed to bio-
logic therapy around the time of pregnancy from 2003 — 2012.
The women were propensity-score matched with 600 preg-
nancies among women with autoimmune disease who did not
take biologic drugs while pregnant.
About one in five (18%) of the biologic-exposed pregnancies
resulted in preterm delivery, compared with 16% of controls, a
non-significant difference. There was also no significant differ-
ence in the prevalence of SGA births between the two groups.
Rheumatoid arthritis and inflammatory bowel disease were
the most common autoimmune diseases in the cohort.
Almost all the women taking biologics were on the TNF-alpha
inhibitors: infliximab, etanercept or adalimumab.
Because so few women take biologics during pregnancy, small
sample sizes are always a challenge in answering safety ques-
tions, the authors say.
Their findings are an important addition to the evidence
and “may lead to increased prescriber comfort and patient
acceptance”.
Evidence suggests higher autoimmune disease activity at con-
ception and during pregnancy carries its own risks, they say.
Annals of the Rheumatic Diseases 2018; online 7 March
MEDICALOBSERVER.COM.AU MARCH 2018
NO
ACCIDENT:
More than
a million
firearms
were
destroyed
after
massacre
THE 22-year absence of
mass shootings in Australia
is a public health success,
say researchers.
In a an attempt to coun-
ter gun lobby claims that it
is chance, they have com-
pared the number of inci-
dents before and after the
gun ownership restrictions
imposed following the Port
Arthur massacre.
More than a million
firearms were destroyed
under the National Firearms
Agreement, which was
introduced after 35 people
were murdered by Martin
Bryant in 1996.
In the 18 years up to and
including the killings, there
were 13 gun homicides in
which five or more people
died, not including the per-
petrator. In the 22 years
since, there have been no
such incidents.
Using mathematical
modelling, the Sydney
University researchers
worked out that the odds
of the two-decade absence
of mass killings being
chance were about
200,000 to one.
“This was no accident,”
co-author Associate Pro-
fessor Philip Alpers says.
“Australia followed standard
public-health procedures
to reduce the risk of multi-
ple shooting events, and
we can see the evidence.
It worked.”
Annals of Medicine 2018;
online 12 March
QUOTABLE QUOTES
“We still have a
very metrocen-
tric approach to
training doctors.”
Dr Scott Lewis, from
Wudinna in South Australia,
calls for more registrars to
be trained in the bush
“Urging patients
to receive their
flu vaccination
too early in
the year may
put them at
serious risk.”
RACGP president
Dr Bastian Seidel decries a
pharmacy push for early jabs
“I am glad I did
medicine as I
am better person
because of it.”
Dr RIchard Mason, from
Hornsby, NSW, reflects
on 50 years of service to
his local community