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OBJECTIVES: In trials of acute severe infections or inflammations frequent administration of non-randomised treatment (ie, intercurrent event) in response to clinical events is expected. These events may affect the interpretation of trial findings. Swissped-RECOVERY was set up as one of the first randomised controlled trials worldwide, investigating the comparative effectiveness of anti-inflammatory treatment with intravenous methylprednisolone or intravenous immunoglobulins in children and adolescents with Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). We present one approach towards improving the interpretation of non-randomised treatment in a randomised controlled trial. DESIGN: This is a pre-planned ancillary analysis of the Swissped-RECOVERY trial, a randomised multicentre open-label two-arm trial. SETTING: 10 Swiss paediatric hospitals (secondary and tertiary care) participated. PARTICIPANTS: Paediatric patients hospitalised with PIMS-TS. Interventions: All patient-first intercurrent events, if applicable, were presented to an independent adjudication committee consisting of four international paediatric COVID-19 experts to provide independent clinical adjudication to a set of standardised questions relating to whether additional non-randomised treatments were clinically indicated and disease classification at the time of the intercurrent event. RESULTS: Of 41 treatments in 75 participants (24/41 (59%) and 17/41 (41%) in the intravenous methylprednisolone and immunoglobulin arms of the trial, respectively), two-thirds were considered indicated. The most common treatment (oral glucocorticoids, 14/41, 35%) was mostly considered not indicated (11/14, 79%), although in line with local guidelines. Intercurrent events among patients with Shock-like PIMS-TS at baseline were mostly considered indicated. A significant proportion of patients with undifferentiated PIMS-TS at baseline were not attributed to the same group at

Patients with inflammatory arthritis represent a possible high-risk group to COVID-19 due to their immunosuppressive regimen designed to maintain low disease activity. Thus, substantial effort has been put forth to understand the impact of COVID-19 on these patients. Patients with rheumatic diseases as a whole do not appear to be more susceptible to acquiring COVID-19. Furthermore, immunosuppression generally did not increase the likelihood of developing severe COVID-19, with the important exception of medium and high-dose glucocorticoid use. In addition, a small number of COVID-19 patients have developed new inflammatory arthritis; whether this represents an unmasking of previous subclinical disease or a bone fide virus-induced arthritis is unclear. Nevertheless, it appears that inflammatory arthritis patients currently on immunosuppression should continue their medication to prevent future flares and limit glucocorticoid usage. While this continues to be a rapidly evolving field, these data are reassuring to both patients with and providers treating inflammatory arthritides.

"The development of a Northern Territory outstation/homelands policy which meets the needs and aspirations of a dynamic and highly mobile population is extremely important. It is a complex and difficult task, but one which provides an important opportunity for outstations/homelands to be viewed as an integral component of the Northern Territory Government’s vision for ‘a framework for a sustainable future where development takes place within a context of land and sea conservation’ as envisaged in the Northern Territory Parks and Conservation Masterplan 2005. An innovative outstation/homeland policy which solves the problem of government service delivery of Indigenous Australians’ citizenship entitlements—so that it provides a choice for Indigenous Australians where they want to live and how they want to engage nationally and internationally in social, cultural and economic life—is urgently needed..." - Introduction, page 1

"The development of a Northern Territory outstation/homelands policy which meets the needs and aspirations of a dynamic and highly mobile population is extremely important. It is a complex and difficult task, but one which provides an important opportunity for outstations/homelands to be viewed as an integral component of the Northern Territory Government’s vision for ‘a framework for a sustainable future where development takes place within a context of land and sea conservation’ as envisaged in the Northern Territory Parks and Conservation Masterplan 2005. An innovative outstation/homeland policy which solves the problem of government service delivery of Indigenous Australians’ citizenship entitlements—so that it provides a choice for Indigenous Australians where they want to live and how they want to engage nationally and internationally in social, cultural and economic life—is urgently needed..." - Introduction, page 1

Yesterday’s Autumn Statement contained important announcements about the up-rating of benefits. Shelter’s Kate Webb analyses the changes in Local Housing Allowance, suggesting that while the chancellor has recognised the risk that rents will outpace LHA, it is far from certain that this has been adequately addressed.