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Christopher J McNally,1,2 Mark W Ruddock,1 Tara Moore,2 Declan J McKenna2 1Randox Laboratories Ltd, Crumlin, Co. Antrim BT29 4QY, Northern Ireland; 2Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, Northern IrelandCorrespondence: Declan J McKenna Tel +44 2870124356Email dj.mckenna@ulster.ac.ukAbstract: Prediction of prostate cancer in primary care is typically based upon serum total prostate-specific antigen (tPSA) and digital rectal examination results. However, these tests lack sensitivity and specificity, leading to over-diagnosis of disease and unnecessary, invasive biopsies. Therefore, there is a clinical need for diagnostic tests that can differentiate between benign conditions and early-stage malignant disease in the prostate. In this review, we evaluate research papers published from 2009 to 2019 reporting biomarkers that identified or differentiated benign prostatic hyperplasia (BPH) from prostate cancer. Our review identifies hundreds of potential biomarkers in urine, serum, tissue, and semen proposed as useful targets for differentiating between prostate cancer and BPH patients. However, it is still not apparent which of these candidate biomarkers are most useful, and many will not progress beyond the discovery stage unless they are properly validated for clinical practice. We conclude that this validation will come through the use of multivariate panels which can assess the value of biomarker candidates in combination with clinical parameters as part of a risk prediction calculator. Implementation of such a model will help clinicians stratify patients with prostate cancer symptoms in primary care, with tangible benefits for both the patient and the health service.Keywords: prostate cancer, benign prostatic hyperplasia, biomarkers, differentiation, transrectal ultrasound-guided biopsy

Manisha R Panchal,1 Helen Coope,2 D John McKenna,3 Anton B Alexandroff31Department of Dermatology, Sherwood Forest Hospitals, Kingsmill Hospital, Nottinghamshire, 2Novartis Pharmaceuticals UK Ltd, West Sussex, 3Department of Dermatology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UKAbstract: Biologics are novel and important agents in the treatment of severe psoriasis. These agents block specific molecular steps in the inflammatory cascade, thereby reducing activation and proliferation of keratinocytes. Prescreening for biologic agents and careful monitoring of patients is important. There are four biologics currently licensed and used in the treatment of psoriasis in the European Union. This is an evidence-based review examining clinical trials and focusing on the long-term safety data for four biologic agents. Current British Association of Dermatology guidance for the use of biologics in psoriasis and guidelines on the management of psoriasis from the National Institute for Health and Clinical Excellence have been used. Advances on safety information since 2009 in clinical trials are reviewed. The results show that overall there is no statistical significance in the incidence of adverse effects of biologics versus placebo. However, there are serious adverse effects that are reported for biologics that need to be assessed for and addressed promptly. Results of studies discussing major adverse cardiovascular events are also reviewed.Keywords: psoriasis, biologic agents, safety profile, major cardiovascular events