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Introduction: The Trilife study describes the real-life use, in France, of the beclomethasone/formoterol/glycopyrronium triple fixed-dose combination in solution for inhalation, which is indicated as continuous treatment for moderate-to-severe chronic obstructive pulmonary disease., Methods: This prospective, non-interventional, multicentric study, involving hospital and office-based pulmonologists, evaluates the proportion of patients for whom the triple fixed combination was prescribed in compliance with the indication and dosage specified in the summary of product characteristics (SPC). Patients were followed for six months., Results: In a population of 346 patients, the prescription was compliant with the SPC for 75.1% of patients (95% confidence interval: [70.6; 79.7]). The only variable associated with compliance with SPC in multivariate analyses was smoking (P=0.019). The results also show improved patient adherence to treatment and improved clinical status in terms of moderate or severe exacerbations, dyspnea, quality of life and satisfaction with treatment., Conclusion: Three quarters of the fixed triple combination prescriptions by French pulmonologists comply with the indication and dosage specified in the summary of product characteristics., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Background and Aims: Statin-associated muscle symptoms (SAMS) are a major cause of treatment discontinuation. Clinical Pharmacogenetics Implementation Consortium (CPIC) recommend dose adjustment for statin treatment according to known SLCO1B1 genotype to reduce SAMS. We hypothesized that the association between SLCO1B1 genotype and SAMS is misestimated because of publication bias., Methods: We searched published systematic reviews on the association between SLCO1B1 genotype and SAMS. To assessed publication bias, we used funnel plot visual inspection, Egger's test, and the Bayes Factor (BF Publication-bias ) from Robust Bayesian Meta-Analysis (RoBMA). We compared the odds ratios (OR Uncorrected ) from meta-analyses before and after correcting for publication bias using trim-and-fill (OR Trim&Fill ) and RoBMA (OR RoBMA ) methods., Results: We included 8 cohort and 11 case-control studies, totaling 62 OR of three SLCO1B1 genotypes and six statin drugs. In the primary analysis, the funnel plot was suggestive of publication bias, confirmed by Egger's test (p=0.001) and RoBMA (BF Publication-bias  = 18). Correcting the estimate for publication bias resulted in loss of the association, from a significant OR Uncorrected (1.31 95%CI [1.13-1.53]) to corrected ORs suggesting no difference: OR Trim&Fill (1.07 95%CI [0.89-1.30]) and OR RoBMA (1.02 95%CI [1.00-1.33]). This suggested that publication bias overestimated the association by 18 % and 23 %, respectively. Similar results were found for genotype rs4149056, simvastatin and atorvastatin., Conclusions: The effect of the SLCO1B1 genotype on the risk of developing SAMS is overestimated in the published literature, especially rs4149056. This could lead prescribers to incorrectly decreasing statin doses or even avoiding statin use, leading to a loss of the potential cardiovascular benefit of statins., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

All the factors potentially influencing tacrolimus dose requirement and combinations thereof have never been thoroughly investigated, precluding accurate prediction of tacrolimus starting dose. This prospective, non-interventional, multicenter study in de novo adult kidney transplant recipients over the first year after transplantation aimed to investigate the factors influencing tacrolimus dose-standardized trough blood concentration (C 0 /D) over the first week post-transplant (D4-D7, primary objective), D8-M3 and M3-M12 (secondary objectives). Statistical analysis employed mixed linear models with repeated measures. Eighteen sites enrolled 440 patients and followed them up for 9.5 ± 4.1 months. Age at baseline ( p = 0.0144), end-stage renal disease ( p = 0.0092), CYP3A phenotype ( p < 0.0001), dyslipidemia at baseline ( p = 0.0031), hematocrit ( p = 0.0026), total bilirubin ( p = 0.0261) and plasma creatinine ( p = 0.0484) independently increased with log(C 0 /D) over D4-D7, explaining together 72.3% of the interindividual variability, and representing a robust model to estimate tacrolimus initial dose. Donor age and CYP3A phenotype were also influential over D8-M3 and M3-12, in addition to recipient age. Corticosteroids, diabetes at baseline, and ASAT yielded inconstant results between D8-M3 and M3-M12. We found no ethnicity effect when CYP3A phenotype was accounted for, and no food effect. Intra-individual variability over M3-M12 was moderate, and significantly lower in patients with chronic hepatic disorder ( p = 0.0196) or cancer ( p = 0.0132)., Competing Interests: SA and LS are employees of SANDOZ S.A.S, Levallois-Perret, France, which funded the study. JB, SG, and AL-C are employees of RCTs, the contract research organization that conducted the study on behalf of SANDOZ S.A.S. AH is a biostatistician at University Hospital of Limoges, France. PM, DA, and LR received honoraria from SANDOZ S.A.S as members of the study’s independent Scientific Committee. PM is a consultant/medical expert for Astellas, BMS, Chiesi, Exeltis, MedIncell, Pfizer, Siemens and Womed. DA is a consultant/medical expert for Astellas, Astra Zeneca, BMS and Chiesi. LR is a consultant/medical expert for BMS and Sanofi., (Copyright © 2024 Marquet, Anglicheau, Humeau, Adrouche, Saada, Bisiaux, Guillemin, Lardy-Cléaud and Rostaing.)

Half of severely asthmatic adolescents treated with omalizumab transitioning to adulthood discontinue the treatment, suggesting insufficient asthma control. However, most of the other half have low rates of HCRU markers, their asthma being under control. https://bit.ly/49ixpxt., Competing Interests: Conflict of interest: C. Taillé reports support for the present manuscript from Novartis; and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Chiesi, GSK, Novartis and Sanofi, outside the submitted work. Conflict of interest: M. Humbert reports support for the present manuscript from Novartis; and consulting fees from AstraZeneca, Chiesi, GSK, Novartis and Sanofi, outside the submitted work, and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, GSK, Novartis and Sanofi, outside the submitted work. Conflict of interest: A. Bourdin reports support for the present manuscript from Novartis; and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Chiesi, GSK, Novartis and Sanofi, outside the submitted work. Conflict of interest: C. Thonnelier reports support for the present manuscript from Novartis. Conflict of interest: A. Lajoinie reports support for the present manuscript from Novartis. Conflict of interest: J. Chassetuillier reports support for the present manuscript from Novartis. Conflict of interest: M. Molimard reports support for the present manuscript from Novartis; and consulting fees from Novartis and Stallergen, outside the submitted work; participation on a data safety monitoring board or advisory board for Banook, outside the submitted work. Conflict of interest: A. Deschildre reports support for the present manuscript from Novartis; grants or contracts from Fondation du Souffle, Conseil Régional Hauts-de-France programme 2014–2018 (grant number ARCiR 2015–284), outside the submitted work; consulting fees from Novartis, ALK, GSK, Sanofi, Aimmune Therapeutics, DBV Technologies, Nestlé Health Science and Boehringer Ingelheim, outside the submitted work; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, ALK, GSK, Sanofi, Aimmune Therapeutics, DBV Technologies, Nestlé Health Science and Boehringer Ingelheim, outside the submitted work; support for attending meetings and/or travel from ALK, Sanofi, Boehringer Ingelheim, Stallergenes Greer, Novartis, AstraZeneca, Meda, DBV Technologies, Aimmune and Nutricia, outside the submitted work; and participation on data safety monitoring board for BOOM study (www.ClinicalTrials.gov identifier NCT04045301, Lead Investigator: Philippe Bégin, Montreal), outside the submitted work., (Copyright ©The authors 2024.)

Background: Secukinumab efficacy and retention data are emerging in patients with axial spondyloarthritis (axSpA) in real-world settings. However, limited data are available on the predictive factors that affect the retention rate. The key objective was to determine whether objective signs of inflammation (OSI) were predictive of secukinumab retention at 1 year., Methods: FORSYA is a French, multicentric, non-interventional, retrospective study in adult axSpA patients who received secukinumab treatment between its launch (11 August 2016) and 31 August 2018. The time to secukinumab discontinuation and retention were analysed using a Kaplan-Meier (KM) analysis. OSI was predefined by at least one of the criteria: C reactive protein ≥5 mg/L or erythrocyte sedimentation rate ≥28 mm/hour at secukinumab initiation or MRI inflammation at the sacroiliac or spine level., Results: In total, 906 patients from 48 centres were included in the analysis, 42.2% of whom were men, with a mean age of 46.2±11.7 years and a mean disease duration of 9.3±9.1 years. The 1-year KM retention rate (95% CI) for secukinumab was 59% (55%-62%), whereas for patients with and without OSI, it was 58% (54%-62%) and 63% (53%-73%), respectively. In multivariate analysis, lack of prior exposure to tumour necrosis factor inhibitor (TNFi), absence of OSI and inflammatory bowel disease (IBD) were associated with a better retention of secukinumab at 1 year., Conclusion: Following its approval in France, ~59% of axSpA patients retained secukinumab in daily practice, at 1 year. Prior exposure to TNFi, OSI and IBD were identified as risk factors for secukinumab discontinuation., Competing Interests: Competing interests: MD: grant/research support from: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma; consultant of AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma; Speakers bureau: AbbVie, Eli Lilly, Merck, Novartis, Pfizer and UCB Pharma; JL: employee of RCTs, a CRO provider on behalf of Novartis Pharma; ED: employee of Novartis with stocks; PC: research grants, consultant and speaker fees from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Chugai, Janssen, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, and UCB; PG: research grants, consultation fees, or speaker honoraria from AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB; ARW: consulting (Pfizer, AbbVie, Novartis, Lilly and Janssen); honoraria (AbbVie, Bristol-Myers Squibb, Galapagos, Fresenius-Kabi, Mylan-Viatris, MSD, Novartis, Lilly, UCB, Pfizer, Roche-Chugai and Sanofi); and support for attending meetings (Abbvie, Amgen and Fresenius-Kabi); AS: research grants, consultant fees and speaker fees from AbbVie, Bristol Myers Squibb, Lilly, MSD, Nordic, Novartis, Pfizer, Roche-Chugai and UCB; AT: Research grants, consultant fees and speaker fees from AbbVie, Fresenius-Kabi, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai and Sanofi; DW: financial interests: none. Lasting or permanent links: none. Occasional interventions: AbbVie, BMS, MSD, Pfizer, Roche Chugai, Amgen, Nordic Pharma, UCB, Novartis, Lilly, Sandoz and Grunenthal. Indirect interests: AbbVie, Pfizer, Roche Chugai, MSD, UCB, Mylan and Fresenius Kabi; CL: Research grants, consultant fees and speaker fees from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Fresenius, Janssen, Lilly, MSD, Novartis, Pfizer, Roche Chugai and UCB., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Background: This real-life study aimed to assess omalizumab treatment patterns in adult and paediatric asthma patients, and to describe asthma control and healthcare resource use (HCRU) at omalizumab initiation and discontinuation., Methods: The French healthcare database system (Système National des Données de Santé (SNDS)) was used to identify asthma patients aged ≥6 years who initiated omalizumab for at least 16 weeks from 2009 to 2019. We examined omalizumab treatment patterns using dispensation records., Results: We identified 16 750 adults and 2453 children initiating omalizumab. Median treatment persistence before discontinuation (T STOP ) was 51.2 (95% CI 49.3-53.4) months in adults and 53.7 (95% CI 50.6-56.4) months in children. At 2 years of omalizumab exposure, rate of hospitalisation for asthma decreased by 75% and use of oral corticosteroids (OCS) by 30%, in adults and children. Among adults who discontinued omalizumab while asthma was controlled, 70%, 39% and 24% remained controlled and did not resume omalizumab at 1, 2 and 3 years after discontinuation, respectively. These proportions were higher in children (76%, 44% and 33%, respectively). Over 2 years of follow-up after discontinuation, HCRU remained stable in adults and children, notably rate of hospitalisations for asthma (none before T STOP , 1.3% and 0.6% at 2 years) and use of OCS (in adults and children, respectively: 20.0% and 20.2% before T STOP , 33.3% and 24.6% at 2 years)., Conclusion: This is the first large-scale study describing omalizumab real-life exposure patterns in adult and paediatric asthma patients in France with >10 years of follow-up. We showed the long-term maintenance of low HCRU in adults and children who discontinued omalizumab while asthma was controlled, notably for OCS use and hospitalisations for asthma., Competing Interests: Conflict of interest: The study was supported by Novartis, which was the data controller of the study. D. Kamar and C. Thonnelier are employees of Novartis. Novartis was involved in the study design, data analysis, decision to publish and preparation of the manuscript. D. Kamar additionally reports consulting fees and support for attending meetings from Ividata Life Sciences providing services for Novartis. A. Lajoinie and A. Rigault are employees of RCTs. RCTs did not fund the study but was in charge of designing and performing the study as data processor. A. Rigault was an employee of the French health insurance until 1 September 2020. M. Humbert, A. Bourdin, C. Taillé, A. Deschildre and M. Molimard received honoraria paid by Novartis as members of the study Independent Scientific Committee. M. Humbert also reports consulting fees from AstraZeneca, Chiesi, GSK, Novartis and Sanofi; lecture honoraria from AstraZeneca, GSK, Novartis and Sanofi; outside the submitted work. A. Bourdin and C. Taillé also report lecture honoraria from AstraZeneca, Chiesi, GSK, Novartis and Sanofi; outside the submitted work. A. Deschildre also reports grants from Fondation du Souffle; Conseil Régional Hauts-de-France program 2014–2018 (grant ARCiR 2015-284); consulting fees from Novartis, ALK, GSK, Sanofi, Regeneron, Aimmune Therapeutics, DBV Technologies, Nestlé Health Science and Stallergenes Greer; lecture honoraria from Novartis, ALK, GSK, Sanofi, Aimmune Therapeutics, DBV Technologies, Nestlé Health Science and Boehringer Ingelheim; support for attending congresses from ALK, Sanofi, Boehringer Ingelheim, Stallergenes Greer, Novartis, AstraZeneca, Meda, DBV Technologies, Aimmune and Nutricia; acted on the Data Safety Monitoring Board (DSMB) for the BOOM study (ClinicalTrials.gov identifier: NCT04045301; Lead Investigator: Philippe Bégin, Montreal, QC, Canada); outside the submitted work. M. Molimard also reports consulting fees from Novartis and Stallergenes; participation on advisory board for Banook; outside the submitted work., (Copyright ©The authors 2022.)

Objectives: To estimate the frequency of reporting composite indices evaluating axial spondyloarthritis (axSpA) disease activity in daily practice and to assess its impact on the secukinumab (SEC) retention rate., Methods: Study design: Retrospective, multicentre., Data Collected: (1) Recommended composite indices : Bath Ankylosing Spondyltitis Disease Activity Index (BASDAI) +C reactive protein or Ankylosing Spondylitis Disease Activity Score (ASDAS) at the time of initiation of SEC and at least once during the first year of follow-up; (2) Drug retention rate : percentage of patients still on SEC over time according to whether at least one recommended composite index had been optimally reported., Results: A recommended composite index has been collected in 22% of the 906 enrolled axSpA patients. The percentage of patients still on treatment after 1, 2 and 3 years of follow-up was greater in those for whom at least one composite index had been optimally reported (respectively, 64% (57-71) vs 57% (54-61), 55% (48-62) vs 41% (38-45) and 52% (44-59) vs 38% (34-42), log rank test, p=0.016) with a lower risk of SEC discontinuation for these patients (HR: 0.70 (95% CI 0.5 to 0.88), Cox model, p=0.003)., Conclusion: This study suggests that reporting of recommended composites indices for monitoring axSpA might be associated with higher retention rates of biological therapies., Competing Interests: Competing interests: The principal investigator (MD) and the members of the scientific committee of the study (CL, AS, AT, AR-W, DW, PG and PC) have received honorarium fees from NOVARTIS Pharma, France. ED, the study coordinator is an employee of NOVARTIS Pharma France. JL is an employee of RcTs the company in charge of the monitoring of the study and its statistical analysis, this company had a financial contract with NOVARTIS Pharma France., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

With Osteoarthritis (oa): As one of the leading causes of disability in adults worldwide, its toll on patients and its economic burden for payers are substantial. The issue of change in OA management with the evolution of reimbursement schemes needs to be addressed., Objective: To assess the impact of terminating the reimbursement of symptomatic slow-acting drugs in OA (SYSADOAs) in France in terms of volume and cost, from a healthcare payer perspective., Principal Results: We obtained costs and volumes from French public national databases. We considered three exposure periods around cutoff dates according to decisions of decreased then terminated SYSADOA reimbursement. The periods included 19 345 (control), 20 066 (secondary), and 16 200 (primary) patients, respectively. Mean ages were 66.2 (±11.8), 65.3 (±11.6) and 64.6 (±11.5) years and about 70% were women. The volume of nonsteroidal anti-inflammatory drug (NSAID) deliveries estimated by defined daily doses (DDDs) decreased during the periods from 40.5 (±76.3) DDDs per patient in 2008 to 29.6 (±66.4) in 2015. The volume of analgesic deliveries increased slowly over the three periods, from 70.2 (±108.9) DDDs in 2008 to 76.9 (±123.1) in 2015 for all patients., Major Conclusions: Our results did not show a measurable impact of terminating SYSADOA reimbursement on the delivery of NSAIDs and analgesics or on hospitalizations. However, neither do they allow for concluding that terminating SYSADOA reimbursement did not generate an increase in deliveries of non-reimbursed drugs, with their associated potential risks for public health., Competing Interests: Declaration of Competing Interest G Badot was in the staff of Genevrier laboratory involved in the study. F Mistretta's institution received fees from Genevrier laboratory. F Rannou received fees for relevant activities outside of the submitted work from Pierre Fabre, Sanofi Aventis, Pfizer, Bayer, and Expansciences. No conflict of interest was reported by other authors., (Copyright © 2020. Published by Elsevier Inc.)

BACKGROUND Potential benefits of once-daily, prolonged-release tacrolimus over the immediate-release formulation include improved adherence to immunosuppressives post transplantation. An observational study was performed to characterize real-world practice surrounding conversion from immediate- to prolonged-release tacrolimus in kidney transplant recipients. MATERIAL AND METHODS We performed a prospective, observational study of renal transplant recipients converted from immediate- to prolonged-release tacrolimus capsules. Conversion took place at the baseline visit, within the first 6 months of transplantation (early conversion group) or between 6 and 12 months of transplantation (late conversion group). Data collection was performed at routine follow-up at 6 and 12 months. Endpoints included conversion ratio from immediate- to prolonged-release tacrolimus, reasons for conversion, additional visits due to conversion, safety, and tolerability. RESULTS The analysis population comprised 591 patients. Baseline characteristics were similar between the 2 groups. The mean conversion ratio of the daily dose of tacrolimus was 0.98±0.17 in the early group and 0.99±0.09 in the late group. Time from conversion (mean ±SD) to first measurement of trough tacrolimus blood concentration was 12.1±11.6 and 27.6±26.7 days in the early and late groups, respectively. The highest number of additional visits required was 6 in the early conversion group, in 3 patients (0.7%), and 3 in the late conversion group, in 2 patients (1.6%). Conversion from immediate- to prolonged-release tacrolimus was associated with a very low rate of graft rejection. CONCLUSIONS Favorable clinical outcomes and safety profiles were observed with conversion from immediate- to prolonged-release tacrolimus over 1 year following renal transplantation, with no marked differences between the early and late conversion groups.

Introduction: Dressings are a mainstay for wound management; however, dressing adherence to the wound or periwound area can cause pain and trauma at removal. Dressing-related trauma includes skin reactions, adherence to the wound, and skin stripping. The development of atraumatic wound contact layer dressings has been a major advancement in reducing trauma., Objective: This study compares the benefits of a cellulose acetate mesh (CAM) coated with soft silicone versus a flexible polyamide net (FPN) coated with soft silicone., Materials and Methods: A multicenter, randomized controlled study was conducted in 70 patients (35 in CAM group [1 patient exclused due to not receiving treatment], 35 in the FPN group) with traumatic, postsurgical, and burn wounds. Wounds were assessed once per week for 4 weeks to measure dressing adherence to the wound bed, percent reepithelialization, and patient tolerance. All wounds were prepared according to standard of care wound management protocol at the time of assessment., Results: In this study, 97.06% (n = 33) of patients in the CAM group and 91.43% (n = 32) in the FPN group did not report dressing adherence during any of the assessments. Average time to complete reepithelialization was 16 days in the CAM group versus 15 days in the FPN group (P = .4958), and both products had excellent tolerance., Conclusions: This study demonstrated that CAM coated with a soft silicone performed as well as the FPN contact layer in minimizing dressing adherence, time to complete reepithelialization, and patient tolerance.

Objective: To evaluate the predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis (RA)., Methods: A post hoc analysis was performed on a prospective 2-year study of 59 patients with active RA starting on antitumour necrosis factor (TNF). Tenderness and synovitis was assessed clinically at baseline, followed by blinded ultrasound assessment (B-mode and power Doppler ultrasound (PDUS)) on the hands and feet (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal and 10 metatarsophalangeal (MTP) joints). Radiographs of these joints were performed at baseline and at 2 years. The risk of radiographic progression with respect to the presence of baseline tenderness or synovitis, as well as its persistence (after 4 months of anti-TNF), was estimated by OR (95% CI)., Results: Baseline tender joints were the least predictive for radiographic progression (OR=1.53 (95% CI 1.02 to 2.29) p<0.04), when compared to synovitis (clinical OR=2.08 (95% CI 1.39 to 3.11) p<0.001 or PDUS OR=1.80 (95% CI 1.20 to 2.71) p=0.005, respectively). Tender joints with the presence of synovitis were predictive of radiographic progression (OR=1.89 (95% CI 1.25 to 2.85) p=0.002), especially seen in the MTP joints. Non-tender joints with no synovitis were negatively predictive (OR=0.57 (95% CI 0.39 to 0.82) p=0.003). Persistence of tender joints was negatively predictive (OR=0.38 (95% CI 0.18 to 0.78) p=0.009) while persistence of synovitis was predictive (OR=2.41 (95% CI 1.24 to 4.67) p=0.01) of radiographic progression., Conclusions: Synovitis is better than tenderness to predict for subsequent structural progression. However, coexistence of tenderness and synovitis at the level of an individual joint is predictive of structural damage, particularly in the MTP joints., Trial Registration Number: NCT00444691.

Aims: To validate strategies to prevent exercise-induced hypoglycaemia via insulin-dose adjustment in adult patients with type 1 diabetes (T1D) on pump therapy., Methods: A total of 20 patients randomly performed four 30-min late post-lunch (3 h after lunch) exercise sessions and a rest session: two moderate sessions [50% maximum oxygen consumption (VO2 max)] with 50 or 80% basal rate (BR) reduction during exercise + 2 h and two intense sessions (75% VO2 max) with 80% BR reduction or with their pump stopped. Two additional early post-lunch sessions (90 min after lunch) were analysed to compare hypoglycaemia incidence for BR reduction versus bolus reduction., Results: In all, 100 late post-lunch sessions were analysed. Regardless of exercise type and BR reduction, no more hypoglycaemic events occurred in the period until the next morning than occurred after the rest sessions. In the afternoon, no more hypoglycaemic events occurred with 80% BR reduction/moderate exercise or with pump discontinuation/intense exercise than for the rest session, whereas more hypoglycaemic events occurred with 50% BR reduction/moderate exercise and 80% BR reduction/intense exercise. After early post-lunch exercise (n = 37), a trend towards fewer hypoglycaemic episodes was observed with bolus reduction versus BR reduction (p = 0.07). Mean blood glucose fell by ∼3.3 mmol/l after 30 min of exercise, irrespective of dose reduction, remaining stable until the next morning with no rebound hyperglycaemia., Conclusion: In adults with T1D, to limit the hypoglycaemic risk associated with 30 min of exercise 3 h after lunch, without carbohydrate supplements, the best options seem to be to reduce BR by 80% or to stop the pump for moderate or intense exercise, or for moderate exercise 90 min after lunch, to reduce the prandial bolus rather than the BR., (© 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

The main contributions of meta-analysis methodology to antiplatelet therapy in the field of cardiovascular prevention are presented with regard to the different sectors of the health system: help with therapeutic information, help in the planning of clinical trials for the pharmaceutical industry and help in decision-making for Health Authorities. The results of meta-analysis of available data concerning aspirin in cardio-vascular prevention are discussed, in an attempt to define optimal daily dose and duration of aspirin treatment.