Telaprevir-Related Dermatitis.

Telaprevir-related dermatitis.

JAMA Dermatol. 2013 Feb; 149(2): 152-8
Roujeau JC, Mockenhaupt M, Tahan SR, Henshaw J, Martin EC, Harding M, van Baelen B, Bengtsson L, Singhal P, Kauffman RS, Stern RS

To evaluate the incidence, type, and severity of telaprevir-associated skin reactions.Three dermatologists assessed available information including photographs, biopsy results, and clinical summaries of all cases with skin eruptions reported as moderate or severe during the telaprevir clinical development program. For cases from placebo-controlled trials, they were masked to exposure. Settings: Phase 1 to 3 studies of telaprevir combination therapy for hepatitis C.All patients with skin eruptions enrolled in telaprevir clinical trials prior to 2011Incidence, diagnosis, morphologic features, extent, and severity of skin eruption.Skin eruptions were more frequent in patients who received telaprevir as part of hepatitis C treatment compared with pegylated interferon (peginterferon) and ribavirin alone (56% vs 34% overall; 3.7% vs 0.4% severe). Occurring at any time during the 12 weeks of telaprevir combination regimen, in more than 90% of cases, this eruption is pruritic eczematous dermatitis. None of the clinical or genetic factors examined were substantial risk factors for dermatitis. Three cases of Stevens-Johnson Syndrome (SJS), and 11 cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) were suspected, with 2 SJS and 3 DRESS cases considered likely.Telaprevir-related dermatitis occurs in a majority of telaprevir-treated patients. It is an eczematous dermatitis that differs in timing and appearance from the eruptions usually associated with drug reactions. The strong signal for an increased risk of DRESS or SJS requires particular vigilance in telaprevir-treated patients. HubMed – drug


Substance use following bariatric weight loss surgery.

JAMA Surg. 2013 Feb; 148(2): 145-50
Conason A, Teixeira J, Hsu CH, Puma L, Knafo D, Geliebter A

To assess substance use before and after bariatric weight loss surgery (WLS). There is a paucity of research investigating the occurrence of substance use following bariatric WLS. It was hypothesized that patients who underwent WLS would exhibit an increase in substance use (drug use, alcohol use, and cigarette smoking) following surgery to compensate for a marked decrease in food intake.Prospective study.A major urban community hospital.A total of 155 participants (132 women and 23 men) who underwent WLS were recruited from a preoperative information session at a bariatric surgery center.Participants received either laparoscopic Roux-en-Y gastric bypass surgery (n = 100) or laparoscopic adjustable gastric band surgery (n = 55). Participants completed questionnaires to assess eating behaviors and substance use at preoperative baseline and 1, 3, 6, 12, and 24 months after surgery.Substance use as assessed by the Compulsive Behaviors Questionnaire.Participants reported significant increases in the frequency of substance use (a composite of drug use, alcohol use, and cigarette smoking, hereafter referred to as composite substance use) 24 months after surgery. Specifically, participants experienced a significant increase in the frequency of composite substance use from baseline to 24 months after surgery (P = .02), as well as significant increases from 1 month, 3 months, and 6 months to 24 months after surgery (all P ? .002). In addition, participants who underwent laparoscopic Roux-en-Y gastric bypass surgery reported a significant increase in the frequency of alcohol use from baseline to 24 months after surgery (P = .011). The response rate to the survey was 61% at 1-month follow-up, 41% at 3-month follow-up, 43% at 6-month follow-up, 49% at 12-month follow-up, and 24% at 24-month follow-up.Patients may be at increased risk for substance use following bariatric WLS. In particular, patients who undergo laparoscopic Roux-en-Y gastric bypass surgery may be at increased risk for alcohol use following WLS. Our study is among the first to document significant increases in substance use following WLS using longitudinal data. HubMed – drug


Associations between the Risk of Internet Addiction and Problem Behaviors among Korean Adolescents.

Korean J Fam Med. 2013 Mar; 34(2): 115-22
Sung J, Lee J, Noh HM, Park YS, Ahn EJ

The number of internet users is increasing rapidly and internet addiction among adolescents has become a serious public health problem in Korea. In the light of behavioral addiction, this study was aimed to identify the associations between the risk of internet addiction and other problem behaviors which can lead to addiction, such as cigarette smoking, alcohol drinking, drug abuse, and sexual intercourse among a nationally representative sample of Korean adolescents.Data from the 2010 Korean Youth Risk Behavior Web-based Survey (respondents, 73,238) were analyzed. Risk of internet addiction was assessed by the ‘Korean Internet Addiction Proneness Scale for Youth-Short Form: Self Report’ which was developed by the Korean National Information Society Agency in 2008. Multiple logistic regression analysis was used to calculate the odds ratios of problem behaviors among adolescents at high risk for internet addiction and adolescents at low risk for internet addiction.The odds of smoking experience, drug abuse experience, and sexual intercourse experience were significantly higher among boys at high risk for internet addiction compared to boys at low risk for internet addiction. Among girls at high risk of internet addiction, the odds of smoking experience, drinking experience, and drug abuse experience were significantly higher compared with girls at low risk of internet addiction.The risk of internet addiction was associated with cigarette smoking, alcohol drinking, drug abuse, and sexual intercourse experience among Korean adolescents. HubMed – drug