A5008216930- Pharmaceutical studies and practices
- Vitamin D Research Studies
- Dermatology and Skin Diseases
- Parathyroid Disorders and Treatments
- COVID-19 Clinical Research Studies
- Pneumonia and Respiratory Infections
- Asthma and respiratory diseases
- Pharmacological Effects and Toxicity Studies
- Child and Adolescent Health
- Health Systems, Economic Evaluations, Quality of Life
- Food Allergy and Anaphylaxis Research
- Healthcare cost, quality, practices
- Long-Term Effects of COVID-19
- Antibiotic Use and Resistance
- SARS-CoV-2 and COVID-19 Research
- Allergic Rhinitis and Sensitization
- Kawasaki Disease and Coronary Complications
- Pancreatitis Pathology and Treatment
- Immunodeficiency and Autoimmune Disorders
- Electrolyte and hormonal disorders
- Intensive Care Unit Cognitive Disorders
- Pharmaceutical Practices and Patient Outcomes
- Statistical Methods in Clinical Trials
- Pharmaceutical Economics and Policy
- Adrenal Hormones and Disorders
Evelina London Children's Healthcare
2013-2025
King's College London
2018-2025
Guy's and St Thomas' NHS Foundation Trust
2016-2025
Thomas Foundation
2023
Great Ormond Street Hospital
2011-2022
University College London
2011-2022
National Institute for Health Research
2013-2021
Public Health England
2021
Oxford University Clinical Research Unit
2021
Intensive Care National Audit & Research Centre
2021
Summary Background and objectives Vitamin D deficiency is an important contributor to the development of hyperparathyroidism independently associated with cardiovascular bone disease. The hypothesis was that nutritional vitamin (ergocalciferol) supplementation in children CKD stages 2–4 delays onset secondary hyperparathyroidism. Design, setting, participants, & measurements A randomized, double-blinded, placebo-controlled study CKD2–4 who had 25-hydroxyvitamin [25(OH)D] conducted....
Vitamin D deficiency is widely prevalent and often severe in children adults with chronic kidney disease (CKD). Although native vitamin {25-hydroxyvitamin [25(OH)D]} thought to have pleiotropic effects on many organ systems, its skeletal been most studied. The 25(OH)D causally linked rickets fractures healthy those CKD, contributing the CKD–mineral bone disorder (MBD) complex. There are few studies provide evidence for therapy or guidelines use CKD. A core working group (WG) of European...
The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia (CAP) are unclear.To determine whether lower-dose is noninferior to higher 3-day treatment 7 days.Multicenter, randomized, 2 × factorial noninferiority trial enrolling 824 children, aged 6 months older, clinically diagnosed CAP, treated on discharge from emergency departments inpatient wards 28 hospitals in the UK 1 Ireland between February 2017 April 2019, last visit May 21, 2019.Children were...
BackgroundPaediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS), also known as in children (MIS-C) emerged April, 2020. The paediatric comparisons within the RECOVERY trial aimed to assess effect of intravenous immunoglobulin or corticosteroids compared usual care on duration hospital stay for PIMS-TS and compare tocilizumab (anti-IL-6 receptor monoclonal antibody) anakinra (anti-IL-1 antagonist) those inflammation refractory initial treatment.MethodsWe...
Fibroblast growth factor 23 (FGF23), a bone-derived phosphaturic hormone, is elevated in chronic kidney disease (CKD). There are scarce data on the levels of its essential co-receptor klotho, and longitudinal changes FGF23 also unknown. We examined soluble klotho (s-klotho) over 1 year 154 children with CKD Stages 1–5 (CKD1–5), were dialysis or who have received transplantation. In CKD1–5 receiving dialysis, correlated inversely estimated glomerular filtration rate (eGFR) (P < 0.001),...
In patients with chronic kidney disease (CKD), renal synthesis of active vitamin D [1,25-dihydroxyvitamin (1,25(OH)2D)] declines and is associated hypocalcaemia, secondary hyperparathyroidism the spectrum CKD–mineral bone disorder (MBD). advanced CKD, analogues, including alfacalcidol, calcitriol paricalcitol, are routinely administered. There few studies on use analogues in children CKD dialysis. It difficult to define bone-specific outcomes that can guide treatment CKD-MBD. A core working...
BackgroundAntibiotic resistance is a global public health threat. Antibiotics are very commonly prescribed for children presenting with uncomplicated lower respiratory tract infections (LRTIs), but there little evidence from randomised controlled trials of the effectiveness antibiotics, both overall or among key clinical subgroups. In ARTIC PC, we assessed whether amoxicillin reduces duration moderately bad symptoms in (non-pneumonic) LRTI primary care, and subgroups.MethodsARTIC PC was...
Abstract Background Conventional systemic drugs are used to treat children and young people (CYP) with severe atopic dermatitis (AD) worldwide, but no robust randomized controlled trial (RCT) evidence exists regarding their efficacy safety in this population. While novel therapies have expanded therapeutic options, high cost means traditional agents remain important, especially lower-resource settings. Objectives To compare the of ciclosporin (CyA) methotrexate (MTX) CYP AD TREatment Atopic...
The main conventional systemic treatments for atopic dermatitis (AD) are methotrexate (MTX) and ciclosporin (CyA). Dupilumab was the first novel agent to enter routine clinical practice. There no head-to-head randomized controlled trials or real-world studies comparing these agents directly. Network meta-analyses provide indirect comparative efficacy safety data have shown strong evidence dupilumab CyA.
While the methodological principle of ‘blinding’ for minimising bias in randomised controlled trials (RCT) is widely debated and accepted, rarely this depth thinking applied to its correct handling with respect design, reporting analysis. Beyond general comprehension definition word, practical aspects establishing blinding investigator-initiated pharmacological are often grossly underestimated,1 very much an afterthought. The resulting inadequacy can lead trial delayed increased costs,1 also...
Abstract The Paediatric Use Marketing Authorisation (PUMA) was introduced in the European Union to incentivise development of off-patent medicines children. However, there is limited data on accessibility PUMA products at healthcare provider level. This study aimed identify factors affecting real-world United Kingdom (UK). Inductive thematic analyses archives Neonatal and Pharmacy Group (NPPG) online forum were conducted. A web-based survey also distributed NPPG members September 2022...
A-STAR is a prospective, longitudinal register study aimed at evaluating short- and long-term effectiveness, safety, cost-effectiveness of systemic treatments. This letter presents the baseline characteristics cohort describes future directions register's development.
This is a secondary analysis of multicentre randomised controlled trial ciclosporin and methotrexate in children young people (CYP) with severe atopic dermatitis (AD). Longitudinal trough erythrocyte polyglutamates (MTX-PG) concentrations were measured to evaluate their associations treatment response adverse events. Both (4 mg/kg/day) (0.4 mg/kg/week) led significant reduction disease severity scores over the 36-week period. Higher associated lower may serve as useful tool for therapeutic...
Abstract Secondary hyperparathyroidism (SHPT) is an important complication of advanced chronic kidney disease (CKD) in children, which often difficult to treat with conventional therapy. The calcimimetic cinacalcet allosteric modulator the calcium-sensing receptor. It has proven be effective and safe adults suppress parathyroid hormone (PTH), but data on its use children are limited. To date, studies only consist two randomized controlled trials, nine uncontrolled interventional or...
We investigated the effects of nutritional vitamin D supplementation on markers bone and mineral metabolism, i.e. serum levels fibroblast growth factor 23 (FGF23), Klotho, alkaline phosphatase (BAP) sclerostin, in two cohorts with chronic kidney disease (CKD).In all, 80 D-deficient children were selected: 40 mild to moderate CKD from ERGO study, a randomized trial ergocalciferol [estimated glomerular filtration rate (eGFR) 55 mL/min/1.73 m2], advanced observational Cardiovascular Comorbidity...
In children and adolescents with conduct disorder (CD), pharmacotherapy is considered when non-pharmacological interventions do not improve symptoms functional impairment. Risperidone, a second-generation antipsychotic increasingly prescribed off-label in this indication, but its efficacy tolerability poorly studied CD, especially young people normal intelligence. The Paediatric European Risperidone Studies (PERS) include series of trials to assess short-term efficacy, maintenance effects...