ADARRC

What is the incidence and timing of recurrent herpes zoster in older adults? The incidence of recurrent herpes zoster is comparable with the incidence of a first episode zoster infection, supporting the benefit of vaccination for individuals with a history of previous herpes zoster. See the synopsis for specific recurrent incidence risks based on age, sex, and time following initial infection. Qian J, Macartney K, Heywood AE, Sheridan S, Liu B. Risk of recurrent herpes zoster in a population-based cohort study of older adults. J Am Acad Dermatol 2021;85(3):611-618.

Do muscle relaxants provide relief for nonspecific lower back pain? Stick with nonsteroidal anti-inflammatories for the treatment of low back pain. Despite being used for almost 50 years to treat low back pain, the evidence supporting benzodiazepine or non-benzodiazepine “muscle relaxants” is of low certainty. None of the treatments will produce a clinically important difference over placebo treatment. Cashin AG, Folly T, Bagg MK, et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis. BMJ 2021;374:n1446.

Is fluvoxamine effective in preventing hospitalizations in high-risk adults with COVID-19? In this study, compared with placebo, fluvoxamine decreased hospitalizations in high-risk symptomatic adults with COVID-19. Reis G, dos Santos Moreira-Silva EA, Silva DCM, et al, for the TOGETHER investigators. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health 2021;S2214-109X(21)00448-4.

Does a booster dose provide clinical benefit against symptomatic infection and serious illness due to COVID-19 in persons 60 years and older who are fully vaccinated with the Pfizer-BioNTech vaccine? A booster (third) dose of the BNT162b2 mRNA vaccine from Pfizer-BioNTech provides significant additional protection against both infection and serious illness. (LOE = 2b) Bar-On YM, Goldberg Y, Mandel M, et al. Protection of BNT162b2 vaccine booster against Covid-19 in Israel. N Engl J Med 2021;385(15):1393-1400.

Do muscle relaxants provide relief for nonspecific lower back pain? Stick with nonsteroidal anti-inflammatories for the treatment of low back pain. Despite being used for almost 50 years to treat low back pain, the evidence supporting benzodiazepine or non-benzodiazepine “muscle relaxants” is of low certainty. None of the treatments will produce a clinically important difference over placebo treatment. Cashin AG, Folly T, Bagg MK, et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis. BMJ 2021;374:n1446.

What is the incidence and timing of recurrent herpes zoster in older adults? The incidence of recurrent herpes zoster is comparable with the incidence of a first episode zoster infection, supporting the benefit of vaccination for individuals with a history of previous herpes zoster. See the synopsis for specific recurrent incidence risks based on age, sex, and time following initial infection. Qian J, Macartney K, Heywood AE, Sheridan S, Liu B. Risk of recurrent herpes zoster in a population-based cohort study of older adults. J Am Acad Dermatol 2021;85(3):611-618.

Does ivermectin decrease mortality among persons hospitalized with COVID-19? Although the data suggest that ivermectin decreases mortality among persons hospitalized with COVID-19, the messiness of the comparison groups and the concerns over data veracity indicate that more rigorous study is needed. Hill A, Garratt A, Levi J, et al. Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection. Open Forum Infect Dis 2021:ofab358. Erratum: Hill A, Garratt A, Levi J, et al. Erratum: expression of concern: "Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection." Open Forum Infect Dis 2021;8(8):ofab394. [...]

Do pregnant women who become ill with COVID-19 have worse outcomes than pregnant women who are not infected with COVID-19? Pregnant women who become ill with COVID-19 are more likely to die and have adverse perinatal and neonatal outcomes than pregnant women who are uninfected with COVID-19. Villar J, Ariff S, Gunier RB, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr 2021;175(8):817-826.

Are interleukin-6 antagonists effective in decreasing mortality among persons hospitalized with COVID-19? Based on this systematic review, it is unclear if IL-6 antagonists decrease mortality among persons hospitalized with COVID-19. Co-intervention with corticosteroids has muddied the waters, and the data so far are dominated by a single agent (tocilizumab). The other agents do not appear to be effective. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Shankar-Hari M, Vale CL, et al. Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19: a meta-analysis. JAMA 2021;326(6):499-518. [...]

What is the best treatment for multisystem inflammatory syndrome in children? For children with MIS-C caused by SARS-CoV-2, the preferred initial treatment is IVIG plus corticosteroids. Son MB, Murray N, Friedman K, et al, for the Overcoming COVID-19 Investigators. Multisystem inflammatory syndrome in children — initial therapy and outcomes. N Engl J Med 2021;385(1):23-34.