Reduced risk of suicidal behaviours associated with the treatment of hidradenitis suppurativa with tumour necrosis factor alpha antagonists: results from the US FDA Adverse Events Reporting System pharmacovigilance database.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, recurrent condition that presents as painful, suppurating lesions in the apocrine gland-bearing skin regions. HS has been associated with increased suicidal behaviours (SB), independent of any treatment. TNF-alpha antagonists are used to treat moderate-to-severe HS and have also been associated with SB, a factor that could confound the decision to use the TNF-α antagonists in the moderately to severely affected HS patients, who may already be experiencing increased SB risk. OBJECTIVES: To determine presence or absence of a safety signal for SB when HS is treated with TNF-α antagonists. METHODS: We calculated the reporting odds ratios (ROR) with 95% CI of SB associated with treatment for HS with TNF-α antagonists vs. the reference group of all other treatments for HS in the US Food and Drug Administration pharmacovigilance database from 1 January 2004 to 31 March 2019. A second analysis excluded isotretinoin (which has been used to treat HS and has also been associated with SB) from the reference group. RESULTS: There was a signal for decreased risk of SB with TNF-α antagonists (ROR = 0.1959, 95% CI 0.1247-0.3079; z = 7.071, P < 0.0001] vs. all other HS treatments; the ROR did not change significantly after isotretinoin was excluded from the reference group. CONCLUSIONS: Treatment of HS with TNF-α antagonists is associated with a decreased risk of SB.

Applying the OIE Terrestrial Animal Health Code to the welfare of animals exported from Australia.

Australia has implemented a through-chain regulatory framework to address animal welfare issues in the livestock export trade. The framework places the responsibility for ensuring that the welfare of exported animals meets internationally accepted standards on those who hold the licences issued for the export of Australian livestock. It applies to all livestock (cattle, buffalo, sheep, goats, camels) exported from Australia, either for immediate slaughter or for feeding and eventual slaughter. The development of the framework began when the Australian Standards for the Export of Livestock were implemented in December 2004, to safeguard animal welfare from the point when the animals are selected for export up until the moment when they are offloaded in the destination country. The framework has recently been extended to incorporate animal welfare requirements through to the point of slaughter in the destination country. The requirements draw on, and are consistent with, the animal welfare chapters of the World Organisation for Animal Health (OIE) Terrestrial Animal Health Code.