Yolanda B Brauchli

Universität Basel, Basel, BS, Switzerland

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Publications (16)87.54 Total impact

  • Article: Reply.
    Yolanda B Brauchli, Susan S Jick, Christoph R Meier
    Journal of the American Academy of Dermatology 12/2011; 65(6):1229-30. · 4.91 Impact Factor
  • Yolanda B Brauchli, Susan S Jick, Christoph R Meier
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    ABSTRACT: Statins have been suggested as a potential treatment for psoriasis because of their anti-inflammatory properties. However, evidence on the benefits of statins is scarce. We sought to study the association between use of statins or other lipid-lowering agents and the risk of developing psoriasis. We conducted a case-control analysis using the United Kingdom-based General Practice Research Database. We identified patients with an incident psoriasis diagnosis between 1994 and 2005 and matched one control subject to each patient on age, sex, general practice, calendar time, and years of history in the database. We estimated odds ratios (ORs) with 95% confidence intervals (CIs), stratified exposure by timing and duration, and adjusted the ORs for potential confounders. We identified 36,702 incident psoriasis cases and the same number of matched controls. Adjusted ORs for current use (last prescription <30 days before index date) of 1 to 4, 5 to 19, or greater than or equal to 20 prescriptions for statins, as compared with nonuse, were 0.60 (95% CI 0.45-0.80), 1.00 (95% CI 0.84-1.18), and 1.08 (95% CI 0.92-1.28), respectively. The ORs for recent and past use (last prescription 30-89 days and ≥90 days ago, respectively) were around 1, except for past use of 1 to 4 prescriptions (OR 1.39; 95% CI 1.09-1.78). Potential of residual confounding as a result of retrospective study design is a limitation. This large case-control study does not provide evidence for an altered risk of developing psoriasis in association with long-term use of statins. The reduced psoriasis risk for current short-term statin users is interesting, but whether the association is indeed causal needs further investigation.
    Journal of the American Academy of Dermatology 07/2011; 65(1):77-83. · 4.91 Impact Factor
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    ABSTRACT: Whether diabetes mellitus is associated with an increased risk of cholecystectomy remains controversial. To explore the association between diabetes mellitus and the risk of cholecystectomy. Population-based case-control analysis using UK-based General Practice Research Database. Cases of cholecystectomy and up to four controls per case, matched on age, sex, BMI, general practice, calendar time, and years of history in the database were identified between 1994 and 2008. Conditional logistic regression was used to estimate the risk of cholecystectomy in diabetics compared to non-diabetics. Odds ratios (ORs) were calculated, adjusted for smoking, alcohol consumption, statin use, and additional confounders. Amongst 22,574 cases with cholecystectomy and 72,476 controls, 1068 (4.7%) and 3270 (4.5%) had diabetes, respectively, yielding an adjusted OR for developing gallstone disease followed by cholecystectomy of 0.88, 95% CI 78-1.00, p=0.05) in association with diabetes mellitus. Neither glycaemic control, nor increasing diabetes duration or oral antidiabetic therapies were associated with an altered risk of cholecystectomy. Use of statins was protective in patients with (adj. OR 0.66, 95% CI 0.54-0.80, p<0.0001) or without diabetes (adj. OR 0.70, 95% CI 0.62-0.78, p<0.0001). Diabetes mellitus was not associated with an altered risk of cholecystectomy.
    Digestive and Liver Disease 05/2011; 43(9):742-7. · 3.16 Impact Factor
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    ABSTRACT: Depot medroxyprogesterone acetate (DMPA), which has a high rate of use among teenagers in Europe and the United States, has been associated with impaired bone mineral acquisition during adolescence and accelerated bone loss in later life. Studies on the association between DMPA use and fracture risk are limited. We aimed at evaluating the relationship between use of hormonal contraceptives, specifically DMPA, and fracture risk. We conducted a case-control analysis using the United Kingdom-based General Practice Research Database. Participants were females aged 20-44 yr with an incident fracture diagnosis between 1995 and 2008. Odds ratios (OR) with 95% confidence intervals (CI) of incident fracture in relation to exposure to DMPA or combined oral contraceptives were assessed. Adjustments were made for smoking, body mass index, and additional potential confounders. We identified 17,527 incident fracture cases and 70,130 control patients (DMPA exposure: 11 and 8%, respectively). Compared with nonuse, current use of one to two, three to nine, or 10 or more DMPA prescriptions yielded adjusted OR for fractures of 1.18 (95% CI = 0.93-1.49), 1.36 (95% CI = 1.15-1.60), and 1.54 (95% CI = 1.33-1.78), respectively. Fracture risk was highest after longer treatment duration (>2-3 yr), and there was no difference in patients below and above the age of 30 yr. For users of combined estrogen-containing oral contraceptives, the OR were around 1. This population-based study suggests that use of DMPA is associated with a slightly increased risk of fractures.
    The Journal of clinical endocrinology and metabolism 11/2010; 95(11):4909-16. · 6.50 Impact Factor
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    Acta oncologica (Stockholm, Sweden) 03/2010; 49(4):523-5. · 2.27 Impact Factor
  • M. Bodmer, Y. B. Brauchli, C. R. Meier
    Jama-journal of The American Medical Association - JAMA-J AM MED ASSN. 01/2010; 303(12):1147-1147.
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    ABSTRACT: Gallstone disease is a leading cause of morbidity in western countries and carries a high economic burden. Statins decrease hepatic cholesterol biosynthesis and may therefore lower the risk of cholesterol gallstones by reducing the cholesterol concentration in the bile. Data on this association in humans are scarce. To study the association between the use of statins, fibrates, or other lipid-lowering agents and the risk of incident gallstone disease followed by cholecystectomy. Case-control analysis using the UK-based General Practice Research Database. Incident patients between 1994 and 2008 and 4 controls per each patient were identified and matched on age, sex, general practice, calendar time, and years of history in the database. The study population was 76% women and the mean (SD) age was 53.4 (15.0) years at the index date. Conditional logistic regression was used to estimate the odds ratio (OR) of developing gallstones followed by cholecystectomy in relation to exposure to lipid-lowering agents, stratified by exposure timing and duration. The ORs and 95% confidence intervals (CIs) were adjusted for smoking, body mass index, ischemic heart disease, stroke, and estrogen use. The adjusted OR (AOR) for developing gallstone disease followed by cholecystectomy in relation to exposure to lipid-lowering agents. A total of 27,035 patients with cholecystectomy and 106,531 matched controls were identified, including 2396 patients and 8868 controls who had statin use. Compared with nonuse, current statin use (last prescription recorded within 90 days before the first-time diagnosis of the disease) was 1.0% for patients and 0.8% for controls (AOR, 1.10; 95% CI, 0.95-1.27) for 1 to 4 prescriptions; 2.6% vs 2.4% (AOR, 0.85; 95% CI, 0.77-0.93) for 5 to 19 prescriptions, and 3.2% vs 3.7% (AOR, 0.64; 95% CI, 0.59-0.70) for 20 or more prescriptions. The AORs for current use of statins defined as 20 or more prescriptions were similar (around 0.6) across age, sex, and body mass index categories, and across the statin class. Long-term use of statins was associated with a decreased risk of gallstones followed by cholecystectomy.
    JAMA The Journal of the American Medical Association 11/2009; 302(18):2001-7. · 29.98 Impact Factor
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    ABSTRACT: Psoriasis has been associated with lymphohematopoietic and solid cancers; however, reports have been inconsistent. Cancer incidence was compared between psoriasis and psoriasis-free patients, and the roles of psoriasis duration and treatment were explored in this observational study using the UK General Practice Research Database. Among 67,761 patients, 1,703 patients had incident cancer; of whom 54% had a history of psoriasis. Incidence rate ratios for lymphohematopoietic and pancreatic cancers were 1.81 (95% confidence interval (CI) 1.35-2.42) and 2.20 (95% CI 1.18-4.09), respectively. In a nested case-control analysis, adjusted odds ratios (ORs) for cancer overall were 1.50 (95% CI 1.30-1.74) for psoriasis of >or=4 years duration and 1.53 (95% CI 0.97-2.43) for patients receiving systemic treatment (marker of disease severity). Lymphohematopoietic malignancy risk was highest in patients with systemic treatment. The OR for patients without systemic treatment was 1.59 (95% CI 1.01-2.50) for psoriasis of <2 years and 2.12 (95% CI 1.45-3.10) for that of >or=2 years duration. Risks of bladder/kidney and colorectal cancers were increased with longer-duration psoriasis. Psoriasis patients may have an increased overall risk of incident cancer (mainly lymphohematopoietic and pancreatic). Longer-term psoriasis and more severe disease may increase the risk of some cancers. These observations need further confirmation, particularly because of the potential of findings by chance in observational studies with subgroup analyses.
    Journal of Investigative Dermatology 05/2009; 129(11):2604-12. · 6.19 Impact Factor
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    ABSTRACT: Observations in controlled trials and case reports have linked lithium exposure to induction or exacerbation of psoriasis. A causal relationship between lithium exposure and incident psoriasis has been questioned, and observational studies are lacking. We conducted a case-control analysis using the United Kingdom-based General Practice Research Database to study the association between the use of lithium or antipsychotics and the risk of developing an incident diagnosis of psoriasis. We identified cases with an incident diagnosis of psoriasis between 1994 and 2005, and controls were matched to the cases on age, sex, general practice, calendar time, and years of history in the database. We used conditional logistic regression to estimate the risk of developing a first-time diagnosis of psoriasis in relation to previous exposure to lithium and antipsychotic drugs, stratified by exposure timing and duration. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for smoking, body mass index, and additional potential confounders. We identified 36,702 incident cases of psoriasis and the same number of matched controls. Compared with nonuse, current use of 5 or more prescriptions for lithium and atypical antipsychotics yielded adjusted ORs of 1.68 (95% CI, 1.18-2.39; P < 0.01) and 0.76 (95% CI, 0.55-1.06; P = 0.11), respectively. The OR for olanzapine was 0.50 (95% CI, 0.28-0.89, P = 0.02). Long-term use of lithium was associated with a small increase in risk of incident psoriasis. There was a suggestion of a possible reduced psoriasis risk associated with the use of atypical antipsychotics, mainly olanzapine, a finding that needs further evaluation.
    Journal of clinical psychopharmacology 04/2009; 29(2):134-40. · 5.09 Impact Factor
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    Y B Brauchli, S S Jick, M Miret, C R Meier
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    ABSTRACT: Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce. To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis-free population. We conducted an inception cohort study with a nested case-control analysis within the U.K.-based General Practice Research Database. The study population encompassed 36,702 patients with a first-time recorded diagnosis of psoriasis 1994-2005, matched 1 : 1 to psoriasis-free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs). Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1.66 (95% CI 1.03-2.66) compared with patients without psoriasis, while the OR for patients aged >or= 60 years was 0.99 (95% CI 0.77-1.26). The adjusted ORs of developing MI for patients of all ages with <or= 2 or > 2 prescriptions/year for oral psoriasis treatment were 2.48 (95% CI 0.69-8.91) and 1.39 (95% CI 0.43-4.53), with a similar finding for stroke and TIA. The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease.
    British Journal of Dermatology 01/2009; 160(5):1048-56. · 3.76 Impact Factor
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    Y B Brauchli, S S Jick, C R Meier
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    ABSTRACT: Cross-sectional studies, mostly in hospitalized patients, reported a possible positive association between psoriasis and diabetes mellitus (DM). However, information on the temporal relation is scarce, and incidence rates of new-onset DM in patients with psoriasis are lacking. To assess and compare incidence rates of new-onset DM between patients with psoriasis and a comparison group without psoriasis, and to explore the role of psoriasis severity and body mass index (BMI). We conducted a follow-up study with a nested case-control analysis within the U.K.-based General Practice Research Database. The study population consisted of patients with a first-time diagnosis of psoriasis between 1994 and 2005 and a matched group of psoriasis-free patients. We used psoriasis duration and treatment as proxy for disease severity, and we applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs). Within the study population of 65 449 patients we identified 1061 incident cases of DM. Of these, 59% had a history of psoriasis, yielding a crude incidence rate ratio of 1.36 (95% CI 1.20-1.53). The adjusted OR for patients with >or=2 years disease duration and >2 prescriptions per year for oral psoriasis treatment was 2.56 (95% CI 1.11-5.92). In an analysis restricted to patients with normal BMI, the adjusted OR was 2.02 (95% CI 1.31-3.10). In this large observational study the risk of incident DM was increased for patients with psoriasis as compared with a psoriasis-free comparison group. The risk increased with psoriasis duration and severity and was not driven by high BMI alone.
    British Journal of Dermatology 10/2008; 159(6):1331-7. · 3.76 Impact Factor
  • Y B Brauchli, S S Jick, F Curtin, C R Meier
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    ABSTRACT: Several case reports have associated use of beta-blockers with an increased risk of psoriasis or psoriasiform drug eruptions. To study the association between use of beta-blockers and other antihypertensive drugs and the risk of developing a first-time diagnosis of psoriasis. We conducted a case-control analysis on the U.K.-based General Practice Research Database. We identified cases with an incident psoriasis diagnosis between 1994 and 2005 and matched them to one control patient on age, sex, general practice, calendar time (same index date) and years of history in the database. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of developing a first-time psoriasis diagnosis in relation to previous exposure to antihypertensive drugs, stratified by exposure timing (current vs. past use) and exposure duration based on the number of prescriptions. The study encompassed 36 702 cases with a first-time psoriasis diagnosis and the same number of matched controls. Adjusted ORs for current use of 1-4, 5-19 or >or= 20 prescriptions for beta-blockers, as compared with nonuse, were 0.93 (95% CI 0.76-1.13), 1.10 (95% CI 0.97-1.24), and 1.10 (95% CI 1.01-1.20), respectively. The risk estimates for current use of other antihypertensives at any exposure duration were all close to 1.0. This large population-based case-control analysis does not support the current proposition that beta-blocker use is associated with an increased risk of psoriasis, nor did we find evidence for a substantially altered psoriasis risk for other antihypertensive drugs.
    British Journal of Dermatology 07/2008; 158(6):1299-307. · 3.76 Impact Factor
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    ABSTRACT: In Western Europe tick-borne encephalitis virus infections with fatal outcome are rare, especially in children. We report the case of an adolescent who died of meningoencephalitis after a tick bite that occurred between the first 2 tick-borne encephalitis vaccinations. The case demonstrates the difficulty of differentiating possible adverse events associated with the immunization from symptoms of simultaneous infection with tick-borne encephalitis virus.
    The Pediatric Infectious Disease Journal 05/2008; 27(4):363-5. · 3.57 Impact Factor
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    ABSTRACT: Phenytoin is a drug used for the treatment of different types of seizures. Its variable pharmacokinetics, mainly a consequence of variable bioavailability, saturable protein binding and saturable hepatic metabolism, predisposes the drug to therapeutic drug monitoring. Several methods to analyze the drug in serum exist with immunoassays being the method of choice for routine measurements. Immunoassays are specific and sensitive, but cross-reactivity, possibly leading to erroneous serum levels, is a concern. We report a patient with falsely undetectable phenytoin serum levels. This 73-year old woman was treated with intravenous phenytoin due to epilepsia partialis continua in the context of a bilateral cerebrovascular insult. Anamnestically, a chronic lymphatic leukemia was known. In this patient, serum phenytoin levels became only detectable by the particle enhanced turbidimetric inhibition immunoassay used after precipitation of serum proteins. Protein electrophoresis revealed a monoclonal immunoglobulin, identified as IgMlambda. With other methods such as HPLC and fluorescence depolarization immunoassay, phenytoin was detectable. We propose interference between the monoclonal IgMlambda and/or other serum proteins and the particle-enhanced turbidimetric inhibition immunoassay, rendering phenytoin falsely undetectable in samples of this patient. In such patients, alternative methods such as HPLC should be used to prevent dosage errors.
    Clinica Chimica Acta 04/2008; 389(1-2):174-6. · 2.85 Impact Factor
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    ABSTRACT: Small clinical trials suggest that thiazolidinediones may exert a beneficial effect on skin lesions of patients with psoriasis. Little is known about other classes of antidiabetic drugs and the psoriasis risk. We sought to study the association between use of thiazolidinediones, sulfonylureas, biguanides, or acarbose and the risk of developing a first-time diagnosis of psoriasis. We conducted a case-control analysis on the United Kingdom-based General Practice Research Database. We identified patients with an incident psoriasis diagnosis from 1994 to 2005 and matched one control subject to each patient on age, sex, general practice, calendar time, and years of history in the database. Conditional logistic regression was used to estimate the odds ratio with 95% confidence intervals (CI) of developing a first-time psoriasis diagnosis in relation to previous exposure to antidiabetic drugs, stratified by exposure timing and duration of use and adjusted for a variety of potential confounders. We identified 36,702 patients with a first-time psoriasis diagnosis and the same number of matched control subjects. As compared with no use, the adjusted odds ratio for current use of 1 to 4 prescriptions or greater than or equal to 5 prescriptions for thiazolidinediones were 1.01 (95% CI 0.34-3.01) and 0.33 (95% CI 0.16-0.66), respectively. Current use of greater than or equal to 15 prescriptions for metformin or sulfonylureas yielded adjusted odds ratio of 0.77 (95% CI 0.62-0.96) and 1.07 (95% CI 0.88-1.31), respectively. The findings are based on a small number of patients exposed to thiazolidinediones (100 in total, 48 current users of >or=5 prescriptions). The findings of this large observational study provide further evidence for a potentially beneficial effect of thiazolidinediones on psoriasis. While current long-term use of metformin was also associated with a suggestion of a reduced psoriasis risk, no such effect was seen for use of other oral antidiabetics.
    Journal of the American Academy of Dermatology 03/2008; 58(3):421-9. · 4.91 Impact Factor
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    ABSTRACT: The possible role of alcohol in the development of hepatotoxicity associated with therapeutic doses of paracetamol (acetaminophen) is currently debated. We describe 2 patients who were regular consumers of alcohol and who developed liver failure within 3-5 days after hospitalization and stopping alcohol consumption while being treated with 4 g paracetamol/day. A paracetamol serum level obtained in one of these patients was not in the toxic range. Possible risk factors for the development of hepatotoxicity in patients treated with therapeutic doses of paracetamol are discussed. In patients with risk factors, e.g. regular consumption of alcohol, liver failure is possible when therapeutic doses are ingested. We propose that the paracetamol dose should not exceed 2 g/day in such patients and that their liver function should be monitored closely while being treated with paracetamol.
    Digestion 02/2007; 75(4):232-7. · 1.94 Impact Factor