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Journal of the American Medical Association

 (JAMA) has published positive results from 2 phase 3 trials on the use of roflumilast cream 0.3%(ZORYVE; Arcutis Biotherapeutics, Inc) once per day to treat chronic plaque psoriasis.

Results from the trials showed that ZORYVE led to significant improvements in plaque clearance and itch after 8 weeks in adults and children with plaque psoriasis, with Investigator Global Assessment (IGA) being used to measure success.

Mark Lebwohl MD, FAAD, discussed how plaque psoriasis and the itching that accompanies the condition negatively affects patients’ quality of life. The results from the phase 3 trials indicate that ZORYVE can greatly reduce sores and loss of sleep from itch caused by plaque psoriasis. Also, Lebwohl noted, ZORYVE quickly cleared plaques in cases of varying severity.

The two trials were identical phase 3 randomized, parallel, double-blind, vehicle-controlled, multi-national, multi-center studies. Participants were aged 2 years and above, and had mild, moderate, or severe chronic plaque psoriasis which covered 2% to 20% of their body surface area.

Once a day, participants applied ZORYVE to the affected area, over the course of 8 weeks. In a control group, a vehicle was applied instead of ZORYVE. IGA success after 8 weeks was seen in many more patients using ZORYVE than those using a vehicle.

Improvements in itch began as early as week 2, progressing through week 8. Patients with significant itch saw a 4-point reduction measured by a Worst Itch Numerical Rating Scale. ZORYVE also saw significant success in treating intertriginous areas, often achieving IGA success by week 8. 

Signs and symptoms were significantly improved in patients, and safety and tolerability of the cream were similar to vehicle. No serious adverse events occurred.

Journal of the American Medical Association publishes roflumilast cream 0.3% results from pivotal DERMIS-1 and -2 phase 3 trials in plaque psoriasis. Arcutis Biotherapeutics. Accessed September 23, 2022. 

https://www.arcutis.com/journal-of-the-american-medical-association-publishes-roflumilast-cream-0-3-results-from-pivotal-dermis-1-and-2-phase-3-trials-in-plaque-psoriasis/

Articles

In 2 recent phase 3 trials, safety and efficacy was proven in the use of roflumilast cream 0.3% for the treatment of plaque psoriasis.

Roflumilast cream improves plaque psoriasis symptoms in patients

New research from investigators in New Zealand is providing new insight into the effects of inadequate glycemic control among mothers with 

 during pregnancy on maternal and perinatal morbidity.

Named the TARGET Trial, results of the stepped-wedge, cluster-randomized trial, which randomized patients from 10 hospitals in New Zealand, suggest reaching glycemic targets was not associated with a reduction in the risk of a large for gestational age infant, but investigators pointed out reaching target was associated with a reduction in serious infant morbidity and an increase in serious maternal morbidity.

“This unique trial allowed for the sequential implementation of the newly, recommended tighter treatment targets for women with gestational diabetes and assessed if there are true benefits, without harm, to use of tighter treatment targets,” said lead investigator Caroline Crowther, of the University of Auckland, New Zealand.

Launched with the intent of further examining the effects of glycemic control thresholds on outcomes for both mother and child, Crowther and a team of colleagues designed the TARGET trial as a stepped-wedge, cluster-randomized trial to be conducted at 10 maternity hospitals in New Zealand. With the primary inclusion criteria being a diagnosis of gestational diabetes, investigators identified 1100 women with gestational diabetes between May 2015 and November 2017 for inclusion in the trial.

Per study protocol, all sites used less stringent targets (fasting plasma glucose [FPG] <5.5 mmol/L, 1-hour <8.0 mmol/L, 2 hour postprandial <7.0 mmol/L) and, every 4 months, 2 hospitals moved to use tighter targets (FPG <5.0 mmol/L, 1-hour <7.4 mmol/L, 2 hour postprandial<6.7 mmol/L).The primary outcome of interest for the trial was giving birth to a large for gestational age infant and secondary outcomes of interest pertained to maternal and infant outcomes, which were assessed in intention-to-treat analyses. The 1100 women included in the trial birthed 1108 infants. Among the 1100, 598 women who birthed 602 infants used the tighter glycemic targets and 502 women who birthed 506 infants used less tight targets.

Upon analysis, results indicated the rate of large for gestational age infants was similar among both groups, occurring among 14.7% of mothers using the tighter targets and 15.1% of mothers using the less tight targets (aRR, 0.96 [95% CI, 0.66-1.40]; 

=.839). In analyses adjusted for gestational age at diagnosis of gestational diabetes, BMI, ethnicity, and history of gestational diabetes, investigators found incidence of a composite outcome for infant health that included perinatal death, birth trauma, or shoulder dystocia was lower among those with tighter glycemic targets (aRR, 0.23 [95% CI, 0.06-0.88]; 

=.032), but no differences were observed for other infant secondary outcomes apart from shorter stays in intensive care (

Additional analysis suggested tighter glycemic control was associated with an apparent increase for the composite serious health outcome that included major hemorrhage, coagulopathy, embolism, and obstetric complications (aRR 2.29 [95% CI, 1.14-4.59]; 

=.020). Investigators also pointed out there were no differences observed between trial groups for preeclampsia, induction of labor, or cesarean birth, but more women using tighter targets required pharmacological treatment (aRR, 1.20 [95% CI, 1.00-1.44]; 

Tighter or less tight glycaemic targets for women with gestational diabetes mellitus for reducing maternal and perinatal morbidity: A stepped-wedge, cluster-randomised trial

This article was published by our sister publication Endocrinology Network.

Results of the TARGET trial provide insight into the effects of tight glycemic targets versus less tight targets on maternal and perinatal outcomes among women with gestational diabetes.

 In gestational diabetes, tighter glycemic targets could influence outcomes for mother and child

A lack of physical activity and a sedentary lifestyle was associated with 

, amblyopia, and refractive error in young children, according to recent findings.

By contrast, children who had better visual acuity, finer stereoacuity, and did not need spectacles were more likely to regularly engage in physical activity.

“The relationship between visual function and physical activity engagement may be bidirectional; it is hard to unravel whether physical inactivity results in reduced VA or reduced VA results in reduced physical activity engagement,” said Síofra Harrington, PhD, School of Physics and Clinical and Optometric Sciences.

These findings remain important as one in ten study participants reported no physical activity, but the number rose to one in three among visually impaired patients.

Physical activity in childhood is directly linked to health in adulthood, it remains an urgent health focus among society and policymakers at large. Low physical activity is associated with earlier onset of visual impairments, including age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy.

Harrington and colleagues investigated the association between visual function in children with parent-reported hours of engagement in physical activity outside of school. Data were collected between June 2016 - January 2018 and included 1,626 schoolchildren in randomly selected schools in Ireland.

A standardized questionnaire given to parents or legal guardians recorded physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (<3 hours per week in sports), or regular activity (>3 hours per week engaged in sports).

Primary outcomes examined included visual acuity, stereoacuity, visual impairment, amblyopia, and clinically significant refractive error by physical activity level. Logistic regression models investigated associations and odds ratios (OR) for sociodemographic and visual factors assisted with the activity levels.

Examination results included 723 of the 728 6 - 7 years olds and 887 12 - 13 year olds. By sociodemographic factors, investigators found socioeconomic disadvantage (OR, 6.70; 95% CI, 4.55 - 10.05; 

 <.001) and non-White ethnicity (OR, 8.05; 95% CI, 4.85 - 13.36; 

 <.001) were associated with physical activity engagement.

Both socioeconomic status and ethnicity were controlled for in all further analyses. Data show distance presenting VA was significantly better among participants who reported regular physical activity than those who reported moderate, light or no physical activity in both 6 - 7 year-olds (

Moreover, near presenting VA was significantly better in participants who reported regular rather than moderate, light, or no physical-activity in 6 - 7 year olds (

 = .009). The same was true for stereoacuity in 6 - 7 year olds (

 = .02) and in 12–13 year-old participants (

Data suggest the absence of clinically significant refractive error (SER >-0.50D <2.00D) was associated with regular physical activity in 6 - 7 year olds (OR, 1.73; 95% CI, 1.11 - 2.70; 

 = .015) and 12-13 year olds (OR, 2.00; 95% CI, 1.32 - 3.04; 

Those with better visual impairment (OR, 5.78), amblyopia (OR, 5.86), and participants at school without their spectacles (OR, 2.20) were more likely to report no activity, according to investigators.

They noted that socioeconomically disadvantaged and non-White children were particuarly affected by visual impairment, making it important for policymakers to promote and support physical activity participation for these populations.

“Not only will the health benefits associated with physical activity manifest themselves in childhood but also in adulthood, where the benefits at that time will be material with significant benefits for not only the individual but also the community in terms of independence and quality of life,” Harrington added.

Visual factors associated with physical activity in schoolchildren

,” was published in Clinical and Experimental Optometry.

This article was published by our sister publication HCP Live.

Children regularly engaged in physical activities had significantly better visual and stereoacuity than those who reported moderate, light or no activity.

Visual impairment in children associated with lack of physical activity

The US Food and Drug Administration (FDA) has approved sodium thiosulfate (Pedmark; Fennec Pharmaceuticals Inc.) for use in pediatric patients aged 1 month and older with localized, non-metastatic solid tumors.

Cisplatin-based chemotherapy is used to treat patients with cancer but is associated with risk of ototoxicity. Sodium thiosulfate has been proven to reduce risk for pediatric patients through 2 multicenter open-label, randomized controlled trials.

In the first trial, 114 patients taking 6 cycles of perioperative cisplatin-based chemotherapy for standard risk hepatoblastoma were randomized to receive the therapy either with or without sodium thiosulfate doses.

Brock Grade ≥1 hearing loss was assessed in patients and compared between groups. The sodium thiosulfate and cisplatin arm had a 39% hearing loss rate, while the cisplatin alone arm had a 68% hearing loss rate.

In the second trial, 125 pediatric patients took a chemotherapy regimen with cumulative cisplatin doses of 200 mg/m2 or higher. Doses were injected over periods of 6 hours or less.

Patients were randomized into 2 groups, one of which was given sodium thiosulfate during chemotherapy while the other was not. Hearing loss was assessed in both groups, with the sodium thiosulfate and cisplatin arm group having lower rates than the cisplatin alone arm group.

Vomiting, nausea, decreased hemoglobin, hypernatremia, and hypokalemia were the most common adverse events in both trials, appearing in 25% of cases of sodium thiosulfate and cisplatin compared to 5% of cases of cisplatin alone.

Doses of sodium thiosulfate are measured based on surface area according to actual body weight. Sodium thiosulfate is administered 15 minutes after cisplatin, with infusions lasting 1 to 6 hours.

FDA approves sodium thiosulfate to reduce the risk of ototoxicity associated with cisplatin in pediatric patients with localized, non-metastatic solid tumors. US Food and Drug Administration. September 20, 2022. Accessed September 22, 2022. 

https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-sodium-thiosulfate-reduce-risk-ototoxicity-associated-cisplatin-pediatric-patients

Sodium thiosulfate has been approved by the FDA to treat ototoxicity in pediatric patients with localized, non-metastatic solid tumors.

FDA approved sodium thiosulfate for pediatric use

The US Food and Drug Administration (FDA) has given the GBS6 (PF-06760805; Pfizer) vaccine Breakthrough Therapy Designation for use in pregnant women to help infants avoid Group B 

The vaccine leads to active immunization in mothers, giving their infants vaccine serotypes and protecting them from GBS. The safety and immunogenicity of GBS6 has been tested in pregnant women aged 18 to 30 years in a phase 2 study, where the vaccine was administered during the 2nd or 3rd trimester. This study is ongoing, and Pfizer plans to publish the results upon the study’s completion.

“If approved for pregnant women, GBS6 could help protect newborns from the serious illnesses caused by this disease like meningitis, pneumonia, and sepsis – fulfilling a critical global public health need,” said Annaliesa Anderson, PhD, Senior Vice President and Head of Vaccine Research and Development at Pfizer. “We are encouraged by today’s decision and look forward to discussing GBS6 with the FDA and other regulatory agencies to potentially reduce neonatal deaths and positively impact the existing global disease burden of GBS.”

GBS6 can protect infants from the 6 most common GBS serotypes, which make up 98% of diseases worldwide. GBS can lead to severe infections in infants such as sepsis, pneumonia, and meningitis. About 1 in 4 women carry GBS bacteria which can be passed to their infants. There are about 410,000 infections per year, causing about 147,000 stillbirths and infant deaths.

In the ongoing phase 2 study, GBS is being tested for the safety and immunogenicity of a single dose through intramuscular injection. Studies are being conducted in high-, middle-, and low-income countries so that the vaccine can be available worldwide as soon as possible.

Reference
FDA grants breakthrough therapy designation to pfizer’s group b streptococcus vaccine candidate to help prevent infection in infants via immunization of pregnant women. Business Wire. September 7, 2022. Accessed September 22, 2022.

After promising outcomes in an ongoing phase 2 trial, the FDA has given Pfizer’s GBS6 vaccine Breakthrough Therapy Designation against Group B Streptococcus in infants.

FDA grants GBS6 vaccine breakthrough therapy designation

Sleep duration in children may be increased after interventions focused on earlier bedtime, leading to important benefits in their health, according to a recent review.

Individual health is significantly affected by childhood experiences, with adequate sleep being vital to well-being. This involves proper sleep timing, quality, and duration, and can affect mental well-being, growth, effective social interactions, cognitive processing, and metabolic health.

Trends have indicated that children are not receiving adequate sleep durations, which has been attributed to increased screen time, electronic media use, stimulant intake, and unhealthy sleep behaviors such as poor bedtime routines. This has created a need for the development of effective strategy to encourage proper sleep behavior in children.

Recent reviews have focused on sleep in individuals with sleep problems or medical issues. There are few studies with quantitate data available, and the data available is modest. To improve the data available, investigators sought to estimate the effectiveness of sleep-related interventions in healthy children.

Investigators used key words and index terms to search for studies throughout 7 databases: CENTRAL, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, ClinicalTrials.gov, and World Health Organization trials databases. Individual and cluster randomized clinical trials analyzing the effects of intervention on sleep at a class and school level were gathered and studied.

After excluding duplicates and certain records, 13,728 studies were included for screening. Of these, 411 underwent full text screenings. Over 13,000 participants were included in the studies, of which about 51% were in an intervention group and about 49% were in a control group. The average age of participants ranged from 18 moths to 19 years.

Sleep duration estimates did not see significant differences between age groups, nor did social disadvantage and reported sleep problems affect estimates. Pooled estimates often changed between regions, with North America and Asia showing the greatest differences in sleep duration compared to regions such as Australia.

Significant changes were observed after intervention which focused on lengthening sleep duration. Location of delivery, parental involvement, or medium of delivery did not cause changes in sleep duration. Trials which focused on an earlier bedtime saw a significant and substantial effect on sleep duration.

General sleep interventions led to an average 10.5 minutes of increased sleep duration in children aged 1 to 18 years. The most significant interventions focused on earlier bedtime, leading to an average 47-minute increase in sleep duration.

Based on these results, investigators concluded that specific intervention elements, such as focus on earlier bedtime, should be further studied to support adequate sleep in children.

Magee L, Goldsmith LP, Chaudhry UAR, Donin AS, Wahlich C, Stovold E, et al. Nonpharmacological interventions to lengthen sleep duration in healthy children: a systematic review and meta-analysis. 

. 2022. doi:10.1001/jamapediatrics.2022.3172

In a recent review, children given interventions with focus on earlier bedtime led to a significant increase in sleep duration.

How sleep interventions improve sleep duration in children

Early oseltamivir use helps hospitalized children have shorter hospital stays, along with decreasing chances of 7-day readmission, extracorporeal membrane oxygenation (ECMO) use, ICU transfer, and death, according to a recent study.

About 2.8 to 10.7 million children experience symptomatic illnesses, 1.6 to 6.1 million outpatient medical visits, 11,000 to 45,000 hospitalizations, and 110 to 600 excess deaths annually because of influenza. Oseltamivir is the main form of treatment given to patients suffering from influenza, having been approved by the US Food and Drug Administration in 1999.

The median time for alleviation of influenza symptoms among pediatric patients is improved by 29 hours from oseltamivir compared to placebo. Guidelines from the American Academy of Pediatrics and Infectious Diseases Society of America recommend oseltamivir for the treatment of influenza in hospitalized children.

However, there is still debate over whether oseltamivir uses less hospital resources than alternatives, and if patient outcomes are improved. In a 2009 study, oseltamivir use benefitted adults but not children. Other studies indicated successful pediatric use, but these studies had limited sample sizes.

To determine association between oseltamivir use in pediatric patients and improved outcomes, investigators conducted a multicenter retrospective cohort study, with data taken from hospitalized children afflicted with influenza.

Pediatric patients with influenza discharged from a participating hospital from October 1, 2007, to March 31, 2020, were included in the study. Primary exposure was defined as early use of oseltamivir, meaning that children who had taken oseltamivir on day 0 or day 1 of admission were included.

Hospital length of stay (LOS) was the primary outcome, calculated as the distance between admission data and discharge date. Late intensive care unit (ICU) transfer, 7-day hospital readmission, and a composite outcome of in-hospital death or ECMO use were listed as secondary outcomes.

A total of 55,799 encounters across 36 hospitals were included in the study, and the average age of patients was 3.61 years. Nearly 60% of patients received early oseltamivir. In these cases, the median LOS was 3 days instead of 4, and all-cause 7-day hospital readmission, late ICU transfer, and death or ECMO usewere less likely.

Children treated with early oseltamivir were often olderand were more likely to have complex chronic conditions or require early ICU admission. Data on LOS, 7-day readmissions, and late ICU transfers were similar between subgroups, while differences were seen for in-hospital death or ECMO use.

The findings from this study were consistent with current recommendations for early oseltamivir use, indicating that the treatment will lead to improved outcomes in pediatric patients.

Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM. Association of early oseltamivirwith improved outcomes in hospitalized children with influenza, 2007-2020. 

 2022. doi:10.1001/jamapediatrics.2022.3261

Hospitalized children treated with early oseltamivir (Tamiflu, Gilead Sciences) for influenza had a shorter stay and were less likely to be transferred to an intensive care unit or require other treatment. 

Early oseltamivir improves outcomes in children with influenza

State child abuse policies and mandated reporting policies reduce visits by pregnant people to prenatal care and postpartum health care, according to a recent study.

Analyzing the United States’ overdose crisis, investigators have observed concerns over substance use during pregnancy. In the 2020 National Survey on Drug Use and Health, 8% of pregnant people reported recent illicit drug use. There has also been a significant increase in opioidand amphetamine affected births in the past few years.

Associations have been made between substance use during pregnancy and adverse outcomes during birth, such as low birth weight, preterm birth, and severe maternal morbidity and mortality. Policies addressing prenatal substance use have arisen in some states, including policies that label substance use during pregnancy as child abuse. Certain policies require that healthcare professionals report instances of prenatal substance use to child welfare agencies.

Child abuse policies have been implemented in 23 states and the District of Columbia, while mandated reporting policies have been implemented in 26 states and the District of Columbia. Leading medical and public health organizations have spoken against child abuse policies, expressing concerns that they will lead less pregnant people to be open to prenatal care and substance use disorder (SUD) treatment in fear of punishment.

Prior studies have indicated reluctance of pregnant people who engage in substance use to seek prenatal and postpartum care out of fear of legal consequences. As early and consistent prenatal care leads to healthy outcomes, investigators stressed the importance of pregnant people visiting care centers, especially in cases of SUD.

Investigators conducted a cross-sectional survey, taking data from the Pregnancy Risk Assessment Monitoring System from 2016 to 2019. This data consisted of a sample of women who delivered a live birth during that year, divided into subgroups based on maternal race and ethnicity and infant birth weight. 

A survey was given to women 2 to 6 months postpartum through mail or telephone, with questions about prenatal substance use and health care visits. Over 4000 women were surveyed across 23 states, and the years in which states had child abuse or mandatory reporting policies were noted.

Prenatal care was recorded based on timing and adequacy, while postpartum care was recorded based on a self-reported receipt by women. Less than 1% of data were missing a receipt for a postpartum healthcare visit.

About 34% of women delivered in states with only a child abuse policy, about 16% in states with a mandatory reporting policy, about 33% in states with both, and about 17% in states with neither. Adequate prenatal care was most seen in states with both policies at 75.1%, then states with neither policy at 75%. States with only child abuse policies saw a 64.1% prenatal care rate, and those with only mandatory reporting policies saw a 66.4% prenatal care rate.

Women on average sought prenatal care about a month later in states with one or more policy compared to states with neither. States with one or more policy implemented saw a decrease in women’s likelihood to receive adequate prenatal care. Postpartum care visits were also less likely in these states. Women in these states were 8.7% to 12.4% less likely to visit postpartum care 4 to 6 weeks after delivery than those in states who had neither policy.

These results indicate that child abuse and mandatory reporting policies decrease the likelihood of women receiving prenatal and postpartum care. This supports statements by leading health and medical organizations that these policies may deter pregnant people from seeking care.

Austin AE, Naumann RB, Simmons E. Association of state child abuse policies and mandated reporting policies with prenatal and postpartum care among women who engaged in substance use during pregnancy. 

2022. doi:10.1001/jamapediatrics.2022.3396

Investigators found that women in states with child abuse or mandated reporting policies were less likely to visit prenatal care and postpartum health care. 

Child abuse and mandatory reporting policies decrease visits to prenatal care 

Swedish researchers found that many children and young adults who are prescribed melatonin are still taking it 3 years later and at larger doses.

Using registry data for an urban area centered around Stockholm, the authors determined that 9980 individuals up to aged 25 years were dispensed melatonin in 2016. Most patients (65%) had a neuropsychiatric diagnosis, and only 20% had a sleep disorder.

Prevalence of dispensed melatonin was 0.2% in preschoolers 5 years and younger, 1.4% in children aged 6 to 12 years, 3.4% in adolescents aged 13 to 17 years, and 1.2% in those aged 18 to 25 years.

Comorbid conditions were common, as was polypharmacy, identified in 4567 individuals (46%), more often females than males. Of those who began taking melatonin in 2016, 50% of male patients and 40% of female patients continued to use it throughout the following 3 years, often at increased doses.

I, too, would like to see some long-term studies. But given that sleep difficulties are major problems for children and their families, especially when combined with developmental disabilities such as autism, I continue to use melatonin in high doses if needed for these families. For neurotypical children, however, my go-to remains behavioral interventions.

Tedroff K, von Euler M, Dahlén E. Melatonin usage in children and young adults, a registry-based cohort study. 

 2022;39(30-34). doi:10.1016/j.ejpn.2022.05.007

Many children continue to use melatonin for years after being prescribed the medication, according to a recent study.

Long-term melatonin use in children: Is it safe? 

The US Food and Drug Administration (FDA) has approved SKYSONA (elivaldogene autotemcel; Bluebird Bio) for use in boys aged 4 to 17 years with early, active cerebral adrenoleukodystrophy (CALD).

SKYSONA can be used to slow the neurological decline in boys caused by CALD. This neurological decline is irreversible and leads to major functional disabilities such as loss of communication, requirement for tube feeding, cortical blindness, wheelchair dependence, total incontinence, or complete loss of voluntary movement.

Without treatment, about half of patients with CALD die within 5 years. Allogeneic hematopoietic stem cell transplant was the most effective treatment in the past, which greatly increased risk of severe complications and death. These risks were magnified in patients without a human leukocyte antigen matched donor.

“The agony of watching your child slip away is something no parent should have to bear,” said Elisa Seeger, co-founder of ALD Alliance. “We have made significant strides in providing children diagnosed with CALD the best chance at life with early identification of ALD through expanded newborn screening. Yet with limited treatment options, early diagnosis is still cause for despair instead of hope for many families. Today, parents whose boys receive a CALD diagnosis can have renewed hope for the future.”

Bluebird will also be providing long-term clinical data on SKYSONA to the FDA, including data on an ongoing long-term follow-up study, LTF-304 (NCT02698579). This will allow data on patients followed for 15 years after clinical trials to be submitted.

SKYSONA is set to be released by the end of 2022 throughout Qualified Treatment Centers in the United States. The wholesale acquisition cost of SKYSONA has been set to $3 million in the United States. For additional information, patients can follow the bluebird patient support program, My Bluebird Support.

bluebird bio receives FDA accelerated approval for SKYSONA® gene therapy for early, active cerebral adrenoleukodystrophy (CALD). bluebirdbio. Accessed September 21, 2022. 

https://investor.bluebirdbio.com/news-releases/news-release-details/bluebird-bio-receives-fda-accelerated-approval-skysonar-gene

Bluebird bio has announced that their SKYSONA therapy has been approved for pediatric use by the FDA.

How sleep interventions improve sleep duration in children

Early oseltamivir improves outcomes in children with influenza

Child abuse and mandatory reporting policies decrease visits to prenatal care

Long-term melatonin use in children: Is it safe?

FDA approves SKYSONA for boys aged 4 to 17 years