Systematic Reviews Now Available

Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries
(Systematic Review, released on July 18, 2018)

Selected Key Messages:

Baby-Friendly Hospital Initiative (BFHI) is associated with improved rates ofbreastfeeding initiation and duration.
Health care staff education combined with postpartum home visits may be effective for increasing breastfeeding duration.
Health care staff education alone (with no additional breastfeeding support services) may not be effective for increasing breastfeeding initiation rates.
For women enrolled in the Women, Infants, and Children (WIC) program, peer-support interventions offered by WIC agencies may improve rates of breastfeeding initiation and duration.
Breastfeeding is associated with reduced maternal risk of breast and ovarian cancer,hypertension, and type 2 diabetes.
Workplace, school-based, and community-based interventions and underlying socioeconomic factors need further research.

For more see: https://effectivehealthcare.ahrq.gov/topics/breastfeeding/research

Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update
(Systematic Review, released on July 16, 2018)

Selected Key Messages:

Conclusions are based on studies that enrolled patients with moderate to high disease activity at baseline as measured with Disease Activity 28 Scores and may not apply to the general rheumatoid arthritis (RA) population.
Corticosteroids in combination with methotrexate (MTX) may improve remission rates more than MTX alone (difference range, 2.1% to 42.8%), but they did not differ significantly in disease activity in the long term (up to 5 years).
Two-agent treatments with MTX and tumor necrosis factor (TNF) biologics or non-TNF biologics most likely yield higher treatment response rates than treatment with MTX monotherapy or any biologic monotherapy (range of American College of Rheumatology response differences, 1.2% to 25.6%).
Rates of serious adverse events and discontinuations because of adverse events may not differ between any disease-modifying antirheumatic drugs (DMARDs).
Insufficient information was available about treatment options for patient subgroups, such as disease activity, prior therapy, demographics, and the presence of other serious conditions.
Future research should address the (1) assessment of long-term comparative benefits and harms of DMARDs, (2) determination of treatment decisions based on disease activity severity in early RA, and (3) timing of initiation of biologic medications.

For more see: https://effectivehealthcare.ahrq.gov/topics/rheumatoid-arthritis-medicine-update/final-report-update-2018

About us: AHRQ’s Effective Health Care Program is committed to providing the best available evidence on the outcomes, benefits and harms, and appropriateness of drugs, devices, and health care services and by helping health care professionals, patients, policymakers, and health care systems make informed health care decisions. The program partners with research centers, academic institutions, health professional societies, consumer organizations, and other stakeholders to conduct research, evidence synthesis, evidence translation, dissemination, and implementation of research findings.

To learn more: https://www.effectivehealthcare.ahrq.gov