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We appreciate the attention given by Andy Haines and Philip J Landrigan to the findings of The Lancet's Taskforce on NCDs and economics and our Series paper. 1 Haines and Landrigan emphasise our main findings that many premature NCD deaths will occur in lowincome and middle income countries by 2030, and that investments to manage NCDs cannot only reduce those premature deaths, but also provide economic gains and help achieve SustainableThe Lancet Taskforce on NCDs and economics could substantially enhance its influence and further increase the return on investment in NCD prevention if it were to expand its scope to include a new focus on prevention of pollution. The greatest beneficiaries will be people in the world's most rapidly developing and severely affected countries.We declare no competing interests.

Two-thirds of patients with HM and respiratory failure failed NIV and required ETI, and had high subsequent mortality. Patients who failed NIV had higher Paco, higher Fio, and a trend toward more vasopressor use.

Background and Aim: Vedolizumab is a novel monoclonal antibody used in patients with inflammatory bowel disease, often affecting women of child-bearing age. We aimed to compare maternal and fetal adverse outcomes in pregnancies of women with inflammatory bowel disease exposed to vedolizumab versus those on other treatment. Methods: We performed a systematic literature search through December 2020 looking for studies including outcomes from pregnancies of female inflammatory bowel disease patients treated with vedolizumab. Our primary outcome was a composite of adverse pregnancy-related events in pregnancies of female patients on vedolizumab compared with those of disease-matched controls on other medication regimens. Events of interest included preterm births, early loss of pregnancy, late fetal death, elective termination of pregnancy, and congenital anomalies. Results: Four studies were included in our review meeting criteria for our primary analysis. Compared with those with no vedolizumab exposure, pregnancies with vedolizumab exposure had an increase in overall adverse pregnancy-related outcomes (odds ratio [OR] 2.18, 95% confidence interval [CI], 1.52-3.13). The vedolizumab group also had increased preterm births (OR 2.16, 95% CI, 1.28-3.66), and early loss of pregnancies (OR 1.79, 95% CI, 1.06-3.01) but no difference in number of live births (OR 0.60, 95%CI, 0.36-1.00), or congenital malformations (OR 1.56, 95% CI, 0.56-4.37). Conclusions: Our systematic review highlights possible concern with the general safety of vedolizumab in pregnancy, as an increase in overall total unfavorable outcomes was observed. Premature births and early loss of pregnancy were also more prevalent in pregnant female patients on vedolizumab. It is possible these findings are confounded by disease activity, and further prospective cohort studies of vedolizumab and pregnancy outcomes are warranted. contributions were as follows: Conor Bell: literature search, data entry, data interpretation and drafting of the manuscript. Parul Tandon: critical review of the manuscript. Eric Lentz: literature search, data entry, and poster creation. John K Marshall: critical review of manuscript. Neeraj Narula: study concept and design, data acquisition, data analysis and critical review of manuscript.

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