Abstract:
BACKGROUND:Although beta-blocker therapy has been shown to improve survival in patients with chronic heart failure, this class of drugs tends to be underutilized in diabetic patients due to concerns about adverse metabolic effects, especially on glycemic control. No randomized clinical trial has specifically evaluated the effect of beta-blocker therapy on mortality in diabetic patients with heart failure. Previous meta-analyses combining results of heart failure trials with pharmacologically diverse beta-blockers suggest that the survival benefit in diabetic patients may be diminished compared to benefits in non-diabetic patients. However, some trial results indicate that carvedilol, which blocks beta1-, beta2-, and alpha1-receptors and is a potent antioxidant, may produce at least comparable effects in both patient groups. OBJECTIVES:To evaluate the effect of carvedilol in patients with heart failure and diabetes, specifically to determine if the survival benefit of carvedilol demonstrated in heart failure trials was as great in the subgroups of patients with diabetes. METHODS:A meta-analysis was performed that included 5757 patients with heart failure, 25% of whom had diabetes, from seven large placebo-controlled randomized trials with carvedilol. All large (> 100 patients) placebo-controlled, randomized trials with carvedilol in heart failure were included. The endpoint of all-cause mortality was examined in the overall population, patients without diabetes, and patients with diabetes. The number of patients needed to treat (NNT) for 1 year to prevent one death associated with carvedilol use in diabetic versus non-diabetic patients was also calculated. The log-rank test and the Cox proportional hazards regression were used to compare the event time distributions of carvedilol versus placebo with respect to the outcome of mortality. RESULTS:Similar survival benefits were seen with carvedilol use in diabetic and non-diabetic patients (relative risk reductions of 28% [95% confidence interval (CI) 3-46%; p = 0.03] and 37% [95% CI 22-48%; p < 0.001], respectively). There were no significant differences between the relative mortality risk reductions or the NNT with carvedilol use in diabetic versus non-diabetic patients. The NNT for 1 year to prevent one death was 23 for all patients, as well as for non-diabetic patients, and 25 for the diabetic group. CONCLUSIONS:This meta-analysis provides evidence that the same survival benefit may occur with carvedilol in heart failure patients with and without diabetes. The low NNT in the severe heart failure trial, COPERNICUS, and the diabetic subgroup in this meta-analysis suggests that severe heart failure patients and heart failure patients with diabetes may particularly derive benefit from therapy with carvedilol.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Bell DS,Lukas MA,Holdbrook FK,Fowler MBdoi
10.1185/030079906X80459keywords:
subject
Has Abstractpub_date
2006-02-01 00:00:00pages
287-96issue
2eissn
0300-7995issn
1473-4877journal_volume
22pub_type
杂志文章,meta分析abstract::The results of a series of studies on body fluid, electrolytes and diuretics are discussed. The findings to date indicate that the sex difference between mean potassium plasma levels in men and women is preserved into old age. Contrary to previous suggestions, there would appear to be no transient self-correcting hypo...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:Research indicates that insomnia may contribute significantly to healthcare costs; however, information on the effects of treatments on costs has not been thoroughly published. This study presents predictive models that forecast, from the perspective of commercial managed care, the effects of insomnia medicat...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079907X199619
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Patients with type 2 diabetes (T2DM) often have multiple comorbidities which may impact the selection of antihyperglycemic therapies. The purpose of this study was to quantify the prevalence and co-prevalence of common comorbidities. RESEARCH DESIGN AND METHODS:A retrospective study was conducted using the Q...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2016.1168291
更新日期:2016-07-01 00:00:00
abstract::Insulin secretion was studied in 12 non-insulin dependent diabetics during middle-term administration of the sulphonylurea gliclazide. Blood sugar, C-peptide and glucagon were also estimated during the intravenous glucose tolerance and arginine tests performed before and after therapy. After 3 months of gliclazide the...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998409109560
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:The rates of blood pressure (BP) control worldwide are discouraging. This study had the purpose of assessing the effectiveness of perindopril/amlodipine fixed dose combination on BP-lowering efficacy, and recording adherence, safety and tolerability during a 4 month treatment period. RESEARCH DESIGN AND METH...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1080/03007995.2016.1193481
更新日期:2016-09-01 00:00:00
abstract::A double-blind trial of methocarbamol versus placebo was carried out in 59 matched pairs of patients suffering from painful muscle spasm. Methocarbamol (1500 mg. q.d.s.) was found to be effective in approximately 60% of patients compared with 30% of patients receiving placebo (p less than 0.01). Side-effects were of a...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007997509114791
更新日期:1975-01-01 00:00:00
abstract::For over a century, there has been considerable interest in the management of regional lymph node metastasis in patients with primary breast cancer. Since the advent of sentinel lymph node biopsies, there has been renewed interest in the management of patients with metastasis to the internal mammary nodes. The appropr...
journal_title:Current medical research and opinion
pub_type: 社论
doi:10.1185/030079903125002207
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Patients that undergo total hip replacement (THA) are at risk of revision surgery. This study evaluated the cumulative incidence of revision following a medial collared, triple tapered (MCTT) primary hip stem versus other implants in real-world settings using electronic medical records. METHODS:This was a re...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1822309
更新日期:2020-11-01 00:00:00
abstract::Amlodipine, a dihydropyrimidine calcium antagonist, is effective in the treatment of patients with mild to moderate hypertension at doses of 5-10 mg daily. The aim of the study reported here was to determine whether an early increase in dosage of amlodipine provided an advantage in terms of antihypertensive effect. Th...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/03007999909115172
更新日期:1999-01-01 00:00:00
abstract:INTRODUCTION:This subanalysis compared the efficacy of betahistine plus piracetam dual therapy versus betahistine monotherapy using data from OSVaLD, a 3 month, open-label, observational study conducted in 2272 patients with peripheral vestibular vertigo. Of the 1898 patients included in the original efficacy populatio...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1067193
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:Pioglitazone hydrochloride (Actos † ) and rosiglitazone maleate (Avandia ‡ ) are members of the thiazolidinedione (TZD) class of oral anti-diabetic drugs (OADs) and are used to treat type 2 diabetes mellitus (T2DM). Greater beneficial effects on lipids have been demonstrated with pioglitazone, however. Study...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007990802434874
更新日期:2008-11-01 00:00:00
abstract::The manifestation of pain in any individual patient may result from a variety of underlying mechanisms that also may vary from one disease state to another. Global measures of pain intensity and relief are inadequate for characterizing specific pain qualities or identifying the unique effects of pain treatments on dif...
journal_title:Current medical research and opinion
pub_type: 社论
doi:10.1185/030079904X12924
更新日期:2004-01-01 00:00:00
abstract::Cholinesterase inhibitors, which act by inhibiting the degradation of acetylcholine in the brain, form the mainstay of therapy for AD. Predominant adverse events are cholinergic in nature, the most frequent being gastrointestinal side effects. Here we present a case series of patients with dementia who were treated wi...
journal_title:Current medical research and opinion
pub_type: 信件
doi:10.1185/030079906X162791
更新日期:2007-01-01 00:00:00
abstract::One hundred and eight patients who had been taking phenytoin for a year or more, either alone or in combination with other drugs, were examined for gum hypertrophy by three observers independently. Approximately 90% of the patients showed either mild or no gum hypertrophy and severe swelling occurred in only 1%. The o...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998809111114
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:This meta-analysis compared the median overall survival (mOS) of brentuximab vedotin reported in the pivotal phase 2 study with published results of other therapies for the treatment of relapsed/refractory (R/R) Hodgkin lymphoma (HL) post autologous stem cell transplant (ASCT). RESEARCH DESIGN AND METHODS:A ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/03007995.2015.1048208
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Parenteral sodium ferric gluconate in complex (Ferrlecit [branded SFG]) is used to treat patients with iron deficiency anemia undergoing chronic hemodialysis and receiving supplemental epoetin. This comparative pharmacokinetic study (GeneraMedix, Inc., Study 17909) evaluates whether the recently approved gene...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007995.2011.597738
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To further assess the clinically active dose range of etoricoxib, a COX-2 selective inhibitor, in rheumatoid arthritis (RA). METHODS:RA patients were randomized to etoricoxib 10, 30, 60, or 90 mg or placebo in a double-blind, 12-week study. DMARDs (methotrexate, biologics) or low-dose corticosteroids were al...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2011.614935
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To investigate whether once daily biphasic insulin aspart 30 (BIAsp 30) is noninferior to once daily insulin glargine (IGlar) among Chinese and Japanese insulin-naïve subjects with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS:This was a 24 week treat-to-target trial (NCT01123980) that include...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2013.838155
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Untreated and under-treated pain represent one of the most pervasive health problems, which is worsening as the population ages and accrues risk for pain. Multiple treatment options are available, most of which have one mechanism of action, and cannot be prescribed at unlimited doses due to the ceiling of ef...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2017.1310092
更新日期:2017-06-01 00:00:00
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007999009112691
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Schizophrenia is one of the most debilitating diseases in the United Arab Emirates. Oral antipsychotics (OA) are commonly used in terms of pharmacotherapy; however, these treatments can be rendered ineffective by poor patient adherence. Paliperidone palmitate once monthly (PP1M) is a long acting antipsychotic...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1417246
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Small cell lung cancer (SCLC) patients, who have achieved complete or partial response after chemotherapy, should be followed with prophylactic cranial irradiation (PCI). PCI for extrapulmonary small cell carcinoma (EPSCC) is not routinely recommended. The purpose of this review is to discuss all aspects of ...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2014.904771
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Natalizumab is a highly effective treatment for patients with relapsing-remitting multiple sclerosis (RRMS). Treatment with natalizumab has been associated with progressive multifocal leukoencephalopathy (PML), a rare yet serious disease of the brain. Published studies have quantified the PML risk by the pre...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2013.869492
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To look into current evidence exploring the added value of rLH supplementation to rFSH in GnRH analogues cycles, to identify groups of women that still have no evidence for adjuvant rLH therapy and to discuss ways that may advance research on this topic. METHODS:Eight systematic reviews and meta-analyses exp...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1417827
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVES:Chronic obstructive pulmonary disease (COPD) is becoming a leading cause of morbidity and mortality in China. In the IMPACT trial, fluticasone furoate[FF]/umeclidinium[UMEC]/vilanterol[VI] single-inhaler triple therapy demonstrated lower rates of moderate/severe exacerbations than dual therapy with FF/VI or ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1844646
更新日期:2021-01-01 00:00:00
abstract::Comparison of the methods of determination of conjugated catecholamines shows that, despite their variable absolute values, the relative proportions of the free and conjugated dopamine, norepinephrine and epinephrine are close (mean of 97.3% of dopamine, 73% of norepinephrine and 84% of epinephrine being conjugated) a...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998309109831
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVES:Compare costs and healthcare resource utilization (HCRU) among newly-diagnosed non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran vs apixaban, rivaroxaban, or warfarin. METHODS:Newly-diagnosed adult NVAF patients initiating dabigatran, apixaban, rivaroxaban, or warfarin (index ev...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1409425
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:The management of hyponatremia has evolved in recent years, particularly with the introduction of tolvaptan for hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This commentary presents a summary of recent international recommendations in the for...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1072706
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To compare safety and efficacy of biphasic insulin aspart 70/30 (BIAsp 30) with exenatide in subjects with type 2 diabetes mellitus (T2DM) not achieving glycemic targets with metformin and sulfonylurea in a randomized, open-label, 24-week trial. RESEARCH DESIGN AND METHODS:Subjects (N = 372, T2DM > 6 months,...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007990802597951
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Ramelteon is an MT(1)/MT(2) melatonin receptor agonist indicated for the treatment of insomnia characterized by difficulty with sleep onset. In previous clinical studies, ramelteon reduced latency to persistent sleep (LPS) in subjects with chronic insomnia. The goal of the current analysis was to determine th...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/03007990902858527
更新日期:2009-05-01 00:00:00