Abstract:
BACKGROUND:In clinical practice, persistence with statin therapy is poor. While little is known about relative persistence to specific statins, previous studies have observed greater persistence in patients who achieve greater degrees of lipid lowering. Identification of statin therapies which improve patient persistence has the potential to improve the quality of patient care and clinical outcomes. Therefore, we assessed patient persistence with atorvastatin and simvastatin in primary and secondary prevention patients enrolled in managed care. METHODS:New statin users aged > or =18 years, both with and without prior cardiovascular (CV) events within the 12 month pre-treatment period, were identified from a large national database of managed care patients. Patients initiated atorvastatin or simvastatin therapy from January 1, 2003 to September 30, 2005 and were continuously enrolled in a covered plan for at least 12 months before and after initiation of statin therapy. Subanalyses of patients > or =65 years were also conducted. Measures of interest included demographic and clinical characteristics of the study samples and persistence of statin utilization over the 1-year follow-up period. Persistence was defined as the number of days a patient remained on treatment in the first year following their index date, measured from the date of first fill to study end or the date of discontinuation. RESULTS:A total of 129 764 atorvastatin users and 45 558 simvastatin users without prior CV events were included in the study. For those patients with prior CV events, a total of 6888 atorvastatin users and 4443 simvastatin users were included in the study. Median persistence in patients without prior CV events was 50 days longer for patients initiating therapy with atorvastatin than simvastatin (207 vs. 157 days, p<0.0001) and after adjusting for confounding factors, those treated with atorvastatin were 15% less likely to discontinue therapy during the first year than those treated with simvastatin (HR=0.85; 95% CI 0.84, 0.86; p<0.001). In secondary prevention patients median persistence was 85 days longer in atorvastatin patients than simvastatin patients (266 vs. 181 days, p<0.0001) and atorvastatin patients were 22% less likely to discontinue therapy (HR=0.78; 95% CI 0.75, 0.82; p<0.001). Persistence was worse in the elderly patients, but the relative difference between atorvastatin and simvastatin was similar to the overall patient population. CONCLUSIONS:In patients with and without prior CV disease, persistence is generally poor, even worse in the elderly, but significantly better for atorvastatin patients than simvastatin patients (p<0.001). Further studies are required to determine whether this is due to differences in cost, effectiveness, side-effects, or other attributes of the statins. STUDY LIMITATIONS:Differences in persistence could be, in part, due to unmeasured confounders although all available variables were adjusted in multivariate analyses. Additionally, the claims database lacks some clinical data such as lipid levels, limiting assessments of statin efficacy, and does not include any reasons for discontinuation of therapy.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Foody JM,Joyce AT,Rudolph AE,Liu LZ,Benner JSdoi
10.1185/03007990802203279subject
Has Abstractpub_date
2008-07-01 00:00:00pages
1987-2000issue
7eissn
0300-7995issn
1473-4877pii
4507journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Breast cancer cells can develop resistance to standard hormonal treatment and chemotherapy with the activation of the mTOR pathway; this is supported by results of preclinical and clinical studies. In clinical trials, the addition of everolimus to hormonal treatment or anti-HER2 treatment improved the outcom...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2013.846253
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To examine the economic burden of myelodysplastic syndromes (MDS) and the incremental cost of transfusion dependence. RESEARCH DESIGN AND METHODS:Adults with evidence of MDS were identified between 05/01/2000 and 09/30/2003 from a longitudinal, retrospective claims database for a large, geographically divers...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007990903076699
更新日期:2009-08-01 00:00:00
abstract::Cardiac arrhythmias are the most common cardiac complication reported in pregnant women with and without structural heart disease (SHD); they are more frequent among women with SHD, such as cardiomyopathy and congenital heart disease (CHD). While older studies had indicated supraventricular tachycardia as the most com...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1762555
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:In addition to direct weight reduction, there may be other benefits of obesity treatment including improved insulin sensitivity. The purpose of this study was to characterise concomitant diabetes drug use and the related costs in patients with diabetes treated with orlistat (Xenical) in the first 6 months of ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X74943
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:Ocular surface disease (OSD) is a common side effect of ophthalmic medications containing the preservative benzalkonium chloride (BAK). Little is known whether and how glaucoma treatment patterns and annual costs vary based on the presence of BAK. The objective of this analysis was to estimate first-year trea...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2010.531254
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Statins are hypothesized to have beneficial effects in asthma management through their pleiotropic anti-inflammatory effects. Several studies have examined this relationship, but have yielded conflicting results. This study investigates the effect of statin use on asthma-related hospitalizations and/or emerge...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2013.865599
更新日期:2014-04-01 00:00:00
abstract::Objectives: Atopic dermatitis (AD) is a chronic, relapsing skin condition, with signs and symptoms that impact patients' lives and are best measured from the patient perspective. Therefore, there is a need for AD-specific questionnaires that are consistent with Food and Drug Administration guidance and best measuremen...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2018.1560222
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To estimate the proportion of patients with moderate to severe chronic kidney disease (CKD) whose initial dipeptidyl-peptidase-4 inhibitor (DPP4-i) dosage was concordant with prescribing information (label) recommendations in the United States. METHODS:Adult patients with type 2 diabetes mellitus (T2DM) who ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2017.1416346
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to analyze the characteristics and costs of exogenous endoscopy-related infections, pseudo-infections, and toxic reactions in the US. METHODS:A systematic review of the scientific literature published between 1966 and 2005 was conducted in Medline. Data collection was based o...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079906X121048
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To assess whether maintenance of labor epidural analgesia using programmed intermittent epidural bolus (PIEB) is associated with reduced local anesthetic (LA) consumption, patient-controlled epidural analgesia (PCEA) use, and rescue analgesia requirements compared to continuous epidural infusion (CEI). RESEA...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1181619
更新日期:2016-08-01 00:00:00
abstract::A clinical study was carried out to evaluate the usefulness of intravenous lorazepam, given for sedation instead of opiate narcotics or diazepam, in 25 seriously-ill patients being treated in a respiratory and intensive care unit. All but 3 patients were on assisted ventilation. Standard doses of 4 mg lorazepam were g...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007997609109320
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:This observational study was conducted to document the safety of capecitabine-based adjuvant therapy in patients with resected colon cancer under routine clinical conditions. RESEARCH AND DESIGN METHODS:ML20431 was a prospective, multicenter, non-interventional, observational study. It was designed to answer...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007995.2015.1014030
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To compare the risk of developing uveitis in patients initiating anti-tumor necrosis factor (anti-TNF) agents (adalimumab, etanercept, and infliximab) for ankylosing spondylitis (AS). METHODS:Anti-TNF-naive patients with a diagnosis of AS and without a history of uveitis (N = 2115) who subsequently initiated...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2014.969368
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Migraine is a chronic, disabling neurological disease affecting >1 billion people worldwide. Migraine remains undertreated in Asia, including Taiwan. Galcanezumab is a humanized monoclonal antibody that selectively binds calcitonin gene-related peptide, a peptide firmly established in the pathophysiology of m...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1815181
更新日期:2020-10-01 00:00:00
abstract::Nine patients with persistently elevated diastolic blood pressure, exceeding 130 mmHg, received an oral dose of labetalol ranging from 200 mg to 400 mg. In all patients, this produced a significant and gradual decline in recumbent systolic and diastolic blood pressure, unaccompanied by symptoms or complications, with ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007997709110155
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines development group examined the properties of oral H(1)-antihistamines and made proposals about an 'optimal' drug. Several criteria should be met by oral H(1)-antihistamines in terms of their pharmacological, and clinical efficacy and safety pro...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2011.648263
更新日期:2012-01-01 00:00:00
abstract::The efficacy of trimetazidine, an anti-ischaemic agent, has been largely assessed and presented in the international literature through its metabolic effects, selective and specific fatty acid oxidation inhibition and lack of haemodynamic effects in stable angina pectoris. As such, trimetazidine has opened up a new cl...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079903125002261
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Over the last two decades the development and analysis of a number of registries have enhanced the knowledge of the epidemiology, presentation, natural history, and pathophysiology of pulmonary arterial hypertension (PAH). The understanding of the effectiveness of available treatments has also been greatly i...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2014.960514
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:A novel preoperative procedure From Home To Operation (FHTO) seeks to combat increasing operation and infection rates. This is the first prospective randomized controlled trial (RCT) comparing the cost-effectiveness and cost-utility of FHTO and conventional ward procedures for standardized Laparoscopic Cholec...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/030079907x233223
更新日期:2007-11-01 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::Migraine is a very common disorder, affecting about 11% of adult populations in Western countries. Prevalence is highest during the peak productive years--between the ages of 25 and 55. The prevalence is higher in females than males at all post-pubertal ages, but the sex ratio varies with age. In the United States, mi...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/0300799039117005
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:A double-blind randomized trial evaluated the efficacy and tolerability of rivastigmine and donepezil in patients with Alzheimer's disease (AD) over 2 years. Baseline data indicated that some patients had symptoms suggestive of concomitant Lewy body disease. This retrospective analysis investigated whether A...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/030079906x80279
更新日期:2006-01-01 00:00:00
abstract::Two double-blind randomised trials are reported comparing the effectiveness of the antihistamines, clemastine and chlorpheniramine in comparable doses, in relieving the symptoms of allergic rhinitis. In the first trial, treating 58 adults seen in a general practice, both drugs were prescribed in tablet form; l mg. cle...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007997509113659
更新日期:1975-01-01 00:00:00
abstract:OBJECTIVES:To investigate the effect of nebivolol, a third generation beta-blocker, on blood pressure (BP) reduction and polysomnographic parameters in hypertensive patients with mild-to-moderate obstructive sleep apnoea (OSA). METHODS:In this double-blind, parallel group study, patients were randomized to nebivolol 5...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007995.2010.497326
更新日期:2010-08-01 00:00:00
abstract::Objective: The aim of this study was to provide recommendations for improving the design of subsequent studies through analysis of the registered coronavirus disease 2019 (COVID-19) clinical trials.Methods: A retrospective analysis of 189 trial retrievals achieved on 20 February 2020.Results: A total of 189 trials are...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1771294
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of epoetin theta and epoetin beta in anaemic patients with chronic kidney disease, undergoing haemodialysis and previously on stable maintenance therapy with epoetin beta. METHODS:In this multicentre, randomised, controlled, double-blind study 270 haemodialysis patients wer...
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:10.1185/03007995.2010.511084
更新日期:2010-10-01 00:00:00
abstract::Twenty-five acutely disturbed psychotic patients were treated in an open study with a single injection of zuclopenthixol acetate 5% in 'Viscoleo, a thin vegetable oil. Patients were assessed post-injection for 3 days using the BPRS, CGI, and a specially designed behaviour/activity scale. Doses of 50 to 150 mg proved e...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007999009111492
更新日期:1990-01-01 00:00:00
abstract::Sodium meclofenamate (200 to 400 mg daily) was compared with aspirin (2.4 to 4.8 g daily) for the treatment of rheumatoid arthritis in a 6-month, double-blind, multicentre study. Two groups of patients participated, one receiving stabilized doses of concomitant gold or steroid therapy and one not receiving such therap...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:Gastro-oesophageal reflux disease (GORD) is a recurring condition with many patients requiring long-term maintenance therapy. Therefore initial choice of treatment has long-term cost implications. The aim was to compare the costs and effectiveness of treatment of GORD the (unconfirmed by endoscopy) with seven...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X65330
更新日期:2005-10-01 00:00:00
abstract::An open clinical evaluation was carried out in 736 African out-patients suffering from rheumatic and inflammatory disorders to assess the efficacy and tolerability of tenoxicam in relieving the signs and symptoms of their condition. On entry, all previous treatment was discontinued and patients received a simple daily...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1185/03007999109111519
更新日期:1991-01-01 00:00:00