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 objectives were to evaluate the long-term cost-effectiveness of pioglitazone compared to rosiglitazone in treating patients with T2DM and dyslipidemia, and determine the extent to which reported beneficial lipid effects of pioglitazone would improve clinical and economic outcomes through reduced macrovascular complications. † Actos is a trade name of Takeda Pharmaceuticals Co. Ltd., Deerfield, IL, US ‡ Avandia is a trade name of GlaxoSmithKline, Research Triangle, NC, US. RESEARCH DESIGN AND METHODS:The validated CORE Diabetes Model (CDM) was used to simulate changes in glycosylated hemoglobin (HbA(1c)), complications, and direct medical costs. Baseline parameters came from a multi-center, double-blind trial comparing lipid and glycemic effects of pioglitazone (n = 400) and rosiglitazone (n = 402) among individuals with T2DM and untreated dyslipidemia. Sensitivity analyses examined the impact of cohort, clinical, and cost inputs on incremental cost effectiveness ratios (ICERs). RESULTS:In the base case, pioglitazone was associated with mean (standard deviation [SD]) quality-adjusted life years (QALYs) of 7.476 (0.123) vs. 7.326 (0.128) for rosiglitazone. Pioglitazone had $3038 higher total direct costs, but $580 lower complication costs. Risks of four cardiovascular complications were reduced with pioglitazone (relative risks 0.860-0.942), while risks of 17 other complications were slightly higher (relative risks 1.001-1.056). The ICER for pioglitazone treatment was $20 171/QALY. Results were most sensitive to the effects of HbA(1c), high-density lipoprotein-cholesterol, overall lipid effects, and pioglitazone acquisition costs. CONCLUSIONS:Study limitations include issues of generalizability of the trial patient population, as well as inability to capture non-adherence and variation in 'real-world' treatment patterns. Nevertheless, pioglitazone (when compared to rosiglitazone) was found to have long-term value as a treatment option for T2DM patients with dyslipidemia treated within the US payer setting.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Tunis SL,Minshall ME,St Charles M,Pandya BJ,Baran RWdoi
10.1185/03007990802434874subject
Has Abstractpub_date
2008-11-01 00:00:00pages
3085-96issue
11eissn
0300-7995issn
1473-4877pii
4740djournal_volume
24pub_type
杂志文章abstract::The glomerular and tubular function of 7 patients with a spectrum of renal impairment was measured before, during and after 4-days' treatment with cefuroxime and gentamicin. Neither the mean plasma urea nor creatinine concentrations of the group increased after combined treatment, nor was the excretion of cefuroxime s...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998009109458
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To investigate if combined intraocular pressure (IOP)-lowering medication with travoprost/timolol fixed combination and a carbonic anhydrase inhibitor, brinzolamide, is superior to both travoprost monotherapy and travoprost/timolol fixed-combination therapy in primary open-angle glaucoma and ocular hypertensi...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007990802159273
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To perform an open, non-controlled, multiple-dose, international, multicentre, phase III study to evaluate epoetin zeta, a biosimilar epoetin referenced to epoetin alfa, for the treatment of chemotherapy-induced anaemia in patients with cancer. METHODS:Safety, tolerability and efficacy of subcutaneously admi...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007990903050876
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To investigate the efficacy of the cholesterol absorption inhibitor ezetimibe in patients with refractory familial hyperlipidaemia or intolerant to statin therapy. METHODS:This prospective study assessed the safety and efficacy of ezetimibe in 200 patients with refractory familial hyperlipidaemias not achiev...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/030079905X28872
更新日期:2005-03-01 00:00:00
abstract::The results of recent clinical trials with rivastigmine show that in the approved indication of mild to moderate Alzheimer's disease (AD), the drug is effective in the long term. Rivastigmine produces a significant delay in the decline of the three components of AD that have been identified by European guidelines as e...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/0300799039117029
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:In contrast to the trial design of acute mania studies, there is no standard design for bipolar maintenance studies. Over the past 15 years, the design of monotherapy maintenance studies in bipolar disorder has evolved significantly, but recent study designs continue to differ in important ways. SCOPE:We re...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2010.489830
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:Self-reported healthcare resource utilization (HRU), medication out-of-pocket (OOP) expenditures and impact of OOP expenses on HRU were assessed for respondents with type 2 diabetes mellitus (T2DM) or elevated cardiometabolic risk. METHODS:The 5-year longitudinal SHIELD study surveyed a stratified sample of ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007990802520045
更新日期:2008-12-01 00:00:00
abstract::Understanding of the damaging effects of significance testing has steadily grown. Reporting p values without dichotomizing the result to be significant or not, is not the solution. Confidence intervals are better, but are troubled by a non-intuitive interpretation, and are often misused just to see whether the null va...
journal_title:Current medical research and opinion
pub_type: 信件
doi:10.1185/03007995.2011.618493
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To review the evidence evaluating the efficacy of vardenafil in subgroups of hypertensive patients with erectile dysfunction (ED). METHODS:Meta-analysis of randomized, double-blinded, placebo-controlled, flexible-dose vardenafil clinical trials that were >or=12 weeks in duration evaluated men with a >or=6-mo...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/030079907X219616
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of fenofibrate on sleep apnoea indices. METHODS:Proof-of-concept study comprising a placebo run-in period (1 week, 5 weeks if fibrate washout was required) and a 4-week randomized, double-blind treatment period. Thirty-four subjects (mean age 55 years, body mass index 34 kg/m 2 , fa...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007991003693581
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:This study was designed to assess the safety of 25- and 50-mg dosage strengths of zonisamide for initial titration in patients with epilepsy. RESEARCH DESIGN AND METHODS:This phase 3, multicenter, open-label, uncontrolled study conducted at 26 study sites in the United States included male and female patient...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1185/030079904125003629
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Thymectomy is a standard treatment of myasthenia gravis (MG). Immunomodulating agents are frequently given during the post-thymectomy latency period until complete remission is fully consolidated, but serious side effects is a relevant clinical problem for patients on long-term immunomodulating treatment. O...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/030079906X104650
更新日期:2006-05-01 00:00:00
abstract::Studies in several populations have indicated that genetic variation at the apolipoprotein E (apoE) structural locus influences the risk of coronary artery disease (CAD) and myocardial infarction (MI). This study aimed at investigating whether apoE polymorphism has an allelic and/or genotypic impact on the risk of MI ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079902125000444
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:Compare migraine duration with frovatriptan (versus baseline) in migraineurs reporting long- (24-72 h) or short-duration (<24 h) migraines at baseline. METHODS:Post hoc analysis of two postmarketing surveillance studies of migraineurs in German primary care clinics using frovatriptan (2.5 mg) to treat a sin...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2010.503488
更新日期:2010-09-01 00:00:00
abstract::Four hundred and twenty-seven hypertensive patients in the United Kingdom have so far been admitted to two on-going open multicentre trials, and have been treated with acebutolol for periods ranging from 1 to 6 months. Oral dosages were within the range of 100 mg to 1200 mg/day in divided doses and were increased or d...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007997609112001
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To estimate the costs and consequences of using pamidronate compared to zoledronic acid in the prophylactic management of skeletal morbidity among breast cancer patients in the UK. DESIGN AND SETTING:This was a modelling study performed from the perspective of the UK's National Health Service (NHS). METHODS...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X40472
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:Docetaxel and paclitaxel show significant clinical activity in metastatic breast cancer (MBC) and have been approved for MBC by the U.S. Food and Drug Administration, but it is still unclear whether a paclitaxel-based regimen improves outcomes over a docetaxel-based regimen in patients with MBC. We therefore...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/03007995.2012.756393
更新日期:2013-02-01 00:00:00
abstract::The most common side-effect of statins, mainly during dose titration, is liver toxicity, In these cases, sufficient control of low density lipoprotein cholesterol (LDL-C) in patients with heterozygous familial hypercholesterolaemia (HFH) becomes problematical. In patients with intolerance to resins as well, especially...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:UNLABELLED:Therapeutic interventions that block the renin-angiotensin-aldosterone system (RAAS) have an important role in slowing the progression of cardiovascular risk actors to established cardiovascular diseases. In recent years, angiotensin receptor blockers (ARBs) have emerged as effective and well-tolerated alter...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079907x210723
更新日期:2007-07-01 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: To characterize the incidence of select chronic comorbidities in the era of modern (pre-integrase-inhibitor) highly active antiretroviral therapy (HAART) in British Columbia, Canada. Methods: We used data from the Comparative Outcomes And Service Utilization Trends (COAST) study, a population-based cohort s...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2019.1645999
更新日期:2019-11-01 00:00:00
abstract::The potential advantages of eletriptan lie firstly in its lipophilicity reflected as an increased rate of absorption and Tmax compared to sumatriptan. This is manifested in a modest advantage over sumatriptan in terms of speed of onset, 2 h headache response and 2 h pain free. However, eletriptan has not yet been show...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/0300799039117004
更新日期:2001-01-01 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:INTRODUCTION AND OBJECTIVE:As evidence grows about the management of hyponatremia, a number of different international and national recommendations/guidelines from professional organizations have recently been published that offer guidance on decision-making. However, they include several important differences that cou...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2014.920314
更新日期:2014-07-01 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::Faecal blood loss arising from tenoxicam at a dose of 20 mg/day was compared to that arising from piroxicam at a dose of 20 mg/day in a double-blind, parallel comparative study in 12 healthy male volunteers. Faecal blood loss was measured for a 1-week run-in on placebo, during 4 weeks of treatment and for a 2-week pos...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998509109629
更新日期:1985-01-01 00:00:00
abstract::Objective: We compare estimates of proportion of days covered (PDC) based on dispensation-only data versus linked prescription and dispensation information, and we analyse their differences in a real-world cohort of patients with osteoporosis.Methods: Prospective cohort study. We compared four alternative measures of ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2019.1601944
更新日期:2019-09-01 00:00:00
abstract::A double-blind, parallel group trial of a 1 mg sodium cromoglycate metered dose inhaler, a 5 mg formulation and a placebo aerosol was undertaken in 139 asthmatic patients with extrinsic allergic asthma. None of the patients had previously been treated with sodium cromoglycate and few (15%) were familiar with the use o...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998909110134
更新日期:1989-01-01 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:OBJECTIVE:To develop a patient-completed screening tool to help differentiate nociceptive and neuropathic pain. RESEARCH DESIGN AND METHODS:A multicenter study was performed for item reduction (initial 89-item questionnaire) and model building. Patients (N = 586) with non-headache chronic pain completed the questionna...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/030079906X115702
更新日期:2006-08-01 00:00:00