Abstract:
PURPOSE:Type 2 diabetes is associated with increased cardiovascular risk. The comparative effectiveness of statin plus fibrate combination therapy and statin monotherapy in reducing risk of cardiovascular disease in real-world settings is unknown. METHODS:A retrospective database analysis was performed using a large managed care claims database of patients identified with type 2 diabetes based on diagnosis codes from January 2002 through December 2003 and continuously enrolled for the entire study period, 5.5 years. A statin plus fibrate combination therapy group (patients who used statins less than 6 months and augmented with fibrates for more than 6 months) and a statin monotherapy group (patients who used statins persistently) among patients with type 2 diabetes were followed for 3 years to examine the relationship between the intervention and cardiovascular events using a multivariable logistic regression model, propensity score method, and instrumental variable approach. RESULTS:The statin plus fibrate combination therapy group of 318 and the statin monotherapy group of 9928 were identified from 75,515 diabetics. After adjusting for factors that can impact cardiovascular outcomes, the combination therapy group did not significantly experience a reduction in cardiovascular disease, as compared with the statin monotherapy group (OR = 0.77; p = 0.083). The statin plus fibrate combination therapy group was significantly associated with a reduction in cardiovascular events after propensity matching (OR = 0.53; p = 0.002). Using the physician prescribing preference instrument to adjust for unmeasured confounding, we did not find evidence that subjects in the statin plus fibrate combination therapy group versus stain monotherapy group experienced a significant reduction in cardiovascular events (p = 0.124). CONCLUSIONS:We did not find a difference in effectiveness regarding cardiovascular outcomes between the statin plus fibrate combination therapy and the statin monotherapy after controlling for hidden bias.
journal_name
Pharmacoepidemiol Drug Safjournal_title
Pharmacoepidemiology and drug safetyauthors
Suh HS,Hay JW,Johnson KA,Doctor JNdoi
10.1002/pds.3261subject
Has Abstractpub_date
2012-05-01 00:00:00pages
470-84issue
5eissn
1053-8569issn
1099-1557journal_volume
21pub_type
杂志文章abstract:PURPOSE:The purpose of this study is to quantify the impact of the different outcomes and definitions of suicidality on the association between antiepileptic drugs (AEDs) and suicidality. METHODS:Retrospective cohort studies of selected AEDs (carbamazepine, gabapentin, lamotrigine, phenytoin, pregabalin, topiramate an...
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