Abstract:
OBJECTIVE:Delayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) and fingolimod are approved oral disease-modifying treatments for relapsing-remitting multiple sclerosis. In phase 3 trials, DMF (DEFINE/CONFIRM) and fingolimod (FREEDOMS/FREEDOMS II) resulted in significant reductions in clinical and magnetic resonance imaging activity, with acceptable safety profiles. Direct comparisons of these treatments are not possible due to a lack of head-to-head trials. We compared 2 year efficacy of DMF versus fingolimod at the approved dosage using a matching-adjusted indirect approach. RESEARCH DESIGN AND METHODS:Individual patient data from DEFINE and CONFIRM, and aggregate data from FREEDOMS and FREEDOMS II, were pooled and compared using the matching-adjusted in-direct method. To account for cross-trial differences, data from trials with available individual patient data were adjusted to match aggregate data (i.e. average patient characteristics) from trials without patient-level data. Data from DMF-treated patients were weighted such that average baseline characteristics matched those of fingolimod-treated patients. After matching, weighted treatment outcomes for DMF-treated patients (240 mg twice daily) were compared with summary outcomes for fingolimod-treated patients (0.5 mg once daily). All comparison results of DMF versus fingolimod used fingolimod as the reference. RESULTS:After matching, baseline characteristics were balanced between DMF and fingolimod. At year 2, the efficacy of DMF was similar to that of fingolimod for annualized relapse rate (rate ratio [95% confidence interval (CI)]: 1.11 [0.88, 1.40]), 12 week confirmed disability progression (hazard ratio [95% CI]: 0.90 [0.63, 1.29]), and Multiple Sclerosis Functional Composite (mean difference [95% CI]: 0.04 [-0.05, 0.13]). For patient-reported outcomes (EuroQoL 5-Dimensions questionnaire), the mean differences (95% CI) were 0.05 (0.01, 0.08) for utility score and 3.22 (0.58, 5.86) for visual analog scale score, significantly favoring DMF. There was no significant difference in the percentage of patients with no evidence of disease activity (NEDA) for DMF versus fingolimod among matching-adjusted patients with complete NEDA data: rate ratio (95% CI): 0.92 (0.51, 1.64). CONCLUSIONS:Using the matching-adjusted indirect comparison approach, the efficacy of DMF and fingolimod were similar on all clinical outcomes, while patient-reported outcomes showed greater benefit with DMF. Study limitations include possible confounding from unobserved/unknown differences between trials, and trial length may have been insufficient to detect significant differences on disability progression. CLINICAL TRIAL REGISTRATION:NCT00420212 (DEFINE); NCT00451451 (CONFIRM); NCT00289978 (FREEDOMS); NCT00355134 (FREEDOMS II).
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Fox RJ,Chan A,Zhang A,Xiao J,Levison D,Lewin JB,Edwards MR,Marantz JLdoi
10.1080/03007995.2016.1248380subject
Has Abstractpub_date
2017-02-01 00:00:00pages
175-183issue
2eissn
0300-7995issn
1473-4877journal_volume
33pub_type
杂志文章,meta分析abstract:BACKGROUND:Basal cell carcinoma (BCC) is the most common cancer. Most cases of BCCs are treated with only optimal surgical resection. However, unresectable, locally advanced or metastatic tumors might have potential to progress. In this patient group, there is no standardized treatment approach. Vismodegib is a new sel...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2015.1018988
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:There is a general perception that research is underdeveloped in rehabilitation professions. However, a PubMed search found that the growth in publications in the rehabilitation field was twice that of the general medical field. Despite this growth, another study focusing on Europe found that the proportion ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1815685
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To examine the impact of an electronic data capture system on patient satisfaction and patient-physician interactions in a rheumatology clinical setting. STUDY DESIGN:In this multicenter study, 1079 patients with rheumatoid arthritis completed questionnaires quarterly about their health and satisfaction with...
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:10.1185/030079907X210624
更新日期:2007-08-01 00:00:00
abstract::Angiotensin converting enzyme (ACE) inhibitors have been avoided as an initial therapeutic option in the treatment of hypertension in African-Americans. A major reason for this has been the widespread perception of clinicians that these agents have poor blood pressure (BP) lowering efficacy in this population. Remarka...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:Neurogenic bladder refers to morphofunctional alterations of the bladder-sphincter complex secondary to central or peripheral neurological lesions. Discal etiology can be suggested by clinical observation in patients complaining of classical lower back pain, but not excluded even without musculoskeletal pain....
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2013.807788
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to estimate utility values for hypothetical health states that describe differences in weight and quality of life associated with type 2 diabetes mellitus (DM) from Canadians with type 2 DM. The impact on utility values was examined separately for participants with a body mass ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2014.899207
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Recent survey data have reported the incidence rate of needlestick injuries (NIs) and NIs which draw blood sustained by nurses caring for patients with diabetes in an in-patient hospital setting. The purpose of this study was to deduce the potential short-term annual economic impact resulting from such NI, and ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X65286
更新日期:2005-12-01 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:BACKGROUND:Patients with hypereosinophilic syndrome (HES) vary considerably in their clinical presentation with regard to the severity and pattern of end-organ involvement. Clinical manifestations range from nonspecific symptoms to life-threatening, multisystem damage caused by eosinophil infiltration and local release...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2010.493132
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:The objectives of this survey were to understand (1) the effects of overactive bladder (OAB) and urinary incontinence (UI) on women's lives and to understand (2) women's needs and expectations of health care providers and treatment related to these disorders. METHODS:Women (N = 1046) with self-reported sympt...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X59076
更新日期:2005-09-01 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::Hypertension is another predictor of erectile dysfunction (ED). This is further evidence supporting a link between the pathogenesis of atherosclerotic disease and ED. In one study (TOMHS) involving hypertensive patients, the incidence of ED was 14.4%. The drugs used to treat hypertension may cause ED. However, there i...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/0300799009117037
更新日期:2000-01-01 00:00:00
abstract::In order to assess the effect of ACTH on the adrenal cortex when used as a therapeutic or diagnostic agent, adrenocortical function was tested before and 2 hours after 0.5 mg tetracosactrin given intramuscularly in 31 healthy children, divided into 4 groups according to age and sex. Mean plasma cortisol levels were sh...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007997709115283
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To report the long-term effect of the dorzolamide/timolol (DTFC) and latanoprost/timolol (LTFC) fixed combinations on intraocular pressure (IOP) and visual field defects over time in naïve primary open-angle glaucoma (POAG) patients. STUDY DESIGN AND METHODS:Prospective, 4-year, open-label, interventional st...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/03007995.2010.508702
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To determine the effects of long-term atomoxetine treatment on sexual development in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) as compared with placebo and with a national US survey in non-Hispanic white children and adolescents. METHODS:This double-blind, placebo-controll...
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:10.1185/03007995.2011.599372
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The RED LEVEL study (REnal Disease: LErcanidipine Valuable Effect on urine protein Losses) directly compares, in an explorative fashion, the effects of lercanidipine + enalapril and amlodipine + enalapril combinations on renal parameters in hypertensive subjects. RESEARCH DESIGN AND METHODS:This was a 1 year...
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:10.1080/03007995.2016.1218838
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:GOAL (Gauging Osteoarthritis [OA] with Limbrel*), an open-label, post-marketing study was performed to determine the overall efficacy and gastrointestinal (GI) tolerability of flavocoxid, a novel, plant-based, anti-inflammatory medication, in a 'real world' clinical practice setting. To this end, the study e...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007991003694522
更新日期:2010-05-01 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::The influence of buflomedil on brain circulation was investigated in an open, preliminary trial in 12 patients with dementia caused by multi-cerebral infarcts. Patients were given 150 mg buflomedil 3-times daily for a period of 6 months. Assessments carried out before treatment included regional cerebral blood flow me...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998709111107
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism (PE), is a major cause of morbidity and mortality. VTE is a common disorder, with an estimated annual incidence of approximately 5-12 persons per 10,000. The prognosis for patients who develop VTE is exacerbated by the r...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2010.516090
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:In epidural analgesia, synthetic opioids increase the potency of amide local anesthetics by modifying their analgesic properties. The purpose of this systematic review and meta-analysis is to compare the efficacy and safety of bupivacaine with ropivacaine and levobupivacaine in combination with sufentanil (B...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/03007995.2014.946127
更新日期:2014-11-01 00:00:00
abstract::A national survey of psychotherapeutic drug use was carried out in the U.S.A. in 1979. Data were obtained from a probability sample (n = 3161) of adults in the general population, using a clinically-oriented interview lasting an average of 90 minutes. The data provide estimates of the prevalence of using anxiolytic an...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007998409109542
更新日期:1984-01-01 00:00:00
abstract::In a study of 32 patients, there were 29 cases of intra-uterine fetal death and 3 cases of hydatidiform mole. The intravenous administration of either prostaglandin E1, E2 or F2 successfully induced labor in 29 out of the 32 cases. 2 patients delivered following additional intravenous oxytocin and there was 1 failur...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007997409114769
更新日期:1974-01-01 00:00:00
abstract:OBJECTIVE:To compare the analgesic efficacy and safety of oxymorphone extended release (ER) and oxycodone controlled release (CR) in patients with moderate to severe cancer pain. RESEARCH DESIGN AND METHODS:This randomized, multicenter, double-blind, 2-period crossover study included adult outpatients (>or= 18 years o...
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:10.1185/030079904125003854
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:An economic analysis (based on interim data from a long-term, randomised, multi-centre, controlled, clinical trial) to evaluate chemotherapy with XELOX (capecitabine/oxaliplatin) versus FOLFOX6 (5Fluorouracil/leucovorin/oxaliplatin) as an adjuvant treatment for high risk colorectal cancer patients in Greece....
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:10.1185/03007990902719117
更新日期:2009-03-01 00:00:00
abstract::In a double-blind study of 102 patients with a mean age of 79 years, zopiclone was compared to flunitrazepam. The patients rated their sleep in a diary. There was no statistically significant difference between the relatively low dose of 5 mg zopiclone and 1 mg flunitrazepam for eleven out of the twelve variables meas...
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:10.1185/03007999509110492
更新日期:1995-01-01 00:00:00
abstract:INTRODUCTION:Normoglycaemia in people with diabetes results in improved outcome. Continuous glucose monitoring provides detailed diagnostic information used to optimise therapy with the goal of achieving normoglycaemia. The objective of this study was to review the published literature evaluating the single device avai...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007990903094452
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Most studies investigating the benefits of statins have focused on North American and European populations. This study focuses on evaluating the lipid-lowering effects of rosuvastatin and atorvastatin in Asian patients. OBJECTIVES:The DIrect Statin COmparison of LDL-C Values: an Evaluation of Rosuvastatin t...
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:10.1185/030079907x242809
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:Chronic respiratory failure (CRF) is a syndrome defined by certain disturbances in arterial blood gases. Non-invasive mechanical ventilation (NIMV) is an increasingly used treatment modality in respiratory failure. The aim of this study was to investigate the long-term effects of NIMV on pulmonary function an...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2010.508703
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:In ST-segment elevation myocardial infarction (STEMI), current guidelines discourage treatment of the non-culprit lesions at the time of the primary intervention. Latest trials have challenged this strategy suggesting benefit of early complete revascularization. We performed a Bayesian multiple treatment net...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1260534
更新日期:2017-03-01 00:00:00