Abstract:
BACKGROUND:Recent postmarketing trials produced conflicting results about the risk for hospitalized heart failure (hHF) associated with dipeptidyl peptidase-4 (DPP-4) inhibitors, creating uncertainty about the safety of these antihyperglycemic agents. OBJECTIVE:To examine the associations of hHF with saxagliptin and sitagliptin. DESIGN:Population-based, retrospective, new-user cohort study. SETTING:18 health insurance and health system data partners in the U.S. Food and Drug Administration's Mini-Sentinel program. PATIENTS:Patients aged 18 years or older with type 2 diabetes who initiated therapy with saxagliptin, sitagliptin, pioglitazone, second-generation sulfonylureas, or long-acting insulin products from 2006 to 2013. MEASUREMENTS:Hospitalized HF, identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes 402.x1, 404.x1, 404.x3, and 428.xx recorded as the principal discharge diagnosis. RESULTS:78 553 saxagliptin users and 298 124 sitagliptin users contributed an average of 7 to 9 months of follow-up data to 1 or more pairwise comparisons. The risk for hHF was not higher with DPP-4 inhibitors than with the other study drugs. The hazard ratios from the disease risk score (DRS)-stratified analyses were 0.83 (95% CI, 0.70 to 0.99) for saxagliptin versus sitagliptin, 0.63 (CI, 0.47 to 0.85) for saxagliptin versus pioglitazone, 0.69 (CI, 0.54 to 0.87) for saxagliptin versus sulfonylureas, and 0.61 (CI, 0.50 to 0.73) for saxagliptin versus insulin. The DRS-stratified hazard ratios were 0.74 (CI, 0.64 to 0.85) for sitagliptin versus pioglitazone, 0.86 (CI, 0.77 to 0.95) for sitagliptin versus sulfonylureas, and 0.71 (CI, 0.64 to 0.78) for sitagliptin versus insulin. Results from the 1:1 propensity score-matched analyses were similar. Results were also similar in subgroups of patients with and without prior cardiovascular disease and in a subgroup defined by the 2 highest DRS deciles. LIMITATION:Residual confounding and short follow-up. CONCLUSION:In this large cohort study, a higher risk for hHF was not observed in users of saxagliptin or sitagliptin compared with other selected antihyperglycemic agents. PRIMARY FUNDING SOURCE:U.S. Food and Drug Administration.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Toh S,Hampp C,Reichman ME,Graham DJ,Balakrishnan S,Pucino F,Hamilton J,Lendle S,Iyer A,Rucker M,Pimentel M,Nathwani N,Griffin MR,Brown NJ,Fireman BHdoi
10.7326/M15-2568subject
Has Abstractpub_date
2016-06-07 00:00:00pages
705-14issue
11eissn
0003-4819issn
1539-3704pii
2517404journal_volume
164pub_type
杂志文章abstract::Recently acquired knowledge about vitamin D metabolism has improved our understanding in different varieties of osteomalacia. Many new causes of osteomalacia continue to be found. Radiologic and biochemical changes are not always characteristic and may occasionally be misleading. Bone biopsy after a double tetracyclin...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-89-6-966
更新日期:1978-12-01 00:00:00
abstract::To understand the factors that distinguish terminally ill, incompetent patients who are given do-not-resuscitate status by physicians against the wishes of the patient's family, I reviewed the charts of 20 such patients (cases) seen in consultation by the ethics committee at the Massachusetts General Hospital over 10 ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-10-819
更新日期:1988-11-15 00:00:00
abstract::Treatment selection markers, sometimes called predictive markers, are factors that help clinicians select therapies that maximize good outcomes and minimize adverse outcomes for patients. Existing statistical methods for evaluating a treatment selection marker include assessing its prognostic value, evaluating treatme...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-154-4-201102150-00006
更新日期:2011-02-15 00:00:00
abstract::In recent years there has been increasing attention to the appropriate interpretation of a clinical study. One special concern has been the difficulty inherent in interpreting studies that were not statistically significant: Was the sample size sufficient to detect a clinically important effect if, in fact, it existed...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-2-248
更新日期:1983-08-01 00:00:00
abstract::Antimicrobial prophylaxis prevents recurrent urinary tract infections in susceptible women, but its cost effectiveness has not been studied. In a recent placebo-controlled trial of urinary prophylaxis, we also assessed cost effectiveness using a decision analysis model. In our hospital the direct cost of 1 patient yea...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-94-2-251
更新日期:1981-02-01 00:00:00
abstract::Antinuclear antibodies are present in most patients receiving procainamide. To ascertain whether IgG antiguanosine antibodies are associated with the development of the symptoms of systemic lupus erythematosus, we compared the levels of these antibodies in the sera of 65 patients receiving procainamide: 18 with procai...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-3-310
更新日期:1986-03-01 00:00:00
abstract::Effective health care is a core determinant of successful aging, and medications are one of the most important therapeutic tools of health care providers. Most older adults use at least one prescription drug. Costs for these drugs are a substantial out-of-pocket expense for Medicare beneficiaries, and low-income older...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-139-5_part_2-200309021-00009
更新日期:2003-09-02 00:00:00
abstract::Data on body weight and weight change collected from nationally representative samples of U.S. adults are reviewed. The body mass index (weight [kg]/height [m2]) has a low correlation with height and is used to compare body weights between persons of differing heights. The BMI varies to a greater degree in women than ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-119-7_part_2-199310011-00004
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To determine whether prolonging the duration of tamoxifen administration beyond the cessation of a combined chemotherapy regimen benefits patients with primary breast cancer with positive findings in axillary nodes who benefit initially from the combined regimen. DESIGN:Nonrandomized, nonconcurrent cohort st...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-106-5-649
更新日期:1987-05-01 00:00:00
abstract:Background:Acute pancreatitis (AP) varies in severity, prompting development of systems aimed at predicting prognosis to help guide therapy. Although several prediction approaches are available, their test characteristics and clinical utility are not completely understood. Purpose:To evaluate the test characteristics ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0650
更新日期:2016-10-04 00:00:00
abstract:OBJECTIVE:To evaluate the safety and efficacy of all-trans retinoic acid to induce complete remission and to examine its effects on duration of remission and survival in patients with acute promyelocytic leukemia. DESIGN:Phase II evaluation and comparison with historical control patients. SETTING:Tertiary care cancer...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-120-4-199402150-00004
更新日期:1994-02-15 00:00:00
abstract:OBJECTIVE:To determine whether oral acyclovir reduces the incidence of recurrent herpes labialis in otherwise healthy patients with proven frequently recurrent disease. DESIGN:Randomized, double-blind, placebo-controlled, crossover trial. SETTING:Outpatient facility of the Clinical Center, National Institutes of Heal...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-118-4-199302150-00004
更新日期:1993-02-15 00:00:00
abstract::It is hypothesized that peritoneal fluid might be used as an alternative vehicle for monitoring the clinical chemistry of patients on peritoneal dialyses and save these patients the venesection and resultant blood loss. Peritoneal fluid was obtained before 47.2% of 106 dialysis treatments and compared with simultaneou...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-1-67
更新日期:1978-07-01 00:00:00
abstract::Recent national recommendations have proposed that physicians should titrate lipid therapy to achieve low-density lipoprotein (LDL) cholesterol levels less than 1.81 mmol/L (<70 mg/dL) for patients at very high cardiovascular risk and less than 2.59 mmol/L (<100 mg/dL) for patients at high cardiovascular risk. To exam...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-145-7-200610030-00010
更新日期:2006-10-03 00:00:00
abstract::Disseminated candidiasis has become an important infection, particularly in immunocompromised and postoperative patients. Although serologic tests may, in some settings, facilitate a premortem diagnosis, the disease is usually diagnosed by comprehensive clinical evaluation. Detection of the relatively newly recognized...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-89-1-91
更新日期:1978-07-01 00:00:00
abstract:UNLABELLED:Chinese translation BACKGROUND:Black persons are more likely than white persons to be diagnosed with colorectal cancer and to die from it. The extent to which genetic or biological factors versus disparities in screening rates explain this variance remains controversial. OBJECTIVE:To define the prevalence ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-159-1-201307020-00004
更新日期:2013-07-02 00:00:00
abstract::Computerized axial tomography permits accurate cross-sectional radiographic visualization of visceral organs. Thus, "radiographic area" of an organ slice can be calculated and converted to actual area from a standard grid printed on the roentgenogram. Because the width between slices is known, the volume of an organ s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-2-185
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Extended-duration low-molecular-weight heparin has been shown to prevent venous thromboembolism (VTE) in high-risk surgical patients. OBJECTIVE:To evaluate the efficacy and safety of extended-duration enoxaparin thromboprophylaxis in acutely ill medical patients. DESIGN:Randomized, parallel, placebo-contro...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-153-1-201007060-00004
更新日期:2010-07-06 00:00:00
abstract:DESCRIPTION:Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer. METHODS:The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M15-2886
更新日期:2016-02-16 00:00:00
abstract:BACKGROUND:Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice. OBJECTIVE:To assess public attitudes regarding physician deception of insurance companies. DESIGN:Cross-sectional survey using clinical vignettes. SETTING:Philad...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-6-200303180-00011
更新日期:2003-03-18 00:00:00
abstract:BACKGROUND:Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain. OBJECTIVE:To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-131-1-199907060-00003
更新日期:1999-07-06 00:00:00
abstract::Cost-effectiveness analysis and other forms of decision analysis are becoming more common in the medical literature and are increasingly influential in the development of health policy. Nevertheless, many clinicians find it difficult to apply policies developed from these analyses to individual encounters with patient...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-11-199506010-00007
更新日期:1995-06-01 00:00:00
abstract:STUDY OBJECTIVE:To critically assess original studies evaluating the role of preoperative pulmonary function testing in predicting postoperative outcomes. DESIGN:MEDLINE search of English-language articles from 1966 to 1987 using the following medical subjects headings respiratory function tests, lung, lung diseases, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-112-10-763
更新日期:1990-05-15 00:00:00
abstract::Ninety-six patients with life-threatening ventricular arrhythmias refractory to two or more conventional agents were treated with amiodarone and followed for 6 to 40 months (mean, 15 months). Currently, 75 are alive and well. Seven patients died from nonarrhythmic and five from arrhythmic causes. Nonfatal arrhythmias ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-5-577
更新日期:1983-05-01 00:00:00
abstract::Two kindreds affected by maturity-onset type of hyperglycemia in young people were studied. The postglucose-load hyperglycemia segregated as an autosomal dominant trait; it was always mild, never requiring insulin, and generally seemed to start in the first two decades of life. Glucose, insulin, glucagon, and growth h...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-5-595
更新日期:1978-05-01 00:00:00
abstract::In observational studies or nonrandomized experiments, treated and control groups may differ in their outcomes even if the treatment has no effect; this may happen if the groups were not comparable before the start of treatment. The groups may fail to be comparable in either of two ways: They may differ with respect t...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-115-11-901
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:The news media are often criticized for exaggerated coverage of weak science. Press releases, a source of information for many journalists, might be a source of those exaggerations. OBJECTIVE:To characterize research press releases from academic medical centers. DESIGN:Content analysis. SETTING:Press rele...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-9-200905050-00007
更新日期:2009-05-05 00:00:00
abstract:STUDY OBJECTIVE:To determine the relative importance of adiposity and fat distribution to cardiovascular risk profile. DESIGN:A cross-sectional study. SETTING:Clinical research center funded by the National Institutes of Health. PATIENTS:Convenience sample of 33 healthy premenopausal women with a wide range of body ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-11-867
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:Motor vehicle crashes (MVCs) remain a leading cause of injury-related deaths in the United States. Primary seat belt laws allow vehicle occupants to be ticketed solely for not wearing seat belts, and secondary laws allow ticketing only for failure to wear seat belts in the setting of other violations. OBJEC...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-2368
更新日期:2015-08-04 00:00:00
abstract::Individual differences in metabolism of the sulfonamides may predispose patients to idiosyncratic reactions. Sulfonamides are metabolized by N-acetylation (mediated by a genetically polymorphic enzyme) and oxidation to potentially toxic metabolites. We examined 6 patients who had severe reactions to sulfonamides and c...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-2-179
更新日期:1986-08-01 00:00:00