Abstract:
PURPOSE:Although the efficacy of canagliflozin has been well established in clinical trials, research regarding its use and impact on outcomes in clinical practice has been limited by the availability of data on observations up to and beyond 6 months after the initial use of canagliflozin. The purpose of this study was to evaluate changes in glycemic control after the initiation of canagliflozin use in a managed care population. METHODS:A retrospective cohort analysis in adults with type 2 diabetes mellitus was conducted using medical and pharmacy claims data and laboratory results from the Humana Research Database. The differences between hemoglobin (Hb) A1c levels pre- and postindex were assessed. Changes from pre- to postindex in the percentages of patients achieving glycemic control (eg, HbA1c <7% or <8%) were evaluated. HbA1c levels were also observed during days 31 to 90, 91 to 180, 181 to 270, and 271 to 360 postindex relative to preindex to assess the durability of HbA1c change over time. Analyses were conducted in the full cohort and in 3 subgroups: (1) HbA1c ≥7% at baseline; (2) age ≥65 years; (3) and Medicare members age ≥65 years and HbA1c ≥7% at baseline. FINDINGS:Among the 1562 patients meeting the study criteria, the mean HbA1c values pre- and postindex were 8.6% and 7.9%, respectively (P < 0.0001); in the subgroup with HbA1c ≥7% at baseline, these values were 8.9% and 8.0%; in the subgroup aged ≥65 years, 8.5% and 7.9%; and in the subgroup aged ≥65 years with HbA1c ≥7% at baseline, 8.8% and 8.1% (all subgroups, P < 0.001). The percentages of patients meeting glycemic-control thresholds (HbA1c <7%, <8%) were significantly greater at postindex in the full study cohort and in all 3 subgroups (all, P < 0.001). Based on longitudinal HbA1c results in the postindex periods, HbA1c reduction appeared durable across 12 months. IMPLICATIONS:The findings from this study suggest that treatment with canagliflozin is associated with improved glycemic control, as evidenced by HbA1c reduction and glycemic goal attainment. Even though not all patients had valid HbA1c measurements available in each quarter during the follow-up period, the reductions in mean HbA1c appeared durable across the postindex intervals. The observations from this majority Medicare Advantage with Prescription Drug sample and, more specifically, in the subgroups limited to patients aged ≥65 years are particularly informative for payers and providers managing or caring for patients of this age with diabetes.
journal_name
Clin Therjournal_title
Clinical therapeuticsauthors
Bailey RA,Schwab P,Xu Y,Pasquale M,Renda Adoi
10.1016/j.clinthera.2016.07.009subject
Has Abstractpub_date
2016-09-01 00:00:00pages
2046-2057.e2issue
9eissn
0149-2918issn
1879-114Xpii
S0149-2918(16)30452-0journal_volume
38pub_type
杂志文章abstract:BACKGROUND:In people with type 1 or type 2 diabetes, poor adherence to insulin therapy can compromise disease management. There are several reasons for poor adherence, including social embarrassment, inconvenience, needle anxiety, fear of injection pain, and complicated regimens. Attempts to facilitate implementation o...
journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.clinthera.2005.11.019
更新日期:2005-01-01 00:00:00
abstract::In a previous report of a multicenter study (Kannel et al, 1990), the results of 6 months' treatment with lovastatin in 489 adults with primary hypercholesterolemia were presented. The present report contains the results from the 236 women patients. The intial dose of lovastatin was 20 mg daily and could be increased ...
journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章,多中心研究
doi:
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abstract::The overall objective of this research project was to measure the types and amounts of Mexican drug products being purchased and declared to US Customs by US residents crossing the border in Laredo, Texas. Data for this study were obtained from the US Customs Declaration Form, which each person completes as he or she ...
journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/s0149-2918(96)80079-8
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abstract::Exposure of the eye to airborne particles in patients predisposed to allergy often results in the signs and symptoms of allergic conjunctivitis such as red, itchy eyes and ocular discharge. The mediators of these allergic symptoms include histamine, inflammatory substances such as prostaglandins, and other products of...
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pub_type: 杂志文章,多中心研究
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journal_title:Clinical therapeutics
pub_type: 杂志文章,随机对照试验
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章,meta分析,评审
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章
doi:10.1016/j.clinthera.2020.06.009
更新日期:2020-08-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:
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journal_title:Clinical therapeutics
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章,meta分析
doi:10.1016/j.clinthera.2018.03.004
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The role of folate in pregnancy is well established, with most prenatal vitamins (PNVs) on the market containing at least 800 μg of folic acid. Folic acid must be converted in the body to L-methylfolate, the natural and biologically active form of folate. The role of vitamin B(12) in pregnancy is less charac...
journal_title:Clinical therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clinthera.2011.02.010
更新日期:2011-02-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.clinthera.2007.12.032
更新日期:2007-12-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Hypoglycemia in people with insulin-treated type 2 diabetes can be a limiting factor for management and a barrier to optimizing glycemic control. Even mild episodes of hypoglycemia can affect an individual's quality of life, and fear of hypoglycemia can lead to underinsulinization. This article explores the prevalence...
journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.clinthera.2016.09.020
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare the efficacy and safety of nebulized arformoterol 15 microg/2 mL twice daily (ARF15 BID) and 30 microg/4 mL once daily (ARF30 QD) in subjects with moderate to severe chronic obstructive pulmonary disease (COPD). METHODS:In this single-dose, multicenter, randomized, modifi...
journal_title:Clinical therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clinthera.2009.08.012
更新日期:2009-08-01 00:00:00
abstract::Idiopathic chronic hiccup (ICH) is defined as recurring hiccup attacks that last for longer than an arbitrary time limit (eg, 1 month) and for which no organic cause can be found. In patients with ICH, therapy is largely empiric. For practical purposes, idiopathic hiccup can be assumed to have its origin either in the...
journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章
doi:10.1016/s0149-2918(97)80055-0
更新日期:1997-09-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/j.clinthera.2013.05.019
更新日期:2013-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.clinthera.2020.06.014
更新日期:2020-08-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0149-2918(02)80034-0
更新日期:2002-08-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
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更新日期:2013-06-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/s0149-2918(00)83032-5
更新日期:2000-11-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/j.clinthera.2011.08.013
更新日期:2011-10-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/j.clinthera.2019.04.027
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:Each year in France, varicella and zoster affect large numbers of children and adults, resulting in medical visits, hospitalizations for varicella- and zoster-related complications, and societal costs. Disease prevention by varicella vaccination is feasible, wherein a plausible option involves replacing the com...
journal_title:Clinical therapeutics
pub_type: 杂志文章
doi:10.1016/j.clinthera.2015.01.006
更新日期:2015-04-01 00:00:00
abstract::The bacteriologic profile in 1081 pediatric patients with culture-positive symptomatic bacteriuria was studied over a 30-month period in a 500-bed acute care hospital in Riyadh, Saudi Arabia. Microbial isolates were considered significant if their numbers equaled or exceeded 10,000 colony-forming units/mL in symptomat...
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pub_type: 杂志文章
doi:10.1016/s0149-2918(96)80010-5
更新日期:1996-03-01 00:00:00
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journal_title:Clinical therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clinthera.2013.06.020
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Despite increasing investigation in the area of cardiovascular instability in preterm infants, huge gaps in knowledge remain. None of the current treatments for hypotension, including the use of inotropic agents, have been well studied in the preterm population, and data regarding safety and efficacy are lac...
journal_title:Clinical therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.clinthera.2006.09.006
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Meclofenoxate hydrochloride is a psychostimulant in the nootropic agent group available in capsule and tablet formulations approved for traumatic cataphora, alcoholic poisoning, anoxia neonatorum, and children's enuresis in China. Although these 2 generic formulations are marketed in China, information regar...
journal_title:Clinical therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clinthera.2008.09.013
更新日期:2008-09-01 00:00:00