Current medical research and opinion
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Randomized Controlled Trial Multicenter Study
Acute postoperative pain relief with immediate-release tapentadol: randomized, double-blind, placebo-controlled study conducted in South Korea.
To broaden the ethnic groups in which tapentadol IR is evaluated for treating acute postoperative pain to include Asians. ⋯ NCT01516008.
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Although the need for combination therapy of hypertension was obvious from the early intervention trials, administration of such therapy as fixed-dose or single-pill combinations has only reached general acceptance in recent years. The main reason for this change of mind documented in the recommendation of using single-pill combinations in almost every recent hypertension guideline is our increasing knowledge about non-adherence to drug therapy. In the multifactorial origin of non-adherence, the complexity of therapy, especially in elderly patients with comorbidities and polypharmacy, has been identified as a major factor involved. So an important rule in hypertension treatment, and maybe in drug therapy in general, is to keep things as simple as possible.
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Randomized Controlled Trial
Assessment of the safety and efficacy of extended-release oxycodone/acetaminophen, for 14 days postsurgery.
To investigate the safety and satisfaction of patients treated ≤ 14 days after unilateral bunionectomy with extended-release oxycodone/acetaminophen (ER OC/APAP), a biphasic (ER and immediate release) fixed-dose combination analgesic being developed for moderate to severe acute pain. ⋯ These results show that ER OC/APAP demonstrated an expected safety and tolerability profile and good patient satisfaction in a postsurgical model of acute pain.
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For properly selected patients experiencing chronic pain, extended-release opioid formulations may represent an appropriate pain management choice. For the many adults, elderly, and children who have medical conditions that make swallowing solid, oral-dose formulations difficult (dysphagia) or painful (odynophagia), this option may be limited. The combination of chronic pain with dysphagia (CPD) presents a challenge to physicians and patients alike when oral opioid analgesia is needed to control pain, but patients are unable to swallow solid, oral dosage forms. ⋯ The number of patients with CPD may be larger than is currently anticipated by healthcare providers. Physicians should proactively include a discussion of dysphagia as part of the patient examination. CPD is an unmet medical need. There are novel opioid formulations in clinical development that address the limitations of current opioid treatments. This manuscript reviews the problems associated with dysphagia on medication administration and adherence, currently available treatment options, and opioid analgesic formulations currently in clinical development.
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Randomized Controlled Trial Multicenter Study Comparative Study
The SimpleMix study with biphasic insulin aspart 30: a randomized controlled trial investigating patient-driven titration versus investigator-driven titration.
The study aimed to confirm the efficacy, through non-inferiority, of patient-driven versus investigator-driven titration of biphasic insulin aspart 30 (BIAsp 30) in terms of glycemic control assessed by HbA1c change. ⋯ Non-inferiority of patient-driven versus investigator-driven titration with regard to change from baseline to end-of-treatment HbA1c could not be confirmed. It is possible that a clinic visit 12 weeks after intensification of treatment with BIAsp 30 in patients with type 2 diabetes inadequately treated with basal insulin may benefit patient-driven titration of BIAsp 30. A limitation of the study was the relatively small number of patients recruited in each country, which does not allow country-specific analyses to be performed. Overall, treatment with BIAsp 30 was well tolerated in both treatment groups.