Current medical research and opinion
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of luseogliflozin as monotherapy in Japanese patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled, phase 3 study.
Luseogliflozin--a novel, orally bioavailable, 1-thio-D-glucitol derivative and a selective sodium glucose cotransporter 2 inhibitor--has shown efficacy and tolerability in previous phase 2 studies. This phase 3, randomized, double-blind, placebo-controlled, comparative study aimed to confirm the superiority of 24 week luseogliflozin 2.5 mg monotherapy over placebo in reducing hemoglobin A1c (HbA1c) levels in Japanese patients with type 2 diabetes mellitus (T2DM). ⋯ JapicCTI-111661.
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The present review was performed to identify possible differences observed between adults and elderly patients and between males and females in randomized clinical trials of breakthrough pain (BTP). ⋯ There is a need for more information regarding the use of opioids for BTP according to age and gender.
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Alpha2-adrenoceptor (α2 AR) antagonists inhibit the growth of breast cancer cells. The action of beta2-adrenoceptors (β2 AR) on cell proliferation is still controversial. In this study, we investigated the association of α2a and β2 AR expression with tumor-relevant biological markers and clinical outcome. ⋯ In hormone receptor positive breast cancer patients, strong β2 AR expression is correlated with better DFS than weak β2 AR expression and an interaction may exist between β2 AR and hormone receptor pathways. Some limitations of this study were the relatively small sample size and the intrinsic nature of retrospective study per se. Findings of the study are for hypothesis only and need to be confirmed in large prospective studies.
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Neuropathic pain (NP) is a common type of chronic pain in which 60% of patients present with localized symptoms. Early diagnosis of NP is often a challenge in primary care. Moreover, so far no standard diagnostic procedure for localized NP (LNP) is available. To help general practitioners, a screening tool was developed and evaluated. ⋯ The proposed screening tool was shown to be easy and useful for detecting NP and LNP in chronic pain patients as a fast first assessment tool in primary care, thus facilitating the choice of a topical treatment. LIMITATIONS AND STRENGTHS: The drop-out rate was high but was accounted for by using correction factors in the diagnostic accuracy calculations. A strength is the unselected chronic patient population: spectrum of disease correctly reflects day-to-day clinical practice and is not biased. Diagnostic accuracy of the tool therefore appears to be realistic.
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Comparative Study
Real-world comparative effectiveness and safety of rivaroxaban and warfarin in nonvalvular atrial fibrillation patients.
Rivaroxaban was shown to be effective in reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF) in a randomized controlled trial setting. ⋯ This analysis suggests that rivaroxaban and warfarin do not differ significantly in real-world rates of composite stroke and systemic embolism and major, intracranial, or GI bleeding. Rivaroxaban, however, was associated with significantly fewer VTE events and significantly better treatment persistence compared with warfarin.