Current medical research and opinion
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Comparative Study
Comparing two tyrosine kinase inhibitors for treatment of advanced renal cell carcinoma in Medicare and commercially insured patients.
The objective of this study was to compare treatment characteristics, survival and costs for sunitinib and pazopanib for advanced renal cell carcinoma (RCC) in a real-world setting. ⋯ Mortality data and proxy variables for treatment effectiveness indicate comparable clinical value for both medications. Sunitinib treatment trended towards higher index medication and total healthcare costs despite higher pre-index total costs and worse health status indicators at baseline with pazopanib. Non-adherence with sunitinib was associated with significantly higher total healthcare costs, which may indicate differences in tolerability between the two agents and requires further investigation.
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To evaluate the healthcare utilization, treatments, and costs incurred by women with uterine fibroids (UF), compared to those without UF, for 5 years before and 5 years after diagnosis. ⋯ Patients with UF incurred significantly higher healthcare utilization and costs than those without UF, both pre- and post-diagnosis.
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To assess factors predictive of all-cause, 30 day hospital readmission among patients with type 2 diabetes in the United States. ⋯ These results highlight the importance of the appropriate recognition of and treatment for type 2 diabetes, prior to and during hospitalization and following discharge, in order to impact a subsequent hospitalization. In our analysis, escalation of diabetic treatments (especially those escalated from having no records of anti-diabetic medications to treatment with insulin) was the strongest predictor of 30 day readmission. Limitations of this study include the fact that hospitalizations and other encounters, outside the Humedica network, were not captured in this analysis.
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The risk of stroke in atrial fibrillation (AF) increases with number of risk factors (RFs). However, the combined effect from multiple RFs on the incidence of ischemic stroke and transient ischemic attack (TIA) among US patients without AF has not been fully examined. ⋯ In a large cohort of elderly patients without AF, the risk of ischemic stroke/TIA increased substantially in the presence of multiple RFs, highlighting potentially unmet medical needs. This observation implies that future studies may be warranted to investigate the effect of prophylactic anticoagulation in high risk non-AF patients.
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Randomized Controlled Trial Multicenter Study Comparative Study
Safety and efficacy of oxycodone/naloxone vs. oxycodone vs. morphine for the treatment of chronic low back pain: results of a 12 week prospective, randomized, open-label blinded endpoint streamlined study with prolonged-release preparations.
Opioid-induced constipation (OIC) is the most prevalent patient complaint associated with opioid use and interferes with analgesic efficacy. ⋯ Under the conditions of this PROBE design, OXN was associated with a significantly better tolerability, a lower risk of OIC and a significantly better analgesic efficacy than OXY or MOR.