Current medical research and opinion
-
Objective: To perform evaluations of the CONTOUR PLUS LINK 2.4 blood glucose monitoring system (BGMS) assessed according to ISO 15197:2013 criteria. Methods: Clinical trial registered at ClinicalTrials.gov (NCT01824355). In a laboratory study (Study 1), capillary fingertip blood samples from 100 subjects were evaluated in duplicate, using three test strip lots. ⋯ Most subjects found the BGMS easy to use. There were three non-serious, non-device related adverse events. Conclusion: The BGMS exceeded minimum ISO 15197:2013-specified accuracy criteria in the laboratory and in the hands of lay users with diabetes.
-
Objective: To compare the rates of successfully treated patients (STPs) with vortioxetine versus venlafaxine in major depressive disorder (MDD), using dual endpoints that combine improvement of mood symptoms with optimal tolerability or functional remission, and conduct a simplified cost-effectiveness analysis. Methods: The 8-week SOLUTION study (NCT01571453) assessed the efficacy and safety of vortioxetine (10 mg/day) versus venlafaxine XR (150 mg/day) in adult Asian patients with MDD. Rates were calculated post-hoc of STP Mood and Tolerability (≥50% reduction from baseline in Montgomery-Åsberg Depression Rating Scale [MADRS] total score and no treatment-emergent adverse events) and STP Mood and Functioning (≥50% reduction from baseline in MADRS total score and Sheehan Disability Scale total score ≤6). ⋯ Conclusions: Higher rates of dual treatment success were seen with vortioxetine versus venlafaxine. Although vortioxetine was not dominant in the base case, the incremental cost per STP for vortioxetine versus venlafaxine were overall within acceptable ranges. These results support the benefits previously reported with vortioxetine versus other antidepressants in broad efficacy, tolerability profile and cost-effectiveness.
-
Objective: Rituximab is used as an off-label treatment for relapsing-remitting multiple sclerosis (RRMS); however, the comparative efficacy and safety of rituximab versus currently licensed disease-modifying drugs (DMDs) for RRMS is unknown. A systematic literature review was conducted to evaluate the available data pertaining to efficacy and safety of rituximab in adult patients with RRMS and highly active relapsing multiple sclerosis (HA-RMS); data quality was critically assessed via risk of bias (RoB) assessment. Methods: Biomedical literature databases were searched until mid-2018 and key proceedings were searched from 2016 to 2018. ⋯ Two-thirds of the non-randomized RRMS studies were associated with critical/serious RoB; the single RCT was associated with low RoB. Furthermore, all of the non-randomized HA-RMS studies were associated with critical/serious RoB. Conclusions: Available evidence of off-label rituximab use for the treatment of patients with RRMS suggests generally favorable efficacy versus placebo and interferons/glatiramer acetate; however, the poor quality of the included studies limits any robust conclusions.
-
Background: Mantle cell lymphoma (MCL), a rare and aggressive disease, accounts for approximately 5% of all B-cell non-Hodgkin's lymphomas. Evidence on the burden of this disease, for patients and healthcare providers, is scarce. Methods: Four systematic literature reviews were developed to identify epidemiological, real-world clinical, economic and humanistic burden data on patients with MCL. ⋯ Conclusions: We identified significant data gaps for many G20 countries for epidemiology, real-world clinical, economic and humanistic burden. These literature reviews demonstrate the ongoing unmet need for MCL patients globally. Future research to further understand the real-world impact of MCL is needed along with new therapeutic options to improve patient outcomes.
-
Objective: To evaluate the risk of death from Alzheimer's disease among cancer survivors in a population-based setting. Methods: Within Surveillance, Epidemiology and End Results (SEER)-9 registries, cancer patients who were diagnosed between 1975 and 2016 have been reviewed. Observed/expected ratios for the risk of death from Alzheimer's disease were calculated for the overall group as well as for clinically defined subgroups. "Observed" is the number of observed deaths from Alzheimer's disease in the studied group, while "Expected" is the number of deaths from Alzheimer's disease in a demographically similar group within the US and within the same period. ⋯ Death from Alzheimer's disease seems to be particularly associated with older age at time of cancer diagnosis (O/E for patients ≥70 years: 1.29 [95% CI: 1.26-1.31] versus O/E for patients <70 years: 1.01 [95% CI: 0.98-1.03]), American Indian race (O/E for American Indian patients: 1.94 [95% CI: 1.30-2.78] versus O/E for White patients: 1.12 [95% CI: 1.10-1.14]), localized tumor stage (O/E for patients with localized disease stage: 1.13 [95% CI: 1.11-1.15] versus O/E for patients with distant disease stage: 1.04 [95% CI: 0.93-1.15]) and brain tumors (O/E for brain tumors: 2.54 [95% CI: 1.42-4.19]). Conclusion: Long-term cancer survivors (≥10 years) are more likely to die from Alzheimer's disease compared to the US general population. This risk seems to be higher among patients with older age at the time of cancer diagnosis, American Indian race and those with brain tumors.