International journal of clinical practice
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Int. J. Clin. Pract. · May 2014
Does treatment response to ambrisentan vary by pulmonary arterial hypertension severity? Implications for clinicians and for the design of future clinical trials.
Recent clinical trials in pulmonary arterial hypertension have included World Health Organization functional classes I and II patients. However, the impact of baseline functional class and other measures of severity on outcomes has not been evaluated in detail. ⋯ Patients with both less severe and more severe PAH benefited from ambrisentan therapy vs. placebo in 12-week clinical trials and during long-term follow up, but greater improvement vs. placebo was seen for those with higher BNP levels.
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Int. J. Clin. Pract. · May 2014
Review Comparative StudyGLP-1 receptor agonists vs. DPP-4 inhibitors for type 2 diabetes: is one approach more successful or preferable than the other?
In patients with type 2 diabetes (T2D), incretin-based therapies improve glycaemic control with low incidence of hypoglycaemia and without weight gain, both advantages over traditional add-ons to metformin. Dipeptidyl peptidase-4 (DPP-4) inhibitors are administered orally and provide a physiological increase in glucagon-like peptide-1 (GLP-1) levels, while GLP-1 receptor agonists (GLP-1RAs) are injectable and deliver pharmacological levels of GLP-1RA. This review aims to distinguish between GLP-1RAs and DPP-4 inhibitors, and discuss when each may be favoured in clinical practice. ⋯ GLP-1RAs provide superior glycaemic control and weight loss vs. DPP-4 inhibitors in patients with T2D. DPP-4 inhibitors may sometimes be preferred to a GLP-1RA if weight is not a concern, oral administration is a desirable feature or when a GLP-1RA cannot be tolerated.
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Int. J. Clin. Pract. · May 2014
Randomized Controlled TrialImpact of interdisciplinary treatment on physical and psychosocial parameters in patients with fibromyalgia: results of a randomised trial.
Fibromyalgia (FM) is a persistent disorder that can have a devastating effect on patients' lives. The purpose of the study was to assess the effects of an interdisciplinary treatment for FM on patients' physical and psychosocial parameters. ⋯ An interdisciplinary intervention may be appropriate for patients referred to a hospital pain management unit.
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Int. J. Clin. Pract. · May 2014
Comparative StudySurvival outcomes in patients with early stage, resected pancreatic cancer - a comparison of gemcitabine- and 5-fluorouracil-based chemotherapy and chemoradiation regimens.
We conducted a comparative survival analysis between patients with resected pancreatic cancer who received adjuvant treatment with either gemcitabine- or 5-fluorouracil-based chemotherapy and chemoradiation regimens. ⋯ Patients with low-grade resected pancreatic cancer may have better outcomes with 5-fluorouracil-based chemotherapy without radiation when compared with 5-fluorouracil with radiation.