Issues in emerging health technologies
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(1) Febuxostat is a selective inhibitor of xanthine oxidase. Its use in the management of hyperuricemia and gout is being studied. (2) In a 52-week, phase III randomized clinical trial, febuxostat was superior to allopurinol for lowering uric acid levels. Its efficacy in preventing gout attacks was similar to that of allopurinol. Despite a similar rate of adverse effects, individuals on febuxostat were more likely to stop treatment than those on allopurinol. (3) The most commonly observed adverse effects with febuxostat include liver function test abnormalities, diarrhea, headache, nausea, vomiting, abdominal pain, and dizziness. (4) Given that renal dysfunction is a risk factor for hyperuricemia and gout, the safety and efficacy of febuxostat in this population should be considered, but only limited data are available. (5) The diffusion of febuxostat may be limited by its price relative to that of allopurinol, regardless of whether febuxostat proves to have advantages in specific populations.
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Issues Emerg Health Technol · Aug 2006
Comparative StudyBpTRU(tm) blood pressure monitor for use in a physician's office.
The BpTRU(tm) is an automated device that takes serial blood pressure (BP) measurements in a physician's office. (1) Preliminary data from non-randomized, uncontrolled trials suggest that the average of five BpTRU measurements, taken while the patient is alone, more reliably reflects "resting" BP compared to manual measurements taken with a stethoscope and sphygmomanometer. (2) BpTRU helps reduce the overestimation of BP due to improper measurement technique, or due to a patient's anxiety in a physician's presence ("white coat" effect). (3) The BpTRU device can improve hypertension management by replacing conventional manual BP measurements, which are often poorly performed and inaccurate. (4) BpTRU is more expensive than the manual manometers used in a physician's office. The serial measurement, taken in a private examining room, requires an average of six to 12 minutes, which could increase the duration of a patient's visit.