Current Medical Research and Opinion最新文献

{"title":"Quality of life outcomes with a new sustained‑release pregabalin in a phase 3 trial of peripheral neuropathic pain.","authors":"Seoungoh Lee, Taewon An, Sohee Kim","doi":"10.1080/03007995.2026.2719074","DOIUrl":"10.1080/03007995.2026.2719074","url":null,"abstract":"<p><strong>Background: </strong>Peripheral neuropathic pain (PNP) imposes substantial burdens on quality of life (QoL). A new sustained-release (SR) pregabalin formulation (YHD1119) was developed using gastroretentive technology to improve dosing convenience. This phase 3 trial evaluated QoL outcomes to compare the new SR pregabalin with immediate-release (IR) pregabalin in Korean patients with PNP.</p><p><strong>Methods: </strong>In this randomized, double-blind, active-controlled trial, adults with PNP due to diabetic peripheral neuropathy or postherpetic neuralgia received SR pregabalin or IR pregabalin for 12 weeks. The present analysis focused on health-related QoL outcomes, including the 12-item Short Form Health Survey (SF-12), the Weekly Sleep Interference Scale (WSIS), the Patient Global Impression of Change (PGIC), and the Clinician Global Impression of Change (CGIC).</p><p><strong>Results: </strong>A total of 296 participants were included in the per-protocol analysis. SF-12 Physical Component Summary increased by 2.50 with SR and 3.08 with IR (<i>p</i> = 0.5243), and Mental Component Summary increased by 2.57 and 0.89, respectively (<i>p</i> = 0.1157). WSIS scores improved significantly in both groups (mean change -2.12 for SR and -2.19 for IR), with no meaningful difference at week 12 (<i>p</i> = 0.3691). PGIC responder rates were 50.0% with SR and 56.0% with IR (<i>p</i> = 0.2456), and CGIC responders were 58.9% and 68.0% (<i>p</i> = 0.0880), indicating comparable perceived benefit between formulations.</p><p><strong>Conclusion: </strong>Once-daily SR pregabalin (YHD1119) achieved QoL outcomes comparable to twice-daily IR pregabalin across general health status, sleep interference, and global impressions over 12 weeks. These findings support the new SR pregabalin as a practical alternative that maintains patient-reported therapeutic benefit while offering the convenience of once-daily dosing.</p><p><strong>Study registration: </strong>This study was registered at <i>ClinicalTrials.gov</i> (identifier NCT02985216).</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1435-1443"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global health status time to deterioration after systemic treatments of advanced gastric cancer: a systematic review and trial-level analysis.","authors":"Giuseppe A Colloca, Antonella Venturino","doi":"10.1080/03007995.2026.2724207","DOIUrl":"10.1080/03007995.2026.2724207","url":null,"abstract":"<p><strong>Objective: </strong>Although health-related quality of life (HRQoL) endpoints have often demonstrated a benefit from treatments that have prolonged overall survival (OS), their relationship with OS and other clinical trial endpoints remains unclear. The study aims to conduct a systematic review of phase III trials assessing HRQoL, time-to-deterioration (TTD), and imaging-related endpoints in patients with advanced gastric cancer receiving systemic therapy.</p><p><strong>Methods: </strong>A systematic review identified phase III trials reporting results of OS, TTD and imaging-related endpoints, such as progression-free survival (PFS) and objective response rate (ORR). From each trial the results of the four endpoints were extracted. An arm-level and a trial-level analysis were carried out.</p><p><strong>Results: </strong>Sixteen articles were identified, reporting the results of HRQoL endpoint of 17 trials. From the trials complete data of 21 study arms and 15 trial-level comparisons were available. At the arm-level analysis, all the endpoints reported a significant correlation with OS. The trial-level analysis documented a consistent relationship of treatment effects between PFS and OS (R²=0.313; β = 0.174; p-value = 0.030), but not between ORR and OS and between TTD and OS.</p><p><strong>Conclusion: </strong>None of the endpoints examined can be considered a surrogate for OS, although PFS remains the variable that correlates most closely with OS in the trial-level analysis. The TTD of the EORTC-QLQ-C30 GHS subscale requires standardization and subsequent prospective and retrospective re-evaluation as a surrogate endpoint. However, it warrants greater attention in future studies as a co-primary or secondary outcome, as it could provide additional and clinically relevant information compared with imaging-related outcomes.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1423-1434"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant initiation after sublingual immunotherapy in Japanese cedar pollinosis: a real-world propensity score-matched cohort study.","authors":"Rie Matsushita, Sachiko Tanaka-Mizuno, Koji Kawakami","doi":"10.1080/03007995.2026.2722388","DOIUrl":"10.1080/03007995.2026.2722388","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether sublingual immunotherapy (SLIT) for Japanese cedar pollinosis is associated with subsequent initiation of antidepressants, and to assess its clinical implications for mental health management in real-world clinical practice.</p><p><strong>Methods: </strong>We conducted a retrospective real-world cohort study using a large nationwide administrative claims database in Japan from 2014 to 2021. Adult patients diagnosed with Japanese cedar pollinosis were identified and classified as SLIT users or non-users using a new-user design. Propensity score matching was performed to balance patients' baseline characteristics, including age, sex, insurance type, and medical history. The primary outcome was initiation of antidepressant prescriptions. Hazard ratios were estimated using matched cohorts.</p><p><strong>Results: </strong>A total of 4,126 SLIT users and 88,455 non-users were identified, with 3,991 propensity-matched patients in each group. Before matching, mental disorders were more prevalent among SLIT users than among non-users, whereas allergic rhinitis severity was similar between groups. Crude initiation rates of antidepressants were 5.0 and 2.9 per 1,000 person-years among SLIT users and non-users, respectively. After matching, no statistically significant association was observed between SLIT use and antidepressant initiation (hazard ratio = 1.11, 95% confidence interval = 0.73-1.69). Kaplan-Meier analysis also showed no significant between-group differences.</p><p><strong>Conclusion: </strong>No statistically significant association was observed between SLIT for Japanese cedar pollinosis and antidepressant initiation. These findings suggest that mental health outcomes should continue to be monitored independently of immunotherapy use in routine clinical practice. Further adequately powered studies with longer follow-up periods are warranted to better characterize depressive outcomes in this population.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1357-1365"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between red blood cell distribution width and prediabetes: evidence from a single center cohort study.","authors":"Tuba Taslamacioglu Duman, Burcin Meryem Atak Tel, Satilmis Bilgin, Sevgi Ture, Ridvan Ulus, Gulali Aktas","doi":"10.1080/03007995.2026.2717472","DOIUrl":"10.1080/03007995.2026.2717472","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes is a condition characterized with chronic inflammation. Alterations in hemogram parameters, especially, red cell distribution width (RDW), and mean platelet volume (MPV) are associated with inflammatory diseases. In present study, we aimed to compare hemogram parameters of subjects with prediabetes to healthy volunteers.</p><p><strong>Methods: </strong>Patients with prediabetes were enrolled to the study who visited outpatient internal medicine clinics of our institution Hospital, between January 2023 and September 2025. Control subjects were healthy individuals who visited our clinics for a routine check-up. Hemogram parameters of prediabetes and control groups were compared.</p><p><strong>Results: </strong>Study cohort was consisted of 324 subjects; 172 in prediabetes and 152 in control group. Median RDW of the prediabetes group (15,3 (2,1)%) was significantly higher than the RDW of control subjects (14,75 (3,1)%), (<i>p</i> < 0.001). Median MPV of the patients with prediabetes (7,9 (2,4)fL), was significantly lower than that of the controls (8,59 (2,4)fL), (<i>p</i> = 0.01). RDW, but not MPV, was significantly correlated with FPG (<i>r</i> = 0.18, <i>p</i> = 0.001), HbA1c (<i>r</i> = 0.4, <i>p</i> < 0.001), triglyceride (<i>r</i> = 0.23, <i>p</i> < 0.001), and serum albumin (<i>r</i> = 0.5, <i>p</i> < 0.001). The sensitivity and specificity of RDW (when higher than 14.7%) in detecting prediabetes were 69% and 49%, respectively (AUC: 0.67, <i>p</i> < 0.001, 95%CI: 0.61-0.73). Regression analysis, considering RDW, age, triglyceride, FPG and BMI, revealed that RDW was an independent predictor of prediabetes (OR: 1.6, <i>p</i> < 0.001, 95%CI: 1.3-1.9).</p><p><strong>Conclusions: </strong>We suggest that RDW reflects certain changes in cardiometabolic health that occur in association with the development of prediabetes.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1289-1297"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of hospitalization duration and cost structure for chronic schizophrenia patients in psychiatric hospitals.","authors":"Zhiguo Liu, Kaijun Sun, Xinyi Liu, Wenjie Shi, Xiaoying Qin, Zhiyong Fan","doi":"10.1080/03007995.2026.2719084","DOIUrl":"10.1080/03007995.2026.2719084","url":null,"abstract":"<p><strong>Objective: </strong>Chronic schizophrenia patients in psychiatric hospitals often have prolonged stays, high insurance resource consumption, and low efficiency. Studies quantifying the joint optimization of payment and operational efficiency are lacking, complicating the trade-off between cost control and relapse prevention. This study aimed to identify factors associated with hospitalization duration and costs using real-world data and machine learning.</p><p><strong>Methods: </strong>A retrospective study was conducted on inpatients with chronic schizophrenia admitted to Huai'an No.3 People's Hospital from 2022 to 2024. Data on demographics, clinical features, comorbidities, medications, and insurance costs were collected. Factors were screened by descriptive, univariate, and Gamma stepwise regression. Machine learning models (Lasso, Random Forest, XGBoost) were built to predict length of stay, with SHAP used for feature interpretation.</p><p><strong>Results: </strong>A total of 3607 inpatients with chronic schizophrenia were enrolled. Univariate analysis revealed 29 significant variables; Gamma regression identified 18 independent factors. The rehabilitation treatment cost ratio was the strongest risk factor, and the examination cost ratio the strongest protective factor. The Random Forest model performed best (cross-validation R²=0.7143, test R²=0.7318). SHAP analysis showed total hospitalization cost and rehabilitation treatment cost ratio as core predictors.</p><p><strong>Conclusion: </strong>This study identified key factors influencing hospitalization duration and costs in chronic schizophrenia, and developed an accurate and stable model that can support lean management in psychiatric hospitals.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1445-1457"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and echocardiographic differences between ıschemic and hemorrhagic stroke: a sex-stratified retrospective analysis.","authors":"Mehmet Vatansever, Ceyhun Yurtsever, Cemil Güner, Erhan Özdemir, Erdem Özkaya, Ali Yazıcı, Köksal Sarıhan, Osman Topçu, Hüseyin Karal, Burcu Aykanat Yurtsever, Volkan Atasoy","doi":"10.1080/03007995.2026.2719079","DOIUrl":"10.1080/03007995.2026.2719079","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical and echocardiographic characteristics of ischemic and hemorrhagic stroke using sex-stratified analyses and to assess whether routine echocardiographic findings provide complementary cardiovascular information.</p><p><strong>Methods: </strong>This retrospective observational study included 220 adults with neuroimaging-confirmed stroke treated at a secondary-care hospital specializing in physical medicine and rehabilitation between January 2023 and December 2024. Patients were classified as having ischemic stroke (<i>n</i> = 171) or hemorrhagic stroke (<i>n</i> = 49). Demographic characteristics, cardiovascular comorbidities, and routinely reported transthoracic echocardiographic findings were analyzed. Separate multivariable logistic regression models were constructed for women and men using variables with <i>p</i> < 0.10 in univariate analyses.</p><p><strong>Results: </strong>Patients with ischemic stroke were older than those with hemorrhagic stroke (68.4 ± 10.6 vs. 63.4 ± 13.9 years; <i>p</i> = 0.022), and hypertension was more frequent (94.2% vs. 81.6%; <i>p</i> = 0.017). Among men, left ventricular diastolic dysfunction (48.1% vs. 24.1%; <i>p</i> = 0.021) and hypertension (95.2% vs. 79.3%; <i>p</i> = 0.014) were more frequent in ischemic stroke. In the male multivariable model, left ventricular diastolic dysfunction (OR = 4.835, 95% CI 1.593-14.679; <i>p</i> = 0.005) and hypertension (OR = 9.471, 95% CI 2.053-43.691; <i>p</i> = 0.004) were independently associated with ischemic rather than hemorrhagic stroke, whereas ascending aortic dilatation showed an inverse association (OR = 0.235, 95% CI 0.080-0.692; <i>p</i> = 0.009). No variable was independently associated with stroke subtype in women.</p><p><strong>Conclusion: </strong>Sex-stratified analyses identified different cardiovascular association patterns across stroke subtypes. Routine echocardiographic findings, particularly left ventricular diastolic dysfunction, may complement cardiovascular characterization in men with stroke. These exploratory findings require confirmation in larger prospective multicenter studies with formal interaction testing.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1493-1501"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoplastic findings after positive multi-target stool DNA testing in a large gastroenterology practice.","authors":"Timothy Ritter, Rashmi Goyat, Charles Owen, Lucinda Van Anglen, Paul Limburg, Mallik Greene","doi":"10.1080/03007995.2026.2716982","DOIUrl":"10.1080/03007995.2026.2716982","url":null,"abstract":"<p><strong>Background: </strong>Multi-target stool DNA (mt-sDNA) testing is a noninvasive colorectal cancer (CRC) screening option, but real-world data on follow-up colonoscopy (FU-CY) completion and findings after positive results are limited.</p><p><strong>Aim: </strong>To evaluate FU-CY completion and advanced neoplasia (AN) after positive mt-sDNA testing.</p><p><strong>Methods: </strong>Electronic health record data from a convenience sample of adults aged 50-85 years at average risk for CRC with positive mt-sDNA test results between 2014 and 2022 in a large community gastroenterology practice network were analyzed. FU-CY completion was defined as documented FU-CY within 365 days. Outcomes included FU-CY completion, time to FU-CY, and findings. Exploratory logistic regression evaluated factors associated with FU-CY completion.</p><p><strong>Results: </strong>Among 243 patients with positive mt-sDNA test results, 201 (82.7%; 95% confidence interval [CI], 77.4-87.3%) completed FU-CY within 1 year. Median time to FU-CY was 60 days (25th-75th percentile, 39-96 days). AN was identified in 98 patients (48.8%; 95% CI, 41.9-55.7%), driven primarily by advanced precancerous lesions; CRC was detected in 2 patients (1.0%; 95% CI, 0.001-2.4%). The any-neoplasia composite was identified in 168 patients (83.6%; 95% CI, 78.5-88.7%). Age ≥75 years was associated with lower odds of FU-CY completion versus age 50-64 years (odds ratio, 0.28; 95% CI, 0.11-0.73; <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>More than 80% completed FU-CY within 1 year. AN was identified in nearly half of FU-CY completers, driven primarily by APLs.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1319-1328"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world adherence and healthcare resource utilization following transition to aripiprazole once-every-2-months from oral or once-monthly aripiprazole among patients diagnosed with schizophrenia in the United States.","authors":"Kristine Harrsen, Murat Yildirim, Clodagh Beckham, Karimah S Bell Lynum, Norman Atkins, Onur Baser, Katarzyna Rodchenko, Annette Urganus, Shivanshu Awasthi, Soma S Nag","doi":"10.1080/03007995.2026.2722697","DOIUrl":"10.1080/03007995.2026.2722697","url":null,"abstract":"<p><strong>Objective: </strong>To assess adherence and healthcare resource utilization (HCRU) among adults diagnosed with schizophrenia who transitioned from oral aripiprazole or aripiprazole monohydrate once-monthly (AOM) to aripiprazole monohydrate 2-month ready-to-use (Ari 2MRTU).</p><p><strong>Methods: </strong>Data for patients who transitioned to Ari 2MRTU were retrospectively obtained from the Kythera Labs United States closed-claims database. Outcomes were examined 6 months pre- versus post-index (first Ari 2MRTU claim = index).</p><p><strong>Results: </strong>Following transition from oral aripiprazole (<i>n</i> = 153), proportion of days covered (PDC) and medication possession ratio (MPR) increased by 21.3% and 24.6%, respectively, and proportion of adherent patients (MPR ≥ 0.8) increased by 59.2% (all <i>p</i> < 0.001). Mean ± standard deviation all-cause inpatient visits and hospital length of stay (LOS) were lower post- versus pre-index (0.28 ± 0.88 vs 0.67 ± 1.85 visits and 1.05 ± 3.95 vs 2.63 ± 6.14 days<i>, p</i> = 0.019 and <i>p</i> = 0.008, respectively). For schizophrenia-related HCRU, mean LOS (0.19 ± 1.05 vs 0.91 ± 3.94, <i>p</i> = 0.031) and proportion of patients with ≥ 1 outpatient visit (36.0% vs 54.9%, <i>p</i> = 0.019) were lower post- versus pre-index. Following transition from AOM (<i>n</i> = 526), PDC and MPR increased by 38.8% and 36.6%, respectively, and proportion of adherent patients increased by 47.9% (all <i>p</i> < 0.001). All-cause LOS was lower post- versus pre-transition (0.64 ± 2.63 vs 1.05 ± 3.93 days, <i>p</i> = 0.047).</p><p><strong>Conclusion: </strong>Transitioning to Ari 2MRTU was associated with significantly improved adherence and reductions in certain HCRU measures in patients diagnosed with schizophrenia.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1459-1472"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of vagus nerve stimulation therapy for drug-resistant epilepsy across healthcare settings: a structured narrative review.","authors":"Anjali Patel, B Rajgopal","doi":"10.1080/03007995.2026.2723579","DOIUrl":"10.1080/03007995.2026.2723579","url":null,"abstract":"<p><p>Drug-resistant epilepsy (DRE) is associated with substantial healthcare utilization, impaired quality of life (QOL), and considerable societal costs. Vagus nerve stimulation (VNS) has become an established adjunctive treatment for patients who are not suitable candidates for resective epilepsy surgery or who fail to achieve adequate seizure control with pharmacotherapy. This structured narrative review critically evaluates the current evidence on the cost-effectiveness of VNS in DRE. A comprehensive literature search was conducted across PubMed, Web of Science, Embase, Google Scholar, CNKI, and Wanfang Data, and 24 eligible studies comprising observational investigations, real-world database analyses, and economic modelling studies were included. The review synthesized evidence on direct medical costs, indirect societal costs, healthcare utilization, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs), while considering methodological characteristics including study design, modelling approach, time horizon, and healthcare perspective. Overall, many studies, particularly from high-income countries, suggest that although VNS requires substantial upfront costs related to device implantation, these costs may be partially offset time through reductions in seizure frequency, hospitalizations, emergency department visits, and other epilepsy-related healthcare utilization, with several analyses reporting favorable ICERs within accepted willingness-to-pay thresholds. However, considerable heterogeneity exists across the available evidence owing to differences in healthcare systems, reimbursement policies, patient populations, device pricing, modelling assumptions, economic perspectives, outcome measures, and study durations. Consequently, the reported economic outcomes are not directly comparable across settings and should be interpreted cautiously. Furthermore, most evidence originates from high-income countries, while data from middle- and low-income settings remain limited, and many economic evaluations rely on long-term model projections rather than extended real-world follow-up. Current evidence indicates that VNS may provide favorable long-term economic value for appropriately selected patients with DRE, but its cost-effectiveness is context dependent rather than universal. Future research should prioritize standardized economic evaluation methodologies, longer-term prospective studies, and region-specific cost analyses to improve the generalizability of findings and support evidence-based healthcare policy and reimbursement decisions.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1391-1421"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world treatment patterns and outcomes of patients treated with commercial chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma.","authors":"Rafael Fonseca, Matthew James Brunner, Suzanne Fanning, George Nahas, Saurabh P Nagar, Denise De Wiest, Matthew Perciavalle, Oluwabunmi Emidio, Talia Miller, Angele Kotomale, Bruce Feinberg, Zaina P Qureshi","doi":"10.1080/03007995.2026.2717477","DOIUrl":"10.1080/03007995.2026.2717477","url":null,"abstract":"<p><strong>Objective: </strong>To characterize physician-reported prescribing patterns and referral pathways for chimeric antigen receptor T-cell (CAR-T) therapy in patients with relapsed/refractory multiple myeloma (RRMM), and to describe treatment patterns and clinical outcomes among patients receiving commercial ciltacabtagene autoleucel (cilta-cel).</p><p><strong>Methods: </strong>This study comprised a descriptive physician survey and retrospective medical chart review. Seventeen physicians representing geographically diverse private community practices (82.4%) and academic centers (17.6%) completed a standardized questionnaire addressing CAR-T referral patterns and perceived barriers. Medical records of 72 adult patients with RRMM who received cilta-cel between February 28, 2022, and June 30, 2024, following US Food and Drug Administration approval, were abstracted to evaluate treatment pathways and clinical outcomes; safety data were not captured.</p><p><strong>Results: </strong>Physicians reported treating 289 patients who were eligible for CAR-T therapy in the past year; 52.9% indicated that 31%-50% of eligible patients were not referred. For referred patients, efficacy of therapy (76.5%) and good performance status/low frailty (64.7%) were top reasons for referral, whereas patient choice (52.9%), poor performance status/high frailty (47.1%), comorbidity burden (41.2%), and older age (41.2%) were primary reasons for nonreferral. Among the 72 patients who received cilta-cel, approximately half (55.6%) traveled >30 miles to treatment centers, and 27.8% relocated for treatment. In those with a response assessment, the overall response rate was 95.2% and 60.3% achieved at least a complete response. At the end of follow-up (median: 5.6 months), 86.1% were alive, of whom 43.5% achieved remission and were not receiving active treatment.</p><p><strong>Conclusion: </strong>This real-world study adds to the body of evidence on decision-making for use of commercial CAR-T therapies and supports the development of clinical best practices and guidelines, payer decisions, and health system planning for CAR-T treatment in RRMM.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1339-1345"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}