Drugs - Real World Outcomes最新文献

{"title":"Effectiveness of Glipizide and Glipizide Plus Metformin Formulation among Asian Indians with Type 2 Diabetes: a Real-World, Retrospective Electronic Medical Record Analysis.","authors":"Thyparambil Aravindakshan PramodKumar, Rajendra Pradeepa, Saravanan Jebarani, Sadasivam Ganesan, Abhijit Pednekar, Routray Philips, Suraparaju Pavan Kumar, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan","doi":"10.1007/s40801-025-00502-0","DOIUrl":"https://doi.org/10.1007/s40801-025-00502-0","url":null,"abstract":"<p><strong>Background: </strong>In low- and middle-income countries, sulfonylureas are commonly prescribed due to cost-effectiveness. However, data comparing their real-world impact, especially when used alone versus in combination with metformin, remain limited.</p><p><strong>Objective: </strong>This study aimed to assess the effectiveness of glipizide and glipizide plus metformin in individuals with type 2 diabetes (T2D) using real-world data.</p><p><strong>Methods: </strong>Data was obtained from 11,949 individuals with T2D who were prescribed either glipizide or glipizide+metformin and had at least one follow-up within 1 year at a tertiary diabetes care centre in India. The primary outcome was the change in glycated hemoglobin (HbA1c) levels from baseline to follow-up. Secondary outcomes included changes in fasting plasma glucose (FPG), postprandial glucose (PPG), body mass index (BMI), and estimated glomerular filtration rate (eGFR).</p><p><strong>Results: </strong>The mean age of participants was 56 ± 11 years, 59% (n = 7008) were male, and the mean diabetes duration was 10.2 ± 8 years. In the glipizide group (n = 6034), HbA1c decreased from 8.8% to 7.9% (p < 0.001), FPG decreased by 16 mg/dL (p < 0.001), and PPG decreased by 29 mg/dL (p < 0.001). In the glipizide + metformin group (n = 5915), HbA1c levels declined from 8.9% to 7.8% (p < 0.001), and FPG and PPG declined by 23 mg/dL and 44 mg/dL, respectively (p < 0.001). BMI remained stable in the glipizide group, while a reduction of 0.2 kg/m² was observed among overweight/obese individuals in the glipizide + metformin group. The use of glipizide and glipizide + metformin effectively improved glycemic control without adverse anthropometric changes. C-peptide levels were preserved across all treatment groups, demonstrating sustained β-cell function. HbA1c reductions were observed consistently across all eGFR categories. Furthermore, as glipizide plus metformin is one of the least expensive antidiabetic drugs in India (₹1460/year [$16.87]) it can help improve accessibility to treatment even among those in lower socio-economic statuses.</p><p><strong>Conclusions: </strong>Glipizide as monotherapy or in combination with metformin, significantly improved glycemic control even in those with decreasing renal function, with no adverse effects on weight and with preservation of β-cell function. While long-term studies are needed to assess the sustainability of these benefits, glipizide can be considered a cost-effective therapeutic option for T2D in low- and middle-income countries.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Sex-Related Pharmacodynamic Differences in Photosensitive Epilepsy Treated with Valproate: Findings from a Retrospective, Observational, Single-Center, Within-Patient, Cohort Study.","authors":"Dorothee Kasteleijn-Nolst Trenité, Ronald C Reed, Alessandro Ferretti, Anteo Di Napoli, Pasquale Parisi","doi":"10.1007/s40801-025-00503-z","DOIUrl":"https://doi.org/10.1007/s40801-025-00503-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Sexual dimorphism in drug efficacy, beyond pharmacokinetics (PK), remains underexplored. Significant sex differences exist in drug metabolism and adverse events, highlighting the need for personalized medicine. The objective of our study was to assess whether there are sex differences in the pharmacodynamic (PD) response to valproic acid (VPA) in photosensitive epilepsy, focusing on electroencephalographic (EEG) biomarkers (e.g., photoparoxysmal response [PPR] raw data and transformed PPR data, the standardized photosensitivity range [SPR]) that cannot be attributed to pharmacokinetics alone. On the basis of some exploratory published evidence plus our own clinical observations of VPA treatment in patients with epilepsy plus photosensitivity over time, we hypothesized that an EEG pharmacodynamic difference might exist between females and males.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective, observational, single-center, within-patient EEG cohort study conducted on antiseizure medicine (ASM)-naïve photosensitive individuals before and after VPA treatment (nonrandomized). The data we reviewed had been collected from a referral hospital in the Netherlands from 1990 to 2000. Changes in EEG data, including raw PPR data (transformed into SPR), were analyzed before and after VPA therapy in 48 patients, including 27 females and 21 males, ranging in age from 8 to 50 years old for the entire cohort. Co-primary outcomes included a between-sex comparison in the distribution of within-patient SPR changes from pre-VPA to steady-state VPA therapy, and complete PPR elimination on EEG. Secondary outcomes included the comparison of percentage of males and females meaningfully responding to VPA across SPR change categories, VPA dose, potential impact of plasma [VPA] concentrations on SPR changes, and associaton of patient age with SPR values. Statistical analyses included univariate linear regression models, chi-squared tests, non-parametric Wilcoxon-Mann-Whitney tests, and Fisher's exact tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our first co-primary outcome revealed a statistically significant difference in the distribution of within-patient SPR changes from pre-VPA to steady-state VPA therapy. Males experienced a significantly greater reduction in SPR compared with females. The mean decrease in SPR was -7.0 ± 2.6 in males only versus -3.9 ± 3.3 in females only (p = 0.0018). The next co-primary outcome, the percent of patients with complete PPR elimination, or a SPR value = 0 on second EEG, was observed in ten (47.6%) males compared with four (14.8%) females, a 3.2-fold difference (p = 0.0237). One secondary outcome, the percentage of males with a VPA clinically meaningful to optimal response was 1.93-fold greater than females, at 100:51.8%, respectively (p &lt; 0.0001). Between-sex VPA total daily milligram dose did not differ. Plasma [VPA] concentrations, although nearly twice as high in females, were not st","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Burden of Partial Response to Standard Doses of Proton Pump Inhibitors in Patients with Clinically Diagnosed Gastroesophageal Reflux Disease: A Real-World Evidence Study in India.","authors":"Yogesh Garje, Rajiv Saikia, Sunil Gupta, Soujanya Peri, Praveen Sharma, Shruti Dharmadhikari, Ashwini Satpathy, Chintan Khandhedia, Neeraj Markandeywar, Amey Mane, Suyog Mehta, Sadhna Joglekar","doi":"10.1007/s40801-025-00497-8","DOIUrl":"10.1007/s40801-025-00497-8","url":null,"abstract":"<p><strong>Background: </strong>Partial response to standard-dose proton pump inhibitors (PPIs) in gastroesophageal reflux disease (GERD) is common, yet real-world data on its burden and management in Indian settings remain limited.</p><p><strong>Objective: </strong>This study aimed to understand the burden, clinical profile, drug utilization patterns across specialties, the effectiveness of Pantoprazole 80 mg dual delayed-release (DDR) formulation, and management strategies used in the treatment of partial responders with clinically diagnosed GERD in Indian settings.</p><p><strong>Methods: </strong>This was a multicentric, retrospective observational study. Data on adult patients with GERD with a follow-up duration of at least 4 weeks from baseline were extracted from electronic medical records (EMR) of outpatient settings from five centers, which included drug utilization patterns, clinical and treatment profiles, and effectiveness of PPIs.</p><p><strong>Results: </strong>Among EMRs of 5205 patients with GERD, 38.0% were on rabeprazole and 36.6% on pantoprazole (mean age: 53.3 years; standard deviation: 14.3 years), and 55.0% were male. Heartburn was the primary complaint in 76.0% of cases. Cardiovascular co-morbidities with dyslipidemia were reported in 66.7% (1742/2610) patients. Pantoprazole and rabeprazole were preferred across specialties, where 31.1% (592/1906) and 17.7% (350/1979) adhered to treatment, respectively. Total burden of partial responders was 41.7%, including patients who switched PPIs, changed PPI dosage, or added other medications. Pantoprazole 40 mg twice daily (BD) showed 49.1% improvement in heartburn and 50.9% in abdominal pain. Pantoprazole 80 mg DDR once daily demonstrated significantly higher symptom relief, with a 60.2% reduction in heartburn (p < 0.001) and a 66.1% reduction in abdominal pain (p < 0.001). These findings suggest that higher-dose pantoprazole therapy may be a clinically effective strategy for managing partial responders to standard-dose PPIs.</p><p><strong>Conclusions: </strong>A significant proportion of patients with GERD were partial responders to PPIs. Pantoprazole and rabeprazole had high patient adherence across disciplines. Both pantoprazole DDR 80 mg once daily (OD) and 40 mg BD demonstrated significant symptom reduction in partial responders, supporting their use in optimizing GERD management in Indian clinical settings.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Risks of Central Nervous System Disturbance Associated with Medications for Herpes Zoster: Findings from a Regional Population-Based Cohort Study Using the Shizuoka Kokuho Database.","authors":"Ryoya Hagiwara, Eiji Nakatani, Hideaki Kaneda, Hiroshi Okada, Hideo Hashizume, Nagato Kuriyama, Akira Sugawara","doi":"10.1007/s40801-025-00500-2","DOIUrl":"https://doi.org/10.1007/s40801-025-00500-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Herpes zoster commonly occurs in older adults, whose renal function often declines, necessitating careful dosing of antivirals such as acyclovir, valacyclovir, and famciclovir. Insufficient dose adjustment can increase central nervous system (CNS) disturbance risk. Although previous reports show varying neurotoxic risk among these drugs, the safety profiles of these drugs remain underexplored. CNS disturbance significantly impacts quality of life, but it is rare and primarily documented through case reports, with little thorough investigation or comparison across drugs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the potential risks of CNS disturbance associated with acyclovir and valacyclovir compared with famciclovir in patients with herpes zoster, highlighting the potential influence of renal function and dose adjustments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a population-based cohort study using data from the National Health Insurance and the Late-Stage Medical Care System for the Elderly in Japan, including patients diagnosed with herpes zoster and newly prescribed oral or intravenous antiviral drugs between April 2012 and September 2021. The outcome was defined as the occurrence of CNS disturbance within 1 month from the index date. Patients with neurological, infectious or psychiatric disorders during the 1-year baseline period were excluded. The incidence of CNS disturbance with 95% confidence intervals (CIs) was compared between dialysis and nondialysis patients, owing to incomplete renal function data. In addition, we compared the incidence of CNS disturbance among groups using propensity score matching to adjust for confounders, with famciclovir users as the control group. Postmatching, risk differences with 95% CIs, and number needed to harm (NNH) were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final cohort consisted of 82,646 patients (8646 acyclovir, 46,643 valacyclovir, and 27,357 famciclovir users). Severe renal dysfunction was associated with CNS disturbance. The CNS disturbance incidence was 0.33% in nondialysis and 2.29% (risk difference 1.96%, 95% CI [0.39-3.53]) in dialysis patients using acyclovir/valacyclovir versus 0.18% and 0.60% (risk difference 0.42%, 95% CI [- 0.76 to 1.6]) for famciclovir, respectively. After propensity score matching, CNS disturbances were observed in 0.50% of patients in the acyclovir group versus 0.17% in the famciclovir group and in 0.29% of patients in the valacyclovir group versus 0.17% in the famciclovir group. The risk of CNS disturbance remained higher in both the acyclovir group (risk difference 0.33%, 95% CI [0.16-0.51], NNH 278) and the valacyclovir group (0.12%, [0.04-0.19], 833) compared with the famciclovir group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Acyclovir and valacyclovir, when compared with famciclovir, are associated with an increased risk of CNS disturbance in patients with herpes zoster, particularly among those with","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Vaccination for Human Papillomavirus (HPV) and Autonomic Dysfunction and Menstrual Irregularities: A Self-Controlled Case Series Analysis.","authors":"Linda Wastila, Yu-Hua Fu, Chih Chun Tung, Danya M Qato","doi":"10.1007/s40801-025-00504-y","DOIUrl":"https://doi.org/10.1007/s40801-025-00504-y","url":null,"abstract":"<p><strong>Background: </strong>Limited research has addressed safety concerns related to vaccination against the human papillomavirus (HPV).</p><p><strong>Objective: </strong>To investigate the association between receipt of HPV vaccination and autonomic dysfunction and menstrual irregularities in girls and young women.</p><p><strong>Methods: </strong>Using a 25% random sample of IQVIA PharMetrics^® Plus for Academics claims database from 2016 to 2020, we conducted a self-controlled case series study in commercially insured girls and young women receiving their first HPV vaccine dose (analyses conducted between March 2024 and April 2025). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated for two outcomes-autonomic dysfunction and menstrual irregularities. We conducted further analyses stratified by number of HPV vaccine doses received per beneficiary and by age (9-17 years vs. 18-26 years), as well as adjusted for age as a time-varying covariate. The IRRs were estimated over a maximum risk case post-vaccination period of 36 months compared to a 6-month within-person control pre-vaccination period.</p><p><strong>Results: </strong>There were 1654 individuals in the autonomic dysfunction cohort and 3140 individuals in the menstrual irregularities cohort. When adjusted for age, HPV vaccination was associated with elevated IRRs for autonomic dysfunction (IRR 1.23; 95% CI 1.08-1.41) and menstrual irregularities (IRR 1.30; 95% CI 1.18-1.43). IRRs for individual outcomes varied by age group, with the younger cohort showing a significantly higher age-adjusted IRR than the older cohort for menstrual irregularities (IRR 1.51; 95% CI 1.33-1.72 vs. IRR 1.15; 95% CI 0.99-1.33, respectively). Although the risk of experiencing autonomic dysfunction was not significant in the adjusted younger cohort, young women aged 18-26 years had a heightened age-adjusted risk (IRR 1.40; 95% CI 1.12-1.75). Findings from the dose-response analysis were inconclusive.</p><p><strong>Conclusions: </strong>HPV vaccination is associated with elevated risks of autonomic dysfunction and menstrual irregularities, which vary by age. Further research is needed to identify additional risk factors associated with HPV vaccination safety.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Patterns of Use of Natural Health Products and Medicines in New Zealand: A Pilot Study Using an Online Market Research Panel.","authors":"E Lyn Lee, Jeff Harrison, Joanne Barnes","doi":"10.1007/s40801-025-00482-1","DOIUrl":"10.1007/s40801-025-00482-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Traditional, complementary and alternative medicine (TCAM), including natural health products (NHPs), are used by many consumers to address their [perceived] health needs. While many developed countries have national data on NHPs use, limited information is available for New Zealand (NZ). Current, robust data on the prevalence and patterns of NHPs use in NZ are required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This project explored the feasibility of conducting a national study and collecting preliminary data on the prevalence and patterns of use of NHPs, including access to and expenditure on NHPs, and of the use of conventional medicines in NZ using a newly designed bespoke questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An online cross-sectional survey was administered to a sample of the adult population in NZ via an online market research panel in November 2021. Self-reported data on participants' use of NHPs (including photographs of products), consultations with TCAM practitioners and use of conventional medicines were collected. Data on the prevalence and patterns of use of NHPs were analysed and reported using descriptive statistics. Multivariable logistic regression was applied to assess the impact of sociodemographic variables on NHPs, TCAM practitioners and conventional medicines use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final sample comprised 992 participants. Sociodemographic data for these participants were comparable to those reported for the NZ Census 2018. The frequency of missing data was &lt; 10% for most of the questions; data quality for broad-level prevalence analysis was good, but was moderate to poor for analysis at the specific NHP or TCAM practitioner level. The specific product(s) and their respective ingredient list(s) could not be determined for most NHPs described as photographs were not uploaded, rendering product names unverifiable. Preliminary data indicate that 57.6% of participants have used NHPs and 22.9% consulted a TCAM practitioner in the last 12 months. Among current NHP users, 71.1% concurrently used one or more conventional medicines. Over half (53%) of the NHPs were self-selected (not recommended by a health practitioner). The median daily cost per NHP was NZD 0.28 (interquartile range NZD 0.14-0.50) and the median cost for visits to a TCAM practitioner over the last 12 months was NZD 120 (interquartile range NZD 40-270). Female participants, younger individuals and conventional medicine users were more likely to use NHPs/consult a TCAM practitioner/use any TCAM. Higher-income participants were more inclined to consult a TCAM practitioner. Individuals born overseas were more likely to use any type of TCAM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There was a high prevalence of use of NHPs and of consultations with TCAM practitioners, which may reflect the extent of use in the general NZ population. Recognising the potential impact on patients' health outcomes, there is a need for a larger","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"237-265"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Association Between Postpartum Hemorrhage and Antidepressant Use: A Mendelian Randomization Study.","authors":"Zhenzhen Chen, Qingqing Lv, Shiteng Lin, Wanlong Lin, Wei Zhuang","doi":"10.1007/s40801-025-00490-1","DOIUrl":"10.1007/s40801-025-00490-1","url":null,"abstract":"<p><strong>Background: </strong>The relationship between antidepressants, depression, and the incidence of postpartum hemorrhage (PPH) has been reported in observational studies, but the causal link between these factors remains unknown. Clarifying this relationship is important for treating depression during pregnancy and managing PPH.</p><p><strong>Objective: </strong>We aimed to assess the causal relationship between antidepressants, depression, and PPH using a two-sample Mendelian randomization method.</p><p><strong>Methods: </strong>Single nucleotide polymorphisms were identified from publicly available genetics summary databases (FinnGen database, access date: 28 December, 2023, version R9, phenocode: ANTIDEPRESSANTS, 195,321 participants; the genome-wide association studies [GWAS] catalog, access date: 3 April, 2024, GWAS ID: ebi-a-GCST90016607; Integrative Epidemiological Unit database, access date: 3 April, 2024, GWAS ID: ieu-a-1187) as alternative exposure factors for antidepressants and depression. Subsequently, inverse variance weighting, Mendelian randomization-Egger regression, weighted median, simple method, and weighted method were employed for Mendelian randomization analyses, and the results were validated for pleiotropy, heterogeneity, and sensitivity.</p><p><strong>Results: </strong>The analyses employed three sets of genetic tools, comprising two sets of 9 and 32 single nucleotide polymorphisms that are strongly associated with depression and another set of 26 single nucleotide polymorphisms that are associated with antidepressants. The inverse variance weighting indicated that antidepressants are associated with PPH (odds ratio = 1.36, 95% confidence interval 1.10-1.69, p = 0.005). Conversely, none of the five methods of Mendelian randomization analysis identified an effect of depression on PPH.</p><p><strong>Conclusions: </strong>This Mendelian randomization analysis indicated that antidepressant use is associated with PPH. However, the evidence does not support a causal relationship between depression and PPH.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"325-333"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza Vaccination Among Patients with Noncommunicable Diseases: A Survey About Awareness, Usage, and Unmet Needs in the Czech Republic.","authors":"Zdeněk Zadražil, Lenka Cesneková, Jan Kynčl, Zuzana Krištúfková, Laura Colombo, Sanjay Hadigal","doi":"10.1007/s40801-025-00483-0","DOIUrl":"10.1007/s40801-025-00483-0","url":null,"abstract":"<p><strong>Background: </strong>People with noncommunicable diseases (NCDs) are at a higher risk of contracting vaccine-preventable diseases, such as influenza, with a higher likelihood of severity and complications. However, the immunization rates for the influenza vaccine among this population in the Czech Republic are very low.</p><p><strong>Objective: </strong>This survey, among adults with NCDs in the Czech Republic, assessed the knowledge, attitudes, and gaps toward vaccination in general and influenza vaccination in particular.</p><p><strong>Methods: </strong>The survey was conducted between February 2023 and March 2023 among patients with NCDs in the Czech Republic. A structured web-based questionnaire with open-ended questions was administered. This study is a preplanned subgroup ancillary analysis of a previous multicentric study conducted on 1106 patients.</p><p><strong>Results: </strong>In all, 120 patients were enrolled, with 62% (74) aged between 41 and 60 years. Approximately 30% (36) had taken the influenza vaccine in the last 2 years and 70% (84) had not. Of the total sample, only 46% (55) had a positive opinion about influenza vaccines; this increased to 91% (33) among those vaccinated against the influenza virus. The main drivers of influenza vaccination were general physician (GP) recommendation [50% (18)] and patient initiative [47% (17)]. The main barriers to the influenza vaccine were lack of belief regarding its need [52% (44)], experience of mild severity of influenza [30% (25)], and lack of GP recommendation [25% (21)]. Physicians, dedicated websites, and family members are the most common sources of information regarding influenza. Even among those vaccinated for influenza, only 17% (6) had information about the risk of not taking the vaccine. A high level of dissatisfaction with the information was found among patients not vaccinated against influenza. People wanted more information on who should not receive the influenza vaccination. Unvaccinated patients sought information on side effects and efficacy. Only 40% (48) of the respondents said that they are likely/extremely likely to take an influenza vaccination in the future.</p><p><strong>Conclusions: </strong>Healthcare practitioners are the key influencers for people to get vaccinated. The dissemination of information about the importance of influenza vaccines for people with NCDs needs to be increased in the Czech Republic.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"311-324"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intravenous Iron Replacement Therapy on Healthcare Costs for Patients with Iron Deficiency Anemia in the USA: A Retrospective Analysis.","authors":"Nicole M Engel-Nitz, Winghan Jacqueline Kwong, Kevin Wang, Summer Tran, Amy Anderson","doi":"10.1007/s40801-025-00496-9","DOIUrl":"10.1007/s40801-025-00496-9","url":null,"abstract":"<p><strong>Background: </strong>Intravenous iron replacement therapy for the treatment of iron deficiency anemia is often required in patients with chronic diseases including cancer, heart failure, or chronic kidney disease.</p><p><strong>Objective: </strong>We aimed to compare healthcare resource utilization and costs for patients treated with intravenous ferric carboxymaltose (FCM) or low-dose iron for iron deficiency anemia.</p><p><strong>Methods: </strong>This analysis of Optum Research Database administrative claims data included patients with iron deficiency anemia who received intravenous iron from 2017 to 2019 and had diagnoses of cancer, heart failure, or chronic kidney disease. Patients were continuously enrolled for 6-month baseline and 12-month follow-up periods. Follow-up all-cause total costs for FCM and low-dose iron cohorts were compared using generalized linear models; inpatient costs were estimated with two-part models to account for patients without hospitalizations. Models were adjusted for age, sex, geographic region, insurance type, index year, baseline comorbidity scores, and healthcare costs. Sensitivity analyses compared FCM with an iron sucrose subgroup.</p><p><strong>Results: </strong>For patients with cancer (n = 10,763), mean adjusted all-cause total costs were numerically lower for FCM than low-dose iron by $2369 (cost ratio [CR] 0.97, P = 0.182) and significantly lower for FCM than iron sucrose by $6712 (CR 0.93, P < 0.001). For heart failure (n = 8337), the mean all-cause total cost was numerically lower for FCM than low-dose iron by $2022 (CR 0.97, P = 0.198) and significantly lower for FCM than iron sucrose by $3892 (CR 0.95, P = 0.024). For chronic kidney disease (n = 10,617), the mean all-cause total cost was statistically significantly lower for FCM than low-dose iron by $3623 (CR 0.94, P = 0.006) and iron sucrose by $4161 (CR 0.93, P = 0.004). For all groups, the FCM and low-dose iron cohorts differed in both the odds of having any inpatient costs and the level of inpatient cost (cancer: odds ratio 0.79, P < 0.001; CR 0.88, P < 0.001; heart failure: odds ratio 0.76, P < 0.001; CR 0.89, P < 0.001; chronic kidney disease: odds ratio 0.75, P < 0.001; CR 0.84, P < 0.001). Inpatient cost results were consistent for iron sucrose.</p><p><strong>Conclusions: </strong>Despite the typically higher drug acquisition cost of FCM versus low-dose intravenous iron, the price differential was offset by the lower inpatient cost incurred in the FCM cohort in each patient population. These findings suggest the potential economic benefit of FCM to reduce inpatient utilization and associated costs to patients and health plans compared with low-dose intravenous iron.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"213-226"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Modern Systemic Therapies on Survival in Patients with Anaplastic Thyroid Cancer: A Single-Center Retrospective Cohort Review.","authors":"Austin Luong, Darin Poei, Lydia Chow, Ming Li, Qi Nie, Trevor Angell, Liyang Tang, Robert Hsu, Jacob Thomas","doi":"10.1007/s40801-025-00493-y","DOIUrl":"10.1007/s40801-025-00493-y","url":null,"abstract":"<p><strong>Background: </strong>Anaplastic thyroid carcinoma (ATC) is a highly aggressive cancer historically associated with a median survival of about 5 months. Recent advances in tumor genomic testing have identified targetable BRAF mutations in about 35-40% of ATC cases and have shown high levels of programmed death ligand-1 (PD-L1) expression in ATC. These observations have led to clinical trials showing favorable outcomes with targeted therapy and immunotherapy for ATC.</p><p><strong>Objective: </strong>We aimed to evaluate treatments and outcomes of patients diagnosed with anaplastic thyroid cancer treated at our institution in order to determine the impact of targeted therapy and immunotherapy.</p><p><strong>Methods: </strong>A retrospective review of ATC patients at a single institution was performed. Data were collected from institutional electronic medical records, including demographic information, treatments administered, and outcomes including survival.</p><p><strong>Results: </strong>A total of 28 patients were identified within the period under study. Systemic therapy was initiated in 61% of patients. The median overall survival for all patients was 7.3 months. There was a statistically significant improvement in overall survival for patients who received targeted therapy or immunotherapy compared to those who did not.</p><p><strong>Conclusions: </strong>In this single-institution cohort of 28 patients with ATC, patients who received either targeted therapies or immunotherapy demonstrated markedly improved outcomes. Further clinical trials are required to determine the optimal systemic therapy for this patient population.</p>","PeriodicalId":11282,"journal":{"name":"Drugs - Real World Outcomes","volume":" ","pages":"295-300"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}