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Efficacy of Ixekizumab in Chinese Patients with Moderate-to-Severe Psoriasis and Special Body Area Involvement: Sub-analysis of a Randomized, Double-Blind, Multicenter Phase 3 Study. 伊昔单抗对中重度银屑病和特殊体质患者的疗效:一项随机、双盲、多中心 3 期研究的子分析。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-30 DOI: 10.1007/s12325-024-02976-w
Xia Li, Yangfeng Ding, Chunlei Zhang, Yan Lu, Fuqiu Li, Weili Pan, Shuping Guo, Jinnan Li, Bilian Zhao, Jie Zheng
{"title":"Efficacy of Ixekizumab in Chinese Patients with Moderate-to-Severe Psoriasis and Special Body Area Involvement: Sub-analysis of a Randomized, Double-Blind, Multicenter Phase 3 Study.","authors":"Xia Li, Yangfeng Ding, Chunlei Zhang, Yan Lu, Fuqiu Li, Weili Pan, Shuping Guo, Jinnan Li, Bilian Zhao, Jie Zheng","doi":"10.1007/s12325-024-02976-w","DOIUrl":"10.1007/s12325-024-02976-w","url":null,"abstract":"<p><strong>Introduction: </strong>Special body area involvement is common in psoriasis and can be challenging to treat. We investigated the efficacy of ixekizumab (IXE) in Chinese patients with moderate-to-severe psoriasis and fingernail, scalp, or palmoplantar involvement.</p><p><strong>Methods: </strong>A post-hoc sub-analysis of a phase 3 trial, in which patients were randomized to receive placebo, IXE 80 mg every 2 (IXE Q2W) or 4 (IXE Q4W) weeks. At Week 12, patients classified as IXE responders [static Physician's Global Assessment (sPGA) score of 0 or 1 [0,1)] were re-randomized (2:1) to IXE Q4W or placebo until Week 60. Efficacy was assessed by body-region specific parameters including Nail Psoriasis Severity Index (NAPSI), Psoriasis Scalp Severity Index (PSSI), and Palmoplantar Psoriasis Area Severity Index (PPASI).</p><p><strong>Results: </strong>Of 438 patients, 99.1% (434) had ≥ 1 special area involvement [fingernail (76.5%, 335), scalp (97.3%, 426), palmoplantar (27.9%, 122)]. Significantly greater improvements from baseline in NAPSI score were observed with IXE Q4W and Q2W at Week 12 versus placebo (p < 0.001 for both). These improvements were further increased and sustained over 60 weeks in IXE Q4W and Q2W responders who were re-randomized to IXE Q4W, who achieved a 77.9% and 89.7% improvement from baseline, respectively, at Week 60. Significantly higher proportions of patients receiving IXE Q4W and Q2W achieved NAPSI 50 at Week 12 versus placebo (44.4%, 36.6% vs. 14.1%; p < 0.001 and < 0.01, respectively). Similarly, significantly higher proportions of patients receiving IXE Q4W and Q2W achieved PSSI 100 and PPASI 100 at Week 12 versus placebo (60.6% and 65.1% vs. 1.2%, and 67.4%, 84.3% vs. 21.4%, respectively; p < 0.001 for all comparisons). Improvements across all outcomes were sustained in patients re-randomized to IXE Q4W until Week 60.</p><p><strong>Conclusion: </strong>IXE led to a rapid onset of action and sustained efficacy over 60 weeks in Chinese patients with moderate-to-severe psoriasis and special body area involvement.</p><p><strong>Clinicaltrials: </strong>gov identifier, NCT03364309.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosis, Treatment Patterns, and Outcomes in Real-World Patients with RET Fusion-Positive Non-small Cell Lung Cancer in China 中国RET融合阳性非小细胞肺癌患者的诊断、治疗模式和疗效。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02983-x
Shun Lu, Lan Shen, Qiming Wang, Haiyang Chen, Yi Zhao, Ying Li, Grace Segall, Manoj Khanal, Xue Zhang, Ding Ding, Jingxin Shao, Long Pang
{"title":"Diagnosis, Treatment Patterns, and Outcomes in Real-World Patients with RET Fusion-Positive Non-small Cell Lung Cancer in China","authors":"Shun Lu,&nbsp;Lan Shen,&nbsp;Qiming Wang,&nbsp;Haiyang Chen,&nbsp;Yi Zhao,&nbsp;Ying Li,&nbsp;Grace Segall,&nbsp;Manoj Khanal,&nbsp;Xue Zhang,&nbsp;Ding Ding,&nbsp;Jingxin Shao,&nbsp;Long Pang","doi":"10.1007/s12325-024-02983-x","DOIUrl":"10.1007/s12325-024-02983-x","url":null,"abstract":"<div><h3>Introduction</h3><p>Epidemiological studies on non-small cell lung cancer (NSCLC) have noted <i>RET</i> fusions as an oncogenic driver. However, real-world data on <i>RET</i> biomarker testing and treatment patterns in China remain limited. This study aimed to examine demographics, clinical and molecular features, and <i>RET</i> testing and treatment patterns and outcomes in patients with <i>RET</i> fusion-positive NSCLC.</p><h3>Methods</h3><p>Utilizing real-world data from the Chinese Multi-center Lung Cancer Precision Medicine Registry, this retrospective cohort study focused on Chinese patients diagnosed with <i>RET</i> fusion-positive NSCLC between January 1, 2016, and November 30, 2021. The cohort was divided into early-stage and advanced-stage subgroups. Demographics, clinical and molecular profiles, treatment received, and outcomes including real-world event free survival (rwEFS), real-world progression free survival (rwPFS), and overall survival (OS) were assessed.</p><h3>Results</h3><p>The study included 121 patients with <i>RET</i> fusion-positive NSCLC, comprising 80 early-stage and 58 advanced-stage patients. High biomarker testing rates were observed at diagnosis (75% for early-stage, 78% for advanced-stage). <i>RET</i> testing was often conducted via tissue samples (95.9%) and next-generation sequencing (89.3%). <i>KIF5B</i> (57.0%) and <i>CCDC6</i> (20.7%) were the most common gene fusion partners. The most frequent oncogenic mutations were <i>TP53</i> (15.7%) and <i>EGFR</i> (6.6%). Platinum-based chemotherapy was the most common first-line treatment among advanced-stage patients. Median rwPFS was 9.22 months for advanced-stage patients on first-line chemotherapy, and median OS was 30.7 months for all advanced-stage patients. The 2-year rwEFS rate for early-stage patients was 86.0%, with a median OS of 91.9 months.</p><h3>Conclusions</h3><p>The study observed high biomarker testing rates at initial diagnosis for early- and advanced-stage <i>RET</i> fusion-positive NSCLC patients in China. The heterogeneous treatment pattern of advanced patients suggests the need for more precise, evidence-based treatment to guide clinical decisions. Given the existing therapeutic regimens fall short of adequately addressing treatment needs, targeted therapies are essential to improve outcomes.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4248 - 4265"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Correlation Between Body Mass Index and Health-Related Quality of Life: Data from Two Weight Loss Intervention Studies 身体质量指数与健康相关生活质量之间的相关性:两项减肥干预研究的数据。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02932-8
Pavol Kral, Thomas Holst-Hansen, Anamaria V. Olivieri, Cristina Ivanescu, Mark Lamotte, Sara Larsen
{"title":"The Correlation Between Body Mass Index and Health-Related Quality of Life: Data from Two Weight Loss Intervention Studies","authors":"Pavol Kral,&nbsp;Thomas Holst-Hansen,&nbsp;Anamaria V. Olivieri,&nbsp;Cristina Ivanescu,&nbsp;Mark Lamotte,&nbsp;Sara Larsen","doi":"10.1007/s12325-024-02932-8","DOIUrl":"10.1007/s12325-024-02932-8","url":null,"abstract":"<div><h3>Introduction</h3><p>The correlation between body mass index (BMI) and utility in participants with obesity was assessed using health-related quality-of-life data collected in two weight loss intervention studies, SCALE and STEP 1.</p><h3>Methods</h3><p>Short Form Health Survey 36-Item (SF-36) scores from SCALE and STEP 1 were mapped to EuroQoL-5 dimensions-3 levels (EQ-5D-3L) using an established algorithm to derive utilities for the UK. SF-36 scores from STEP 1 were converted into Short Form 6 dimension (SF-6D) utilities for Portugal using the tool developed by the University of Sheffield. The correlation between baseline BMI and utility was assessed by multiple linear regression analyses, controlling for demographic and clinical parameters.</p><h3>Results</h3><p>A higher baseline BMI correlated with lower EQ-5D-3L and SF-6D utilities, although the trend was non-significant. Assuming linearity between BMI ranges 30–40 kg/m<sup>2</sup>, an additional unit of BMI correlated with 0.0041 and 0.0031 lower EQ-5D-3L scores in SCALE and 0.0039 and 0.0047 lower EQ-5D-3L and 0.0027 and 0.0020 lower SF-6D scores in STEP 1 for men and women, respectively.</p><h3>Conclusion</h3><p>In individuals with comparable demographic characteristics and weight-related comorbidities, a 1 unit change in BMI leads to a difference of up to 0.005 in utility indices.</p><h3>Trial Registration</h3><p>ClinicalTrials.gov identifiers: SCALE (NCT01272219) and STEP 1 (NCT03548935).</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4228 - 4247"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02932-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Cost-Effectiveness Analysis of Axicabtagene Ciloleucel versus Tisagenlecleucel in the Treatment of Diffuse Large B-cell Lymphoma Based on a Real-World French Registry 基于法国真实世界登记的Axicabtagene Ciloleucel与Tisagenlecleucel治疗弥漫大B细胞淋巴瘤的成本效益分析》(Axicabtagene Ciloleucel versus Tisagenlecleucel in the Treatment of Diffuse Large B-cell Lymphoma based on a Real-World French Registry)。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02971-1
Markqayne Ray, Jean-Gabriel Castaigne, Alexandra Zang, Anik Patel, Elizabeth Hancock, Nicholas Brighton, Emmanuel Bachy
{"title":"A Cost-Effectiveness Analysis of Axicabtagene Ciloleucel versus Tisagenlecleucel in the Treatment of Diffuse Large B-cell Lymphoma Based on a Real-World French Registry","authors":"Markqayne Ray,&nbsp;Jean-Gabriel Castaigne,&nbsp;Alexandra Zang,&nbsp;Anik Patel,&nbsp;Elizabeth Hancock,&nbsp;Nicholas Brighton,&nbsp;Emmanuel Bachy","doi":"10.1007/s12325-024-02971-1","DOIUrl":"10.1007/s12325-024-02971-1","url":null,"abstract":"<div><h3>Introduction</h3><p>Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are chimeric antigen receptor T-cell therapies that were evaluated in third and later line (3L+) relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) in the ZUMA-1 and JULIET trials, respectively. As of October 2021, the DESCAR-T registry included 729 French patients with 3L+ r/r DLBCL who received axi-cel or tisa-cel. Using these data, propensity score matching was used to conduct an adjusted comparison between axi-cel and tisa-cel. Axi-cel was associated with statistically significant improvements in overall survival (OS) and progression-free survival (PFS), and significantly more frequent Grade ≥ 3 immune effector cell-associated neurotoxicity syndrome (ICANS), compared with tisa-cel. There was no significant difference in Grade ≥ 3 cytokine release syndrome (CRS). The current analysis assessed the cost-effectiveness of axi-cel versus tisa-cel in the treatment of 3L+ r/r DLBCL using propensity score-matched data from the DESCAR-T registry.</p><h3>Methods</h3><p>A partitioned survival model was used to extrapolate costs and quality-adjusted life years (QALYs) over a lifetime. Survival curves for PFS and OS were based on independent mixture cure models fitted to digitized Kaplan–Meier data for the propensity score-matched DESCAR-T populations. Average duration of intensive care unit stays for each of axi-cel and tisa-cel in DESCAR-T were used to inform adverse event costs. Selected parametric survival distributions were based on clinical expert validation. Utility values were derived from ZUMA-1, and costs were obtained from French registries and published sources. List prices were used for both axi-cel and tisa-cel. Costs and outcomes were discounted at an annual rate of 2.5%.</p><h3>Results</h3><p>Axi-cel is associated with an incremental cost-effectiveness ratio of €15,520 per QALY compared with tisa-cel.</p><h3>Conclusion</h3><p>Based on explicit willingness-to-pay thresholds applied in Europe, axi-cel is expected to be a cost-effective use of healthcare resources in real-world clinical settings compared with tisa-cel in 3L+ r/r DLBCL.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4282 - 4298"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progression from Non-alcoholic Steatohepatitis to Advanced Liver Diseases and Mortality Among Medicare Patients 医疗保险患者从非酒精性脂肪性肝炎发展为晚期肝病的情况及死亡率。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02979-7
Yestle Kim, Joe Medicis, Matthew Davis, Dominic Nunag, Robert Gish
{"title":"Progression from Non-alcoholic Steatohepatitis to Advanced Liver Diseases and Mortality Among Medicare Patients","authors":"Yestle Kim,&nbsp;Joe Medicis,&nbsp;Matthew Davis,&nbsp;Dominic Nunag,&nbsp;Robert Gish","doi":"10.1007/s12325-024-02979-7","DOIUrl":"10.1007/s12325-024-02979-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Non-alcoholic steatohepatitis (NASH) may progress to more advanced liver disease. This study aimed to characterize NASH progression and mortality in the Medicare population.</p><h3>Methods</h3><p>Patients with NASH in 100% Medicare fee-for-service claims accrued from 2015–2021 who were ≥ 66 years old at index diagnosis, continuously enrolled for ≥ 12 months prior to and ≥ 6 months following index (unless death), and had no evidence of other causes of liver disease were included. Diagnosis codes defined severity states: non-cirrhotic NASH, compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), and liver transplant (LT). Survival analyses of disease progression and mortality were conducted for each state and by year of progression (Y1–5). Cox proportional hazards models assessed risk factors of worsening disease.</p><h3>Results</h3><p>Mean age and follow-up were 72.2 and 2.8 years in 14,806 unique patients (<i>n</i> = 12,990 NASH; 1899 CC; 997 DCC; 209 HCC; 140 LT). Progression rates were highest for patients with CC (11–37% for Y1–5), followed by DCC (3–18%), NASH (3–12%), and HCC (2–4%). Mortality rates were highest for patients with HCC (41–85% for Y1–5), followed by DCC (41–76%), LT (7–33%), CC (6–26%), and NASH (2–12%). Patients with any disease progression had a 5-year mortality rate more than double that of patients without progression (41% vs. 16%).</p><p>Delayed progression from NASH was associated with lower mortality risk; the 5-year mortality rate was 26% lower for patients with progression in Y2 vs. Y1 (32% vs. 43%) and further decreased for progression in Y3-Y5. Risk factors included age, nursing home use, congestive heart failure, coagulopathy, fluid/electrolyte disorders, and unexplained weight loss.</p><h3>Conclusion</h3><p>Medicare patients ≥ 66 years with NASH experience high risk of disease progression associated with increased mortality rates. Slower disease progression is associated with lower mortality rates, suggesting that therapies that can delay or prevent NASH progression may reduce morbidity and mortality.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4335 - 4355"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02979-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PIONEER REAL UK: A Multi-Centre, Prospective, Real-World Study of Once-Daily Oral Semaglutide Use in Adults with Type 2 Diabetes 先锋英国:一项关于 2 型糖尿病成人每日口服一次塞马鲁肽的多中心、前瞻性、真实世界研究。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02973-z
Ponnusamy Saravanan, Heather Bell, Uffe Christian Braae, Edward Collins, Alisa Deinega, Ketan Dhatariya, Alena Machell, Antonia Trent, Anna Strzelecka
{"title":"PIONEER REAL UK: A Multi-Centre, Prospective, Real-World Study of Once-Daily Oral Semaglutide Use in Adults with Type 2 Diabetes","authors":"Ponnusamy Saravanan,&nbsp;Heather Bell,&nbsp;Uffe Christian Braae,&nbsp;Edward Collins,&nbsp;Alisa Deinega,&nbsp;Ketan Dhatariya,&nbsp;Alena Machell,&nbsp;Antonia Trent,&nbsp;Anna Strzelecka","doi":"10.1007/s12325-024-02973-z","DOIUrl":"10.1007/s12325-024-02973-z","url":null,"abstract":"<div><h3>Introduction</h3><p>Oral semaglutide provides an alternative to injectable glucagon-like peptide-1 receptor agonists (GLP-1RAs) for treatment of type 2 diabetes (T2D). The PIONEER REAL studies evaluate clinical outcomes of oral semaglutide treatment of T2D in a real-world setting. PIONEER REAL UK focused on adults living with T2D in the UK.</p><h3>Methods</h3><p>The multi-centre, prospective and non-interventional single-arm study enrolled 333 participants and followed them for 34–44 weeks. Participants were treated as part of routine clinical practice and had not been previously treated with injectable glucose-lowering medication. The primary endpoint was change in glycated haemoglobin (HbA<sub>1C</sub>) from baseline to end of study (EOS). Secondary endpoints included change in body weight, proportion of participants with HbA<sub>1C</sub> &lt; 7% (53 mmol/mol) at EOS and proportion of participants with ≥ 1%-point HbA<sub>1C</sub> reduction and body weight reduction of ≥ 3% or ≥ 5% at EOS. Treatment satisfaction was assessed by Diabetes Treatment Satisfaction Questionnaire (DTSQ) status and change.</p><h3>Results</h3><p>Of 333 participants, 299 completed the study and 227 were on treatment at EOS. People treated with oral semaglutide experienced significantly reduced HbA<sub>1C</sub> by an estimated change of – 1.1%-points (95% CI – 1.27 to – 0.96; <i>P</i> &lt; 0.0001) or – 12.2 mmol/mol (CI – 13.87 to – 10.47; <i>P</i> &lt; 0.0001). Estimated change in body weight was – 4.8 kg (CI – 5.47 to – 4.12; <i>P</i> &lt; 0.0001). At EOS, an HbA<sub>1C</sub> level &lt; 7% (53 mmol/mol) was recorded in 46.3% of participants. A ≥ 1%-point reduction in HbA<sub>1C</sub> combined with a ≥ 3% reduction in body weight was observed in 36.4% of participants, and 27.1% had a ≥ 1%-point reduction in HbA<sub>1C</sub> and a ≥ 5% body weight reduction. Treatment satisfaction improved significantly during the study. No new safety concerns or cases of severe hypoglycaemia were reported.</p><h3>Conclusion</h3><p>People living with T2D in the UK experienced a meaningful decrease in HbA<sub>1C</sub> and body weight after initiation of oral semaglutide treatment. No new safety issues were observed.</p><h3>Trial Registration</h3><p>ClinicalTrials.gov: NCT04862923.</p><p>Graphical plain language summary available for this article.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4266 - 4281"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02973-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Macitentan and Tadalafil Combination Therapy in Incident and Prevalent Pulmonary Arterial Hypertension: Real-World Evidence from the OPUS/OrPHeUS Studies 马西替坦和他达拉非联合疗法在肺动脉高压发病率和流行率中的应用:来自 OPUS/OrPHeUS 研究的真实世界证据。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-24 DOI: 10.1007/s12325-024-02964-0
Kelly M. Chin, Richard Channick, Nick H. Kim, Gwen MacDonald, Rose Ong, Nicolas Martin, Assunta Senatore, Vallerie V. McLaughlin
{"title":"Macitentan and Tadalafil Combination Therapy in Incident and Prevalent Pulmonary Arterial Hypertension: Real-World Evidence from the OPUS/OrPHeUS Studies","authors":"Kelly M. Chin,&nbsp;Richard Channick,&nbsp;Nick H. Kim,&nbsp;Gwen MacDonald,&nbsp;Rose Ong,&nbsp;Nicolas Martin,&nbsp;Assunta Senatore,&nbsp;Vallerie V. McLaughlin","doi":"10.1007/s12325-024-02964-0","DOIUrl":"10.1007/s12325-024-02964-0","url":null,"abstract":"<div><h3>Introduction</h3><p>Historically, patients recently (≤ 6 months) diagnosed with pulmonary arterial hypertension (PAH; incident) have had poorer survival than those with a longer (&gt; 6 months) time from PAH diagnosis (prevalent). Despite guideline recommendations for initial combination therapy for most patients with PAH, many are initiated and maintained on monotherapy. Real-world evidence to evaluate the benefit of early combination treatment in newly-diagnosed patients is lacking.</p><h3>Methods</h3><p>Patients with PAH initiating combination therapy with the endothelin receptor antagonist macitentan and the phosphodiesterase-5 inhibitor tadalafil (M+T) were identified from the combined dataset of the US, multicenter OPUS (prospective, observational drug registry; NCT02126943) and OrPHeUS (retrospective, medical chart review; NCT03197688) studies (2013–2020). Descriptive analyses were performed for the incident and prevalent cohorts, as well as the subcohort of incident patients who received M+T as first-line combination therapy (incident initial combination).</p><h3>Results</h3><p>In OPUS/OrPHeUS, 1336 patients with PAH received M+T during the observation period. For the incident [<i>n</i> = 453 (33.9%)], incident initial combination [<i>n</i> = 272 (20.4%)], and prevalent [<i>n</i> = 837 (62.6%)] cohorts: median (Q1, Q3) M+T exposure was 14.2 (4.2, 27.5), 12.2 (3.2, 25.5), and 14.7 (4.5, 28.0) months. 12-month Kaplan–Meier estimates (95% confidence limits) for survival were 91.2% (87.7, 93.7), 88.5% (83.2, 92.2), and 92.9% (90.6, 94.6), for patients free from hospitalization were 59.4% (54.1, 64.4), 56.3% (49.1, 62.9), and 62.3% (58.5, 65.9), and for patients persisting on combination therapy were 68.6% (63.9, 72.8), 65.0% (58.8, 70.6) and 66.9% (63.5, 70.0). Adverse events (OPUS only) were reported in 77.8%, 80.2%, and 80.3% of patients, respectively, with no unexpected adverse events observed.</p><h3>Conclusions</h3><p>Despite a historically worse prognosis, incident patients receiving M+T, including as initial combination therapy, had similar survival and hospitalization as prevalent patients. Safety profiles were similar across cohorts. Together, these data support the use of early combination therapy with macitentan and tadalafil.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4205 - 4227"},"PeriodicalIF":3.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02964-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Key Challenges to Understanding the Burden of Respiratory Syncytial Virus in Older Adults in Southeast Asia, the Middle East, and North Africa: An Expert Perspective 了解东南亚、中东和北非老年人呼吸道合胞病毒负担的主要挑战:专家视角》。
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-23 DOI: 10.1007/s12325-024-02954-2
Hakan Günen, Ashraf Alzaabi, Abdelaziz Bakhatar, Sana Al Mutairi, Kittipong Maneechotesuwan, Daniel Tan, Mohammed Zeitouni, Bhumika Aggarwal, Arnas Berzanskis, Otávio Cintra
{"title":"Key Challenges to Understanding the Burden of Respiratory Syncytial Virus in Older Adults in Southeast Asia, the Middle East, and North Africa: An Expert Perspective","authors":"Hakan Günen,&nbsp;Ashraf Alzaabi,&nbsp;Abdelaziz Bakhatar,&nbsp;Sana Al Mutairi,&nbsp;Kittipong Maneechotesuwan,&nbsp;Daniel Tan,&nbsp;Mohammed Zeitouni,&nbsp;Bhumika Aggarwal,&nbsp;Arnas Berzanskis,&nbsp;Otávio Cintra","doi":"10.1007/s12325-024-02954-2","DOIUrl":"10.1007/s12325-024-02954-2","url":null,"abstract":"<div><h3>Introduction</h3><p>Respiratory syncytial virus (RSV) is a common, highly contagious pathogen and a leading cause of serious illness among infants and older adults. While existing scientific evidence has predominantly focused on the epidemiology and disease burden of RSV in infants, data in older adults remain limited in some countries, including those in Southeast Asia (SEA) and the Middle East and North Africa (MENA) region. Here, we outline the key challenges for understanding the burden of RSV in older adults in SEA and the MENA region and we propose opportunities for improving understanding and eventually reducing the impact of RSV.</p><h3>Main Findings and Conclusions</h3><p>A key challenge identified by the expert group, particularly in older adults, is a lack of awareness (among healthcare professionals, policy makers, and the public) of RSV burden and the associated risks for severe outcomes. This is often confounded by the complexities of underdiagnosis, surveillance limitations, and comorbidities. To address these issues, we suggest medical education initiatives for physicians in SEA and the MENA region to better understand the need to protect older adults from RSV, and encourage more widespread routine testing to better understand the burden of RSV. We also recommend surveillance studies in these regions to provide comprehensive and accurate epidemiological data on RSV in older adults. Finally, in the absence of current surveillance data in these regions, we propose extrapolating existing global data and local pediatric data to inform the likely burden of RSV in older adults.</p><p>A graphical abstract is available with this article.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4312 - 4334"},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02954-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Summary of Research: Dapagliflozin Utilization in Chronic Kidney Disease and Its Real-World Effectiveness Among Patients with Lower Levels of Albuminuria in the USA and Japan 研究摘要:美国和日本白蛋白尿水平较低的慢性肾病患者使用达帕格列净的情况及其实际疗效
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-19 DOI: 10.1007/s12325-024-02961-3
Navdeep Tangri, Anjay Rastogi, Tadashi Sofue
{"title":"Summary of Research: Dapagliflozin Utilization in Chronic Kidney Disease and Its Real-World Effectiveness Among Patients with Lower Levels of Albuminuria in the USA and Japan","authors":"Navdeep Tangri,&nbsp;Anjay Rastogi,&nbsp;Tadashi Sofue","doi":"10.1007/s12325-024-02961-3","DOIUrl":"10.1007/s12325-024-02961-3","url":null,"abstract":"<div><p>This is a summary of the original article ‘Dapagliflozin Utilization in Chronic Kidney Disease and Its Real-World Effectiveness Among Patients with Lower Levels of Albuminuria in the USA and Japan’. The slowing down of kidney function decline is important for managing chronic kidney disease (CKD) and preventing its complications. Clinical trials of dapagliflozin, a sodium–glucose cotransporter-2 inhibitor (SGLT-2i), have shown reductions in disease progression and death in patients with CKD and elevated levels of albuminuria. This summary of research provides an overview of a previously published article that aimed to find out whether dapagliflozin is also effective in patients with lower levels of albuminuria [urinary albumin-to-creatinine ratio (UACR) below 200 mg/g]. Starting dapagliflozin was associated with slower kidney function decline in patients with CKD and UACR below 200 mg/g compared with not starting. This effect was also observed in a subgroup analysis of patients without type 2 diabetes. These results suggest that the established benefits of SGLT-2is may extend to patients with lower levels of albuminuria.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"3973 - 3976"},"PeriodicalIF":3.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02961-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Cost-Utility Analysis of Ferric Derisomaltose Versus Ferric Carboxymaltose in Patients with Iron Deficiency Anemia in China 中国缺铁性贫血患者服用地异麦芽糖铁与羧甲基麦芽糖铁的成本效用分析
IF 3.4 3区 医学
Advances in Therapy Pub Date : 2024-09-18 DOI: 10.1007/s12325-024-02987-7
Fengkui Zhang, Aizong Shen, Waqas Ahmed, Richard F. Pollock
{"title":"A Cost-Utility Analysis of Ferric Derisomaltose Versus Ferric Carboxymaltose in Patients with Iron Deficiency Anemia in China","authors":"Fengkui Zhang,&nbsp;Aizong Shen,&nbsp;Waqas Ahmed,&nbsp;Richard F. Pollock","doi":"10.1007/s12325-024-02987-7","DOIUrl":"10.1007/s12325-024-02987-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Intravenous (IV) iron is the recommended treatment for patients with iron deficiency anemia (IDA) unresponsive to oral iron treatment, in whom oral iron is contraindicated, or where rapid iron replenishment is required. Ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) are high-dose, rapid-infusion, IV iron formulations that have recently been compared in three head-to-head randomized controlled trials (RCTs), which showed significantly higher incidence of hypophosphatemia after administration of FCM than FDI. The present study objective was to evaluate the cost–utility of FDI versus FCM in a population of patients with IDA in China.</p><h3>Methods</h3><p>A previously-published patient-level simulation model was used to model the cost–utility of FDI versus FCM in China. The number of infusions of FDI and FCM was modeled based on the approved posology of the respective formulations using simplified tables of iron need in a population of patients with body weight and hemoglobin levels informed by a Chinese RCT of FCM. Data on the incidence of hypophosphatemia was obtained from the PHOSPHARE-IDA RCT, while data on disease-related quality of life were obtained from SF-36v2 data from the PHOSPHARE-IBD RCT.</p><h3>Results</h3><p>Over the 5-year time horizon, patients received 3.98 courses of iron treatment on average, requiring 0.90 fewer infusions of FDI than FCM (7.69 vs. 6.79). This resulted in iron procurement and administration cost savings of renminbi (RMB) 206 with FDI (RMB 3,519 vs. RMB 3,312). Reduced incidence of hypophosphatemia-related fatigue resulted in an increase of 0.07 quality-adjusted life years and further cost savings of RMB 782 over 5 years, driven by reduced need for phosphate testing and replenishment. FDI was therefore the dominant intervention.</p><h3>Conclusions</h3><p>The results showed that FDI would improve patient quality of life and reduce direct healthcare expenditure versus FCM in patients with IDA in China.</p></div>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":"41 11","pages":"4191 - 4204"},"PeriodicalIF":3.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12325-024-02987-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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