Advances in Therapy最新文献

{"title":"Treatment Patterns and Perceptions of Treatment Options in Japanese Pediatric and Adolescent Patients with Atopic Dermatitis.","authors":"Akio Tanaka, Yumi Kang, Junichi Danjo, Takashi Matsuo, Hitoe Torisu-Itakura, Simran Marwaha, Peter Anderson, James Piercy, Atushi Otsuka","doi":"10.1007/s12325-026-03536-0","DOIUrl":"https://doi.org/10.1007/s12325-026-03536-0","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a relapsing, chronic inflammatory skin condition characterized by intense itching and eczematous lesions. AD is common in pediatric patients, but treatment options are limited for these patients and data on treatment patterns are scarce. This study aimed to descriptively evaluate treatments used in pediatric AD and physician- and patient-reported perspectives of available options in real-world practice in Japan.</p><p><strong>Methods: </strong>Data were drawn from the Adelphi Real World Pediatric and Adolescent AD Disease Specific Programme™, a cross-sectional survey, with retrospective data collection, of physicians and patients in Japan from July to December 2022. Physicians completed patient record forms for their next 3-10 consecutively consulting patients, collecting data on demographics and clinical characteristics, treatment regimens, and perceptions around treatment choice and satisfaction. Patients/caregivers also provided their perceptions on treatment choice and satisfaction. Analyses were descriptive.</p><p><strong>Results: </strong>Overall, 55 physicians provided data for 537 pediatric patients, with 111 patients/caregivers also reporting data. The patient population was 63.3% (n = 340) male, and mean ± standard deviation age was 12.6 ± 4.2 years, with 54.0% (n = 290) of patients classified as pediatric (aged ≤ 14 years) and 46.0% (n = 247) adolescent (aged 15-17 years). Patient treatments included topical corticosteroids (TCS; 89.1%, n = 457/513), biologics (12.3%, n = 63/513), oral JAK-is (7.6%, n = 39/513), and immunosuppressants (1.8%, n = 9/513). Physicians reported that they believe better control could be achieved in 64.8% (n = 332) of patients compared with 93.1% (n = 81) of patients self-reporting this.</p><p><strong>Conclusions: </strong>TCS was the most common treatment in pediatric AD management, in agreement with the current guideline recommendation. Overall, most physicians and patients believed that better control could be achieved. However, in mild patients, most patients believed better control could be achieved, while physicians did not. This suggests that views of disease control, and desire for improved disease control, may differ between physicians and patients.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728028","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}

{"title":"Reconsidering Obesity in India Through a Gut-Metabolic Lens: Mechanistic Insights and the Emerging Role of Synbiotics in Individuals with the Thin-Fat Phenotype.","authors":"Nirmal Kumar Ganguly, Sanjay Kalra, Nitin Kapoor, Pariksha Rao, Manorama Bakshi","doi":"10.1007/s12325-026-03577-5","DOIUrl":"https://doi.org/10.1007/s12325-026-03577-5","url":null,"abstract":"<p><p>India's escalating burden of obesity and metabolic disease is characterized by a distinctive \"thin-fat\" phenotype, in which individuals with normal or near-normal body mass index exhibit disproportionate visceral adiposity, reduced skeletal muscle mass, and heightened susceptibility to insulin resistance. Conventional obesity models centered primarily on caloric imbalance fail to adequately explain this pattern, underscoring the need for a more integrative pathophysiological framework. Emerging evidence implicates gut microbiome dysbiosis, impaired fermentation of dietary fibers, reduced short-chain fatty acid (SCFA) signaling, altered bile acid metabolism, metabolic endotoxemia, and dysregulated adipose tissue crosstalk as key contributors to metabolic vulnerability in South Asian populations. This commentary synthesizes mechanistic insights into the gut-metabolic axis and examines their relevance to India's phenotype-specific challenges. Key pathways, including SCFA-mediated incretin secretion, Toll-like receptor 4 (TLR4)-driven inflammatory signaling, angiopoietin-like protein 4 (ANGPTL4)-mediated lipid partitioning, and microbiota-dependent bile acid biotransformation, are discussed as interconnected drivers of metabolic dysfunction. Emerging clinical evidence from randomized controlled trials evaluating synbiotic and prebiotic-botanical formulations is also discussed, highlighting their potential benefits as adjuncts to lifestyle modification. Given India's dietary patterns and widespread deficiency of fermentable fiber intake, synbiotics may represent a scalable and biologically coherent strategy to support metabolic health. However, heterogeneity of formulations, interindividual microbiome variability, and limited long-term outcome data necessitate cautious interpretation. Advancing precision microbiome-targeted interventions will require population-specific research, multi-omics integration, and rigorous clinical evaluation.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715718","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}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists: Their Therapeutic Potential in Cystic Fibrosis.","authors":"Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Nikolaos Papanas","doi":"10.1007/s12325-026-03599-z","DOIUrl":"https://doi.org/10.1007/s12325-026-03599-z","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is a monogenic disorder leading to pulmonary disease, pancreatic insufficiency and cystic fibrosis-related diabetes (CFRD). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are now being investigated in people with cystic fibrosis (pwCF) and CFRD. To date, their therapeutic potential has been almost exclusively studied in case reports or case series. These agents improved glycated haemoglobin (HbA_1c) and continuous glucose monitoring (CGM) parameters. Benefits were also observed in weight reduction, particularly for subjects on cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy elexacaftor/tezacaftor/ivacaftor (ETI). However, discordant results have also been reported. Moreover, GLP-1RAs have improved pulmonary function, even following lung transplantation. Importantly, the dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist tirzepatide has also yielded favourable outcomes. Finally, preliminary evidence suggests potential inhibition of bone resorption, pointing to a therapeutic perspective in cystic fibrosis-related bone disease (CFBD). However, potential adverse events should not be ignored. These include risk of acute pancreatitis, nausea/vomiting, nutritional depletion, bowel dysmotility and distal intestinal obstruction syndrome, as well as others. Adverse events should be addressed with caution, and dose adjustments may be useful. Large prospective multicentre studies are now required to validate these outcomes and to suggest implications for clinical practice.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697348","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}

{"title":"Empowering Patients: The Role of Shared Treatment Decision-Making in Advanced Bladder Cancer-A Podcast.","authors":"Ravindran Kanesvaran, Patrizia Giannatempo, Alex Filicevas","doi":"10.1007/s12325-026-03535-1","DOIUrl":"10.1007/s12325-026-03535-1","url":null,"abstract":"<p><p>Shared treatment decision-making refers to an approach to care in which patients and their clinicians work in partnership to choose between treatment options, or delay/forgo treatment, concordant with patient values and considering the best available evidence. Research in various diseases, including cancer, has shown that patients who feel informed in treatment decisions have greater satisfaction with their medical care, better adherence to treatment, and better quality-of-life outcomes. The treatment landscape for advanced bladder cancer has evolved in recent years and several treatment options are now available, increasing the importance of shared treatment decisions. Various factors may be relevant to shared decision-making in advanced bladder cancer, including the attributes of different treatment options (e.g., efficacy, toxicity profile, or treatment regimen), patient characteristics (e.g., priorities, health status, or social factors), disease characteristics (e.g., extent of disease or treatment history), and treatment access, highlighting the need to tailor treatment to individual patients. Challenges or barriers to shared treatment decision-making include the lack of knowledge in patients newly diagnosed with cancer, and potential discordance between patients and clinicians regarding treatment goals. However, tools are available that can facilitate shared treatment decision-making and help patients prepare for discussions. In this podcast, we discuss the concept of shared treatment decision-making and the range of considerations related to its application in the management of advanced bladder cancer. With the increasing focus on patient-centered care, shared treatment decision-making can help create individualized treatment plans for patients with advanced bladder cancer, which can be facilitated by in-depth discussions between patients, carers, and clinicians about treatment goals and the benefits and risks of available treatment options. Infographic and podcast audio are available for this article.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687809","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}

{"title":"Adherence to Obstetrician-/Gynecologist-Ordered Multi-target Stool DNA Test Screening and Follow-Up Colonoscopy: A National Multi-payer Study of US Women.","authors":"Mallik Greene, Leobon Gameng, Peter Nowd, Travelle Ellis, Christine Molmenti, Jemel Bingham","doi":"10.1007/s12325-026-03590-8","DOIUrl":"https://doi.org/10.1007/s12325-026-03590-8","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) screening remains below national targets among US women. Primary care providers (PCPs) play an important role in promoting CRC screening adherence. Many US women see an obstetrician/gynecologist (OB/GYN) as their PCP. We evaluated adherence among US women to multi-target stool DNA (mt-sDNA) testing and follow-up colonoscopy ordered by OB/GYNs.</p><p><strong>Methods: </strong>We linked Exact Sciences Laboratories (ESL) orders with a national multi-payer claims database (2016-2022). Eligible participants were average-risk women aged 45-75 years with continuous health plan enrollment (- 180 to 0 days baseline; 0-365 days to assess mt-sDNA adherence; and, after a positive mt-sDNA result, 0-365 days to assess colonoscopy). Primary outcomes were mt-sDNA completion within 365 days of kit shipment and colonoscopy completion within 365 days of a positive mt-sDNA test. Logistic regression evaluated factors associated with mt-sDNA adherence.</p><p><strong>Results: </strong>Of 160,068 women with OB/GYN-ordered mt-sDNA, 71.4% (n = 114,360/160,068) completed testing within 365 days. Test positivity was 8.6% (n = 9773/114,360). Among those with positive results, 71.3% (n = 6971/9773) completed colonoscopy within 365 days. Test adherence increased with age (45-49 years, 67.1%; 50-64 years, 71.8%; 65-75 years, 76.7%), was higher in non-metropolitan areas, and rose with higher ZIP code median household income. Test adherence was higher among individuals with traditional Medicare (85.2%) and Medicare Advantage (77.3%) than commercial insurance (71.3%) and Medicaid (61.7%).</p><p><strong>Conclusion: </strong>In routine practice, more than 70% of women completed OB/GYN-ordered mt-sDNA testing and, after a positive result, more than 70% completed colonoscopy within 1 year. OB/GYN clinicians may play a key role in improving CRC screening adherence, with opportunities to address gaps by payer, income, and race/ethnicity.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687803","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}

{"title":"Real-World Evidence for Sevelamer vs Calcium-Containing Phosphate Binders in Long-Term Effectiveness and Safety Among Patients with Non-Dialysis CKD: The REVEAL Study.","authors":"Ping Li, Chaofan Li, Shuang Liang, Xuefeng Sun, Xinru Guo, Xieguanxuan Xu, Lichen Hao, Xiangmei Chen, Zhe Feng, Guangyan Cai","doi":"10.1007/s12325-026-03572-w","DOIUrl":"10.1007/s12325-026-03572-w","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated serum phosphate is a major risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). Both calcium- and non-calcium-containing phosphate binders (CPBs and NCPBs) are effective at lowering serum phosphate in patients with non-dialysis-dependent CKD (ND-CKD). The critical knowledge gap is whether CPBs or NCPBs provide meaningful long-term benefits for patients with ND-CKD, including slowing progression to end-stage renal disease (ESRD) and reducing cardiovascular events.</p><p><strong>Methods: </strong>This retrospective study was based on the Optum Clinformatics^® administrative claims data from between 1 August 2000 and 30 November 2021. Adults with ND-CKD and hyperphosphataemia or serum phosphorus ≥ 1.78 mmol/L (≥ 5.5 mg/dL) who had received either sevelamer (a NCPB) or a CPB for ≥ 90 days underwent propensity score matching (PSM) to balance baseline characteristics. The primary endpoint was initiation of renal replacement therapy (RRT) over 3 years. Secondary composite endpoints were the incidence of major adverse cardiovascular events (MACE; myocardial infarction, stroke and all-cause death) and MACE plus (MACE, unstable angina pectoris and heart failure).</p><p><strong>Results: </strong>Of 9047 patients who underwent PSM (sevelamer, n = 6644; CPBs, n = 2403), data from 4798 were analysed (2399 in each group). Over 3 years, RRT initiation had significantly lower incidence with sevelamer than CPBs (65.0% vs 70.3%; hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.79-0.91, P < 0.0001). MACE (44.9% vs 50.7%; HR 0.91, 95% CI 0.84-0.99, P = 0.0249) and MACE plus (51.9% vs 59.1%; HR 0.88, 95% CI 0.81-0.95, P = 0.0009) also had significantly lower incidence with sevelamer than CPBs. RRT initiation had significantly lower incidence with sevelamer versus CPB in subgroup analyses by age, sex, race, disease stage and medical history.</p><p><strong>Conclusion: </strong>In this real-world long-term study, sevelamer was associated with beneficial outcomes over CPBs for hyperphosphataemia treatment in patients with ND-CKD. Further definitive studies are needed to confirm this finding.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687812","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}

{"title":"Adverse Childhood Experiences and Disease Activity Are Associated with Post-Traumatic Stress Symptoms in Crohn's Disease.","authors":"Giorgia Spagnolo, Daniele Ferrarese, Federica Di Vincenzo, Jacopo Iaccarino, Marco Murgiano, Michele Vecchione, Guglielmo Sicilia, Daniele Napolitano, Antonio Maria D'Onofrio, Antonio Gasbarrini, Giovanni Camardese, Daniela Pia Rosaria Chieffo, Franco Scaldaferri","doi":"10.1007/s12325-026-03587-3","DOIUrl":"https://doi.org/10.1007/s12325-026-03587-3","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) is a chronic inflammatory bowel disease associated with a substantial psychological burden, including post-traumatic stress symptoms (PTSS). However, PTSS do not develop in all patients, suggesting individual vulnerability factors. Adverse childhood experiences (ACEs) are a transdiagnostic risk factor for stress-related psychopathology and may influence psychological responses to chronic disease. We examined whether ACEs moderate the relationship between clinical disease activity and PTSS in patients with CD.</p><p><strong>Methods: </strong>In this cross-sectional study, outpatients with CD completed self-report measures assessing PTSS and ACEs. Clinical disease activity was assessed using the Harvey-Bradshaw Index. Data were analyzed using Pearson correlation coefficients and hierarchical moderated regression analyses.</p><p><strong>Results: </strong>A total of 161 outpatients with CD were included. Clinically significant PTSS were observed in 32.1% of the sample. Disease activity was positively associated with PTSS (r = .33, p < .01), as was cumulative ACE exposure (r = .38, p < .01). In regression analyses, both disease activity (β = .22, p = .013) and ACEs (β = .35, p < .001) independently predicted PTSS, whereas disease duration was inversely associated (β =  - .19, p = .047). A significant interaction between disease activity and ACEs emerged (ΔR² = .034, p = .013), indicating a stronger association between disease activity and PTSS among patients with greater childhood adversity.</p><p><strong>Conclusion: </strong>Early-life adversity appears to increase vulnerability to PTSS in the context of active CD. ACE-informed assessments may help identify patients at higher psychological risk and guide trauma-informed clinical care.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687793","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}

{"title":"Foslevodopa/Foscarbidopa Subcutaneous Infusion Safety and Efficacy in Patients with and Without Prior Deep Brain Stimulation.","authors":"Tove Henriksen, Juan Carlos Martínez-Castrillo, Mark H B Huisman, Sara Dhanani, Elizabeth Peckham, Jason Aldred, Lars Bergmann, Megha B Shah, Resmi Gupta, Pavnit Kukreja, Juan Carlos Parra, Victor S C Fung","doi":"10.1007/s12325-026-03579-3","DOIUrl":"https://doi.org/10.1007/s12325-026-03579-3","url":null,"abstract":"<p><strong>Introduction: </strong>As Parkinson's disease (PD) advances, limitations of oral medication include pill burden, increasing \"Off\" time, and \"On\" time with bothersome dyskinesia. Deep brain stimulation (DBS) can improve motor complications, but disease progression may warrant further intervention later. An approved nonsurgical option, continuous subcutaneous infusion of foslevodopa/foscarbidopa (LDp/CDp), has been shown to improve motor fluctuations, though the impact of prior DBS on its efficacy and safety is unknown.</p><p><strong>Methods: </strong>Post hoc analysis of a 52-week open-label phase 3 trial (NCT03781167) evaluated baseline characteristics, safety, and efficacy in patients treated with LDp/CDp with or without prior DBS. Fisher's exact test, t test, Wilcoxon rank-sum test, and analysis of covariance were performed.</p><p><strong>Results: </strong>Twenty-four (9.8%) of 244 patients received prior DBS. Both groups had similar baseline characteristics, although prior patients treated with DBS had significantly more time since diagnosis and more \"speech\" and \"gait\" impairment (Movement Disorders Society-Unified Parkinson's Disease Rating Scale [MDS-UPDRS] Parts II/III single items). Both groups showed significant within-group improvements in \"Off\" time and \"On\" time without dyskinesia, and the between-group difference for these improvements was not significant, indicating LDp/CDp had efficacy regardless of DBS exposure. The no DBS group had significant improvement in sleep and quality of life, while the prior DBS group had nonsignificant trends in the same direction. The no DBS group had significant improvement in MDS-UPDRS Part II score but worsening in Part III score, as expected with advancing disease; change from baseline in the prior DBS group was not significant. The safety data were similar in both groups, with the only significant difference being a higher percentage of prior patients treated with DBS experiencing severe treatment-emergent adverse events than no DBS (45.8% vs 23.6%).</p><p><strong>Conclusion: </strong>While limited by small prior DBS patient numbers, this post hoc study suggests generally similar overall baseline, safety, and efficacy profiles in LDp/CDp-treated prior DBS and no DBS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT03781167.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687778","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}

{"title":"Evaluating Cost-Effectiveness in Relation to the Supporting Clinical Evidence Across the Type 2 Diabetes Continuum: A Review of Metformin and SGLT2is.","authors":"Ian W Campbell, Kerstin M G Brand, Ulrike Gottwald-Hostalek, Julian Dettenbach","doi":"10.1007/s12325-026-03592-6","DOIUrl":"https://doi.org/10.1007/s12325-026-03592-6","url":null,"abstract":"<p><p>Metformin is a safe and effective glucose-lowering agent, widely regarded as the first-line treatment option for type 2 diabetes (T2D), and available at very low cost. Recent updates to the American Diabetes Association (ADA) Standards of Care guidance demonstrate a shift towards the earlier use of newer, more expensive, anti-diabetic agents for the treatment of T2D, based on concurrent conditions such as cardiovascular and/or renal complication reduction, and significant weight loss. As of 2026, this has culminated in sodium-glucose cotransporter 2 inhibitors (SGLT2is) being recommended for patients with T2D and established atherosclerosis cardiovascular disease (ASCVD) or indicators of high ASCVD, heart failure or chronic kidney disease, independently of the use of metformin. The main evidence base supporting the use of SGLT2is in these patient populations come from cardiovascular and renal outcome trials, which recruited patients usually with long-standing T2D and high levels of cardiovascular and/or renal comorbidities. Whether the cardiovascular and renal benefits shown during these trials are generalisable to the early T2D or even pre-diabetic population may be debated. Ultimately, this leaves the question as to whether patients with early T2D and no cardiovascular and/or renal complications should receive treatment with SGLT2is, at a higher cost, where clinical evidence of superiority to established therapies like metformin are scarce. As T2D is a chronic, progressive disease, often advancing through pre-diabetes, early T2D and eventually treatment intensification, the cost-effectiveness of treatments at each stage of the disease must also be considered to understand the long-term economic burden. This review explores the available cost-effectiveness evidence, supported by clinical data, for the use of metformin and SGLT2is across the complete T2D continuum.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669779","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}

{"title":"Health-Related Quality of Life and Work-Related Outcomes in People with Obesity or Overweight Treated with Tirzepatide or Other Obesity Medications: United States Results from the Adelphi Real World Obesity Disease Specific Programme™.","authors":"Theresa Hunter Gibble, Andrea Leith, Lewis Harrison, Claire Gerber, Sonya Kokil Raikar, Gayathri Ashok, Esther Artime","doi":"10.1007/s12325-026-03580-w","DOIUrl":"https://doi.org/10.1007/s12325-026-03580-w","url":null,"abstract":"<p><strong>Introduction: </strong>This real-world exploratory study in the United States (US) aimed to describe the socio-demographics, clinical characteristics, health-related quality of life (HRQoL), and work-related outcomes among people with obesity (PwO) undergoing a weight management program.</p><p><strong>Methods: </strong>Secondary data from the US cohort of Adelphi Real World Obesity III Disease Specific Programme™ (October 2023 and April 2024, and October 2024 and January 2025) were analyzed. This cross-sectional survey included physicians and their consulting PwO without T2D who had a physician-confirmed diagnosis of obesity [body mass index (BMI) ≥ 30 kg/m²] or overweight (BMI of ≥ 27 kg/m² and < 30 kg/m²) with ≥ 1 obesity-related complication. Outcomes were summarized for three study groups based on a weight management approach at data capture: (1) tirzepatide group (received tirzepatide), (2) obesity management medication (OMM) group (received OMM excluding tirzepatide), and (3) non-OMM group (did not receive an OMM). Analyses were descriptive.</p><p><strong>Results: </strong>The study included 1082 PwO (mean age: 47 years; female: 67.4%; tirzepatide: n = 199; OMM: n = 158; non-OMM: n = 725). The average time since OMM initiation was 7.4 months and 7.6 months for PwO in the tirzepatide and OMM groups, respectively. PwO in the tirzepatide group reported higher scores for most of the Short Form Health Survey version 2 (SF-36v2) domains than other groups; however, minimal differences were observed across all groups. A general trend towards greater work impairment among PwO in the non-OMM group than PwO in the tirzepatide and OMM groups was observed.</p><p><strong>Conclusion: </strong>This real-world exploratory study in the US suggests that PwO taking tirzepatide reported less impairment in some of the SF-36v2 domains than those not on tirzepatide. PwO on tirzepatide or alternative OMM treatment appeared to have numerically lower impairment in work-related outcomes than those not on treatment. These findings warrant evaluation for long-term impact of tirzepatide and OMMs on work-related and HRQoL outcomes among PwO.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662078","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}