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switch therapy in hypertension

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https://www.readbyqxmd.com/read/29321043/what-is-in-your-wallet-a-cluster-randomized-trial-of-the-effects-of-showing-comparative-patient-out-of-pocket-costs-on-primary-care-prescribing-for-uncomplicated-hypertension
#1
Robyn Tamblyn, Nancy Winslade, Christina J Qian, Teresa Moraga, Allen Huang
BACKGROUND: Drug expenditures are responsible for an increasing proportion of health costs, accounting for $1.1 trillion in annual expenditure worldwide. As hundreds of billions of dollars are being spent each year on overtreatment with prescribed medications that are either unnecessary or are in excess of lowest cost-effective therapy, programs are needed that optimize fiscally appropriate use. We evaluated whether providing physicians with information on the patient out-of-pocket payment consequences of prescribing decisions that were in excess of lowest cost-effective therapy would alter prescribing decisions using the treatment of uncomplicated hypertension as an exemplar...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29282032/riociguat-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-results-from-an-early-access-study
#2
Vallerie V McLaughlin, Pavel Jansa, Jens E Nielsen-Kudsk, Michael Halank, Gérald Simonneau, Ekkehard Grünig, Silvia Ulrich, Stephan Rosenkranz, Miguel A Gómez Sánchez, Tomás Pulido, Joanna Pepke-Zaba, Joan Albert Barberá, Marius M Hoeper, Jean-Luc Vachiéry, Irene Lang, Francine Carvalho, Christian Meier, Katharina Mueller, Sylvia Nikkho, Andrea M D'Armini
BACKGROUND: Following positive results from the Phase III CHEST-1 study in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), the Phase IIIb CTEPH early access study (EAS) was designed to assess the safety and tolerability of riociguat in real-world clinical practice, as well as to provide patients with early access to riociguat before launch. Riociguat is approved for the treatment of inoperable and persistent/recurrent CTEPH. METHODS: We performed an open-label, uncontrolled, single-arm, early access study in which 300 adult patients with inoperable or persistent/recurrent CTEPH received riociguat adjusted from 1 mg three times daily (tid) to a maximum of 2...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29233198/clinical-efficacy-and-safety-of-switch-from-bosentan-to-macitentan-in-children-and-young-adults-with-pulmonary-arterial-hypertension
#3
Ebru Aypar, Dursun Alehan, Tevfik Karagöz, Hayrettin Hakan Aykan, İlker Ertugrul
BACKGROUND: Macitentan is an orally active, potent, dual endothelin receptor antagonist and is the only registered treatment for pulmonary arterial hypertension that significantly reduced morbidity and mortality in a long-term event-driven study. Aim Few studies compared the clinical efficacy and safety of switch from bosentan to macitentan only in adult patients with pulmonary arterial hypertension. We aimed to evaluate the clinical efficacy and safety of switch from bosentan to macitentan in children and young adults...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29223433/contemporary-rates-and-correlates-of-statin-use-and-adherence-in-nondiabetic-adults-with-cardiovascular-risk-factors-the-kp-champ-study
#4
MULTICENTER STUDY
Alan S Go, Dongjie Fan, Sue Hee Sung, Alda I Inveiss, Victoria Romo-LeTourneau, Usha G Mallya, Susan Boklage, Joan C Lo
BACKGROUND: Statin therapy is highly efficacious in the prevention of fatal and nonfatal atherosclerotic events in persons at increased cardiovascular risk. However, its long-term effectiveness in practice depends on a high level of medication adherence by patients. METHODS: We identified nondiabetic adults with cardiovascular risk factors between 2008 and 2010 within a large integrated health care delivery system in Northern California. Through 2013, we examined the use and adherence of newly initiated statin therapy based on data from dispensed prescriptions from outpatient pharmacy databases...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29199910/impact-of-four-times-daily-dosing-of-oral-treprostinil-on-tolerability-and-daily-dose-achieved-in-pulmonary-hypertension
#5
James C Coons, Cheryl Bunner, David C Ishizawar, Michael G Risbano, Belinda Rivera-Lebron, Michael A Mathier, Stephen Y Chan, Marc A Simon
Oral treprostinil (TRE) is a prostacylin that is approved for the treatment of patients with pulmonary arterial hypertension (PAH). Dosing is approved for two or three times daily (t.i.d.); however, adverse effects, including gastrointestinal-related symptoms, may limit the ability to reach optimal doses. We report our experience with a four times daily (q.i.d.) regimen of oral TRE for goal-directed therapy of PAH. We describe three patients that were transitioned from infusion or inhaled TRE to oral TRE with initial t...
January 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/29116618/treatment-of-stable-angina-with-a-new-fixed-dose-combination-of-ivabradine-and-metoprolol-effectiveness-and-tolerability-in-routine-clinical-practice
#6
Dimitar Divchev, Georg Stöckl
INTRODUCTION: In this prospective, multicenter, observational cohort study, the effectiveness and tolerability of the first fixed-dose combination (FDC) formulation of the selective heart rate reducing agent ivabradine and the beta-blocker metoprolol was evaluated in stable angina pectoris (AP) patients in a clinical practice setting. METHODS: Stable AP outpatients received a FDC of ivabradine and metoprolol (b.i.d.) for 4 months, in addition to cardiovascular standard therapy...
December 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/29106031/comparison-of-morning-vs-bedtime-administration-of-the-combination-of-valsartan-amlodipine-on-nocturnal-brachial-and-central-blood-pressure-in-patients-with-hypertension
#7
Takeshi Fujiwara, Satoshi Hoshide, Yuichiro Yano, Hiroshi Kanegae, Kazuomi Kario
The aim of this study was to compare the effect of morning and bedtime administration of valsartan/amlodipine combination therapy (80/5 mg) on nocturnal brachial and central blood pressure (BP) measured by ambulatory BP monitoring in patients with hypertension. This was a 16-week prospective, multicenter, randomized, open-label, crossover, noninferiority clinical trial. Patients underwent 24-hour ambulatory BP monitoring at randomization, at switching, and at the end of the study. Twenty-three patients (mean age, 68...
November 5, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29070699/inhibition-of-pyruvate-dehydrogenase-kinase-improves-pulmonary-arterial-hypertension-in-genetically-susceptible-patients
#8
Evangelos D Michelakis, Vikram Gurtu, Linda Webster, Gareth Barnes, Geoffrey Watson, Luke Howard, John Cupitt, Ian Paterson, Richard B Thompson, Kelvin Chow, Declan P O'Regan, Lan Zhao, John Wharton, David G Kiely, Adam Kinnaird, Aristeidis E Boukouris, Chris White, Jayan Nagendran, Darren H Freed, Stephen J Wort, J Simon R Gibbs, Martin R Wilkins
Pulmonary arterial hypertension (PAH) is a progressive vascular disease with a high mortality rate. It is characterized by an occlusive vascular remodeling due to a pro-proliferative and antiapoptotic environment in the wall of resistance pulmonary arteries (PAs). Proliferating cells exhibit a cancer-like metabolic switch where mitochondrial glucose oxidation is suppressed, whereas glycolysis is up-regulated as the major source of adenosine triphosphate production. This multifactorial mitochondrial suppression leads to inhibition of apoptosis and downstream signaling promoting proliferation...
October 25, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29041880/-efficacy-of-antihypertensive-therapy-combined-with-psychotropic-drugs-in-patients-with-hypertension-and-affective-disorders
#9
V V Skibitskiy, V D Kovalev, N A Kurzanov, I A Ponomareva
AIM: To compare effects of isolated antihypertensive therapy (AHT) and AHT combined with anxiolytic and antidepressant on parameters of 24‑hour blood pressure (BP) profile, severity of affective disorders, and quality of life (QL) in patients with uncontrolled arterial hypertension (AH) and anxiety or depressive disorders. MATERIAL AND METHODS: We randomized 140 patients (age 48.6±5.9 year, 72 women) into 2 groups. During 1 year patients of each group received 2 variants of pharmacotherapy: isolated AHT and AHT combined with psychotropic medication (PM) - anxiolytic for persons with anxiety disorder and antidepressant for persons with depressive disorder (AHT+PM)...
July 2017: Kardiologiia
https://www.readbyqxmd.com/read/29039837/-a-patient-with-severe-idiopathic-pulmonary-arterial-hypertension-is-there-a-way-out
#10
N A Tsareva, S N Avdeev, G V Neklyudova
The paper considers a clinical example of current therapy for idiopathic pulmonary arterial hypertension in a female patient with its clinical deterioration. It shows the tactics of switching from one drug (bosentan) to others (macitentan) within in the same pathogenetic therapy group (endothelin receptor antagonists). The latest pulmonary hypertension classification (Nice, 2013) is presented. The current strategies of pathogenetic therapy for pulmonary hypertension are discussed.
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28954978/stroke-and-the-cell-therapy-saga-towards-a-safe-swift-and-efficient-utilization-of-cells
#11
Nathalie Kubis
The first clinical trials of cell therapy in stroke were first published in the 2000s and consisted of neural stems cells transplanted via the intracerebral pathway. Since mesenchymal stem cells showed similar capacities to differentiate into neural cells and allowed autologous cell transplantation, they were then preferentially studied, including diabetes and hypertension. More recently, bone marrow derived mononuclear cells were successfully transplanted in stroke with no need of culture processing, and simple collection by density gradient centrifugation rendering them immediately ready for use...
2017: Keio Journal of Medicine
https://www.readbyqxmd.com/read/28914848/-effect-of-a-fixed-dose-combination-of-perindopril-arginine-amlodipine-on-the-level-and-variability-of-blood-pressure-according-to-its-office-visit-to-visit-measurements-and-self-measurements-at-home-a-subanalysis-of-the-prevoshodstvo-superiority-program
#12
O D Ostroumova
AIM: To study the effect of a fixed-dose combination of perindopril arginine/amlodipine (prestans) on the goal levels and variability of blood pressure (BP) according to its office visit-to-visit measurements and self-measurement (OVVM and SM) in a subgroup of 483 people from the population of the Russian observational SUPERIORITY program, most cases of whom are given the combination replacing the previously ineffective mono- and combination antihypertensive therapy (AHT). SUBJECTS AND METHODS: The subanalysis included data on 483 patients (34% men) aged 57...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28895069/feasibility-safety-and-efficacy-of-an-alternative-schedule-of-sunitinib-for-the-treatment-of-patients-with-metastatic-renal-cell-carcinoma-a-retrospective-study
#13
Sebastiano Buti, Maddalena Donini, Melissa Bersanelli, Alessia Gattara, Francesco Leonardi, Rodolfo Passalacqua
BACKGROUND: Standard treatment with sunitinib for patients with metastatic renal cancer provides an 'on-off' schedule (daily administration of a 50-mg capsule for 4 weeks, followed by a 2-week break; consecutive 6-week cycles). We developed an alternative intermittent schedule to reduce the toxicity and symptoms of tumor regrowth during the rest period and to allow prolonged continuation of therapy, maintaining dose intensity. OBJECTIVE: The objective of this study was to provide a retrospective evaluation of the feasibility, safety, and efficacy of an alternative schedule of sunitinib in patients who did not tolerate classical treatment...
December 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28861351/efficacy-and-safety-of-bimatoprost-in-glaucoma-and-ocular-hypertension-in-non-responder-patients
#14
Nicholas Brennan, Mohammad H Dehabadi, Sandhya Nair, Ana Quartilho, Catey Bunce, Ian Reekie, Raal Obikpo
AIM: To establish the efficacy and safety of bimatoprost 0.03% monotherapy in glaucoma and ocular hypertension (OHT) patients with inadequate intraocular pressure (IOP)on current therapy. METHODS: Pre- and post-switch IOPs were analyzed for 59 consecutive patients who were switched from current therapy to bimatoprost monotherapy between 2011-2015. Demographic information, diagnosis, and any adverse events were recorded. Change in IOP post-pre switch was analyzed using a 2-sided Student's paired t-test at the 5% significance level...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28854078/changes-in-treatment-patterns-and-incremental-health-care-utilization-due-to-p2y12-associated-complications-in-patients-with-acute-coronary-syndrome
#15
Ami Vyas, Lori D Bash, Mehul D Patel, Ross J Simpson
BACKGROUND: P2Y12 antiplatelet therapy (APT) is highly efficacious in reducing the incidence of ischemic events in patients with acute coronary syndrome (ACS); however, it is associated with several adverse complications. Data on P2Y12-associated complications and adherence to APT are sparse. OBJECTIVE: To describe the characteristics, frequency of P2Y12-associated complications, adherence and persistence to P2Y12 APT, and health care utilization among ACS patients on P2Y12 APT...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28854077/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-for-newly-diagnosed-and-treatment-naive-atrial-fibrillation-patients-an-update-using-2013-2014-data
#16
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Few studies have assessed adherence to non-vitamin K antagonist oral anticoagulants (NOACs), especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To compare adherence and treatment patterns among NOACs for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Incident and treatment-naive NVAF patients were identified during 2013-2014 from a large claims database in this retrospective cohort study...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28828980/single-pill-triple-fixed-dose-combination-therapy-with-single-component-drug-monitoring-in-treatment-resistant-hypertension-a-pilot-study
#17
Reinhold Kreutz, Jurgen Scholze, Antonios Douros
BACKGROUND: Single-pill fixed dose combination (FDC) therapies are widely used in the treatment of arterial hypertension. OBJECTIVE: This pilot study aimed to evaluate the effects of a FDC therapy combined with therapeutic drug monitoring (TDM) on blood pressure (BP) in patients with treatment resistant hypertension. METHOD: The study population included patients with suspected treatment-resistant hypertension during treatment with at least 3 antihypertensive drugs...
August 21, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28770596/high-rates-of-viral-suppression-in-adults-and-children-with-high-cd4-counts-using-a-streamlined-art-delivery-model-in-the-search-trial-in-rural-uganda-and-kenya
#18
Dalsone Kwarisiima, Moses R Kamya, Asiphas Owaraganise, Florence Mwangwa, Dathan M Byonanebye, James Ayieko, Albert Plenty, Doug Black, Tamara D Clark, Bridget Nzarubara, Katherine Snyman, Lillian Brown, Elizabeth Bukusi, Craig R Cohen, Elvin H Geng, Edwin D Charlebois, Theodore D Ruel, Maya L Petersen, Diane Havlir, Vivek Jain
INTRODUCTION: The 2015 WHO recommendation of antiretroviral therapy (ART) for all HIV-positive persons calls for treatment initiation in millions of persons newly eligible with high CD4+ counts. Efficient and effective care models are urgently needed for this population. We evaluated clinical outcomes of asymptomatic HIV-positive adults and children starting ART with high CD4+ counts using a novel streamlined care model in rural Uganda and Kenya. METHODS: In the 16 intervention communities of the HIV test-and-treat Sustainable East Africa Research for Community Health Study (NCT01864603), all HIV-positive individuals irrespective of CD4 were offered ART (efavirenz [EFV]/tenofovir disoproxil fumarate + emtricitabine (FTC) or lamivudine (3TC)...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28761569/efficacy-and-safety-of-switching-from-prostaglandin-analog-therapy-to-prostaglandin-timolol-fixed-combination-or-prostaglandin-brimonidine-therapy
#19
Kenji Inoue, Mieko Masumoto, Kyoko Ishida, Goji Tomita
BACKGROUND: To compare the safety and efficacy between switching to prostaglandin/timolol fixed combination eye drops (PG/timolol FCs) and adding brimonidine to PG analogue monotherapy. METHODS: Eyes of 53 patients with primary open-angle glaucoma or ocular hypertension who were receiving PG analogue monotherapy were included. Participants were randomly divided into two treatment groups: one was prescribed PG/timolol FCs (switched group), and for the other, 0.1% brimonidine was added to the PG analogue (added group)...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28695464/improving-adherence-to-treatment-and-reducing-economic-costs-of-hypertension-the-role-of-olmesartan-based-treatment
#20
Francesco Vittorio Costa
Poor adherence to antihypertensive treatment is the single most important factor of unsatisfactory blood pressure (BP) control. This review focuses on therapy-related factors affecting adherence and suggests how to improve it with a wise choice of treatment schedule. Complex drug treatment schemes, poor tolerability and drug substitutions are frequent causes of poor adherence which, in turn, causes insufficient BP control, greater incidence of cardiovascular events and, finally, higher global health costs...
July 10, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
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