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elderly diabetes trial

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https://www.readbyqxmd.com/read/28107773/safety-and-effectiveness-of-tofogliflozin-in-elderly-japanese-patients-with-type-2-diabetes-mellitus-a-post-marketing-study-j-step-el-study
#1
Kazunori Utsunomiya, Naoki Shimmoto, Masayuki Senda, Yuji Kurihara, Ryoji Gunji, Shoko Fujii, Seigo Kakiuchi, Hisataka Fujiwara, Hiroyuki Kameda, Masahiro Tamura, Kohei Kaku
AIMS/INTRODUCTION: While sodium glucose cotransporter 2 inhibitors are a promising treatment for type 2 diabetes mellitus, they are associated with concerns about specific adverse drug reactions. We conducted a 1-year post-marketing study of tofogliflozin, a novel agent in this class, in Japanese elderly patients with type 2 diabetes mellitus. MATERIALS AND METHODS: This was a prospective, observational, and multicenter post-marketing study conducted in the context of routine clinical practice...
January 20, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28105986/canagliflozin-dapagliflozin-and-empagliflozin-monotherapy-for-treating-type-2-diabetes-systematic-review-and-economic-evaluation
#2
Rhona Johnston, Olalekan Uthman, Ewen Cummins, Christine Clar, Pamela Royle, Jill Colquitt, Bee Kang Tan, Andrew Clegg, Saran Shantikumar, Rachel Court, J Paul O'Hare, David McGrane, Tim Holt, Norman Waugh
BACKGROUND: Most people with type 2 diabetes are overweight, so initial treatment is aimed at reducing weight and increasing physical activity. Even modest weight loss can improve control of blood glucose. If drug treatment is necessary, the drug of first choice is metformin. However, some people cannot tolerate metformin, which causes diarrhoea in about 10%, and it cannot be used in people with renal impairment. This review appraises three of the newest class of drugs for monotherapy when metformin cannot be used, the sodium-glucose co-transporter 2 (SGLT2) inhibitors...
January 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28078647/sitagliptin-a-review-in-type-2-diabetes
#3
Lesley J Scott
The dipeptidyl peptidase-4 inhibitor sitagliptin (Januvia(®); Glactiv(®); Tesavel(®); Xelevia™) is approved in more than 130 countries worldwide as monotherapy and in combination with other antihyperglycaemic drugs for the treatment of adult patients with type 2 diabetes (T2D). Extensive clinical experience has firmly established the glycaemic efficacy of oral sitagliptin (±other antihyperglycaemic drugs) in a broad spectrum of patients with T2D, including obese, elderly and renally impaired patients and those with established cardiovascular (CV) disease (CVD)...
January 11, 2017: Drugs
https://www.readbyqxmd.com/read/28065766/changes-in-one-year-mortality-in-elderly-patients-admitted-with-acute-myocardial-infarction-in-relation-with-early-management
#4
Etienne Puymirat, Nadia Aissaoui, Guillaume Cayla, Alexandre Lafont, Elisabeth Riant, Marco Mennuni, Olivier Saint-Jean, Didier Blanchard, Patrick Jourdain, Meyer Elbaz, Patrick Henry, Vincent Bataille, Elodie Drouet, Geneviève Mulak, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin
BACKGROUND: Elderly patients are underrepresented in acute myocardial infarction trials. Our aim was to determine whether, in elderly patients, changes in management in the past 15 years is associated with improved one-year mortality after hospital admission for myocardial infarction. METHODS: We used data from 4 one-month French registries, conducted 5 years apart from 1995 to 2010, including 3,389 elderly patients (≥75 years). RESULTS: From 1995 to 2010, mean age remained stable (82...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28056430/the-effects-of-sitagliptin-a-dpp-4-inhibitor-on-cognitive-functions-in-elderly-diabetic-patients-with-or-without-alzheimer-s-disease
#5
Ahmet Turan Isik, Pinar Soysal, Adnan Yay, Cansu Usarel
AIMS: The present study aimed to evaluate effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4I), on cognitive functions in elderly diabetic patients with and without cognitive impairment. METHODS: 253 elderly patients with type 2DM, were enrolled in this prospective and observational study. After comprehensive geriatric assessment, the patients were divided into either sitagliptin or non-sitagliptin group. RESULTS: A total of 205 patients who completed the study (52 with Alzheimer's Disease (AD)) were re-evaluated 6months later...
December 21, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28045962/association-of-tsh-elevation-with-all-cause-mortality-in-elderly-patients-with-chronic-kidney-disease
#6
Mei-Hsing Chuang, Kuo-Meng Liao, Yao-Min Hung, Yi-Chang Chou, Pesus Chou
Chronic kidney disease (CKD) is a widespread condition in the global population and is more common in the elderly. Thyroid-stimulating hormone (TSH) level increases with aging, and hypothyroidism is highly prevalent in CKD patients. However, the relationship between low thyroid function and mortality in CKD patients is unclear. Therefore, we conducted a retrospective cohort study to examine the relationship between TSH elevation and all-cause mortality in elderly patients with CKD. This retrospective cohort study included individuals ≥65 years old with CKD (n = 23,786) in Taipei City...
2017: PloS One
https://www.readbyqxmd.com/read/27993663/risks-of-serious-toxicities-from-intermittent-versus-continuous-androgen-deprivation-therapy-for-advanced-prostate-cancer-patients-a-population-based-study
#7
Huei-Ting Tsai, Ruth M Pfeiffer, George K Philips, Ana Barac, Alex Z Fu, David F Penson, Yingjun Zhou, Arnold L Potosky
PURPOSE: Randomized trials have reported that intermittent androgen deprivation therapy (IADT) for patients with advanced prostate cancer (PCa) may improve sexual and physical functioning compared to continuous ADT (CADT) without compromising survival. It is unknown whether IADT alters the risk of serious toxicities associated with CADT. MATERIALS AND METHODS: We conducted a population-based cohort study of 9,772 men aged 66 or older diagnosed with advanced PCa from 2002-2011 treated with ADT...
December 16, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27991477/nutritional-status-and-outcomes-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcome-and-practice-patterns-study-phase-5-2012-2015
#8
Fadwa S Al-Ali, Brian A Bieber, Ronald L Pisoni, Hany Ezzat, Mohammed AlGhonaim, Fayez AlHejaili, Sumaya AlGhareeb, Abdulkarim Saleh, Yacoub Al Maimani, Anas Alyousef, Haroun Z Ahmed, Abdullah Hamad
Nutrition is an important factor in maintaining good health of hemodialysis (HD) patients, affecting their morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international observational study assessing differences in dialysis practices and outcomes across >20 countries. Here, we present the results for the Gulf Cooperation Council (GCC) countries regarding nutrition data and its relationship with outcomes as a part of the DOPPS Phase 5 study (2012-2015). Data were from Phase 5 of the DOPPS...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27919826/should-blood-pressure-goal-be-individualized-in-hypertensive-patients
#9
REVIEW
Alexandra Yannoutsos, Rania Kheder-Elfekih, Jean-Michel Halimi, Michel E Safar, Jacques Blacher
The aim of the present review is to consider the clinical relevance of individualized blood pressure (BP) goal under treatment in hypertensive patients according to their age, comorbidities or established cardiovascular (CV) disease. Evidence from large-scale randomized trials to support a lower BP goal, as initially recommended by guidelines in high-risk hypertensive patients, were lacking. Recently, the randomized intervention SPRINT trial studied two treatment targets for systolic BP (120mm Hg versus 140mm Hg in the intensive and standard treatment group, respectively) among high-risk hypertensive patients, without diabetes and without a history of prior stroke...
December 2, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27917712/the-role-of-antiplatelet-therapy-in-primary-prevention-a-review
#10
Lauge Østergaard, Emil L Fosbøl, Matthew T Roe
The efficacy of antiplatelet therapy for the secondary prevention of cardiovascular disease after an ischemic event is well established. However, the role for antiplatelet therapy for the primary prevention of cardiovascular disease is more complex because of the interplay of efficacy vs safety in individuals without established cardiovascular disease who have a relatively low, but linear trajectory of cardiovascular risk. Several large randomized trials have investigated the efficacy and safety of antiplatelet therapy (primarily aspirin) for patients without established cardiovascular disease...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27885860/pioglitazone-for-the-treatment-of-alzheimer-s-disease
#11
Daniela Galimberti, Elio Scarpini
Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Pharmacological treatment of AD includes Anticholinesterase Inhibitors (AChEIs) for mild-moderate AD, and memantine for severe AD. These drugs provide mainly symptomatic short-term benefits without clearly influencing the progression of the disease. Pioglitazone (AD4833) is an insulin sensitizer of the thiazolidinedione class of nuclear Peroxisome-Proliferator Activated Receptor γ (PPARγ) agonists. It binds to PPARγ, affecting gene transcription and reducing inflammation...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27873152/a-comparison-of-pharmacokinetic-and-pharmacodynamic-properties-between-faster-acting-insulin-aspart-and-insulin-aspart-in-elderly-subjects-with-type-1-diabetes-mellitus
#12
Tim Heise, Ulrike Hövelmann, Eric Zijlstra, Kirstine Stender-Petersen, Jacob Bonde Jacobsen, Hanne Haahr
BACKGROUND: Due to population aging, an increasing number of elderly patients with diabetes use insulin. It is therefore important to investigate the characteristics of new insulins in this population. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with faster absorption. This study investigated the pharmacological properties of faster aspart in elderly subjects with type 1 diabetes mellitus (T1DM). METHODS: In a randomised, double-blind, two-period crossover trial, 30 elderly (≥65 years) and 37 younger adults (18-35 years) with T1DM received single subcutaneous faster aspart or IAsp dosing (0...
November 21, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27870655/blood-pressure-treatment-levels-and-choice-of-antihypertensive-agent-in-people-with-diabetes-mellitus-an-overview-of-systematic-reviews
#13
Mattias Brunström, Mats Eliasson, Peter M Nilsson, Bo Carlberg
OBJECTIVE: Multiple systematic reviews address the effect of antihypertensive treatment in people with diabetes. Here, we summarize current systematic reviews concerning antihypertensive treatment effect at different blood pressure (BP) levels, and relative treatment effect of different antihypertensive agents. METHODS: We searched MEDLINE, BIOSIS, DARE and CDSR during years 2005-2016. Eligibility criteria, number of trials and participants, outcomes analysed, statistical methods used for data synthesis, and principal results were extracted for each review...
November 18, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27823868/effects-of-glimepiride-versus-saxagliptin-on-%C3%AE-cell-function-and-hypoglycemia-a-post-hoc-analysis-in-older-patients-with-type-2-diabetes-inadequately-controlled-with-metformin
#14
Shira Perl, William Cook, Cheryl Wei, Peter Ohman, Boaz Hirshberg
PURPOSE: The management of hyperglycemia is challenging in older patients with type 2 diabetes owing to excess fragility and risk for adverse outcomes should hypoglycemia episodes occur. We evaluated baseline β-cell function as a potential risk factor for the development of hypoglycemia when saxagliptin or glimepiride was added in patients aged ≥65 years whose type 2 diabetes was poorly controlled on stable metformin monotherapy. METHODS: A post hoc analysis of data from the GENERATION (Efficacy and Tolerability of Saxagliptin Compared with Glimepiride in Elderly Patients with Type 2 Diabetes: A Randomized, Controlled Study) trial, which enrolled 720 patients aged ≥65 years, was conducted...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27823681/a-comparison-of-reduced-dose-prasugrel-and-standard-dose-clopidogrel-in-elderly-patients-with-acute-coronary-syndromes-undergoing-early-percutaneous-revascularization-design-and-rationale-of-the-randomized-elderly-acs-2-study
#15
Luca A Ferri, Nuccia Morici, Daniele Grosseto, Giovanni Tortorella, Irene Bossi, Paolo Sganzerla, Michele Cacucci, Girolamo Sibilio, Stefano Tondi, Anna Toso, Maurizio Ferrario, Nicola Gandolfo, Amelia Ravera, Matteo Mariani, Elena Corrada, Leonardo Di Ascenzo, Anna Sonia Petronio, Claudio Cavallini, Nadia Moffa, Stefano De Servi, Stefano Savonitto
BACKGROUND: Elderly patients display higher on clopidogrel platelet reactivity as compared with younger patients. Treatment with prasugrel 5mg has been shown to provide more predictable and homogenous antiplatelet effect, as compared with clopidogrel, suggesting the possibility of reducing ischemic events after an acute coronary syndrome (ACS) without increasing bleeding. STUDY DESIGN: The Elderly-ACS 2 study is a multicenter, randomized, parallel-group, open-label trial designed to demonstrate the superiority of a strategy of dual antiplatelet treatment using a reduced 5-mg daily dose of prasugrel over a standard strategy with a daily clopidogrel dose of 75mg in patients older than 74years with ACS (either ST- or non-ST-elevation myocardial infarction) undergoing early percutaneous revascularization...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27822619/the-5-lidocaine-medicated-plaster-its-inclusion-in-international-treatment-guidelines-for-treating-localized-neuropathic-pain-and-clinical-evidence-supporting-its-use
#16
REVIEW
Ralf Baron, Massimo Allegri, Gerardo Correa-Illanes, Guy Hans, Michael Serpell, Gerard Mick, Victor Mayoral
When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.e., pharmaceutical agents acting locally on the peripheral nervous system, and the topical route offers advantages over systemic administration. Notably, only a small fraction of the dose reaches the systemic circulation, thereby reducing the risk of systemic adverse effects, drug-drug interactions and overdose...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27769783/dietary-fat-composition-total-body-fat-and-regional-body-fat-distribution-in-two-caucasian-populations-of-middle-aged-and-older-adult-women
#17
Taulant Muka, Lauren C Blekkenhorst, Joshua R Lewis, Richar L Prince, Nicole S Erler, Albert Hofman, Oscar H Franco, Fernando Rivadeneira, Jessica C Kiefte-de Jong
OBJECTIVE: We aimed to study whether dietary fat composition (n-3 and n-6 polyunsaturated fatty acids ratio (PUFAs) and PUFAs and saturated fatty acids (SFAs) ratio) is associated with total body fat (TF) and body fat distribution and whether this association was modified by the presence of chronic disease in middle-aged and elderly women in two population-based cohorts in the Netherlands and Australia. METHODS: The study was performed in the Rotterdam Study (RS), a prospective cohort study among subjects aged 55 years and older (N = 1182 women) and the Calcium Intake Fracture Outcome Study (CAIFOS), a 5-year randomized controlled trial among women age 70+ (N = 891)...
September 28, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27754190/sp-05-3-does-the-sprint-trial-change-the-target-blood-pressure-in-the-elderly
#18
Clive Rosendorff
Many guidelines for the management of hypertension have recommended that the goal of antihypertensive treatment in the elderly (usually specified as 80 years or above) should be less than 150/90 mmHg. SPRINT included subjects 50 years or above, and a substantial proportion of subjects 75 years and older. These are individuals at high risk for adverse cardiovascular events because of high prevalence of hypertension and atherosclerotic disease. The less stringent BP goals have been based on a percieved danger of lowering BP to levels that threaten vital organ pefusion (myocardium, brain, kidney)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754167/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#19
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754163/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#20
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
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