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https://www.readbyqxmd.com/read/28902603/the-utility-of-conservative-treatment-modalities-in-the-management-of-osteonecrosis
#1
Feroz Osmani, Savyasachi Thakkar, Jonathan Vigdorchik
INTRODUCTION: Osteonecrosis is an ischemic pathologic process associated with a number of conditions affecting a range of age groups. The problem faced in the management of osteonecrosis is whether conservative treatment is a viable and effective option for patients. In this systematic review, we investigated the efficacy of various nonoperative treatment modalities for hip and knee osteonecrosis, including pharmacological management and biophysical modalities. METHODS: We identified 16 studies based on electronic searches through the PubMed, Embase, CINAHL Plus, and Cochrane databases from January 2001 to November 2015...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28878673/review-of-the-reported-measures-of-clinical-validity-and-clinical-utility-as-arguments-for-the-implementation-of-pharmacogenetic-testing-a-case-study-of-statin-induced-muscle-toxicity
#2
REVIEW
Marleen E Jansen, T Rigter, W Rodenburg, T M C Fleur, E J F Houwink, M Weda, Martina C Cornel
Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28873416/cost-effectiveness-analysis-of-use-of-a-polypill-versus-usual-care-or-best-practice-for-primary-prevention-in-people-at-high-risk-of-cardiovascular-disease
#3
Sue Jowett, Pelham Barton, Andrea Roalfe, Kate Fletcher, F D Richard Hobbs, Richard J McManus, Jonathan Mant
BACKGROUND: Clinical trials suggest that use of fixed-dose combination therapy ('polypills') can improve adherence to medication and control of risk factors of people at high risk of cardiovascular disease (CVD) compared to usual care, but cost-effectiveness is unknown. OBJECTIVE: To determine whether a polypill is cost-effective compared to usual care and optimal guideline-recommended treatment for primary prevention in people already on statins and/or blood pressure lowering therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28832867/cost-effectiveness-of-evolocumab-therapy-for-reducing-cardiovascular-events-in-patients-with-atherosclerotic-cardiovascular-disease
#4
Gregg C Fonarow, Anthony C Keech, Terje R Pedersen, Robert P Giugliano, Peter S Sever, Peter Lindgren, Ben van Hout, Guillermo Villa, Yi Qian, Ransi Somaratne, Marc S Sabatine
Importance: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the composite of myocardial infarction, stroke, or cardiovascular death in patients with established atherosclerotic cardiovascular disease. To our knowledge, long-term cost-effectiveness of this therapy has not been evaluated using clinical trial efficacy data. Objective: To evaluate the cost-effectiveness of evolocumab in patients with atherosclerotic cardiovascular disease when added to standard background therapy...
August 23, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28744103/clinical-utility-of-evolocumab-in-the-management-of-hyperlipidemia-patient-selection-and-follow-up
#5
REVIEW
Dave L Dixon, Leo F Buckley, Cory R Trankle, Dinesh Kadariya, Antonio Abbate
Inhibition of PCSK9 is a novel therapeutic strategy aimed at reducing low-density-lipoprotein cholesterol (LDL-C) and cardiovascular risk. Evolocumab is a fully humanized monoclonal antibody that inhibits PCSK9, an enzyme that binds to LDL receptors and prevents them from recycling to the hepatocyte surface. Clinical trials have demonstrated 50%-70% reductions in LDL-C with evolocumab when used in combination with statin therapy. The recent FOURIER trial demonstrated that evolocumab further reduces cardiovascular events, but not mortality, in high-risk patients already receiving statin therapy...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28557865/the-emerging-role-of-proprotein-convertase-subtilisin-kexin-type-9-inhibition-in-secondary-prevention-from-clinical-trials-to-real-world-experience
#6
Amritanshu S Pandey, Harpreet S Bajaj, Vinay Garg, Avinash Pandey, Subodh Verma
PURPOSE OF REVIEW: The recent advent of a highly efficacious class of low-density lipoprotein cholesterol (LDL-C) lowering agents, the proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors, has transformed dyslipidaemia management in patients with cardiovascular disease as well as those with familial hypercholesterolemia. RECENT FINDINGS: Recent positive results of the landmark Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk cardiovascular outcome trial with evolocumab as an add-on to statin therapy demonstrate further reduction of cardiovascular events...
May 26, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28465771/clinical-characteristics-and-unmet-need-among-patients-with-atherosclerotic-cardiovascular-disease-stratified-by-statin-use
#7
Qing Huang, Michael Grabner, Robert J Sanchez, Vincent J Willey, Mark J Cziraky, Swetha R Palli, Thomas P Power
BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines for blood cholesterol treatment recommend high-intensity statins for adults with atherosclerotic cardiovascular disease (ASCVD). Currently, little is known about the real-world patient characteristics of ASCVD, as well as the clinical and economic consequences of different treatment options for this disease. OBJECTIVES: To compare the demographic, clinical, and economic characteristics of patients with clinical ASCVD who started therapy with high-intensity statins, low-/moderate-intensity statins, or no statins in usual-care settings based on data primarily before the release of the ACC/AHA 2013 guidelines...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28428922/the-cost-benefit-balance-of-statins-in-hawai-i-a-moving-target
#8
Corey J Lum, Kazuma Nakagawa, Ralph V Shohet, Todd B Seto, Deborah A Taira
Statins are lipid-lowering medications used for primary and secondary prevention of atherosclerotic disease and represent a substantial portion of drug costs in the United States. A better understanding of prescribing patterns and drug costs should lead to more rational utilization and help constrain health care expenditures in the United States. The 2013 Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File for the State of Hawai'i was analyzed. The number of prescriptions for statins, total annual cost, and daily cost were calculated by prescriber specialty and drug...
April 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28426345/economic-evaluation-of-ezetimibe-treatment-in-combination-with-statin-therapy-in-the-united-states
#9
Glenn M Davies, Ami Vyas, Carl A Baxter
AIMS: This study assessed the cost-effectiveness of ezetimibe with statin therapy vs statin monotherapy from a US payer perspective, assuming the impending patent expiration of ezetimibe. METHODS: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses...
July 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28366593/cost-effectiveness-of-evolocumab-in-patients-with-high-cardiovascular-risk-in-spain
#10
Guillermo Villa, Mickael Lothgren, Lucie Kutikova, Peter Lindgren, Shravanthi R Gandra, Gregg C Fonarow, Francesc Sorio, Lluis Masana, Antoni Bayes-Genis, Ben van Hout
PURPOSE: Our objective was to assess the cost-effectiveness of evolocumab in patients at high risk of cardiovascular (CV) events from the Spanish National Health System perspective. METHODS: A Markov model was used to assess the cost-effectiveness (incremental [∆] cost per ∆ quality-adjusted life-year [QALY]; or cost utility) of evolocumab plus standard of care (SoC; statins) versus SoC, assuming lifetime treatment. Cohorts with baseline LDL-C >100 mg/dL and familial hypercholesterolemia (FH) or CV event history (secondary prevention [SP]) were considered...
March 30, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28347513/cost-effectiveness-of-maintaining-daily-intake-of-oat-%C3%AE-glucan-for-coronary-heart-disease-primary-prevention
#11
Stephanie R Earnshaw, Cheryl L McDade, YiFang Chu, Lisa E Fleige, John L Sievenpiper
PURPOSE: Oat β-glucan reduces cholesterol levels and thus reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examined the economic impact of daily intake of ≥3 g of oat β-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment. METHODS: A decision model was developed to compare costs and outcomes associated with lowering cholesterol levels with no pharmacologic treatment and normal diet, no pharmacologic treatment plus ≥3 g/d of oat β-glucan, and statin therapy plus ≥3 g/d of oat β-glucan...
March 25, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28279072/aspirin-in-older-adults
#12
Mandi Sehgal, Sarah K Wood, Joseph G Ouslander, Charles H Hennekens
In the treatment or secondary prevention of cardiovascular disease (CVD), there is general consensus that the absolute benefits of aspirin far outweigh the absolute risks. Despite evidence from randomized trials and their meta-analyses, older adults, defined as aged 65 years or older, are less likely to be prescribed aspirin than their middle-aged counterparts. In primary prevention, the optimal utilization of aspirin is widely debated. There is insufficient randomized evidence among apparently healthy participants at moderate to high risk of a first CVD event, so general guidelines seem premature...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27927162/use-of-low-density-lipoprotein-particle-number-levels-as-an-aid-in-statin-treatment-decisions-for-intermediate-risk-patients-a-cost-effectiveness-analysis
#13
Dov Shiffman, Andre R Arellano, Michael P Caulfield, Judy Z Louie, Lance A Bare, James J Devlin, Olle Melander
BACKGROUND: The 2013 ACC/AHA guideline recommended either no statin therapy or moderate-intensity statin therapy (MST) for intermediate risk patients-those with 5-7.5% 10-year risk and without cardiovascular disease (CVD), hypercholesterolemia or diabetes. The guideline further suggested that the therapy choice be based on patient-clinician discussions of risks and benefits. Since low-density lipoprotein particle (LDL-P) levels were reported to be associated with CVD independently of traditional risk factors in intermediate and low risk patients, we investigated the cost-effectiveness of using LDL-P levels to identify intermediate risk patients likely to benefit from initiating or intensifying statin therapy...
December 7, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27836822/impact-of-cost-sharing-on-therapeutic-substitution-the-story-of-statins-in-2006
#14
Pengxiang Li, J Sanford Schwartz, Jalpa A Doshi
BACKGROUND: Cost sharing is widely used to encourage therapeutic substitution. This study aimed to examine the impact of increases in patient cost-sharing differentials for brand name and generic drugs on statin utilization on entry into the Medicare Part D coverage gap. METHOD AND RESULTS: Using 5% Medicare Chronic Condition Warehouse files from 2006, this quasi-experimental study examined patients with hyperlipidemia who filled prescriptions for atorvastatin or rosuvastatin between January and March 2006...
November 11, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27753942/os-06-07-combining-short-and-long-term-risk-scores-in-primary-prevention-of-major-cardiovascular-disease-events-in-low-incidence-populations-an-assessment-of-clinical-utility
#15
Giovanni Veronesi, Simona Giampaoli, Francesco Gianfagna, Luigi Palmieri, Diego Vanuzzo, Guido Grassi, Giancarlo Cesana, Marco M Ferrario
OBJECTIVE: To evaluate the clinical utility of the CAMUNI-MATISS 20-year risk score, recently validated for the Italian population, as additional screening tool for individuals at "low" (ESC-SCORE Project predicted 10-year risk ≤ 1%; no preventive action), "intermediate" (ESC-SCORE 1-4%; lifestyle modification/statin treatment) and "high" risk (ESC-SCORE≥ 4% or diabetes; statin treatment) according to the Italian regulation. DESIGN AND METHOD: 40-65 years old initially CVD-free participants to 7 population-based cohorts enrolled in Northern and Central Italy between 1986 and 1996 were followed-up (median 16 years, IQR: 12-20) to the first occurrence of coronary event or ischemic stroke (fatal or non-fatal), coronary or carotid revascularizations...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27662221/cost-benefit-of-appointment-based-medication-synchronization-in-community-pharmacies
#16
Julie A Patterson, David A Holdford, Kunai Saxena
OBJECTIVES: To evaluate the cost-benefit of appointment-based medication synchronization (ABMS) offered in community pharmacies for patients taking chronic medications to prevent negative outcomes associated with hyperlipidemia, hypertension, and diabetes. STUDY DESIGN: Decision-tree analysis based on published literature and publicly available data. METHODS: Program benefits were based on linking published findings of improvements in medication adherence due to the implementation of an ABMS program to a claims-based study of disease-related medical costs associated with different levels of adherence...
September 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27650822/%C3%AE-blockers-and-mortality-after-myocardial-infarction-in-patients-without-heart-failure-multicentre-prospective-cohort-study
#17
MULTICENTER STUDY
Etienne Puymirat, Elisabeth Riant, Nadia Aissoui, Angèle Soria, Gregory Ducrocq, Pierre Coste, Yves Cottin, Jean François Aupetit, Eric Bonnefoy, Didier Blanchard, Simon Cattan, Gabriel Steg, François Schiele, Jean Ferrières, Yves Juillière, Tabassome Simon, Nicolas Danchin
OBJECTIVE:  To assess the association between early and prolonged β blocker treatment and mortality after acute myocardial infarction. DESIGN:  Multicentre prospective cohort study. SETTING:  Nationwide French registry of Acute ST- and non-ST-elevation Myocardial Infarction (FAST-MI) (at 223 centres) at the end of 2005. PARTICIPANTS:  2679 consecutive patients with acute myocardial infarction and without heart failure or left ventricular dysfunction...
September 20, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27643337/os-06-07-combining-short-and-long-term-risk-scores-in-primary-prevention-of-major-cardiovascular-disease-events-in-low-incidence-populations-an-assessment-of-clinical-utility
#18
Giovanni Veronesi, Simona Giampaoli, Francesco Gianfagna, Luigi Palmieri, Diego Vanuzzo, Guido Grassi, Giancarlo Cesana, Marco M Ferrario
OBJECTIVE: To evaluate the clinical utility of the CAMUNI-MATISS 20-year risk score, recently validated for the Italian population, as additional screening tool for individuals at "low" (ESC-SCORE Project predicted 10-year risk ≤ 1%; no preventive action), "intermediate" (ESC-SCORE 1-4%; lifestyle modification/statin treatment) and "high" risk (ESC-SCORE≥ 4% or diabetes; statin treatment) according to the Italian regulation. DESIGN AND METHOD: 40-65 years old initially CVD-free participants to 7 population-based cohorts enrolled in Northern and Central Italy between 1986 and 1996 were followed-up (median 16 years, IQR: 12-20) to the first occurrence of coronary event or ischemic stroke (fatal or non-fatal), coronary or carotid revascularizations...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27599748/statin-adherence-rates-in-patients-utilizing-a-patient-centered-medical-home-based-pharmacy
#19
Erin M Slazak, Jessica T Kozakiewicz, Natalie S Winters, Jason R Smith, Scott V Monte
BACKGROUND: Medication nonadherence contributes to approximately US$290 billion per year in avoidable health-care spending. Statins are of particular interest because of their importance to patient outcomes, costs of treatment failure, and categorization as a Medicare star measure linked to financial reimbursement. OBJECTIVE: To evaluate statin adherence as defined by the proportion of days covered (PDC) among patients who use an embedded dispensing pharmacy in a patient-centered medical home (PCMH)...
September 6, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27585206/the-role-of-a-coronary-artery-calcium-scan-in-type-1-diabetes
#20
Mark R Burge, R Philip Eaton, David S Schade
The coronary artery calcium (CAC) scan has recently emerged as a reproducible noninvasive test to detect asymptomatic atherosclerotic coronary artery disease. It has several advantages over the traditional cardiac stress testing modalities, including lower cost, greater sensitivity for nonobstructing coronary artery lesions, and excellent prognostic value when combined with the Framingham risk parameters. Its chief disadvantage is that it does not identify obstructing coronary artery lesions or noncalcified coronary artery plaque...
September 2016: Diabetes Technology & Therapeutics
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