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https://www.readbyqxmd.com/read/29451078/oncologists-perceptions-of-drug-affordability-using-nccn-evidence-blocks-results-from-a-national-survey
#1
Bijal Shah-Manek, William Wong, Arliene Ravelo, Marco DiBonaventura
BACKGROUND: The increasing prevalence of cancer coupled with approvals of new drugs and technologies used in therapy have brought increased scrutiny to the cost and value of treatments in oncology. To address the rising concern about oncology drug costs, several organizations have developed value frameworks to help assess the value of oncology regimens. The objective of this study was to assess oncologists' perceptions, awareness, and knowledge of all oncology value frameworks in the United States and to understand oncologists' perceptions of affordability in the context of National Comprehensive Cancer Network (NCCN) Evidence Blocks...
February 16, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29406841/slow-titration-and-delayed-intensification-of-basal-insulin-among-patients-with-type-2-diabetes
#2
Michelle Mocarski, Jason Yeaw, Victoria Divino, Mitch DeKoven, German Guerrero, Jakob Langer, Brian Larsen Thorsted
BACKGROUND: Clinical inertia in type 2 diabetes mellitus (T2DM) refers to the failure of clinicians to intensify therapy when indicated. Many T2DM patients remain suboptimally controlled after initiating basal insulin. OBJECTIVE: To examine the prevalence of patients treated with basal insulin but in poor glycemic control (hemoglobin A1c [A1c] ≥ 7%) after initiation and subsequent treatment intensification patterns and glycemic outcomes in a real-world setting...
November 16, 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29397376/semaglutide-versus-dulaglutide-once-weekly-in-patients-with-type-2-diabetes-sustain-7-a-randomised-open-label-phase-3b-trial
#3
Richard E Pratley, Vanita R Aroda, Ildiko Lingvay, Jörg Lüdemann, Camilla Andreassen, Andrea Navarria, Adie Viljoen
BACKGROUND: Despite common mechanisms of actions, glucagon-like peptide-1 receptor agonists differ in structure, pharmacokinetic profile, and clinical effects. This head-to-head trial compared semaglutide with dulaglutide in patients with inadequately controlled type 2 diabetes. METHODS: This was an open-label, parallel-group, phase 3b trial done at 194 hospitals, clinical institutions or private practices in 16 countries. Eligible patients were aged 18 years or older and had type 2 diabetes with HbA1c 7·0-10·5% (53·0-91·0 mmol/mol) on metformin monotherapy...
January 31, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29383626/continuous-infusions-of-b-domain-truncated-recombinant-factor-viii-turoctocog-alfa-for-orthopedic-surgery-in-severe-hemophilia-a-first-case-report
#4
Masahiro Takeyama, Keiji Nogami, Ryohei Kobayashi, Kenichi Ogiwara, Akira Taniguchi, Yasuaki Nakanishi, Yusuke Inagaki, Yasuhito Tanaka, Midori Shima
Continuous infusions (CI) of factor (F)VIII are preferable to the conventional bolus injections for the maintenance of consistent FVIII levels during surgery in patients with severe hemophilia A. A third generation, B domain-truncated recombinant FVIII (turoctocog alfa, Novo Nordisk, NovoEight®), was approved for clinical use in 2014. The hemostatic efficacy and safety of bolus injections of turoctocog alfa in patients undergoing surgery have been reported, but no reports on CI therapy have been published...
January 30, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29369493/injecting-without-pressing-a-button-an-exploratory-study-of-a-shield-triggered-injection-mechanism
#5
Eric Zijlstra, Hans-Veit Coester, Tim Heise, Leona Plum-Mörschel, Ole Rasmussen, Tord Rikte, Line Kynemund Pedersen, Marianne Qvist, Thomas Sparre
AIMS: To evaluate the injection success and user perception of a shield-triggered pen-injector mechanism. METHODS: The trial (ClinicalTrials.gov NCT02627287) was an exploratory, two-centre, one-visit, open-label, randomized controlled trial conducted in Germany in 150 injection-experienced individuals with type 1 or type 2 diabetes. Participants self-administered subcutaneous injections of a placebo solution using a prototype shield-triggered pen-injector, DV3316 (Novo Nordisk, Bagsvaerd, Denmark), and FlexPen (Novo Nordisk, Bagsvaerd, Denmark)...
December 27, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29363040/semaglutide-first-global-approval
#6
Sohita Dhillon
Novo Nordisk has developed a subcutaneous formulation of semaglutide (Ozempic®), a modified human glucagon-like peptide-1 (GLP-1) analogue, for the treatment of type 2 diabetes mellitus. It has been developed using Novo Nordisk's proprietary protein-acylation technology, and is administered using an injection device. Semaglutide lowers blood glucose by stimulating the release of insulin and also lowers body weight. Once-weekly subcutaneous semaglutide has recently been approved in the US, Puerto Rico and Canada, and has received a positive opinion in the EU for the treatment of patients with type 2 diabetes...
February 2018: Drugs
https://www.readbyqxmd.com/read/29349682/managing-obesity-in-primary-care-breaking-down-the-barriers
#7
REVIEW
Nicholas Forgione, Gary Deed, Gary Kilov, Georgia Rigas
Several Australian obesity management guidelines have been developed for general practice but, to date, implementation of these guidelines has been shown to be inadequate. In this review, we explore the barriers to obesity treatment and propose a four-stage plan to manage individuals with obesity in general practice using a framework of a multidisciplinary team. FUNDING: Novo Nordisk.
January 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29211679/contemporary-hormonal-contraception-and-the-risk-of-breast-cancer
#8
Lina S Mørch, Charlotte W Skovlund, Philip C Hannaford, Lisa Iversen, Shona Fielding, Øjvind Lidegaard
BACKGROUND: Little is known about whether contemporary hormonal contraception is associated with an increased risk of breast cancer. METHODS: We assessed associations between the use of hormonal contraception and the risk of invasive breast cancer in a nationwide prospective cohort study involving all women in Denmark between 15 and 49 years of age who had not had cancer or venous thromboembolism and who had not received treatment for infertility. Nationwide registries provided individually updated information about the use of hormonal contraception, breast-cancer diagnoses, and potential confounders...
December 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29205786/pharmacokinetics-and-tolerability-of-semaglutide-in-subjects-with-hepatic-impairment
#9
Lene Jensen, Viera Kupcova, Gerhard Arold, Jonas Pettersson, Julie B Hjerpsted
AIMS: To investigate whether the pharmacokinetic characteristics of semaglutide were altered in subjects with hepatic impairment, assessed using Child-Pugh criteria, versus those with normal hepatic function. METHODS: In this multicentre, open-label, parallel-group trial (sponsor Novo Nordisk, ClinicalTrials.gov ID NCT02210871), four groups of subjects with normal hepatic function (n = 19) or mild (n = 8), moderate (n = 10) or severe (n =7) hepatic impairment received a single, subcutaneous dose of 0...
December 5, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29204855/achieving-good-glycemic-control-early-after-onset-of-diabetes-a-cost-effectiveness-analysis-in-patients-with-type-1-diabetes-in-sweden
#10
Johan Jendle, Åsa Ericsson, Barnaby Hunt, William J Valentine, Richard F Pollock
INTRODUCTION: Sweden has amongst the highest incidence rates of type 1 diabetes (T1D) in Europe. The high incidence and chronic nature of T1D result in high prevalence and economic burden. Improving glycemic control reduces the incidence of microvascular complications, which in turn reduces medical costs. The present study aimed to quantify the reductions in cost and improvements in quality-adjusted life expectancy with varying reductions in HbA1c in the T1D population. METHODS: The IQVIA CORE Diabetes Model was used to simulate a typical Swedish population of patients with T1D experiencing HbA1c reductions from 0...
December 4, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29199116/repaglinide-versus-insulin-for-newly-diagnosed-diabetes-in-patients-with-cystic-fibrosis-a-multicentre-open-label-randomised-trial
#11
Manfred Ballmann, Dominique Hubert, Baroukh M Assael, Doris Staab, Alexandra Hebestreit, Lutz Naehrlich, Tanja Nickolay, Nicole Prinz, Reinhard W Holl
BACKGROUND: As survival among patients with cystic fibrosis has improved in recent decades, complications have become increasingly relevant. The most frequent complication is cystic-fibrosis-related diabetes. The recommended treatment is injected insulin, but some patients are treated with oral antidiabetic drugs to ease the treatment burden. We assessed the efficacy and safety of oral antidiabetic drugs. METHODS: We did a multicentre, open-label, comparative, randomised trial in 49 centres in Austria, France, Germany, and Italy...
November 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29197387/liraglutide-and-metformin-alone-or-combined-therapy-for-type-2-diabetes-patients-complicated-with-coronary-artery-disease
#12
Ying Liu, Xia Jiang, Xin Chen
BACKGROUND: This study is to compare the effects of Liraglutide and Metformin alone or combined treatment on the cardiac function in T2DM patients complicated with CAD. METHODS: 120 T2DM patients were included at Endocrinology Department of Tianjin First Center Hospital (Tianjin, China) from April 2012 to September 2013. The study contained two sections. Section 1: 30 patients in group 1 was treated with Liraglutide (Novo Nordisk) (1.2 mg/d), and 30 patients in group 2 with Metformin (Shiguibao) (1500 mg/d) for 24 weeks...
December 2, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29188338/effects-of-hypoglycaemia-on-working-memory-and-regional-cerebral-blood-flow-in-type-1-diabetes-a-randomised-crossover-trial
#13
Michael Gejl, Albert Gjedde, Birgitte Brock, Arne Møller, Eelco van Duinkerken, Hanne L Haahr, Charlotte T Hansen, Pei-Ling Chu, Kirstine L Stender-Petersen, Jørgen Rungby
AIMS/HYPOTHESIS: The aim of this randomised, crossover trial was to compare cognitive functioning and associated brain activation patterns during hypoglycaemia (plasma glucose [PG] just below 3.1 mmol/l) and euglycaemia in individuals with type 1 diabetes mellitus. METHODS: In this patient-blinded, crossover study, 26 participants with type 1 diabetes mellitus attended two randomised experimental visits: one hypoglycaemic clamp (PG 2.8 ± 0.2 mmol/l, approximate duration 55 min) and one euglycaemic clamp (PG 5...
November 29, 2017: Diabetologia
https://www.readbyqxmd.com/read/29129018/a-32-week-randomized-comparison-of-stepwise-insulin-intensification-of-biphasic-insulin-aspart-biasp%C3%A2-30-versus-basal-bolus-therapy-in-insulin-na%C3%A3-ve-patients-with-type-2-diabetes
#14
Sultan Linjawi, Byung-Wan Lee, Ömür Tabak, Susanna Lövdahl, Shanti Werther, Salahedeen Abusnana
INTRODUCTION: This 32-week, open-label, randomized, parallel-group, multinational trial aimed to compare the efficacy and safety of stepwise insulin intensification of biphasic insulin aspart 30 (BIAsp 30) relative to stepwise intensification of a basal-bolus regimen in insulin-naïve adults with type 2 diabetes (T2D) who continued pretrial treatment with metformin and sulfonylurea. METHODS: Adults with T2D were randomized into one of two treatment arms for 32 weeks: (1) BIAsp 30 once daily (OD), with the possibility of stepwise treatment intensification up to BIAsp 30 three times daily (TID); (2) insulin glargine OD, with the possibility of stepwise treatment intensification with insulin aspart up to TID...
November 11, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29121256/malignant-testicular-germ-cell-tumors-in-postpubertal-individuals-with-androgen-insensitivity-prevalence-pathology-and-relevance-of-single-nucleotide-polymorphism-based-susceptibility-profiling
#15
M Cools, K P Wolffenbuttel, R Hersmus, B B Mendonca, J Kaprová, S L S Drop, H Stoop, A J M Gillis, J W Oosterhuis, E M F Costa, S Domenice, M Y Nishi, L Wunsch, C A Quigley, G T'Sjoen, L H J Looijenga
STUDY QUESTION: What is the prevalence of malignant testicular germ cell tumors (TGCT) and its precursors, (pre-) germ cell neoplasia in situ (GCNIS), in late teenagers and adults who have androgen insensitivity syndrome (AIS) and the impact of an individual's genetic susceptibility to development of TGCT? SUMMARY ANSWER: No GCNIS or TGCT was diagnosed, but pre-GCNIS was identified in 14 and 10% of complete and partial AIS patients, respectively, and was associated with a higher genetic susceptibility score (GSS), with special attention for KITLG (rs995030) and ATFZIP (rs2900333)...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29115204/use-of-the-smartphone-application-pregnant-with-diabetes
#16
Sidse Kjærhus Nørgaard, Vibeke Ladefoged Nichum, Charlotte Barfred, Hellen Marguerite Juul, Anna Lilja Secher, Lene Ringholm, Peter Damm, Elisabeth Reinhardt Mathiesen
INTRODUCTION: The aim of this article was to evaluate the awareness and use of the smartphone application (app) "Pregnant with Diabetes" locally, nationally and internationally. METHODS: In 2013, a patient initiated collaboration with the staff at Centre for Pregnant Women with Diabetes, Rigs-hospitalet, to develop the app "Pregnant with Diabetes". The app communicates clinically important antenatal health information to women with diabetes, based on recommendations from our centre...
November 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29102566/cardiovascular-risk-factors-and-carotid-intima-media-thickness-in-young-adults-born-small-for-gestational-age-after-cessation-of-growth-hormone-treatment-a-5-year-longitudinal-study
#17
Manouk van der Steen, Gerthe F Kerkhof, Carolina C J Smeets, Anita C S Hokken-Koelega
BACKGROUND: Growth hormone treatment reduces blood pressure and lipid concentrations. We assessed long-term changes in blood pressure, lipid concentrations, and carotid intima media thickness over a 5-year period after cessation of growth hormone treatment in adults born small for gestational age. METHODS: We did a longitudinal observational study at a medical centre in the Netherlands between April 1, 2004, and April 1, 2016. We included adults born small for gestational age who were treated with growth hormone (1 mg/m2 per day); treatment started during childhood until adult height...
December 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29083973/amcp-partnership-forum-advancing-value-based-contracting
#18
(no author information available yet)
During the past decade, payment models for the delivery of health care have undergone a dramatic shift from focusing on volume to focusing on value. This shift began with the Affordable Care Act and was reinforced by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which increased the emphasis on payment for delivery of quality care. Today, value-based care is a primary strategy for improving patient care while managing costs. This shift in payment models is expanding beyond the delivery of health care services to encompass models of compensation between payers and biopharmaceutical manufacturers...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29083969/personalized-care-and-the-role-of-insulin-as-a-vehicle-to-optimizing-treatments-in-diabetes-care
#19
Nella Bieszk, Michael Grabner, Wenhui Wei, John Barron, Ralph Quimbo, Tingjian Yan, Beth Biel, James W Chu
BACKGROUND: In patients with type 2 diabetes (T2D) with poor glycemic control, there is an unmet need for treatment optimization involving the initiation and/or intensification of insulin therapy, which is often delayed because of clinical inertia. Educational initiatives that target patients and physicians might be one way to address this need. OBJECTIVE: To evaluate the effectiveness of educational materials mailed to physicians and their patients in affecting initiation of insulin therapy and other health care outcomes...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#20
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
December 2017: Lancet Diabetes & Endocrinology
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