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https://www.readbyqxmd.com/read/28441507/new-metrics-for-economic-evaluation-in-the-presence-of-heterogeneity-focusing-on-evaluating-policy-alternatives-rather-than-treatment-alternatives
#1
David D Kim, Anirban Basu
BACKGROUND: Cost-effectiveness analysis (CEA) methods fail to acknowledge that where cost-effectiveness differs across subgroups, there may be differential adoption of technology. Also, current CEA methods are not amenable to incorporating the impact of policy alternatives that potentially influence the adoption behavior. Unless CEA methods are extended to allow for a comparison of policies rather than simply treatments, their usefulness to decision makers may be limited. METHODS: We conceptualize new metrics, which estimate the realized value of technology from policy alternatives, through introducing subgroup-specific adoption parameters into existing metrics, incremental cost-effectiveness ratios (ICERs) and Incremental Net Monetary Benefits (NMBs)...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28441155/do-triglyceride-lowering-drugs-decrease-risk-of-cardiovascular-disease
#2
Kevin C Maki, Mary R Dicklin
PURPOSE OF REVIEW: This review summarizes the evidence supporting a relationship between lowering triglycerides (TGs) and TG-rich lipoprotein cholesterol (TGRL-C) levels and reduced atherosclerotic cardiovascular disease (ASCVD) event risk. RECENT FINDINGS: Data from observational investigations, including studies of genetic variants, provide evidence consistent with a causal relationship between elevations in TG and TGRL-C and greater risk for ASCVD. Randomized controlled trial evidence of ASCVD risk reduction with therapies that substantially lower TG and TGRL-C is limited by the fact that no large-scale trial results have been published from a study that enrolled subjects selected specifically on the basis of TG or TGRL-C elevation, although three such trials are underway or in the planning stages...
April 22, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28413978/advances-and-challenges-in-drug-design-of-ppar%C3%AE-ligands
#3
Vinicius Gonçalves Maltarollo, Thales Kronenberger, Björn Windshügel, Carsten Wrenger, Gustavo Henrique Goulart Trossini, Kathia Maria Honorio
Peroxisome proliferator-activated receptors (PPAR) are nuclear receptors activated by endogenous fatty acids and prostaglandins that are classified into three types: α, γ and δ, which have different functions and tissue distribution. PPAR modulators have been exploited to the treatment of important metabolic diseases, such as type 2 diabetes mellitus and metabolic syndrome, which are considered relevant epidemic diseases currently. Along the last decades, several studies have reported structural differences between the three PPAR subtypes associated with the discovery of selective ligands, dual and pan-agonists...
April 14, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28401920/occurrence-of-fibrates-and-their-metabolites-in-source-and-drinking-water-in-shanghai-and-zhejiang-china
#4
Akiko Ido, Youhei Hiromori, Liping Meng, Haruki Usuda, Hisamitsu Nagase, Min Yang, Jianying Hu, Tsuyoshi Nakanishi
Fibrates, which are widely used lipidaemic-modulating drugs, are emerging environmental pollutants. However, fibrate concentrations in the environment have not been thoroughly surveyed. Here, we determined concentrations of the most commonly used fibrates and their metabolites in source water and drinking water samples from ten drinking water treatment plants in Shanghai and Zhejiang, China, using solid-phase extraction and liquid chromatography-tandem mass spectrometry. All the target compounds were detected in at least some of the source water samples, at concentrations ranging from 0...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28394011/how-has-the-treatment-of-hypercholesterolemia-in-poland-changed-over-the-last-6-years
#5
Agnieszka Kapłon-Cieślicka, Marcin Michalak, Łukasz Kołtowski, Krzysztof J Filipiak
BACKGROUND: To assess changes in the treatment of hypercholesterolemia in Polish ambulatory care over the last 6 years. METHODS: Data were obtained from two separate questionnaire-based studies, conducted in 2009 and 2015. The analysis included only those patient visits, which were associated with modifications of previous hypercholesterolemia treatment (1924 visits from the year 2009 and 1888 visits from the year 2015). RESULTS: In the present registry, there was a 19 mg/dL reduction in the level of total cholesterol and a 17 mg/dL reduction in the level of low-density lipoprotein compared to year 2009...
April 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28391900/estrogen-associated-severe-hypertriglyceridemia-with-pancreatitis
#6
Sumayah Aljenedil, Robert A Hegele, Jacques Genest, Zuhier Awan
BACKGROUND: Estrogen, whether therapeutic or physiologic, can cause hypertriglyceridemia. Hypertriglyceridemia-induced pancreatitis is a rare complication. CASES: We report 2 women who developed estrogen-associated severe hypertriglyceridemia with pancreatitis. The first patient developed pancreatitis secondary to hypertriglyceridemia associated with in vitro fertilization cycles. Marked reduction in her triglyceride was achieved with dietary restrictions and fibrate...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28391898/severe-decrease-in-high-density-lipoprotein-cholesterol-with-the-combination-of-fibrates-and-ezetimibe-a-case-series
#7
Estelle Nobecourt, Bertrand Cariou, Gilles Lambert, Michel Krempf
A sudden and severe drug-induced decrease in plasma high-density lipoprotein cholesterol (HDL-C) is a rare condition. We report 2 patients with familial hypercholesterolemia treated with statins and fibrates and 2 others with mixed dyslipidemia treated with fibrates, who presented with a sudden and severe decrease in HDL-C (from -44% to -95%, compared with baseline). Three of the patients were treated with fibrates and had a sudden decrease in HDL-C after the adjunction of ezetimibe. HDL-C returned to normal levels after discontinuation of the offending therapies...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28391878/autosomal-dominant-familial-dysbetalipoproteinemia-a-pathophysiological-framework-and-practical-approach-to-diagnosis-and-therapy
#8
REVIEW
Charlotte Koopal, A David Marais, Jan Westerink, Frank L J Visseren
Familial dysbetalipoproteinemia (FD) is a genetic disorder of lipoprotein metabolism associated with an increased risk for premature cardiovascular disease. In about 10% of the cases, FD is caused by autosomal dominant mutations in the apolipoprotein E gene (APOE). This review article provides a pathophysiological framework for autosomal dominant FD (ADFD) and discusses diagnostic challenges and therapeutic options. The clinical presentation and diagnostic work-up of ADFD are illustrated by two cases: a male with premature coronary artery disease and a p...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28376607/statin-utilization-improves-oncologic-and-survival-outcomes-in-patients-with-dyslipidemia-and-surgically-treated-renal-cell-carcinoma
#9
Sean W Berquist, Hak J Lee, Zachary Hamilton, Aditya Bagrodia, Abdelrahman Hassan, Alp T Beksaç, Catherine A Dufour, Song Wang, Reza Mehrazin, Anthony Patterson, Ithaar H Derweesh
BACKGROUND: We evaluated the role of statins in patients who underwent surgery for Renal Cell Carcinoma (RCC) and who had dyslipidemia, as use of statins has been suggested to improve outcomes in RCC. METHODS: Two-center retrospective study of patients with dyslipidemia who underwent surgery for RCC from 7/1995 to 6/2005. Patients were managed by statins or ezetimibe, fibrate agents, or cholestyramine. Analysis was conducted between patients who received statin therapy versus those that did not...
March 30, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28374976/ppar%C3%AE-activation-suppresses-cytochrome-p450-induction-potential-in-mice-treated-with-gemfibrozil
#10
Cunzhong Shi, Luo Min, Julin Yang, Manyun Dai, Danjun Song, Huiying Hua, Gangming Xu, Frank J Gonzalez, Aiming Liu
Gemfibrozil, a peroxisome proliferator-activated receptor α (PPARα) agonist, is widely used for hypertriglyceridaemia and mixed hyperlipidaemia. Drug-drug interaction of gemfibrozil and other PPARα agonists has been reported. However, the role of PPARα in Cytochrome P450 (CYP) induction by fibrates is not well known. In this study, wild-type mice were first fed gemfibrozil-containing diets (0.375%, 0.75% and 1.5%) for 14 days to establish a dose-response relationship for CYP induction. Then, wild-type mice and Pparα-null mice were treated with a 0...
April 4, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28343425/ppar-%C3%AE-agonists-are-still-on-the-rise-an-update-on-clinical-and-experimental-findings
#11
Nicola Ferri, Alberto Corsini, Cesare Sirtori, Massimiliano Ruscica
Non-fasting plasma triglyceride (TG) and remnant cholesterol levels, cholesterol content of triglyceride-rich lipoproteins, have been suggested to be an additional cause of cardiovascular diseases; thus, pharmacological TG-lowering with fibrates, activators of PPAR-alpha system, has been linked to risk reduction. Areas covered: This manuscript reviews available evidence on clinical trials involving highly selective PPAR-α agonists (i.e., pemafibrate) and drugs used in the pre-clinical and experimental setting (e...
May 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28302902/risk-of-febuxostat-associated-myopathy-in-patients-with-ckd
#12
Chung-Te Liu, Chun-You Chen, Chien-Yi Hsu, Po-Hsun Huang, Feng-Yen Lin, Jaw-Wen Chen, Shing-Jong Lin
BACKGROUND AND OBJECTIVES: Febuxostat, a nonpurine xanthine oxidase inhibitor, is widely used to treat hyperuricemia. Although febuxostat-associated rhabdomyolysis was reported in some patients with CKD, the association between CKD and febuxostat-associated myopathy remains uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study included 1332 patients using febuxostat in Taipei Medical University-Wanfang Hospital from February of 2014 to January of 2016...
March 16, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28300080/hypertriglyceridaemia-and-risk-of-coronary-artery-disease
#13
REVIEW
Željko Reiner
An elevated serum level of LDL cholesterol is a well-known risk factor for cardiovascular disease (CVD), but the role of elevated triglyceride levels is debated. Controversies regarding hypertriglyceridaemia as an independent risk factor for CVD have occurred partly because elevated triglyceride levels are often a component of atherogenic dyslipidaemia - they are associated with decreased levels of HDL cholesterol and increased levels of small dense LDL particles, which are highly atherogenic. Findings from several large studies indicate that elevated levels of triglycerides (either fasting or nonfasting) or, more specifically, triglyceride-rich lipoproteins and their remnants, are independently associated with increased risk of CVD...
March 16, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28263783/establishment-of-a-novel-mouse-model-for-pioglitazone-induced-skeletal-muscle-injury
#14
Sho Akai, Shingo Oda, Tsuyoshi Yokoi
Skeletal muscle (SKM) injury is one of the major safety concerns in risk assessment for drug development. However, no appropriate pre-clinical animal model exists to evaluate drug-induced SKM injury except that caused by fibrates and statins. Thiazolidinedione, a PPARγ agonistic drug for type 2 diabetes mellitus, is widely used clinically but can induce adverse effects such as hepatotoxicity and SKM injury, as has been reported in recent decades. Moreover, thiazolidinedione-induced SKM injury has only been reported in humans, and no evidence of SKM injury has been observed in rodents...
March 2, 2017: Toxicology
https://www.readbyqxmd.com/read/28262189/hypercholesterolemia-as-a-risk-factor-for-cardiovascular-disease-current-controversial-therapeutic-management
#15
REVIEW
Arturo Zárate, Leticia Manuel-Apolinar, Renata Saucedo, Marcelino Hernández-Valencia, Lourdes Basurto
Cholesterol is a precursor of steroid hormones and an essential component of the cell membrane; however, altered regulation of the synthesis, absorption and excretion of cholesterol predispose to cardiovascular diseases of atherosclerotic origin. Despite the recognition of historical events for 200 years starting with Chevreul naming "cholesterine"; later on, Lobstein coining the term atherosclerosis and Marchand introducing it, Anichkov identifying cholesterol in atheromatous plaque, and Brown and Goldstein discovering LDL receptor (r-LDL), as well as the emergence of different drugs such as fibrates, statins and cetrapibs during this decade promising to increase HDL, and the most recent, ezetimibe and anti-PCSK9 to inhibit the degradation of r-LDL, morbidity has not been reduced in cardiovascular disease...
October 2016: Archives of Medical Research
https://www.readbyqxmd.com/read/28251701/molecular-effect-of-fenofibrate-on-pbmc-gene-transcription-related-to-lipid-metabolism-in-metabolic-syndrome-patients
#16
I Moreno-Indias, F J Tinahones, M Clemente-Postigo, D Castellano-Castillo, J C Fernández-García, M Macias-Gonzalez, M I Queipo-Ortuño, F Cardona
BACKGROUND: Both fasting and postprandial hypertriglyceridaemia are considered independent risk factors for atherosclerosis. Treatment of hypertriglyceridaemia is based on fibrates, which activate the peroxisome proliferator-activated receptor alpha (PPARα). However, the metabolic pathways that activate or inhibit fibrates, and how the postprandial triglyceride levels are modified, have not yet been fully described. Accordingly, the aim of this study was to determine the feasibility of peripheral blood mononuclear cells (PBMC) to study the effects of fenofibrate in patients with the metabolic syndrome...
March 2, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28248971/clofibrate-inhibits-the-umami-savory-taste-of-glutamate
#17
Matthew Kochem, Paul A S Breslin
In humans, umami taste can increase the palatability of foods rich in the amino acids glutamate and aspartate and the 5'-ribonucleotides IMP and GMP. Umami taste is transduced, in part, by T1R1-T1R3, a heteromeric G-protein coupled receptor. Umami perception is inhibited by sodium lactisole, which binds to the T1R3 subunit in vitro. Lactisole is structurally similar to the fibrate drugs. Clofibric acid, a lipid lowering drug, also binds the T1R3 subunit in vitro. The purpose of this study was to determine whether clofibric acid inhibits the umami taste of glutamate in human subjects...
2017: PloS One
https://www.readbyqxmd.com/read/28242176/2017-taiwan-lipid-guidelines-for-high-risk-patients
#18
REVIEW
Yi-Heng Li, Kwo-Chang Ueng, Jiann-Shing Jeng, Min-Ji Charng, Tsung-Hsien Lin, Kuo-Liong Chien, Chih-Yuan Wang, Ting-Hsing Chao, Ping-Yen Liu, Cheng-Huang Su, Shih-Chieh Chien, Chia-Wei Liou, Sung-Chun Tang, Chun-Chuan Lee, Tse-Ya Yu, Jaw-Wen Chen, Chau-Chung Wu, Hung-I Yeh
In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients...
February 24, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28228373/statins-and-fibrates-for-diabetic-retinopathy-protocol-for-a-systematic-review
#19
Vania Mozetic, Carolina Gomes Freitas, Rachel Riera
BACKGROUND: Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus, and more than 75% of patients who have had diabetes for more than 20 years will have some degree of DR. This disease is highly destructive to self-esteem and puts a high burden on public health and pension systems due to the effects that it has on people of working age. The current mainstay of treatment is laser photocoagulation, which causes impairment of vision and discomfort to patients...
February 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28201850/novel-treatment-strategies-for-primary-biliary-cholangitis
#20
Albert Parés
Despite the presumed immunological pathogenesis of primary biliary cholangitis, no clear or even harmful consequences have resulted from treatments designed to modify the immunological condition. Ursodeoxycholic acid (13-16 mg/kg/d) has, however, clear favorable effects that not only improve biochemical cholestasis, but also delay histological progression. Long-term treatment with ursodeoxycholic acid is associated with excellent transplant-free survival in cases showing a biochemical response at 1 year. Data on the effects of obeticholic acid and fibrates are encouraging...
February 2017: Seminars in Liver Disease
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