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https://www.readbyqxmd.com/read/28944730/optimization-of-medication-use-at-accountable-care-organizations
#1
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944613/propensity-score-matched-all-comers-population-treated-with-ultra-thin-strut-bare-metal-and-sirolimus-probucol-coated-drug-eluting-stents-of-identical-stent-architecture
#2
Florian Krackhardt, Mohd Ali Rosli, Matthias Leschke, André Schneider, Christian Sperling, Tay Mok Heang, Maxime Pons, Pedro Jerónimo Sousa, Behrouz Kherad, Matthias Waliszewski
OBJECTIVE: The objective of this study was to compare the safety and efficacy of a polymer-free sirolimus coated, ultrathin strut drug eluting stent (PF-SES) to its uncoated bare-metal stent (BMS) platform of identical stent architecture. BACKGROUND: Recently published randomized trials comparing BMS to DES with a focus on shortened dual-antiplatelet therapy reported incidences of stent thrombosis (ST) and bleeding complications (LEADERS FREE) in favor of drug eluting stents (DES)...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28943824/prevalence-of-unrounded-medication-doses-and-associated-factors-among-hospitalized-pediatric-patients
#3
Aubrey N Jones, Jamie L Miller, Stephen Neely, Bethany W Ibach, Tracy M Hagemann, Charles L Golding, Teresa V Lewis, Leigh A Peek, Peter N Johnson
OBJECTIVES: This study aims to determine the prevalence and factors associated with unrounded doses ordered via a computerized prescriber order entry (CPOE) system among children during a 1-week reference period. METHODS: This retrospective, cross-sectional study included children younger than 18 years admitted during a 7-day period. An unrounded dose was defined as an unrounded actual dose (eg, dose calculated to the tenths place for non-neonatal intensive care (non-NICU) patients and dose calculated to the hundredth place for NICU patients) or unrounded volume per dose [eg, <0...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28942578/intranasal-sumatriptan-for-acute-migraine-attacks-a-systematic-review-and-meta-analysis
#4
Amr Menshawy, Hussien Ahmed, Ammar Ismail, Abdelrahman Ibrahim Abushouk, Esraa Ghanem, Ravikishore Pallanti, Ahmed Negida
We performed this systematic review and meta-analysis to evaluate the tolerability and efficacy of intranasal sumatriptan, a selective serotonin agonist, compared to placebo or other migraine therapeutics for the treatment of acute migraine attacks. We searched PubMed, SCOPUS, Embase, and Cochrane CENTRAL for relevant randomized controlled trials (RCTs). Data were extracted from eligible studies and pooled as risk ratios (RR), using RevMan software. We performed subgroup and meta-regression analyses for different doses and treatment endpoints...
September 23, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28942563/polypharmacy-in-the-geriatric-oncology-population
#5
REVIEW
Lauren R Hersh, Kathryn Beldowski, Emily R Hajjar
PURPOSE OF REVIEW: This review explores the multiple definitions, epidemiology, and impact of polypharmacy in geriatric oncology patients. Risk factors and clinical implications of polypharmacy are delineated and potential clinical approaches to reduce polypharmacy are reviewed. RECENT FINDINGS: Most sources currently define polypharmacy as the administration of multiple medications that are non-essential, unnecessary, duplicative, or ineffective. Possible risk factors associated with polypharmacy in geriatric cancer patients include comorbid conditions, prescribing cascades, and hospitalization...
September 23, 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28942181/novel-adverse-events-of-vortioxetine-a-disproportionality-analysis-in-usfda-adverse-event-reporting-system-database
#6
Viswam Subeesh, Hemendra Singh, Eswaran Maheswari, Elsa Beulah
BACKGROUND: Signal detection is one of the most advanced and emerging field in pharmacovigilance. It is a modern method of detecting new reaction (which can be desired or undesired) of a drug. It facilitates early adverse drug reaction detection which enables health professionals to identify adverse events that may not have been identified in pre-marketing clinical trials. Vortioxetine, the first mixed serotonergic antidepressant was initially approved by the US Food and Drug Administration (USFDA) on September 30, 2013 for the treatment of adults with Major Depressive Disorder (MDD)...
September 14, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28941579/-fibrates-and-risk-of-venous-thromboembolism-case-no-case-study-in-french-pharmacovigilance-database
#7
Xavier Humbert, Charles Dolladille, Marion Sassier, Marie-Blanche Valnet-Rabier, Thierry Vial, Emmanuelle Guitton, Annabelle Page, Elodie Sole, Pascal Auriche, Antoine Coquerel, Joachim Alexandre, Sophie Fedrizzi
INTRODUCTION: Several studies have investigated the occurrence of venous thromboembolic events (phlebitis and pulmonary embolism) [VTE] and fibrates. Fibrates could be associated with VTE although published data are contradictory. The objective of this study is to confirm the link between VTE and fibrates. MATERIALS AND METHODS: Retrospective disproportionality analysis (case/non-case method) from observations recorded consecutively in the French pharmacovigilance database between 1985 and 2016...
August 1, 2017: Thérapie
https://www.readbyqxmd.com/read/28941311/endocrinopathies-with-use-of-cancer-immunotherapies
#8
Natalie M Villa, Abtin Farahmand, Lin Du, Michael W Yeh, Stephanie Smooke-Praw, Antoni Ribas, Bartosz Chmielowski, Grace Cherry, Angela M Leung
BACKGROUND: Immunomodulatory therapies, including CTLA-4 and PD-1 inhibitors, provide a directed attack against cancer cells by preventing T cell deactivation. However, these drugs also prevent the down-regulation of auto-reactive T cells, resulting in immune-related adverse events (IRAEs). Reports show a varied incidence of endocrine IRAEs, ranging from 0-63%. OBJECTIVE: To describe the frequency and clinical characteristics of endocrine IRAEs in patients taking cancer immunomodulatory therapies...
September 23, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28941225/systems-pharmacology-model-of-gastrointestinal-damage-predicts-species-differences-and-optimizes-clinical-dosing-schedules
#9
Harish Shankaran, Anna Cronin, Jen Barnes, Pradeep Sharma, John Tolsma, Paul Jasper, Jerome T Mettetal
Gastrointestinal (GI) adverse events (AE) are frequently dose limiting for oncology agents, requiring extensive clinical testing of alternative schedules to identify optimal dosing regimens. Here we develop a translational mathematical model to predict these clinical AEs starting from preclinical GI toxicity data. The model structure incorporates known biology and includes stem cells, daughter cells and enterocytes. Published data including cellular numbers and division times informed the system parameters for human and rat...
September 22, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28941039/a-randomized-phase-iib-study-of-mavrilimumab-and-golimumab-in-rheumatoid-arthritis
#10
Michael E Weinblatt, Iain B McInnes, Joel M Kremer, Pedro Miranda, Jiri Vencovsky, Xiang Guo, Wendy I White, Patricia C Ryan, Alex Godwood, Marius Albulescu, David Close, Gerd R Burmester
OBJECTIVE: This 24-week, Phase IIb, double-blind study (NCT01715896) evaluated mavrilimumab (anti-granulocyte-macrophage colony-stimulating factor [GM-CSFR]-α monoclonal antibody) and golimumab (anti-tumor necrosis factor [TNF] monoclonal antibody) in patients with rheumatoid arthritis (RA), with inadequate responses to disease-modifying antirheumatic drugs (DMARD-IR) and/or anti-TNF agents (anti-TNF-IR). METHODS: Patients with active RA and DMARD-IR (≥1 failed regimen), or DMARD-IR (≥1 failed regimen) and anti-TNF-IR (1-2 failed regimens), were randomized 1:1 to subcutaneous mavrilimumab 100 mg every other week (eow) or golimumab 50 mg every 4 weeks (Q4W) alternating with placebo Q4W, plus concomitant methotrexate...
September 21, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28941006/palonosetron-is-nonsuperior-to-ondansetron-in-acute-phase-but-provides-superior-antiemetic-control-in-delayed-phase-for-pediatric-patients-administered-highly-emetogenic-chemotherapy
#11
Juan Tan, Shan Wang, Xiaohua Liang, Chang-Chun Li, Jun Zhang, Zhenzhen Zhao, Xiang-Ru Kong, Xiaobin Deng, Liang Peng, Chao Yang
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) in children remains to be a major side effect despite antiemetic treatment. Palonosetron is a new generation 5-HT3 receptor antagonists effective against acute and delayed nausea and vomiting. This study aimed to compare the therapeutic values of palonosetron and ondansetron in preventing pediatric CINV. METHODS: A prospective, randomized, double-blind, parallel controlled study was conducted in 0-18 years old cancer patients administered highly emetogenic chemotherapy, with different dosage of palonosetron or ondansetron, both followed by dexamethasone...
September 22, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28940400/reply-to-risk-of-malignancies-associated-with-ustekinumab
#12
B Nardone, D P West
For, "Malignancies and ustekinumab: an analysis of the FDA Adverse Event Reporting System and the European Union Drug Regulating Authorities Pharmacovigilance database" [1], Greenspan et al. [2] raise the issue about adding to the understanding of the drug safety profile, underscoring the need for robust evidence in determination of incidence rate and true risk. In response to this important issue, it must be emphasized to the reader that the approach to pharmacovigilance that we have utilized in this instance is not designed to address causality and/or risk quantification, but rather this widely accepted approach focuses on detection of safety signal...
September 22, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28940308/safety-and-pharmacokinetics-of-the-oral-iron-chelator-sp-420-in-%C3%AE-thalassemia
#13
Ali T Taher, Antoine N Saliba, Kevin H Kuo, Patricia J Giardina, Alan R Cohen, Ellis J Neufeld, Yesim Aydinok, Janet L Kwiatkowski, Brenda I Jeglinski, Keith Pietropaolo, Gregory Berk, Vip Viprakasit
Our Phase I, open-label, multi-center, dose-escalation study evaluated the pharmacokinetics (PK) of SP-420, a tridentate oral iron chelating agent of the desferrithiocin class, in patients with transfusion dependent β-thalassemia. SP-420 was administered as a single dose of 1.5 (n=3), 3 (n=3), 6 (n=3), 12 (n=3), and 24 (n=6) mg/kg or as a twice-daily dose of 9 mg/kg (n=6) over 14-28 days. There was a near dose-linear increase in the mean plasma SP-420 concentrations and in the mean values for Cmax and AUC0-τ over the dose range evaluated...
September 22, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28939406/comparison-of-fixed-dose-combinations-of-amlodipine-losartan-potassium-chlorthalidone-and-amlodipine-losartan-potassium-in-patients-with-stage-2-hypertension-inadequately-controlled-with-amlodipine-losartan-potassium-a-randomized-double-blind-multicenter-phase
#14
Soon Jun Hong, Han Saem Jeong, Seung Hwan Han, Ki Yuk Chang, Bum Kee Hong, Bong Ki Lee, Shung Chull Chae, Woo Shik Kim, Chang Gyu Park, Jung Ho Heo, Seung Uk Lee, Young Dae Kim, Kee Sik Kim, Jung Hyun Choi, Hyun Jae Kang, Jae Joong Kim, Seok Min Kang, Young Jin Choi, Joon Han Shin, Kook Jin Chun, Dong Gu Shin, Seong Hoon Park, Jun Kwan, Yu Jeong Choi, Myung Ho Jeong, Jei Keon Chae, Dong Woon Kim, Jung Rae Cho, Kyoo Rok Han, Kyung Heon Won, Sang Ho Park, Sang Kon Lee, Sang Hoon Kim, Jina Jung, Cheol Ho Kim
PURPOSE: The goal of this study was to compare the efficacy and safety of fixed-dose combinations of amlodipine/losartan potassium/chlorthalidone (A/L/C) and A/L in Korean patients with stage 2 hypertension inadequately controlled by A/L. METHODS: This study was an 8-week, randomized double-blind, multicenter, phase III clinical trial. Three hundred forty volunteer patients with stage 2 hypertension were randomized to receive A/L/C or A/L. The primary end point was a change in sitting systolic blood pressure (SitSBP) after 8 weeks of treatment...
September 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28939201/combination-drug-treatment-in-hypertension
#15
REVIEW
Costas Tsioufis, M D Costas Thomopoulos
Combination treatment of hypertension has been introduced almost 50 years ago, because of the marked blood pressure (BP) elevation of recruited patients in the early randomized controlled trials of BP lowering. However, in all subsequent trials combination treatment was per protocol anticipated irrespectively of the initial randomized treatment to ensure either a desirable BP lowering or a comparable level of BP reduction among arms. Beyond clinical trials, combination treatment is mainly used in the clinical practice to reinforce ongoing single-agent treatment to achieve hypertension control...
September 19, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28938684/efficacy-and-safety-of-everolimus-in-chinese-metastatic-hr-positive-her2-negative-breast-cancer-patients-a-real-world-retrospective-study
#16
Chengcheng Gong, Yannan Zhao, Biyun Wang, Xichun Hu, Zhonghua Wang, Jian Zhang, Sheng Zhang
BACKGROUND: Everolimus combined with endocrine therapy has been proved to be effective among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (MBC). We aimed to evaluate the efficacy and safety of everolimus plus endocrine therapy in Chinese real-world practice for the first time, and investigate factors associated with efficacy. METHODS: Seventy-five HR+/HER2- MBC patients were included in this retrospective study who received everolimus plus endocrine therapy after progression on prior endocrine therapy in Fudan University Shanghai Cancer Center (FUSCC) between June 2013 and February 2016...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938672/comparing-the-clinical-efficacy-of-abiraterone-acetate-enzalutamide-and-orteronel-in-patients-with-metastatic-castration-resistant-prostate-cancer-by-performing-a-network-meta-analysis-of-eight-randomized-controlled-trials
#17
Minyong Kang, Chang Wook Jeong, Cheol Kwak, Ja Hyeon Ku, Hyeon Hoe Kim
Various novel androgen receptor (AR) targeting drugs have been developed recently and have shown beneficial effects on survival in patients with metastatic castration-resistant prostate cancer (mCRPC). However, no consensus has been reached regarding which of these agents provides the most favorable oncological outcomes. Here, we aimed to compare the efficacy of novel AR-targeted agents by performing a network meta-analysis of randomized controlled trials (RCTs). We included eight RCTs for men with mCRPC treated with one of the AR targeting agents: abiraterone acetate, enzalutamide, or orteronel...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938644/intravascular-ultrasound-guidance-in-drug-eluting-stents-implantation-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#18
Cheng Qian, Hong Feng, Jianlei Cao, Guangyu Zhang, Yanggan Wang
OBJECTIVE: Previous evidence suggested that intravascular ultrasound (IVUS) guidance could improve outcomes after drug-eluting stents (DES) placement, largely driven by data from observational studies. We, therefore, performed a meta-analysis and trial sequential analysis of randomized controlled trials to overcome this limitation. RESULTS: The retrieval process yielded 7 RCTs with 3,192 patients. Compared to the angiography guidance, IVUS-guided DES implantation was associated with a significant reduction in the major adverse cardiac events (MACE) (OR 0...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938590/ocular-toxicities-associated-with-targeted-anticancer-agents-an-analysis-of-clinical-data-with-management-suggestions
#19
Chen Fu, Dan S Gombos, Jared Lee, Goldy C George, Kenneth Hess, Andrew Whyte, David S Hong
Ocular toxicities are among the most common adverse events resulting from targeted anticancer agents and are becoming increasingly relevant in the management of patients on these agents. The purpose of this study is to provide a framework for management of these challenging toxicities based on objective data from FDA labels and from analysis of the literature. All oncologic drugs approved by the FDA up to March 14, 2015, were screened for inclusion. A total of 16 drugs (12 small-molecule drugs and 4 monoclonal antibodies) were analyzed for ocular toxicity profiles based on evidence of ocular toxicity...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938469/taming-the-flames-targeting-white-adipose-tissue-browning-in-hypermetabolic-conditions
#20
Abdikarim Abdullahi, Marc G Jeschke
In this era of increased obesity and diabetes prevalence, the browning of white adipose tissue (WAT) has emerged as a promising therapeutic target to induce weight loss and improve insulin sensitivity in this population. The browning process entails a shift in the WAT from primarily storing excess energy to the dissipation of energy as heat. However, this idealistic view of WAT browning being the saviour of the metabolic syndrome has been criticized by studies in burns and cancer patients that have shown browning to be detrimental rather than being beneficial...
August 30, 2017: Endocrine Reviews
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