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Wright F, D'Eramo Melkus G, Hammer M, Schmidt BL, Knobf MT, Paul SM, Cartwright F, Mastick J, Cooper BA, Chen LM, Melisko M, Levine JD, Kober K, Aouizerat BE, Miaskowski C. Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue. J Pain Symptom Manage 2015; 50:176-89. [PMID: 25828559 PMCID: PMC4526314 DOI: 10.1016/j.jpainsymman.2015.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 11/25/2022]
Abstract
CONTEXT Fatigue is the most common symptom in oncology patients during chemotherapy. Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. OBJECTIVES An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. METHODS A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (n = 586) completed demographic and symptom questionnaires a total of six times over two cycles of chemotherapy. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling was used to answer the study objectives. RESULTS A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index, who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance, and depressive symptoms reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients' ethnicity and younger age. CONCLUSION The modifiable risk factors that were associated with only morning fatigue were body mass index, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.
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Wright F, D'Eramo Melkus G, Hammer M, Schmidt BL, Knobf MT, Paul SM, Cartwright F, Mastick J, Cooper BA, Chen LM, Melisko M, Levine JD, Kober K, Aouizerat BE, Miaskowski C. Trajectories of Evening Fatigue in Oncology Outpatients Receiving Chemotherapy. J Pain Symptom Manage 2015; 50:163-75. [PMID: 25828560 PMCID: PMC4526403 DOI: 10.1016/j.jpainsymman.2015.02.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 11/28/2022]
Abstract
CONTEXT Fatigue is a distressing persistent sense of physical tiredness that is not proportional to a person's recent activity. Fatigue impacts patients' treatment decisions and can limit their self-care activities. Although significant interindividual variability in fatigue severity has been noted, little is known about predictors of interindividual variability in initial levels and trajectories of evening fatigue severity in oncology patients receiving chemotherapy. OBJECTIVES To determine whether demographic, clinical, and symptom characteristics were associated with initial levels and the trajectories of evening fatigue. METHODS A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N = 586) completed demographic and symptom questionnaires a total of six times over two cycles of chemotherapy. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling was used to answer the study objectives. RESULTS A large amount of interindividual variability was found in the evening fatigue trajectories. A piecewise model fit the data best. Patients who were white, diagnosed with breast, gynecological, or lung cancer, and who had more years of education, childcare responsibilities, lower functional status, and higher levels of sleep disturbance and depression reported higher levels of evening fatigue at enrollment. CONCLUSION This study identified both nonmodifiable (e.g., ethnicity) and modifiable (e.g., childcare responsibilities, depressive symptoms, sleep disturbance) risk factors for more severe evening fatigue. Using this information, clinicians can identify patients at higher risk for more severe evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.
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Hammer M, Kofoed-Johnsen J. The effects of increased dialysate sodium concentration on skeletal muscle and subcutaneous blood flow during hemodialysis. Dialysate sodium and regional blood flow. CONTRIBUTIONS TO NEPHROLOGY 2015; 79:127-31. [PMID: 2225851 DOI: 10.1159/000418164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Berry DL, Cunningham T, Eisenberg S, Wickline M, Hammer M, Berg C. Improving patient knowledge of discharge medications in an oncology setting. Clin J Oncol Nurs 2015; 18:35-7. [PMID: 24476724 DOI: 10.1188/14.cjon.35-37] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Discharge medications for a patient with cancer typically are numerous and complex. During the transition between inpatient stays and ambulatory follow-up visits, patients commonly misunderstand medication instructions, placing them at risk for under- or overdosing. This column discusses the results of an evidence-based practice change project at the Seattle Cancer Care Alliance to improve adult patient knowledge and use of discharge medications. Ensuring patient receipt of written discharge medication instructions and checking in with patients after discharge may be an approach to maximize the safety of self-administered medication.
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Skaugen G, Hammer M, Wahl P, Wilhelmsen Ø. Constrained non-linear optimisation of a process for liquefaction of natural gas including a geometrical and thermo-hydraulic model of a compact heat exchanger. Comput Chem Eng 2015. [DOI: 10.1016/j.compchemeng.2014.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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81
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Hershey DS, Bryant AL, Olausson J, Davis ED, Brady VJ, Hammer M. Hyperglycemic-Inducing Neoadjuvant Agents Used in Treatment of Solid Tumors: A Review of the Literature. Oncol Nurs Forum 2014; 41:E343-54. [DOI: 10.1188/14.onf.e343-e354] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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82
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Ramm L, Jentsch S, Peters S, Augsten R, Hammer M. Investigation of blood flow regulation and oxygen saturation of the retinal vessels in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2014; 252:1803-10. [DOI: 10.1007/s00417-014-2766-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 07/22/2014] [Accepted: 07/30/2014] [Indexed: 12/29/2022] Open
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Miller AD, Sweeney OF, Whiterod NS, Van Rooyen AR, Hammer M, Weeks AR. Critically low levels of genetic diversity in fragmented populations of the endangered Glenelg spiny freshwater crayfish Euastacus bispinosus. ENDANGER SPECIES RES 2014. [DOI: 10.3354/esr00609] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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84
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Miaskowski C, Cooper BA, Melisko M, Chen LM, Mastick J, West C, Paul SM, Dunn LB, Schmidt BL, Hammer M, Cartwright F, Wright F, Langford DJ, Lee K, Aouizerat BE. Disease and treatment characteristics do not predict symptom occurrence profiles in oncology outpatients receiving chemotherapy. Cancer 2014; 120:2371-8. [PMID: 24797450 DOI: 10.1002/cncr.28699] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/31/2014] [Accepted: 02/19/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND A large amount of interindividual variability exists in the occurrence of symptoms in patients receiving chemotherapy (CTX). The purposes of the current study, which was performed in a sample of 582 oncology outpatients who were receiving CTX, were to identify subgroups of patients based on their distinct experiences with 25 commonly occurring symptoms and to identify demographic and clinical characteristics associated with subgroup membership. In addition, differences in quality of life outcomes were evaluated. METHODS Oncology outpatients with breast, gastrointestinal, gynecological, or lung cancer completed the Memorial Symptom Assessment Scale before their next cycle of CTX. Latent class analysis was used to identify subgroups of patients with distinct symptom experiences. RESULTS Three distinct subgroups of patients were identified (ie, 36.1% in Low class; 50.0% in Moderate class, and 13.9% in All High class). Patients in the All High class were significantly younger and more likely to be female and nonwhite, and had lower levels of social support, lower socioeconomic status, poorer functional status, and a higher level of comorbidity. CONCLUSIONS Findings from the current study support the clinical observation that some oncology patients experience a differentially higher symptom burden during CTX. These high-risk patients experience significant decrements in quality of life.
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Klotsche J, Minden K, Niewerth M, Seipelt E, Hammer M, Zink A, Horneff G. SAT0468 Is Early Treatment with Biologics Associated with a Better Long-Term Outcome in Patients with Polyarticular Juvenile Idiopathic Arthritis (JIA)? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aursand E, Dørum C, Hammer M, Morin A, Munkejord S, Nordhagen H. CO2 Pipeline Integrity: Comparison of a Coupled Fluid-structure Model and Uncoupled Two-curve Methods. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.egypro.2014.07.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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87
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Specker C, Laubenthal E, Wassenberg S, Weier R, Vollmer M, Hammer M. Vergleich der Therapie-Compliance durch Befragung von RA-Patienten unter Infusionstherapie mit Rituximab und subkutan verabreichten TNFα-Blockern. AKTUEL RHEUMATOL 2013. [DOI: 10.1055/s-0032-1316384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fickert S, Niks M, Dinter DJ, Hammer M, Weckbach S, Schoenberg SO, Lehmann L, Jochum S. Assessment of the diagnostic value of dual-energy CT and MRI in the detection of iatrogenically induced injuries of anterior cruciate ligament in a porcine model. Skeletal Radiol 2013; 42:411-7. [PMID: 22923156 DOI: 10.1007/s00256-012-1500-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 06/16/2012] [Accepted: 08/05/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is the standard of reference for the non-invasive evaluation of ligament injuries of the knee. The development of dual-energy CT (DE-CT) made it possible to differentiate between tissues of different density by two simultaneous CT measurements with different tube voltages. This approach enables DE-CT to discriminate ligament structures without intra-articular contrast media injection. The aims of this study were on the one hand to determine the delineation of the anterior cruciate ligament (ACL) and on the other hand to assess the diagnostic value of DE-CT and MRI in the detection of iatrogenically induced injury of the ACL in a porcine knee joint model. MATERIALS AND METHODS Twenty porcine hind legs, which were placed in a preformed cast in order to achieve a standardized position, were scanned using DE-CT. Thereafter, a 1.5-T MRI using a standard protocol was performed. The imaging procedures were repeated with the same parameters after inducing defined lesions (total or partial incision) on the ACL arthroscopically. After post-processing, two radiologists and two orthopedic surgeons first analyzed the delineation of the ACL and then, using a consensus approach, the iatrogenically induced lesions. The result of the arthrotomy was defined as the standard of reference. RESULTS The ACL could be visualized both on DE-CT and MRI in 100% of the cases. As for the MRI, the sensitivity and specificity of detecting the cruciate ligament lesion respectively compared with the defined arthrotomy was 66.7% and 78.6% for intact cruciate ligaments, 100% and 75% in the case of a complete lesion, 33.3% and 78.6% for lesions of the anteromedial bundle, and 0% and 100% for lesions of the posterolateral bundle. In comparison, DE-CT demonstrated a sensitivity and specificity of 66.7% and 71.4% in the case of intact cruciate ligaments, 75% and 68.8% in the case of completely discontinued ACLs, 0% and 92.9% in the case of lesions of the anteromedial bundle, and 25% and 87.5% in the case of lesions of the posterolateral bundle. CONCLUSIONS The present ex vivo experiment shows that both study modalities (DE-CT and MRI) are equal with regard to the delineation of the ACL, while MRI achieved higher sensitivity and specificity regarding iatrogenically induced complete ACL lesions. DE-CT could be a possible alternative to MRI for certain indications in the diagnosis of a knee ligament injury.
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Hammer M. Die frühe Rheumatoide Arthritis. AKTUEL RHEUMATOL 2013. [DOI: 10.1055/s-0033-1333722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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90
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Aursand E, Aursand P, Berstad T, Dørum C, Hammer M, Munkejord S, Nordhagen H. CO2 Pipeline Integrity: A Coupled Fluid-structure Model Using a Reference Equation of State for CO2. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.egypro.2013.06.197] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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91
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Hammer M, Doleys DM. Perineuromal stimulation in the treatment of occipital neuralgia: a case study. Neuromodulation 2012; 4:47-51. [PMID: 22151610 DOI: 10.1046/j.1525-1403.2001.00047.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This case study is presented to exemplify the application of a perineuromal approach in the treatment of recalcitrant occipital neuralgia. The patient was a 49-year-old female with severe and disabling occipital neuralgia. The pain persisted despite several surgical procedures, injections in the affected area, and medications. Threading the electrode into the cervical epidural space and attempts at peripheral stimulation using the Weiner and Reed approach were unsuccessful. Immediate benefit was derived when the electrode was advanced subcutaneously and positioned underneath the neuroma apparently created by a C2 nerve transection. A Medtronic Octad (model #3898) was utilized. The patient was contacted at seven and nine months post implantation. She reported 90% improvement in her pain. The improvements were also noted in numerical pain ratings, Beck Depression Inventory, and Oswestry Disability Scale. These improvements were corroborated by her husband. The Minnesota Multiphasic Personality Inventory (MMPI) remained relatively unchanged. This case illustrates the possible utilization of perineuromal stimulation in the treatment of occipital neuralgia. The specific mechanism of action remains unclear. Replication and controlled studies are required to determine the general applicability of this approach.
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Peters S, Deutsch L, Hammer M, Schweitzer D, Dawczynski J. Zwei-Photonen angeregte Fluoreszenz-Mikroskopie zur Interpretation von Fundus-Autofluoreszenz-Analysen in vivo. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1327165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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93
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Jentsch S, Hammer M, Wildner K, Dawczynski J, Deutsch L, Klemm M, Schweitzer D. In vivo Untersuchungen zur zeitaufgelösten Autofluoreszenz bei retinalen Erkrankungen des menschlichen Auges. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1327164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Amorim E, Shih MM, Massaro L, Zaidi S, Jumaa M, Reddy V, Hammer M, Jovin T, Wechsler L. Impact in Rate of Thrombolysis after Implementation of Telestroke Network (S39.004). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s39.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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95
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Voelker M, Hammer M. Dissolution and pharmacokinetics of a novel micronized aspirin formulation. Inflammopharmacology 2011; 20:225-31. [PMID: 22057729 PMCID: PMC3398252 DOI: 10.1007/s10787-011-0099-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 10/18/2011] [Indexed: 11/26/2022]
Abstract
Aspirin (acetylsalicylic acid, ASA) has been used as an analgesic, antipyretic and antiinflammatory drug for many years. A new 500 mg aspirin tablet formulation containing micronized active ingredient and an effervescent component has been developed for potential improvement in the onset of action for acute pain treatment. This paper describes the dissolution and the pharmacokinetics of the new formulation in comparison with regular aspirin tablets, aspirin granules and aspirin effervescent tablets. Micronized aspirin tablets dissolve significantly faster over a pH range from 1.2 to 6.8 compared to regular 500 mg aspirin tablets. Plasma concentration time curve comparison to regular 500 mg aspirin tablets showed a substantial improvement in the time to maximum plasma concentrations (T(max)) (ASA 17.5 min vs. 45 min) and an increase in maximum plasma concentration (C(max)) (ASA 13.8 μg/ml vs. 4.4 μg/ml) while the overall extent of exposure (AUC) remains almost unchanged. The data suggest a potential improvement for onset of action in treating acute pain with the new micronized aspirin formulation.
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Schmidt WE, Christiansen JS, Hammer M, Zychma MJ, Buse JB. Patient-reported outcomes are superior in patients with Type 2 diabetes treated with liraglutide as compared with exenatide, when added to metformin, sulphonylurea or both: results from a randomized, open-label study. Diabet Med 2011; 28:715-23. [PMID: 21388442 PMCID: PMC3123703 DOI: 10.1111/j.1464-5491.2011.03276.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The Liraglutide Effect and Action in Diabetes 6 trial was an open-label trial comparing liraglutide with exenatide as an 'add-on' to metformin and/or sulphonylurea. METHODS Patients with Type 2 diabetes were randomized to liraglutide 1.8 mg once daily or exenatide 10 μg twice daily for 26 weeks. This was followed by a 14-week extension phase, in which all patients received liraglutide 1.8 mg once daily. RESULTS Patient-reported outcomes were measured in 379 patients using Diabetes Treatment Satisfaction Questionnaire status (DTSQs) and DTSQ change (DTSQc). The change in overall treatment satisfaction (DTSQs score) from baseline at week 26 with liraglutide was 4.71 and with exentaide was 1.66 [difference between groups 3.04 (95% CI 1.73-4.35), P<0.0001]. Five of the six items on the DTSQs improved significantly more with liraglutide than with exenatide (differences: current treatment 0.37, P=0.0093; convenience 0.68, P<0.0001; flexibility 0.57, P=0.0002; recommend 0.49, P=0.0003; continue 0.66, P=0.0001). Patients perceived a greater reduction in hypoglycaemia at week 26 with liraglutide than with exenatide [difference in DTSQc score 0.48 (0.08-0.89), P=0.0193] and a greater reduction in perceived hyperglycaemia [difference 0.74 (0.31-1.17), P=0.0007]. During the extension phase, when all patients received liraglutide, DTSQs scores remained stable in patients who continued on liraglutide and increased significantly (P=0.0026) in those switching from exenatide. CONCLUSIONS These results demonstrate significant improvements in patients' treatment satisfaction with liraglutide compared with exenatide.
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Dawczynski J, Jentsch S, Schweitzer D, Hammer M, Strobel J. Änderung von Makulapigment und Drusenmorphologie unter Luteinsupplementation. Klin Monbl Augenheilkd 2011; 229:69-71. [DOI: 10.1055/s-0031-1273339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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98
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Lee WC, Conner C, Hammer M. Cost-effectiveness of liraglutide versus rosiglitazone, both in combination with glimepiride in treatment of type 2 diabetes in the US. Curr Med Res Opin 2011; 27:897-906. [PMID: 21348806 DOI: 10.1185/03007995.2011.559444] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many patients with type 2 diabetes mellitus (T2DM) are not able to maintain adequate HbA(1c) control (<7.0%), even at maximal dosage levels of one or two oral agents, and are at increased risk for diabetes-related complications. OBJECTIVE To estimate the cost-effectiveness of a once-daily GLP-1 analog Victoza [Novo Nordisk] versus a thiazolidinedione (TZD), rosiglitazone in patients with T2DM. Both treatment groups included background therapy with glimepiride. RESEARCH DESIGN AND METHODS The CORE Diabetes Model (CDM) was used to project and compare 35-year clinical and economic outcomes associated with liraglutide 1.2 mg + glimepiride and liraglutide 1.8 mg + glimepiride versus rosiglitazone 4 mg + glimepiride. Baseline cohort characteristics (HbA(1c) (8.4%), age, duration of disease, sex, body-mass index (BMI), blood pressure, and lipids) were based on the Liraglutide Effect and Action in Diabetes-1 (LEAD-1) trial. OUTCOMES Primary outcomes included life expectancy (LE), quality-adjusted life-years (QALYs), total costs and incremental cost-effectiveness ratios (ICERs). results: When compared to rosiglitazone, liraglutide 1.2 mg and 1.8 mg increased mean LE by 0.968 and 1.041 years, and QALYs by 0.764 and 0.837, respectively. Total lifetime costs increased by $26,094 for liraglutide 1.2 mg versus rosiglitazone, and by $47,041 for liraglutide 1.8 mg versus rosiglitazone. ICERs for liraglutide 1.2 mg versus rosiglitazone and 1.8 mg versus rosiglitazone were $34,147 and $56,190, respectively. CONCLUSIONS Compared to rosiglitazone 4 mg plus glimepiride, liraglutide (particularly at the 1.2-mg dose) plus glimepiride is a cost-effective treatment option for improving glucose control in T2DM. Limitations include the projection of short term efficacy results from randomized control trials to longer time horizons. In addition, clinical acceptance and overall use of rosiglitazone in the treatment of diabetes has continued to fall since publication of the clinical trial upon which this modeling analyses was based.
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Davies M, Pratley R, Hammer M, Thomsen AB, Cuddihy R. Liraglutide improves treatment satisfaction in people with Type 2 diabetes compared with sitagliptin, each as an add on to metformin. Diabet Med 2011; 28:333-7. [PMID: 21309842 DOI: 10.1111/j.1464-5491.2010.03074.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Patient-reported outcomes from clinical trials offer insight into the impact of disease on health-related quality of life, including treatment satisfaction. This patient-reported outcomes evaluation was a substudy of a 26-week randomized, open-label trial comparing the once-daily injectable human GLP-1 analogue liraglutide with once-daily oral sitagliptin, both added to metformin. The patient reported outcomes substudy aimed to evaluate treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline and 26 weeks. METHODS In the main 26-week randomized, open-label study (n =658), liraglutide, 1.2 or 1.8 mg, injected with a pen, led to greater HbA1c reduction than oral sitagliptin, 100 mg once daily, both added to metformin = 1500 mg daily: mean HbA1c reduction was 1.5, 1.2 and 0.9% (7, 10 and 14 mmol/mol) for liraglutide 1.8 mg, 1.2 mg and sitagliptin, respectively (P < 0.0001 for both liraglutide doses vs. sitagliptin) and liraglutide patients lost more weight (3 vs.1 kg; P < 0.0001). In this patient-reported outcomes substudy (liraglutide 1.8 mg, n = 171; 1.2 mg, n = 164; sitagliptin, n = 170) DTSQ scores were analyzed by ANCOVA with treatment and country as fixed effects and baseline value as covariate. RESULTS Overall treatment satisfaction, calculated by adding satisfaction scores for `current treatment', `convenience', `flexibility', `understanding', `recommend', and `continue', improved in all groups at 26 weeks; greater improvement with liraglutide (4.35 and 3.51 vs. 2.96; P = 0.03 for liraglutide 1.8 mg vs. sitagliptin) may reflect greater HbA1c reduction and weight loss. Patients perceived themselves to be hyperglycaemic significantly less frequently with liraglutide 1.8 mg (difference = -0.88; P < 0.0001) and 1.2 mg ( -0.49; P = 0.01). Perceived frequency of hypoglycaemia was similar across all groups. CONCLUSIONS Injectable liraglutide may lead to greater treatment satisfaction than oral sitagliptin, potentially by facilitating greater improvement in glycaemic control, weight loss and/ or perception of greater treatment efficacy.
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Schweitzer D, Jentsch S, Böhm V, Hammer M, Dawczynski J. Supplementation mit Lutein und Zeaxanthin – ein möglicher Schutz vor altersbedingter Makuladegeneration. SPEKTRUM DER AUGENHEILKUNDE 2010. [DOI: 10.1007/s00717-010-0424-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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