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Kunz D, Dauvilliers Y, Benes H, García-Borreguero D, Plazzi G, Seboek Kinter D, Coloma P, Rausch M, Sassi-Sayadi M, Thein S. Long-Term Safety and Tolerability of Daridorexant in Patients with Insomnia Disorder. CNS Drugs 2023; 37:93-106. [PMID: 36484969 PMCID: PMC9829592 DOI: 10.1007/s40263-022-00980-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Daridorexant is a dual orexin receptor antagonist for the treatment of insomnia. In two phase III, 12-week studies in patients with insomnia disorder, daridorexant improved sleep and daytime functioning while maintaining a favorable safety profile. The objective of this 40-week extension study was to assess the long-term safety and tolerability of daridorexant. METHODS Adults with insomnia disorder who completed the 12-week studies were invited to enroll in this double-blind extension study. Patients originally randomised to daridorexant (10 mg/25 mg/50 mg) remained on their respective treatments; patients randomised to placebo were re-randomised to daridorexant 25 mg or placebo. The 40-week treatment period was followed by a 7-day placebo run-out. The primary objective was to assess safety/tolerability. Exploratory objectives were to evaluate the efficacy of daridorexant on sleep (self-reported total sleep time) and daytime functioning (Insomnia Daytime Symptoms and Impacts Questionnaire). RESULTS In total, 804 patients were enrolled in the study, of whom 801 received at least one dose of the study treatment and 550 patients (68.4%) completed the study. Overall incidence of treatment-emergent adverse events was similar across groups (35-40%). Daridorexant did not induce next-morning sleepiness and no withdrawal-related symptoms or rebound were observed after treatment discontinuation. Improvements in sleep and daytime functioning were maintained through to the end of the study and were most pronounced with daridorexant 50 mg. Daridorexant 50 mg, compared with placebo, increased self-reported total sleep time by a least-squares mean of 20.4 (95% confidence interval [CI] 4.2, 36.5), 15.8 (95% CI - 0.8, 32.5) and 17.8 (95% CI - 0.4, 35.9) minutes and decreased (i.e., improved) Insomnia Daytime Symptoms and Impacts Questionnaire total scores by a least-squares mean of - 9.3 (95% CI - 15.1, - 3.6), - 9.5 (95% CI - 15.4, - 3.5) and - 9.1 (95% CI - 15.6, - 2.7), at weeks 12, 24 and 36 of the extension study, respectively. CONCLUSIONS Treatment with daridorexant, for up to 12 months, was generally safe and well tolerated. Exploratory efficacy analyses suggest that the sustained improvements in sleep and daytime functioning with daridorexant 50 mg support its use for long-term treatment of insomnia disorder, without concerns of new safety signals. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03679884) [first posted: 21 September, 2018], https://clinicaltrials.gov/ct2/show/NCT03679884 .
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Affiliation(s)
- Dieter Kunz
- Clinic for Sleep & Chronomedicine, St. Hedwig-Krankenhaus, Große Hamburger Straße 5-11, 10115, Berlin, Germany.
| | - Yves Dauvilliers
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Heike Benes
- Somni Bene Institut für Medizinische Forschung und Schlafmedizin Schwerin GmbH, Schwerin, Germany
| | | | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy ,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | | | - Stephen Thein
- Pacific Research Network-an ERG Portfolio Company, San Diego, CA USA
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Kunz D, Beneš H, García-Borreguero D, Dauvilliers Y, Plazzi G, Sassi-Sayadi M, Rausch M, Coloma P, Seboek Kinter D, Thein S. Long-term safety and efficacy of daridorexant in patients with insomnia disorder. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dauvilliers Y, Beneš H, García-Borreguero D, Kunz D, Plazzi G, Thein S, Coloma P, Rausch M, Sassi-Sayadi M, Seboek Kinter D. Efficacy of long-term treatment with daridorexant in patients with insomnia disorder on sleep and daytime functioning: a post-hoc analysis. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bergamini G, Coloma P, Massinet H, Steiner MA. What evidence is there for implicating the brain orexin system in neuropsychiatric symptoms in dementia? Front Psychiatry 2022; 13:1052233. [PMID: 36506416 PMCID: PMC9732550 DOI: 10.3389/fpsyt.2022.1052233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2022] Open
Abstract
Neuropsychiatric symptoms (NPS) affect people with dementia (PwD) almost universally across all stages of the disease, and regardless of its exact etiology. NPS lead to disability and reduced quality of life of PwD and their caregivers. NPS include hyperactivity (agitation and irritability), affective problems (anxiety and depression), psychosis (delusions and hallucinations), apathy, and sleep disturbances. Preclinical studies have shown that the orexin neuropeptide system modulates arousal and a wide range of behaviors via a network of axons projecting from the hypothalamus throughout almost the entire brain to multiple, even distant, regions. Orexin neurons integrate different types of incoming information (e.g., metabolic, circadian, sensory, emotional) and convert them into the required behavioral output coupled to the necessary arousal status. Here we present an overview of the behavioral domains influenced by the orexin system that may be relevant for the expression of some critical NPS in PwD. We also hypothesize on the potential effects of pharmacological interference with the orexin system in the context of NPS in PwD.
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Affiliation(s)
- Giorgio Bergamini
- CNS Pharmacology and Drug Discovery, Idorsia Pharmaceuticals Ltd., Allschwil, Switzerland
| | - Preciosa Coloma
- Clinical Science, Global Clinical Development, Idorsia Pharmaceuticals Ltd., Allschwil, Switzerland
| | - Helene Massinet
- CNS Pharmacology and Drug Discovery, Idorsia Pharmaceuticals Ltd., Allschwil, Switzerland
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Roberts RO, Aakre JA, Kremers WK, Vassilaki M, Knopman DS, Mielke MM, Alhurani R, Geda YE, Machulda MM, Coloma P, Schauble B, Lowe VJ, Jack CR, Petersen RC. Prevalence and Outcomes of Amyloid Positivity Among Persons Without Dementia in a Longitudinal, Population-Based Setting. JAMA Neurol 2019; 75:970-979. [PMID: 29710225 DOI: 10.1001/jamaneurol.2018.0629] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Importance Brain amyloid deposition is a marker of Alzheimer disease (AD) pathology. The population-based prevalence and outcomes of amyloid positivity in a population without dementia are important for understanding the trajectory of amyloid positivity to clinically significant outcomes and for designing AD prevention trials. Objective To determine prevalence and outcomes of amyloid positivity in a population without dementia. Design, Setting, and Participants In the prospective, population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota, participants without dementia were randomly selected from the county population and were clinically and cognitively evaluated at baseline and every 15 months from August 1, 2008, to September 18, 2018. They were also invited to undergo carbon11-Pittburgh compound B positron emission tomography (PET) imaging. Exposures Amyloid positivity (defined as a standardized uptake value ratio >1.42 on PET). Main Outcomes and Measures Prevalence of amyloid positivity in the Olmsted County population without dementia and risk of progression from no cognitive impairment (ie, normal cognition for age) to incident amnestic MCI (aMCI) and from MCI or aMCI to incident AD dementia. Results Of 3894 participants, 1671 underwent PET imaging and were included in the study; 2198 did not undergo imaging, and 25 were excluded for other reasons. The mean (SD) age of participants was 71.3 (9.8) years; 892 (53.4%) were men, and 179 (10.7%) had prevalent MCI. The prevalence of amyloid positivity without cognitive impairment in the population without dementia increased from 2.7% (95% CI, 0.5% to 4.9%) in persons aged 50 to 59 years to 41.3% (95% CI, 33.4% to 49.2%) in those aged 80 to 89 years at baseline. Prevalence of amyloid-positive MCI in the population without dementia increased from 0% in persons aged 50 to 59 years to 16.4% (95% CI, 10.3% to 22.5%) in those aged 80 to 89 years. The incident aMCI risk increased more than 2-fold in participants without cognitive impairment who were amyloid positive vs those who were amyloid negative (hazard ratio [HR], 2.26; 95% CI, 1.52 to 3.35; P < .001). The risk of AD dementia was 1.86 (95% CI, 0.89 to 3.88; P = .10) for amyloid-positive participants with MCI vs amyloid-negative participants with MCI, 1.63 (95% CI, 0.78 to 3.41; P = .20) for participants with aMCI who were amyloid positive vs amyloid negative, and 2.56 (95% CI, 1.35 to 4.88; P = .004) for amyloid-positive participants who were either without cognitive impairment or had aMCI vs those who were amyloid negative. Global cognitive and memory domain z scores declined significantly in amyloid-positive individuals during follow-up. The mean (SD) follow-up time from baseline was 3.7 (1.9) years to incident aMCI and 3.8 (2.0) years to incident AD dementia. Conclusions and Relevance Population-based prevalence of amyloid-positive status and progression rates of amyloid positivity provide valid information for designing AD prevention trials and assessing the public health outcomes of AD prevention and interventions.
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Affiliation(s)
- Rosebud O Roberts
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Jeremiah A Aakre
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Walter K Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Maria Vassilaki
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Rabe Alhurani
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Yonas E Geda
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Psychiatry and Psychology and Neurology, Mayo Clinic, Scottsdale, Arizona
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Preciosa Coloma
- Real World Data Science, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | - Ronald C Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, Rochester, Minnesota
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Rusconi A, Freitas-Olim E, Coloma P, Messerer R, Barrey C. Bicortical facet screws as a new option for posterior C2 fixation: anatomical study and clinical experience. Eur Spine J 2017; 26:1082-1089. [PMID: 28204927 DOI: 10.1007/s00586-017-4997-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/31/2017] [Accepted: 02/06/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE C2 fixation is a demanding procedure, particularly in patients with variants of C1-C2 anatomy. The inferior articular process (IAP) of the axis can be an alternative for screw placement. We report the results of a CT study of C2 IAP anatomy and we present the clinical experience of 28 patients operated with this technique. METHODS Anatomical study: 50 CT angiographies of the vertebral arteries (VA) were used for this study and, therefore, 100 IAPs were considered. We measured on the axial and sagittal planes the length, height and width of the facet, the distance between the anterior cortex and the VA and the distance between the screw entry point and the VA. We also measured the angle between the sagittal plane and the external tangent line of the VA. CLINICAL REPORT 28 patients were treated with C2 IAP screws at the Spine Surgery Department of the University Hospital in Lyon, France, from January 2014 to January 2016. RESULTS Anatomical study: the mean length of C2 IAP was 12 ± 2 mm, the mean distance between the anterior cortical layer and the VA was 5.2 ± 1.4 mm, and the mean angle we found was 0.2° ± 5.3°. CLINICAL REPORT 16 of the 28 patients presented post-traumatic C1-C2 instability, 8 patients presented degenerative disease, 1 patient was treated for pseudoarthrosis, 1 for tumour, 1 for OPLL and 1 for rheumatoid arthritis. All the screws were correctly positioned and there was no VA injury. CONCLUSION IAP screws can represent a safe alternative option for C2 fixation.
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Affiliation(s)
- Angelo Rusconi
- Spine Surgery Department, Lyon University Hospital, 52 Boulevard Pinel, 69500, Bron, France.
| | - E Freitas-Olim
- Spine Surgery Department, Lyon University Hospital, 52 Boulevard Pinel, 69500, Bron, France
| | - P Coloma
- Spine Surgery Department, Lyon University Hospital, 52 Boulevard Pinel, 69500, Bron, France
| | - R Messerer
- Spine Surgery Department, Lyon University Hospital, 52 Boulevard Pinel, 69500, Bron, France
| | - C Barrey
- Spine Surgery Department, Lyon University Hospital, 52 Boulevard Pinel, 69500, Bron, France
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7
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Bachour E, Coloma P, Freitas E, Messerer R, Michel F, Barrey C. [Surgical correction of post-vertebroplasty kyphosis by pedicle substraction osteotomy. Regarding three cases]. Neurochirurgie 2017; 62:321-326. [PMID: 28120770 DOI: 10.1016/j.neuchi.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 05/24/2016] [Accepted: 07/09/2016] [Indexed: 10/20/2022]
Abstract
We report a case of three patients treated with pedicle subtraction osteotomy for post-vertebroplasty kyphosis. These patients were initially treated with a vertebroplasty for vertebral fracture (two cases) and spinal lymphoma (1 case). All of these patients worsened progressively on a clinical and radiographic level with progression of the spinal deformity in the form of kyphosis. The surgery consisted of transpedicular osteotomy instrumented at the level of the vertebra cemented with maximum removal of intra-corporeal cement. One of the three patients required a supplementary anterior approach to achieve good quality bone fusion. In all three cases the post-vertebroplasty kyphosis was able to be reduced by at least 50 % emphasizing the feasibility and relevance of the pedicle subtraction osteotomy in a context of cemented vertebra.
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Affiliation(s)
- E Bachour
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
| | - P Coloma
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
| | - E Freitas
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
| | - R Messerer
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
| | - F Michel
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
| | - C Barrey
- Service de neurochirurgie C et chirurgie du rachis, hôpital neurologique et neurochirurgical P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard-Lyon I, 69003 Lyon, France.
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Roberto G, Leal I, Sattar N, Loomis AK, Avillach P, Egger P, van Wijngaarden R, Ansell D, Reisberg S, Tammesoo ML, Alavere H, Pasqua A, Pedersen L, Cunningham J, Tramontan L, Mayer MA, Herings R, Coloma P, Lapi F, Sturkenboom M, van der Lei J, Schuemie MJ, Rijnbeek P, Gini R. Identifying Cases of Type 2 Diabetes in Heterogeneous Data Sources: Strategy from the EMIF Project. PLoS One 2016; 11:e0160648. [PMID: 27580049 PMCID: PMC5006970 DOI: 10.1371/journal.pone.0160648] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/23/2016] [Indexed: 11/26/2022] Open
Abstract
Due to the heterogeneity of existing European sources of observational healthcare data, data source-tailored choices are needed to execute multi-data source, multi-national epidemiological studies. This makes transparent documentation paramount. In this proof-of-concept study, a novel standard data derivation procedure was tested in a set of heterogeneous data sources. Identification of subjects with type 2 diabetes (T2DM) was the test case. We included three primary care data sources (PCDs), three record linkage of administrative and/or registry data sources (RLDs), one hospital and one biobank. Overall, data from 12 million subjects from six European countries were extracted. Based on a shared event definition, sixteeen standard algorithms (components) useful to identify T2DM cases were generated through a top-down/bottom-up iterative approach. Each component was based on one single data domain among diagnoses, drugs, diagnostic test utilization and laboratory results. Diagnoses-based components were subclassified considering the healthcare setting (primary, secondary, inpatient care). The Unified Medical Language System was used for semantic harmonization within data domains. Individual components were extracted and proportion of population identified was compared across data sources. Drug-based components performed similarly in RLDs and PCDs, unlike diagnoses-based components. Using components as building blocks, logical combinations with AND, OR, AND NOT were tested and local experts recommended their preferred data source-tailored combination. The population identified per data sources by resulting algorithms varied from 3.5% to 15.7%, however, age-specific results were fairly comparable. The impact of individual components was assessed: diagnoses-based components identified the majority of cases in PCDs (93–100%), while drug-based components were the main contributors in RLDs (81–100%). The proposed data derivation procedure allowed the generation of data source-tailored case-finding algorithms in a standardized fashion, facilitated transparent documentation of the process and benchmarking of data sources, and provided bases for interpretation of possible inter-data source inconsistency of findings in future studies.
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Affiliation(s)
- Giuseppe Roberto
- Regional Agency for Healthcare Services of Tuscany, Epidemiology unit, Florence, Italy
- * E-mail:
| | - Ingrid Leal
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - A. Katrina Loomis
- Pfizer Worldwide Research and Development, Groton, Connecticut, United States of America
| | - Paul Avillach
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Biomedical Informatics, Harvard Medical School & Children’s Hospital Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Peter Egger
- GlaxoSmithKline, Worldwide Epidemiology GSK, Stockley Park West, Uxbridge, United Kingdom
| | | | - David Ansell
- The Health Improvement Network, Cegedim Strategic Data Medical Research Ltd, London, United Kingdom
| | - Sulev Reisberg
- Quretec, Software Technology and Applications Competence Center, University of Tartu, Tartu, Estonia
| | - Mari-Liis Tammesoo
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
| | - Helene Alavere
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
| | - Alessandro Pasqua
- Health Search, Italian College of General Practitioners and Primary Care, Firenze, Italy
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hosptial, Aarhus, Denmark
| | | | - Lara Tramontan
- Arsenàl.IT Consortium, Veneto's Research Centre for eHealth Innovation, Treviso, Italy
| | - Miguel A. Mayer
- Hospital del Mar Medical Research Institute (IMIM) and Universitat Pompeu Fabra, Barcelona, Spain
| | - Ron Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands
| | - Preciosa Coloma
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Francesco Lapi
- Regional Agency for Healthcare Services of Tuscany, Epidemiology unit, Florence, Italy
| | - Miriam Sturkenboom
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Johan van der Lei
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Martijn J. Schuemie
- Janssen Research & Development, Epidemiology, Titusville, New Jersey, United States of America
- Observational Health Data Sciences and Informatics, New York, New York, United States of America
| | - Peter Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rosa Gini
- Regional Agency for Healthcare Services of Tuscany, Epidemiology unit, Florence, Italy
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Bos I, Vos SJ, Frölich L, Kornhuber J, Wiltfang J, Maier W, Peters O, Rüther E, Engelborghs S, Niemantsverdriet E, De Roeck EE, Tsolaki M, Freund-Levi Y, Johannsen P, Vandenberghe R, Lleó A, Alcolea D, Frisoni GB, Galluzzi S, Nobili F, Morbelli S, Drzezga A, Didic M, Berckel BN, Salmon E, Bastin C, Dauby S, Santana I, Baldeiras I, Mendonça A, Silva D, Wallin A, Nordlund A, Foskett N, Coloma P, Alexander M, Wientzek-Fleischmann A, Nevado-Holgado A, Gungabissoon U, Novak GP, Gordon MF, Wallin ÅK, Hampel H, Soininen H, Scheltens P, Verhey FR, Visser PJ. P4‐122: Prevalence of Vascular Risk Factors in Different Stages of Prodromal Alzheimer’s Disease and Its Influence on Cognitive Decline. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Lutz Frölich
- Central Institute of Mental Health, University of HeidelbergMannheimGermany
| | | | - Jens Wiltfang
- University Medical Center Goettingen, Georg-August-UniversityGoettingenGermany
| | | | | | | | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic Hospital Network Antwerp (ZNA) Middelheim and Hoge BeukenAntwerpBelgium
- University of AntwerpAntwerpBelgium
| | | | | | - Magda Tsolaki
- Aristotle University of ThessalonikiThessalonikiGreece
| | | | - Peter Johannsen
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen University HospitalCopenhagenDenmark
| | | | - Alberto Lleó
- Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | | | - Giovanni B. Frisoni
- University of GenevaGenevaSwitzerland
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Samantha Galluzzi
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | | | | | | | | | | | - Eric Salmon
- Department of Neurology and Memory Clinic CHU LiègeLiègeBelgium
- GIGA-CRC, University of LiègeLiègeBelgium
| | | | - Solene Dauby
- Department of Neurology and Memory Clinic CHU LiègeLiègeBelgium
| | | | | | | | | | - Anders Wallin
- Institute of Neuroscience and PhysiologyMoelndalSweden
| | - Arto Nordlund
- Institute of Neuroscience and PhysiologyMoelndalSweden
| | - Nadia Foskett
- PBD RWD Roche Products LimitedWelwyn Garden CityUnited Kingdom
| | - Preciosa Coloma
- Real World Data Science (RWD-S) Neuroscience and Established Products F. Hoffmann-La Roche Ltd. Pharmaceuticals Division BaselSwitzerland
| | | | | | | | | | - Gerald P. Novak
- Janssen Pharmaceutical Research and DevelopmentTitusvilleNJ USA
| | | | | | | | | | - Philip Scheltens
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
| | | | - Pieter Jelle Visser
- VU University Medical CenterAmsterdamNetherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht UniversityMaastrichtNetherlands
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Gini R, Schuemie M, Brown J, Ryan P, Vacchi E, Coppola M, Cazzola W, Coloma P, Berni R, Diallo G, Oliveira JL, Avillach P, Trifirò G, Rijnbeek P, Bellentani M, van Der Lei J, Klazinga N, Sturkenboom M. Data Extraction and Management in Networks of Observational Health Care Databases for Scientific Research: A Comparison of EU-ADR, OMOP, Mini-Sentinel and MATRICE Strategies. EGEMS (Wash DC) 2016; 4:1189. [PMID: 27014709 PMCID: PMC4780748 DOI: 10.13063/2327-9214.1189] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction: We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can’t be shared, requiring a distributed network approach where data processing is performed prior to data sharing. Case Descriptions and Variation Among Sites: We created a conceptual framework distinguishing three steps in local data processing: (1) data reorganization into a data structure common across the network; (2) derivation of study variables not present in original data; and (3) application of study design to transform longitudinal data into aggregated data sets for statistical analysis. We applied this framework to four case studies to identify similarities and differences in the United States and Europe: Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR), Observational Medical Outcomes Partnership (OMOP), the Food and Drug Administration’s (FDA’s) Mini-Sentinel, and the Italian network—the Integration of Content Management Information on the Territory of Patients with Complex Diseases or with Chronic Conditions (MATRICE). Findings: National networks (OMOP, Mini-Sentinel, MATRICE) all adopted shared procedures for local data reorganization. The multinational EU-ADR network needed locally defined procedures to reorganize its heterogeneous data into a common structure. Derivation of new data elements was centrally defined in all networks but the procedure was not shared in EU-ADR. Application of study design was a common and shared procedure in all the case studies. Computer procedures were embodied in different programming languages, including SAS, R, SQL, Java, and C++. Conclusion: Using our conceptual framework we found several areas that would benefit from research to identify optimal standards for production of empirical knowledge from existing databases.an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings.
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Affiliation(s)
- Rosa Gini
- Agenzia Regionale di Sanità della Toscana; Erasmus MC University Medical Center
| | - Martijn Schuemie
- Janssen Research & Development, Epidemiology; Observational Health Data Sciences and Informatics (OHDSI)
| | | | - Patrick Ryan
- Janssen Research & Development, Epidemiology; Observational Health Data Sciences and Informatics (OHDSI)
| | - Edoardo Vacchi
- Università degli Studi di Milano, Dipartimento di Informatica
| | - Massimo Coppola
- Consiglio Nazionale delle Ricerche, Istituto di Scienza e Tecnologie dell'Informazione
| | - Walter Cazzola
- Università degli Studi di Milano, Dipartimento di Informatica
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11
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Patadia VK, Coloma P, Schuemie MJ, Herings R, Gini R, Mazzaglia G, Picelli G, Fornari C, Pedersen L, van der Lei J, Sturkenboom M, Trifirò G. Using real-world healthcare data for pharmacovigilance signal detection - the experience of the EU-ADR project. Expert Rev Clin Pharmacol 2015; 8:95-102. [PMID: 25487079 DOI: 10.1586/17512433.2015.992878] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A prospective pharmacovigilance signal detection study, comparing the real-world healthcare data (EU-ADR) and two spontaneous reporting system (SRS) databases, US FDA's Adverse Event Reporting System and WHO's Vigibase is reported. The study compared drug safety signals found in the EU-ADR and SRS databases. The potential for signal detection in the EU-ADR system was found to be dependent on frequency of the event and utilization of drugs in the general population. The EU-ADR system may have a greater potential for detecting signals for events occurring at higher frequency in general population and those that are commonly not considered as potentially a drug-induced event. Factors influencing various differences between the datasets are discussed along with potential limitations and applications to pharmacovigilance practice.
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Affiliation(s)
- Vaishali K Patadia
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
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12
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Coloma P, Huber P. Impact of nuclear effects on the extraction of neutrino oscillation parameters. Phys Rev Lett 2013; 111:221802. [PMID: 24329438 DOI: 10.1103/physrevlett.111.221802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/22/2013] [Indexed: 06/03/2023]
Abstract
study the possible impact of nuclear effects and final state interactions on the determination of the oscillation parameters due to the misreconstruction of nonquasielastic events as quasielastic events at low energies. We analyze a ν(μ) disappearance experiment using a water Čerenkov detector. We find that, if completely ignored in the fit, nuclear effects can induce a significant bias in the determination of atmospheric oscillation parameters, particularly for the atmospheric mixing angle. Even after inclusion of a near detector, a bias in the determination of the atmospheric mixing angle comparable to the statistical error remains.
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Affiliation(s)
- P Coloma
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - P Huber
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
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13
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14
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Christensen E, Coloma P, Huber P. Physics performance of a low-luminosity low energy neutrino factory. Phys Rev Lett 2013; 111:061803. [PMID: 23971560 DOI: 10.1103/physrevlett.111.061803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 06/05/2013] [Indexed: 06/02/2023]
Abstract
We investigate the minimal performance, in terms of beam luminosity and detector size, of a neutrino factory to achieve a competitive physics reach for the determination of the mass hierarchy and the discovery of leptonic CP violation. We find that a low luminosity of 2×10(20) useful muon decays per year and 5 GeV muon energy aimed at a 10 kton magnetized liquid argon detector placed at 1300 km from the source provides a good starting point. This result relies on θ13 being large and assumes that the so-called platinum channel can be used effectively. We find that such a minimal facility would perform significantly better than phase I of the LBNE project and thus could constitute a reasonable step towards a full neutrino factory.
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Affiliation(s)
- E Christensen
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
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