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Alsheikh A, Alshehri A, Alzahrani S, Jammah AA, Alqahtani F, Alotaibi M, Aldahash R, Alhozali AM, Alsabaan F, Almehthel M, Aljuhani N, Aldabeis A, Alamri M, Maghawry W, Alzaman N, Alshaikh A, M Alnozha O, Issak ER, Alsifri S. Evaluating the Clinical Effectiveness and Safety of Semaglutide in Individuals with Uncontrolled Type 2 Diabetes. Real-World Evidence from Saudi Arabia: The Observational, Multicenter, 15-Month EVOLUTION Study. Diabetes Ther 2024; 15:473-485. [PMID: 38110660 PMCID: PMC10838866 DOI: 10.1007/s13300-023-01516-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION This study aimed to assess the safety and effectiveness of semaglutide, administered either by weekly subcutaneous (SC) injection or orally, in real-life practice in Saudi Arabia in individuals with type 2 diabetes mellitus (T2DM). METHODS A retrospective chart review study was conducted at 18 Saudi Arabia centers. An accredited centralized institutional review board approved the study. Medical records were included for individuals of any age ≥ 18 years with uncontrolled T2DM. The primary outcome measure was the laboratory glycated hemoglobin (HbA1c) level. Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after 6 and 12 months of semaglutide initiation. RESULTS The analysis of this study included 1223 patients with uncontrolled T2DM (HbA1c > 7%). The mean (SD) baseline HbA1c was 10.02% (1.17). HbA1c was reduced by an average of 3.02% (0.84) and 3.17% (0.84) at 6 and 12 months, respectively. Results of a repeated measure analysis of variance (ANOVA) indicated significant differences in HbA1c (p value < 0.001). HbA1c levels at 6 and 12 months were significantly lower, 7.00% (0.70) and 6.85% (0.69), than at baseline, 10.02% (1.17). About 193 patients (56.4%) of the 295 patients having HbA1c < 9% achieved HbA1c of 5.7% or less. The frequency of hypoglycemia events was 4.60 (1.10) in the 3 months before semaglutide was initiated. The frequency of hypoglycemia events in the last 3 months was 2.30 (0.80) events and 0.80 (0.50) events at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.07% (1.53) and 19.89% (4.07) at 6 and 12 months, respectively. Lipid profile and blood pressure were improved at 6 and 12 months. CONCLUSION Semaglutide, administered either by SC injection or orally, provided substantial glycemic and weight-loss benefits in adults with T2DM.
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Affiliation(s)
- Abdulrahman Alsheikh
- King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Dr. Suliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | | | | | - Anwar A Jammah
- King Saud University Medical City, Riyadh, Saudi Arabia
- Alhammadi Hospital, Riyadh, Saudi Arabia
| | | | - Metib Alotaibi
- Alhammadi Hospital, Riyadh, Saudi Arabia
- Dr Suliman Alhabeeb Hospital, Alolya, Riyadh, Saudi Arabia
| | - Raed Aldahash
- Dr Suliman Alhabeeb Hospital, Alolya, Riyadh, Saudi Arabia
- King Abdallah Medical City, National Guard, Riyadh, Saudi Arabia
| | - Amani M Alhozali
- King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- International Medical Center, Jeddah, Saudi Arabia
| | | | | | | | | | - Moneer Alamri
- Southern Armed Forces Hospital, Khamis Mushait, Saudi Arabia
| | | | - Naweed Alzaman
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
- Madina Medical Center, Madinah, Saudi Arabia
| | | | - Omar M Alnozha
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
- Saudi German Hospital, Madinah, Saudi Arabia
| | - Emad R Issak
- Department of Internal Medicine, Ain Shams University, Cairo, Egypt.
| | - Saud Alsifri
- Alhada Armed Forces Hospital, Taif, Saudi Arabia
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Issak ER, Amin MM. Timing of corticosteroids in non-severe non-hospitalized COVID-19 patients: open-label, two-center, randomized controlled study (TICS-COV19 study). Korean J Intern Med 2023; 38:207-217. [PMID: 36646988 PMCID: PMC9993104 DOI: 10.3904/kjim.2022.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND/AIMS Corticosteroids (CSs) are frequently used in coronavirus disease 2019 (COVID-19); however, their utility remains controversial in mild to moderate cases. The timing of CSs initiation during the disease course remains unaddressed. The study aims to evaluate the impact of early CSs in non-severe COVID-19. METHODS A randomized controlled, open-label study was conducted on 754 COVID-19 patients randomized into a study group (n = 377) in which patients received CSs with COVID-19 protocol and a control group (n = 377) in which patients received COVID-19 protocol only. RESULTS Both groups were comparable regarding baseline characteristics, presenting symptoms, and inflammatory markers. The composite endpoint (need for O2, need for hospitalization or 28-day mortality) was significantly (p = 0.004) lower in the CS group 42 (11.14%) versus the control group 70 (18.67%) with odds ratio 0.55 (95% confidence interval [CI], 0.36 to 0.83), absolute risk reduction 7.53% (95% CI, 2.46% to 12.59%) and number needed to treat of 13.29 (95% CI, 7.94 to 40.61). Regarding severity at day 10, only (11.1%) of the study group patients were severe versus (18.7%) of the control group patients (p < 0.001). The median time-to-return to daily activity in the CS group was 8.0 days, while in the control group, it was 22.0 days (p < 0.001). CONCLUSION In non-severe COVID-19, CS may decrease hospitalization, severity, and mortality.
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Affiliation(s)
- Emad R. Issak
- Department of Internal Medicine, Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
- Department of Internal Medicine, Asalam Center, Cairo,
Egypt
| | - Mariam M. Amin
- Department of Internal Medicine, Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
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Mohammad EH, Abou El Serour AG, Mohamed EAH, Abbasy AH, Zaatar M, Rageh KA, Shafeek MM, Issak ER. Efficacy of growth hormone supplementation with ultrashort GnRH antagonist in IVF/ICSI for poor responders; randomized controlled trial. Taiwan J Obstet Gynecol 2021; 60:51-55. [PMID: 33495008 DOI: 10.1016/j.tjog.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To compare the ICSI-ET outcomes in poor responders who underwent ovarian stimulation by the ultrashort GnRH antagonist protocol with or without adjuvant GH injection. MATERIAL AND METHODS This randomized controlled study was conducted at Al-Azhar University from December-2018 to June-2019 upon 156 participants. All patients received the same preparations. After randomization, in the study group, women have received GH 4 IU/day subcutaneous injection from the second day of the cycle stopped one day before ovum pickup. While in the control group, women have received subcutaneous saline in the same dosing as in the study group. After intervention, all procedures were the same in both groups. The main outcome measure was the clinical pregnancy rate. Statistical analysis was based on the intention-to-treat population. RESULTS Both groups were comparable with regard their baseline characteristics (p-values > 0.05). Ovulation characteristics were comparable (p-values > 0.05). The level of E2 is significantly (p-value = 0.003) higher in the GH group. The oocyte retrieved number was significantly (p-value < 0.001) higher in the GH group 4.94 ± 1.77 than in the control group 3.74 ± 1.82. The mean number of MII oocytes was significantly (p-value < 0.001) higher in the GH group 3.3 ± 1.36 than in the control group 2.29 ± 1.24. Fertilization characteristics, implantation rate, pregnancy rate were comparable (p-values > 0.05). CONCLUSION Despite the fact that this study showed no significant increase in the clinical and chemical pregnancy rates by the addition of GH to the ultrashort antagonist protocol in poor responders, the number of retrieved oocytes was significantly higher in the GH group. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03759301.
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Affiliation(s)
- Ehab H Mohammad
- Department of Gynecology and Obstetrics, Faculty of Medicine, Al-Azhar University, Egypt
| | - Ahmed G Abou El Serour
- Department of Gynecology and Obstetrics, Faculty of Medicine, Al-Azhar University, Egypt
| | - Eman A H Mohamed
- Department of Embryology, International Islamic Center for Population Studies & Research, Al Azhar University, Egypt
| | - Amr H Abbasy
- Department of Obstetrics & Gynecology, National Research Center, Egypt
| | - Mahmoud Zaatar
- Department of Obstetrics & Gynecology, National Research Center, Egypt
| | - Kamal A Rageh
- Department of Gynecology and Obstetrics, Faculty of Medicine, Al-Azhar University, Egypt
| | - Mohamed M Shafeek
- Department of Obstetrics & Gynecology, National Research Center, Egypt
| | - Emad R Issak
- Department of Internal Medicine, Nova Clinics, Cairo, Egypt.
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Alshaikh A, Alsifri S, Alhozali A, Mosli H, Zawawi T, Mira S, Issak ER. Saudi Scientific Diabetes Society Position Statement: Management of Diabetes Mellitus in the Pandemic of COVID-19. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/ijcm.2020.115020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hamdy A, Azmy O, Lotfy R, Attia AA, Elsherbini MM, Al Sawaf A, Soliman MM, Sharaf MF, Kamel A, Abd El-Raouf MN, Salem S, Rasheed MA, Torky H, Issak ER. Multicenter randomized controlled trial assessing the impact of a cervical traction maneuver (Amr's maneuver) on the incidence of postpartum hemorrhage. Int J Gynaecol Obstet 2018; 144:56-61. [PMID: 30281778 DOI: 10.1002/ijgo.12687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 03/20/2018] [Revised: 07/18/2018] [Accepted: 09/28/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the impact of a cervical traction maneuver (Amr's maneuver) used in conjunction with active management of the third stage of labor (AMTSL) on the incidence of postpartum hemorrhage (PPH). METHOD The present multicenter randomized controlled trial was conducted in Cairo between March 1, 2016, and June 30, 2017. Women aged at least 18 years who had singleton pregnancies and were candidates for vaginal delivery were enrolled. After block randomization, AMTSL was performed for all participants. Following placental delivery, Amr's maneuver using cervical traction for 90 seconds was carried out in the study group. The primary outcome, incidence of PPH (>500 mL blood loss) within 6 hours of delivery, was compared between the study and control groups in an intention-to-treat analysis. RESULTS There were 852 patients randomized to the study (n=426) and control (n=426) groups. The incidence of PPH was significantly lower in the study group compared with the control group (6 [1.4%] vs 19 [4.5%]; P=0.015). Absolute risk reduction of 3.1% (95% CI 0.8-5.6), relative risk reduction of 0.32 (95% CI 0.13-0.78), and number needed to treat of 33 (95% CI 129-18) were observed in the study group. CONCLUSION Amr's maneuver was effective in decreasing the incidence of PPH. ClinicalTrials.gov Identifier: NCT02660567.
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Affiliation(s)
- Amr Hamdy
- Department of Gynecology and Obstetrics, Shoubra Hospital, Cairo, Egypt
| | - Osama Azmy
- Department of Reproductive Health, National Research Centre, Giza, Egypt
| | - Rehab Lotfy
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed A Attia
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Moutaz M Elsherbini
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Al Sawaf
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mahmoud M Soliman
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa F Sharaf
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Kamel
- Department of Gynecology and Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Sondos Salem
- Department of Reproductive Health, National Research Centre, Giza, Egypt
| | - Mazen A Rasheed
- Department of Reproductive Health, National Research Centre, Giza, Egypt
| | - Haitham Torky
- Department of Gynecology and Obstetrics, Faculty of Medicine, October 6th University, Giza, Egypt
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