Current medical research and opinion
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Randomized Controlled Trial Multicenter Study
Effect of saxagliptin as add-on therapy in patients with poorly controlled type 2 diabetes on insulin alone or insulin combined with metformin.
To evaluate efficacy and safety of saxagliptin as add-on therapy in patients with type 2 diabetes (T2D) with inadequate glycemic control on insulin alone or combined with metformin. ⋯ Saxagliptin 5-mg once-daily add-on therapy improves glycemic control in T2D patients on insulin alone or combined with metformin and is generally well-tolerated. NCT00757588.
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Multicenter Study Comparative Study Clinical Trial
Insulin initiation in elderly patients with type 2 diabetes in France: a subpopulation of the LIGHT study.
To examine the management of basal insulin analogue initiation in combination with oral antidiabetic drug (OAD) therapy in elderly patients with type 2 diabetes (aged ≥70 years) by physicians via comparison to the same treatment strategy in younger individuals (<70 years). ⋯ Basal insulin analogues were successfully initiated in elderly patients in combination with OAD therapies and were shown to provide effective glycaemic control. Levels of hypoglycaemia were also similar to those seen in younger patients.
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Multicenter Study Clinical Trial
A prospective study to optimize insulin treatment by switching to insulin glargine in type 2 diabetic patients previously uncontrolled on premixed insulin: the optimization study.
To evaluate the efficacy, safety and treatment satisfaction of insulin glargine plus oral antidiabetic drugs (OADs) in Chinese individuals with Type 2 diabetes inadequately controlled with premixed insulin plus OADs. ⋯ This single-arm study suggested that switching to insulin glargine plus OADs significantly improved glycaemic control, with a low incidence of hypoglycaemia, in patients with Type 2 diabetes uncontrolled on premixed insulin plus OADs. Switching to insulin glargine was also associated with better patient treatment satisfaction compared with previous treatment. The main limitations to this study are the open-label design and the lack of a control arm.
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Multicenter Study Comparative Study
Disability outcomes and dose escalation with etanercept, adalimumab, and infliximab in rheumatoid arthritis patients: a US-based retrospective comparative effectiveness study.
Rheumatoid arthritis (RA) is a chronic disease that if left untreated may substantially impair physical functioning. Etanercept, infliximab, and adalimumab are tumor necrosis factor (TNF) blockers whose FDA-approved indications in the US include moderate to severe RA. TNF-blocker dose escalation has been well documented in the literature; however, the comparative effectiveness of these agents remains uncertain. ⋯ Fewer etanercept patients escalated dose than infliximab or adalimumab patients, but improvements in functional disability were similar. These differences may have been influenced by package labeling, mode of administration, or other factors. RA treatment with infliximab and adalimumab in community settings, characterized by dose escalation, did not yield greater disability improvements compared to etanercept, which remained at a relatively stable dose. Uncontrolled treatment selection in this observational design may have influenced outcomes, and prior methotrexate treatment may partly explain disability improvements smaller than typically observed in clinical trials.
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The prevalence of comorbid anemia in patients with COPD ranges from 7.5% to 34%. The aim of this study is to determine if anemia is a risk factor for readmission in COPD patients. ⋯ This is a retrospective cohort study and thus subject to multiple forms of bias. Although spirometric evidence of COPD was not available, our case identification methods have been previously validated and found to be accurate in recognizing COPD.