Postgraduate medicine
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Postgraduate medicine · Jan 2016
Review Meta AnalysisEfficacy of methylnaltrexone for the treatment of opiod-induced constipation: a meta-analysis and systematic review.
Constipation is a common adverse effect in patients requiring long-term opioid therapy for pain control. Methylnaltrexone, a quaternary peripheral mu-opioid receptor antagonist, is an effective treatment of opioid induced constipation (OIC) without affecting centrally mediated analgesia. Our objective was to conduct a review and meta-analysis to evaluate the efficacy of methylnaltrexone for treatment of OIC, as well as to provide a clinical discussion regarding newly developed alternatives and provide the current treatment algorithm utilized at our institution. ⋯ Results support the use of methylnaltrexone. Furthermore, the use of methylnaltrexone to induce laxation may decrease use of health care resources, increase work productivity, and improve cost utilization. New treatments have been made available; however, controlled clinical studies are needed to demonstrate long-term efficacy, safety and cost-effectiveness. Possible limitations of this study include the relatively small number of randomized, placebo-controlled trials investigating the efficacy of methylnaltrexone versus placebo. There is also the possibility of publication bias, which may lead to overestimating the efficacy of methylnaltrexone in treating OIC.
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Postgraduate medicine · Aug 2015
Review Meta AnalysisPhysical urticaria: Review on classification, triggers and management with special focus on prevalence including a meta-analysis.
Physical urticaria (PU) is a subset of chronic urticaria (CU) induced by physical stimuli. To date, there is no consensus in the literature on the prevalence of PU among patients with CU. ⋯ Our results must be viewed with circumspection because of the small number of eligible articles and heterogeneity among studies. Even so, the results suggest that PU is an important subset of CU and that physicians should be aware of this important condition in order to manage patients appropriately.
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Postgraduate medicine · Jun 2015
Meta AnalysisEfficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin in black/African American patients with type 2 diabetes: Pooled analysis from eight Phase III trials.
The prevalence of type 2 diabetes in black/African Americans from North and South America is high; yet data evaluating antidiabetic agents in this population is scarce. To address this gap, we pooled data from the clinical development program for linagliptin. ⋯ Linagliptin provided clinically significant improvements in glycemic control without increased risk of hypoglycemia and without weight gain, representing a useful type 2 diabetes therapy option for the black/African American population.
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Postgraduate medicine · Jun 2015
Meta AnalysisDiagnostic accuracy of endostatin for malignant pleural effusion: A clinical study and meta-analysis.
The diagnosis of malignant pleural effusion (MPE) remains a clinical challenge. Many studies suggest that endostatin is a potential marker for MPE. This study aimed to determine the diagnostic value of endostatin with respect to MPE and to summarize the overall diagnostic performance of endostatin via a meta-analysis. ⋯ Pleural levels of endostatin are increased in the setting of MPE. However, endostatin exhibits a limited efficacy for the diagnosis of MPE and shows a relatively low sensitivity. The assessment of endostatin in combination with CEA may enhance diagnostic accuracy with respect to MPE.
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Postgraduate medicine · Mar 2015
Meta AnalysisSafety and efficacy of alirocumab 150 mg every 2 weeks, a fully human proprotein convertase subtilisin/kexin type 9 monoclonal antibody: A Phase II pooled analysis.
Alirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9, is in Phase III development for the treatment of hypercholesterolemia. In Phase II studies, 150 mg every 2 weeks (Q2W) was the highest Q2W dose studied, and it is currently the highest Q2W dose under development. To better assess the safety and efficacy of this dose, data across three Phase II studies were pooled. ⋯ At the highest Q2W dose under development (150 mg), alirocumab appears well tolerated and produces robust LDL-C reductions. These data suggest that alirocumab 150 mg Q2W is an appropriate dose for further evaluation in Phase III trials.