Db4 Heart Failure Risk Ofthiazolidinediones Ina Medicaid Managed Care Population

A review of methods used in assessing non-serious adverse drug events in observational studies among type 2 diabetes mellitus patients

“…Fifteen studies (22%) limited the inclusion to more complicated cases (category B), such as inadequately controlled by or not tolerating previous medication [ 40 - 45 ], receiving combination treatment [ 46 - 48 ] or insulin [ 21 , 23 , 45 , 49 ] or treated with maximum dose of medication [ 50 ]. Furthermore, 18 studies (27%) excluded patients based on the presence at baseline of the outcome or a condition that could influence the outcome [ 18 , 24 , 25 , 33 , 37 - 39 , 47 , 51 - 55 ], non-availability of measurements and/or clinical visits [ 35 , 37 , 46 , 47 , 50 , 54 , 56 , 57 ], inability to fill in questionnaires (category C) [ 18 , 21 , 46 , 56 ].…”

The risk of coronary heart disease in type 2 diabetic patients exposed to thiazolidinediones compared to metformin and sulfonylurea therapy

“…26 Another study that compared TZD users to metformin users using Medicaid managed care data found that TZD patients were older, were more likely to have pre-existing diabetes complications, and were more likely to use insulin. 27 Although we included a number of claims-based variables in the propensity score regression models (see the Appendix for a full list of variables), we were not able to include variables not routinely captured in claims data, such as laboratory values of glycosylated hemoglobin, glucose levels, blood lipid levels, or blood pressure measurements, that are direct clinical measures of diabetes severity or CHD risk. We also did not have information on other factors related to CHD risk, such as body mass, exercise, smoking, or duration of diabetes, an important determinant of CHD.…”

“…25 There is evidence that patients started on TZDs are more advanced in their disease progression than diabetics started on monotherapy with metformin and sulphonylureas. 26,27 Therefore, to fulfill the purpose of the study which is to evaluate whether the risk of CHD (MI and CR) differed among adult diabetic patients treated with TZDs or similar patients treated with other oral antidiabetic therapy, we chose as the comparison group patients receiving combined oral metformin and sulfonylurea (M þ S) therapy. In order to simulate random assignment with the observational data available in the data source, a health care claims database, we used an analysis technique, propensity score matching, that controls for imbalances among treatment groups on variables that influence the choice of therapy.…”

Dendrimers for ocular drug delivery

“…However, these therapies suffer from notoriously poor patient compliance due ultimately to the poor delivery efficiency of eye drops. 26–28 Even under ideal conditions, only around 5% of the drug placed on the eye reaches the anterior chamber. 29 Permeation though the tightly packed epithelium of the cornea and sclera is slow for anything but the smallest, most lipophilic compounds.…”