Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Mason, James; Young, Philip J.; Freemantle, Nick

doi:10.1136/bmj.321.7269.1113

Cited by 20 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the case of the ATLAS (Assessment of Treatment with Lisinopril and Survival) trial, [50] for instance, data have been reanalysed from the US perspective with respect to cost differences, [51] and in Switzerland [52] and Italy for cost effectiveness. [53] A similar practice is observed for other large multinational studies such as the PURSUIT (Platelet Glycoprotein IIb/ IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) [54][55][56] and SOLVD (Studies of Left Ventricular Dysfunction) [57][58][59][60][61] trials.…”

Section: Analyses That Do Not Recognize the Hierarchical Structure Insupporting

confidence: 54%

The Analysis of Multinational Cost-Effectiveness Data for Reimbursement Decisions

2010

View full text Add to dashboard Cite

Evidence produced by multinational trial-based cost-effectiveness studies is often used to inform decisions concerning the adoption of new healthcare technologies. A key issue relating to the use of this type of evidence is the extent to which trial-wide economic results are applicable to every single country participating in the study. We consider what role cost-effectiveness analysis alongside multinational trials should have in assisting reimbursement decisions at jurisdiction and national levels. Using the proposed framework as a benchmark to evaluate their relative pros and cons, we then describe and review the statistical approaches used in the multinational trial-based cost-effectiveness literature. The results of the review are used to define the desirable characteristics a statistical method for the analysis of data collected from different jurisdictions should have in order to be consistent with the proposed framework. It is argued that Bayesian hierarchical models that use both patient- and country-level information are the most appropriate tool to analyse multinational trial-based cost-effectiveness data and facilitate the between-country generalizability assessment of the study findings. The merits of each approach are discussed, highlighting problems and limitations, in order to identify areas of future research.

show abstract

Section: Analyses That Do Not Recognize the Hierarchical Structure Insupporting

confidence: 54%

The Analysis of Multinational Cost-Effectiveness Data for Reimbursement Decisions

2010

View full text Add to dashboard Cite

show abstract

“…An ACEI was chosen for this study because of prior data showing that these drugs can mitigate a wide range of experimental radiation injuries (4) and because these agents are very well tolerated and safe in clinical use (23, 24), including use in patients who are not hypertensive (25, 26). Captopril was specifically chosen because it has been tested prospectively as a mitigator in radiation oncology patients.…”

Section: Discussionmentioning

confidence: 99%

“…This rat model has also predicted the efficacy of ACEIs and ARBs for treatment of renal injury in patients receiving TBI (4), and the success of mitigation with captopril in the model was our major justification for the successful test of captopril to mitigate chronic renal failure after BMT in humans (26). …”

Section: Discussionmentioning

confidence: 99%

Captopril and Losartan for Mitigation of Renal Injury Caused by Single-Dose Total-Body Irradiation

2011

View full text Add to dashboard Cite

It is known that angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs) can be used to mitigate radiation-induced renal injury. However, for a variety of reasons, these previous results are not directly applicable to the development of agents for the mitigation of injuries caused by terrorism-related radiation exposure. As part of an effort to develop an animal model that would fit the requirements of the U.S. Food and Drug Administration (FDA) "Animal Efficacy Rule", we designed new studies which used an FDAapproved ACEI (captopril) or an FDA-approved ARB (losartan, Cozaar ® ) started 10 days after a single total-body irradiation (TBI) at drug doses that are equivalent (on a g/m 2 /day basis) to the doses prescribed to humans. Captopril and losartan were equally effective as mitigators, with DMFs of 1.23 and 1.21, respectively, for delaying renal failure. These studies show that radiation nephropathy in a realistic rodent model can be mitigated with relevant doses of FDA-approved agents. This lays the necessary groundwork for pivotal rodent studies under the FDA Animal Efficacy Rule and provides an outline of how the FDA-required large-animal studies could be designed.

show abstract

“…Only 16% of the patients got ACE-inhibitors, a class of drugs that may provide functional benefits for elderly patients with heart failure. 15,16 The most frequent types of advice were withdrawal of furosemide and potassium, and prescription of an ACE-inhibitor. The withdrawal advice was often followed by the responsible physician, but the advice to introduce an ACE-inhibitor was not.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled intervention in cardiovascular drug treatment in nursing homes

Ulfvarson¹,

Adami²,

Ullman³

et al. 2003

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction

Abstract: Objective To estimate the costs and consequences of diagnosing symptomatic heart failure with left ventricular systolic dysfunction and initiating angiotensin converting enzyme inhibitors in primary care.

Cited by 20 publications

References 21 publications

The Analysis of Multinational Cost-Effectiveness Data for Reimbursement Decisions

The Analysis of Multinational Cost-Effectiveness Data for Reimbursement Decisions

Captopril and Losartan for Mitigation of Renal Injury Caused by Single-Dose Total-Body Irradiation

Randomized controlled intervention in cardiovascular drug treatment in nursing homes

Contact Info

Product

Resources

About