SciCombinator

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Journal: Pharmacoepidemiology and drug safety

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BACKGROUND: Studies demonstrate the potential for statins to prevent dementia and Alzheimer’s disease (AD), but the evidence is inconclusive. OBJECTIVE: Conduct a meta-analysis to estimate any benefit of statins in preventing dementia and examine the potential effect of study design and confounding on the benefit of statins in dementia. A secondary goal is to explore factors that may elucidate the mechanisms by which statins exert their potentially beneficial effect. METHODS: Performed systematic literature review to identify relevant publications. Relative risk (RR) estimates were pooled using both fixed and random effect models. Studies were stratified by study design and potential confounding factors. RESULTS: The pooled results for all-type dementia suggest that use of statins is associated with a lower RR of dementia when compared to non-statin users (random effects model: RR 0.82 (95%CI [0.69, 0.97]). The pooled results for AD also suggested a lower RR with statin user compared to non-statin users in random effects models (RR: 0.70, 95% CI [0.60, 0.83]). Study design and methods used to address biases may influence the results. CONCLUSION: These pooled results suggest that statins may provide a slight benefit in the prevention of AD and all-type dementia. This benefit observed in both disease states should be interpreted with caution as observational studies are subject to bias, and it is possible that the slight benefit observed may disappear when these biases are addressed in a well-designed randomized controlled trial. Copyright © 2012 John Wiley & Sons, Ltd.

Concepts: Alzheimer's disease, Scientific method, Experimental design, Epidemiology, Medical statistics, Systematic review, Analysis of variance, Random effects model

28

The study assessed coping practices to HIV treatment side effects among HIV-infected patients receiving antiretroviral therapy (ART) in selected hospitals in Nigeria.

Concepts: Antiretroviral drug, HIV, AIDS, Protease inhibitor, Viral load, Hospital, Assessment

28

BACKGROUND: Generic alendronate was approved in the United States on February 6, 2008. Medicare beneficiaries might pay for generic alendronate out-of-pocket without having claims submitted, resulting in misclassification of generic alendronate use in Medicare data. OBJECTIVES: To estimate the completeness of generic alendronate use in 2008 Medicare Part D data; to identify factors associated with staying on branded alendronate versus switching to a generic product. METHODS: We identified Medicare beneficiaries highly adherent (medication possession ratio ≥80%) with branded alendronate during 1/1/06-2/6/07 (“2007 cohort”) and during 1/1/07-2/6/08 (“2008 cohort”). The outcome was medication status at the end of follow-up (12/31/2007 or 12/31/2008), classified as continued branded alendronate, switched to generic alendronate, switched to another bisphosphonate or presumed discontinued bisphosphonate therapy. Cox regression estimated the hazard ratio (HR) for discontinuation in 2008 compared to 2007. Multinomial logistic regression identified factors associated with medication status for the 2008 cohort. RESULTS: Among 15 310 subjects using branded alendronate in the 2008 cohort, 81% switched to generic alendronate. The proportion presumably discontinuing bisphosphonate therapy was 8.9% in 2008 compared to 7.7% in the 2007 cohort (adjusted HR, 1.15; 95% confidence interval, 1.05, 1.26). Factors associated with staying on branded alendronate in 2008 were higher income, eligibility for a low income subsidy and use of Fosamax® plus vitamin D. CONCLUSION: Evaluation of Medicare prescription drug data suggests that the amount of missing claims for generic alendronate in 2008 was not substantial, and misclassification of exposure in studies examining alendronate use post-generic product availability should be minimal. Copyright © 2012 John Wiley & Sons, Ltd.

Concepts: Pharmacology, Regression analysis, Prescription drug, Medicare, Statistics, Multinomial logit, Medicare Part D, Medicare Prescription Drug, Improvement, and Modernization Act

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To assess the factors influencing adherence in long-term medication use as exemplified by statins.

23

Multiple criteria decision analysis swing weighting (SW) and discrete choice experiments (DCE) are appropriate methods for capturing patient preferences on treatment benefit-risk trade-offs. This paper presents a qualitative comparison of the 2 methods.

Concepts: Critical thinking, Decision theory, Educational psychology, Decision making software, Operations research, Thought, Choice, Discrete mathematics

23

Our study sought to systematically evaluate protocol-specified study methodology in prospective pregnancy exposure registries including pre-specified pregnancy outcomes, power calculations for sample size, and comparator group selection.

Concepts: Sample size, Statistical hypothesis testing, Population genetics, Methodology, Selection, Group selection

18

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and very commonly used, but also have side effects. We determined prevalence of NSAID dosing exceeding the daily limit (EDL) and identified related user characteristics and dosing patterns among current ibuprofen users.

Concepts: Cyclooxygenase, Non-steroidal anti-inflammatory drug, Paracetamol, Ibuprofen, Diclofenac, Analgesic, Naproxen

14

Diagnosis of children with attention-deficit/hyperactivity disorder (ADHD) is increasing. The present study sought to identify characteristics and medication treatment patterns of children with ADHD and compare them by relative age in class, sex, ethnicity, family size, sibling order, and other socioeconomic status, as well as find trends in disparity of pharmacotherapy.

Concepts: Family, Attention-deficit hyperactivity disorder, Order, Stimulant, Taxonomic rank, Class, Sibling, Social status

10

Drug-induced aseptic meningitis (DIAM) is an inflammation of the membranes of the central nervous system caused by certain medications. It is a rare clinical entity whose risk factors are not yet fully elucidated. A local pattern of disproportionality within a global database of suspected adverse drug reactions (ADRs) revealed an increased reporting of aseptic meningitis and amoxicillin-clavulanic acid (AC) in males. The aim of this report is to explore the clinical probability of a higher risk in males to support the use of statistical methods to identify subgroups at risk for adverse drug reactions.

8

Macrolides have been linked to the occurrence of congenital heart defects, but findings are inconsistent. We therefore aimed to estimate the risk of major congenital malformations (MCMs) after fetal exposure to macrolides, focusing on cardiac malformations.

Concepts: Congenital disorder, Congenital disorders, Congenital