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  • 1
    Online Resource
    Online Resource
    Comparative safety of abatacept in rheumatoid arthritis with COPD: A real-world population-based observational study
    Elsevier BV ; 2019
    In:  Seminars in Arthritis and Rheumatism Vol. 49, No. 3 ( 2019-12), p. 366-372
    Details
    In: Seminars in Arthritis and Rheumatism, Elsevier BV, Vol. 49, No. 3 ( 2019-12), p. 366-372
    Type of Medium: Online Resource
    ISSN: 0049-0172
    URL: Article
    DOI: 10.1016/j.semarthrit.2019.03.007
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2048942-0
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  • 2
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    Comparative safety of biologic versus conventional synthetic DMARDs in rheumatoid arthritis with COPD: a real-world population study
    Oxford University Press (OUP) ; 2020
    In:  Rheumatology Vol. 59, No. 4 ( 2020-04-01), p. 820-827
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 59, No. 4 ( 2020-04-01), p. 820-827
    Abstract: Abatacept, a biologic DMARD, was associated with respiratory adverse events in a small subgroup of RA patients with chronic obstructive pulmonary disease (COPD) in a trial. Whether this potential risk is specific to abatacept or extends to all biologics and targeted synthetic DMARDs (tsDMARDs) is unclear. We assessed the risk of adverse respiratory events associated with biologic and tsDMARDs compared with conventional synthetic DMARDs (csDMARDs) among RA patients with concomitant COPD in a large, real-world cohort. Methods We used a prevalent new-user design to study RA patients with COPD in the US-based MarketScan databases. New users of biologic DMARDs and/or tsDMARDs were matched on time-conditional propensity scores to new users of csDMARDs. Adverse respiratory events were estimated using Cox models comparing current use of biologic/tsDMARDs with csDMARDs. Results The cohort included 7424 patients initiating biologic/tsDMARDs and 7424 matched patients initiating csDMARDs. The adjusted hazard ratio of hospitalized COPD exacerbation comparing biologic/tsDMARD vs csDMARD was 0.76 (95% CI: 0.55, 1.06), while it was 1.02 (95% CI: 0.82, 1.27) for bronchitis, 1.21 (95% CI: 0.92, 1.58) for hospitalized pneumonia or influenza and 0.99 (95% CI: 0.87, 1.12) for outpatient pneumonia or influenza. The hazard ratio of the combined end point of COPD exacerbation, bronchitis and hospitalized pneumonia or influenza was 1.04 (95% CI: 0.89, 1.21). Conclusion In this large, real-world comparative safety study, biologic and tsDMARDs, including abatacept, were not associated with an increased risk of adverse respiratory events when compared with csDMARDs in patients with RA and COPD.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/kez359
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1474143-X
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  • 3
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    Trends in the prescription of novel oral anticoagulants in UK primary care
    Wiley ; 2017
    In:  British Journal of Clinical Pharmacology Vol. 83, No. 9 ( 2017-09), p. 2096-2106
    Details
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 83, No. 9 ( 2017-09), p. 2096-2106
    Abstract: Novel oral anticoagulants (NOACs) are alternatives to vitamin‐K antagonists (VKAs) for the prevention of thromboembolism. It is unclear how NOACs have been adopted in the UK since first introduced in 2008. The present study was conducted to describe the trends in the prescription of NOACs in the UK, including dabigatran, rivaroxaban and apixaban. Methods Using the UK's Clinical Practice Research Datalink, the rates of new use of NOACs and VKAs from 2009 to 2015 were calculated using Poisson regression. Patient characteristics associated with NOAC initiation were identified using multivariate logistic regression. Results The overall rate of oral anticoagulant initiation increased by 58% over the study period [rate ratio (RR) 1.58; 95% confidence interval (CI) 1.23, 2.03], even as the rate of new VKA use decreased by 31% (RR 0.69; 95% CI 0.52, 0.93). By contrast, the rate of initiation of NOAC increased, particularly from 2012 onwards, with a 17‐fold increase from 2012 to 2015 (RR 17.68; 95% CI 12.16, 25.71). In 2015, NOACs accounted for 56.5% of oral anticoagulant prescriptions, with rivaroxaban prescribed most frequently, followed by apixaban and then dabigatran. Compared to VKAs, new NOAC users were less likely to have congestive heart failure, coronary artery disease and peripheral vascular disease, and more likely to have a history of ischaemic stroke. Conclusions In the UK, the rate of initiation of NOACs has increased substantially since 2009, and these agents have now surpassed VKAs as the anticoagulant of choice. Moreover, the characteristics of patients initiated on NOACs have changed over time, and this should be accounted for in future studies comparing NOACs and VKAs.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    URL: Article
    DOI: 10.1111/bcp.v83.9
    DOI: 10.1111/bcp.13299
    RVK:
    XA 33650
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 1498142-7
    SSG: 15,3
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  • 4
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    Regarding: Webster‐Clark M., et al. Alternative analytic and matching approaches for the prevalent new‐user design: a simulation study. Pharmacoepidemiol Drug Saf, 31, pp. 796–803; 2022
    Wiley ; 2022
    In:  Pharmacoepidemiology and Drug Safety Vol. 31, No. 12 ( 2022-12), p. 1317-1318
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 31, No. 12 ( 2022-12), p. 1317-1318
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v31.12
    DOI: 10.1002/pds.5543
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1491218-1
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  • 5
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    Thiazolidinediones and the risk of incident strokes in patients with type 2 diabetes: a nested case‐control study
    Wiley ; 2010
    In:  Pharmacoepidemiology and Drug Safety Vol. 19, No. 4 ( 2010-04), p. 343-350
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 19, No. 4 ( 2010-04), p. 343-350
    Abstract: To determine whether the use of thiazolidinediones (TZDs) decreases the risk of incident strokes in patients with type 2 diabetes. Methods We conducted a nested case‐control study within a population‐based cohort from the UK General Practice Research Database (GPRD). The cohort comprised patients over the age of 40 who were prescribed a first oral hypoglycemic agent between 1 January 1988 and 30 June 2008. Cases included all subjects who experienced a first stroke during follow‐up. Up to 10 controls were matched to each case on age (±2 years), sex, date of cohort entry (±1 year), and duration of follow‐up. Rate ratios (RRs) of stroke associated with TZD use, including rosiglitazone and pioglitazone, relative to combinations of other oral hypoglycemic agents, were estimated using conditional logistic regression. Results The cohort comprised 75 717 users of oral hypoglycemic agents, of whom 2417 had a stroke during follow‐up. The rate of stroke in users of TZDs given as monotherapy (RR: 1.20, 95%CI: 0.77, 1.86) or in combination with other oral hypoglycemic agents (RR: 0.78, 95%CI: 0.58, 1.04) was not lower than combinations of other oral hypoglycemic agents. The RRs were similar for rosiglitazone and pioglitazone. Conclusions The results of this study indicate that TZDs do not appear to decrease the incidence of first strokes. Copyright © 2009 John Wiley & Sons, Ltd.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v19:4
    DOI: 10.1002/pds.1883
    Language: English
    Publisher: Wiley
    Publication Date: 2010
    detail.hit.zdb_id: 1491218-1
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  • 6
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    Dopamine agonist use and the risk of heart failure
    Wiley ; 2012
    In:  Pharmacoepidemiology and Drug Safety Vol. 21, No. 1 ( 2012-01), p. 34-41
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 21, No. 1 ( 2012-01), p. 34-41
    Abstract: A potential risk of heart failure was recently observed in randomized trials of the dopamine agonist pramipexole. The extent of the risk with this and other dopamine agonists is unknown. Methods We used the UK General Practice Research Database (GPRD) to identify all users of anti‐parkinsonian drugs, 40–89 years of age, between 1997 and 2009. All incident heart failure cases were identified and classified as probable or possible on the basis of their treatment and mortality. Using a nested case–control approach, each case was matched with up to 10 controls selected among the cohort members. Incidence rate ratios (RR) of heart failure associated with the current use of dopamine agonists were estimated using conditional logistic regression, adjusted for covariates. Results The cohort included 26 814 users of anti‐parkinsonian drugs, with 783 newly diagnosed with heart failure during follow‐up (rate 8.7 per 1000 per year). The incidence rate of heart failure was increased with the current use of any dopamine agonist (RR = 1.58, 95% CI = 1.26–1.96), and particularly so for pramipexole (RR = 1.86, 95%CI = 1.21–2.85) and cabergoline (RR = 2.07, 95%CI = 1.39–3.07), compared with no use. The increase was not significant with ropinirole (RR = 1.23, 95%CI = 0.85–1.97) or pergolide (RR = 1.42, 95%CI = 0.95–2.12). Pramipexole was not associated with a significantly increased rate when compared with all other dopamine agonists collectively (RR = 1.28, 95%CI = 0.82–2.00). Discussion The use of dopamine agonists, especially pramipexole and cabergoline, is associated with an increased risk of heart failure. Copyright © 2011 John Wiley & Sons, Ltd.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v21.1
    DOI: 10.1002/pds.2267
    Language: English
    Publisher: Wiley
    Publication Date: 2012
    detail.hit.zdb_id: 1491218-1
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  • 7
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    The effect of statins on influenza‐like illness morbidity and mortality
    Wiley ; 2017
    In:  Pharmacoepidemiology and Drug Safety Vol. 26, No. 1 ( 2017-01), p. 63-70
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 26, No. 1 ( 2017-01), p. 63-70
    Abstract: The effect of statins on cytokine‐mediated inflammatory responses may impact on the prognosis of influenza. We assessed whether statin use decreases the incidence of adverse influenza‐related outcomes. Additionally, we used a new‐user study design to minimize healthy user bias. We further examined the possibility of non‐causal associations by using unrelated outcomes. Methods We used the UK Clinical Practice Research Datalink to identify all patients aged 30 or older diagnosed with influenza‐like illness during 1997–2010. Statin users were compared with propensity score‐matched patients not receiving statins. The outcome was hospitalization for influenza or pneumonia or death in the 30 days following influenza diagnosis. Logistic regression estimated cumulative incidence ratios. Results The study cohort included 5181 statin users matched to 5181 non‐users. The 30‐day incidence of hospitalization or death was 3.5% in statin users and 5.2% in non‐users, resulting in a 27% lower incidence with statin use (cumulative incidence ratio: 0.73, 95%CI: 0.59–0.89). New statin users were less protected against our composite outcome. The effect of statins was less pronounced among those with respiratory and cardiac disease. Statin use was shown to be associated with a non‐statistically significant risk reduction of motor vehicle accident and burns. Conclusion The attenuation of the effect of statins with the new‐user design, supporting evidence from the assessment of effect modification, and additional sub‐analyses evaluating the effect of statins on non‐related outcomes suggest that the beneficial effect of statins on influenza‐related adverse outcomes may be explained by a healthy user bias. Copyright © 2016 John Wiley & Sons, Ltd.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v26.1
    DOI: 10.1002/pds.4112
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 1491218-1
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  • 8
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    Bias from depletion of susceptibles: the example of hormone replacement therapy and the risk of venous thromboembolism
    Wiley ; 2017
    In:  Pharmacoepidemiology and Drug Safety Vol. 26, No. 5 ( 2017-05), p. 554-560
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 26, No. 5 ( 2017-05), p. 554-560
    Abstract: The data on the association between hormone replacement therapy and the increased risk of venous thromboembolism (VTE) in postmenopausal women are conflicting. The observed differences between oral estrogen and oral estrogen–progestogen combination formulations may be the result of bias from depletion of susceptibles. Methods We used United Kingdom's Clinical Practice Research Datalink to identify the cohort of all women aged 50 to 79 during 1987–2008, with all incident cases of VTE occurring during the study period identified. Using a nested case–control approach, the rate ratios (RRs) of VTE with current use of oral estrogen and oral estrogen–progestogen combinations were estimated as a function of duration of use using conditional logistic regression with cubic splines. Results The cohort of 955 582 postmenopausal women included 23 505 cases of VTE matched to 231 562 controls. The risk of VTE was increased with current use of oral estrogen (RR 1.49; 95% confidence interval: 1.37 to 1.63) and oral estrogen–progestogen (RR 1.54; 95% confidence interval: 1.44 to 1.65), relative to non‐use. When assessed by duration of use, the risks with oral formulations were particularly elevated during the first year of use and were reduced subsequently. Conclusion The phenomenon of depletion of susceptibles should be considered in cohort studies evaluating acute side effects of medications. This can be achieved by estimating the risk as a function not only of current use but also of duration of use. Copyright © 2017 John Wiley & Sons, Ltd.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v26.5
    DOI: 10.1002/pds.4197
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 1491218-1
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  • 9
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    Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Health Services Research Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. Methods Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. Results The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. Conclusions A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    URL: Article
    DOI: 10.1186/s12913-021-06762-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 10
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    Statins and Risk of Rheumatoid Arthritis: A Nested Case–Control Study
    Wiley ; 2016
    In:  Arthritis & Rheumatology Vol. 68, No. 11 ( 2016-11), p. 2603-2611
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 68, No. 11 ( 2016-11), p. 2603-2611
    Abstract: Statins have antiinflammatory/immunomodulatory effects that may be useful in preventing rheumatoid arthritis (RA), but previous observational studies about the risk of RA with statin use yielded conflicting results. The aim of this study was to determine whether high‐intensity statin treatment is associated with reduced risk of RA. Methods Using data from the UK Clinical Practice Research Datalink, we performed a nested case–control analysis in a population‐based cohort of patients who began receiving statins between 1997 and 2009 and were followed up until a first diagnosis of RA, death, end of registration with the physician's practice, or end of January 2011. For each case of RA, 10 age‐, sex‐, and calendar year–matched controls were randomly selected from risk sets. We estimated the hazard ratio (HR) of incident RA in the highest quintile of duration‐weighted average statin intensity compared to the lowest, using conditional logistic regression. Models were adjusted for smoking status, total cholesterol level, obesity, history of cardiovascular disease, coexistent autoimmune disease, hypothyroidism, and persistence with treatment. Results The cohort included 528,654 new users of statins, with 1,357 new cases of RA occurring during a mean follow‐up of 3.3 years, for an incidence rate of 7.9 per 10,000 person‐years. Cases were more likely to be smokers, to have other autoimmune diseases, and to have had lower total cholesterol levels at baseline. The incidence of RA was lower in the highest statin intensity quintile (adjusted HR 0.77 [95% confidence interval 0.63–0.95]) in comparison to the lowest quintile. Conclusion In this large population‐based study, high‐intensity statin treatment was associated with a reduced risk of RA in comparison to low‐intensity statin treatment.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v68.11
    DOI: 10.1002/art.39774
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2754614-7
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