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Obesity Medication

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1. Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update

Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update July 2018 In partnership withComparative Effectiveness Review Number 211 Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov and Patient (...) at: www.effectivehealthcare.ahrq.gov. Search on the title of the report. Persons using assistive technology may not be able to fully access information in this report. For assistance contact epc@ahrq.hhs.gov. Suggested citation: Donahue KE, Gartlehner G, Schulman ER, Jonas B, Coker-Schwimmer E, Patel SV, Weber RP, Lohr KN, Bann C, Viswanathan M. Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update. Comparative Effectiveness Review No. 211. (Prepared by the RTI International–University of North Carolina

2018 Effective Health Care Program (AHRQ)

2. Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes?

Diabetes Canada, have acknowledged that there may be a role for adjunctive therapy in some T1D patients. 10,23,40 In the US, pramlintide acetate injection (Symlin) is the only noninsulin drug approved for adjunctive treatment of T1D. 13,29 Metformin, a T2D medication, is mentioned by Diabetes Canada and the American Diabetes Association for off-label use to reduce insulin requirements and total cholesterol/low-density lipoprotein ratios, 10,17,23 with the caveat that it does not improve hemoglobin A1C (...) Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? | CADTH.ca CADTH Document Viewer Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? Table of Contents Search this document Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? January 2018 Summary There are two major

2018 CADTH - Issues in Emerging Health Technologies

3. Treatment with a fixed dose combination antiretroviral therapy drug containing tenofovir, emtricitabine and efavirenz is associated with cardioprotection in high calorie diet-induced obese rats. Full Text available with Trip Pro

Treatment with a fixed dose combination antiretroviral therapy drug containing tenofovir, emtricitabine and efavirenz is associated with cardioprotection in high calorie diet-induced obese rats. HIV-infection, certain antiretroviral drug classes, especially protease inhibitors (PI), and obesity are associated with increased ischaemic heart disease (IHD) risk. However, the effect of PI-free fixed dose combination (FDC) antiretroviral therapy (ART) on hearts exposed to ischaemia-reperfusion (...) the effects of PI-free FDC ART in myocardial I/R-exposed hearts from obese rats. Obesity was induced in male wistar rats via a 16-week high calorie diet. At week 10, treatment with a FDC ART drug containing TDF/FTC/EFV was initiated. Biometric and metabolic parameters, as well as myocardial functional recovery and infract size (IS), and myocardial signalling proteins following I/R were assessed after 16 weeks. Obese rats presented with increased body and intraperitoneal fat mass, elevated triglyceride

2018 PLoS ONE

4. New Drugs for Type 2 Diabetes: Second-Line Therapy — Recommendations Report

therapies for second- and third-line treatment of type 2 diabetes. Since 2013, several new drugs and a new medication class (sodium-glucose cotransporter-2 [SGLT-2] inhibitors) have been released on the market in Canada. During the same period, CADTH Common Drug Review has provided multiple recommendations in technology assessments of individual drugs for type 2 diabetes. Given the evolving landscape of the treatment of type 2 diabetes, an update of the previous review has been undertaken. This document (...) on varying background therapies and pragmatically allowed for continuation of whatever the existing background therapy was at baseline. Background therapies were no treatment (i.e., they were drug-naive and starting the study intervention); monotherapy (they were taking a single antidiabetic medication or insulin and added the study intervention to that therapy); dual therapy; and combinations of more than two therapies. There were limited data regarding proportions of background therapy for the enrolled

2017 CADTH - Plasma Products

5. New Drugs for Type 2 Diabetes: Second-Line Therapy — Recommendations Report

therapies for second- and third-line treatment of type 2 diabetes. Since 2013, several new drugs and a new medication class (sodium-glucose cotransporter-2 [SGLT-2] inhibitors) have been released on the market in Canada. During the same period, CADTH Common Drug Review has provided multiple recommendations in technology assessments of individual drugs for type 2 diabetes. Given the evolving landscape of the treatment of type 2 diabetes, an update of the previous review has been undertaken. This document (...) on varying background therapies and pragmatically allowed for continuation of whatever the existing background therapy was at baseline. Background therapies were no treatment (i.e., they were drug-naive and starting the study intervention); monotherapy (they were taking a single antidiabetic medication or insulin and added the study intervention to that therapy); dual therapy; and combinations of more than two therapies. There were limited data regarding proportions of background therapy for the enrolled

2017 CADTH - Plasma Products

6. Safety and Efficacy of Weight-Loss Pharmacotherapy in Persons Living with HIV: A Review of the Literature and Potential Drug-Drug Interactions with Antiretroviral Therapy. (Abstract)

Safety and Efficacy of Weight-Loss Pharmacotherapy in Persons Living with HIV: A Review of the Literature and Potential Drug-Drug Interactions with Antiretroviral Therapy. The prevalence of obesity among persons living with human immunodeficiency virus (HIV) has increased significantly and may be linked to the use of antiretroviral therapy. Although weight-loss medications approved by the United States Food & Drug Administration (FDA) are recommended as an adjunct to diet and exercise to treat (...) obesity in the general population, little is known about the safety and efficacy of these drugs specifically in persons living with HIV.Review of available evidence regarding the effective use of weight-loss pharmacotherapy in persons living with HIV and potential to interact with antiretroviral therapy.Persons living with HIV are frequently not reported or included in clinical trials for weight-loss medications, however, treatment efficacy is likely similar to the general population. Several

2019 Pharmacotherapy

7. Weight status and nonadherence to asthma maintenance therapy among children enrolled in a public drug insurance plan. (Abstract)

Weight status and nonadherence to asthma maintenance therapy among children enrolled in a public drug insurance plan. The pediatric obese-asthma phenotype is associated with poor control, perhaps because of medication nonadherence. This study aimed to assess whether weight status is associated with nonadherence in children prescribed new asthma maintenance therapies.A historical cohort was constructed from a clinical database linking individual patient and prescription data to Quebec's (...) prescription claims registry. Children aged 2-18 years with specialist-diagnosed asthma who were newly prescribed one of the following maintenance controllers: leukotriene receptor antagonists (LTRA); low-dose inhaled corticosteroids (ICS); medium/high-dose ICS; or combination therapy (ICS with long-acting beta-2 agonists and/or LTRA), at the Asthma Center of the Montreal Children's Hospital from 2000-2007 were included. Primary nonadherence was defined as not claiming any prescriptions, whereas secondary

2019 Journal of Asthma

8. Association Trends Between Antihypertensive Drug Therapies and Diastolic Hypotension in Emirati Patients with Type 2 Diabetes: A Single-Center Retrospective Longitudinal Study Full Text available with Trip Pro

Association Trends Between Antihypertensive Drug Therapies and Diastolic Hypotension in Emirati Patients with Type 2 Diabetes: A Single-Center Retrospective Longitudinal Study Diabetes mellitus (DM) is associated with multiple complications, including cardiovascular diseases. Previously, it was believed that the latter are mainly caused by hypertension and increased systolic blood pressure. However, recent studies have challenged this concept, by showing that diastolic dysfunction may also (...) be involved in the cardiovascular events that are associated with DM. Pharmacologic management of hypertension in patients with type 2 DM appears to adversely influence diastolic function.Four hundred and eight medical records of hypertensive and obese Emirati patients with type 2 DM were included in the present retrospective study. The main objectives of the present study were (1) to determine the prevalence of low diastolic blood pressure (DBP) and diastolic hypotension in this group of patients and (2

2018 Diabetes Therapy

9. Initial combination therapy with vildagliptin plus metformin in drug-naïve patients with T2DM: a 24-week real-life study from Asia. (Abstract)

Initial combination therapy with vildagliptin plus metformin in drug-naïve patients with T2DM: a 24-week real-life study from Asia. To assess the effectiveness and safety of vildagliptin/metformin initial combination therapy in drug-naïve patients with type 2 diabetes mellitus (T2DM).INITIAL was a 24-week prospective, observational study in T2DM patients with glycated hemoglobin (HbA1c) ≥ 7.5%, and prescribed vildagliptin/metformin as initial combination therapy. The primary endpoint was change (...) hypoglycemic episode. There were no serious adverse events or deaths.Overall, in a relatively young drug-naïve T2DM Asian study population with high baseline HbA1c and often associated with cardiovascular risk factors, vildagliptin/metformin combination therapy was associated with significant and clinically relevant HbA1c reduction from baseline. This effect was seen at week 12, was maintained over 24 weeks, and was accompanied by good tolerability.

2018 Current medical research and opinion

10. Therapeutic drug monitoring and use of an adjusted body weight strategy for high-dose voriconazole therapy. Full Text available with Trip Pro

Therapeutic drug monitoring and use of an adjusted body weight strategy for high-dose voriconazole therapy. A high-dose 12 mg/kg/day (6 mg/kg twice daily) voriconazole regimen was recommended by the CDC to treat patients injected with contaminated methylprednisolone acetate that caused a multi-state fungal outbreak in 2012-13. Therapeutic drug monitoring results of this unique regimen are unknown, as is the most appropriate dosing weight for obese patients. We evaluated voriconazole trough (...) measurements for this dosing scheme, as well as the use of adjusted body weight dosing for obese patients.Voriconazole trough levels were analysed in obese (BMI ≥35 kg/m 2 ) and non-obese (BMI <35 kg/m 2 ) patients who were given initial therapy with 12 mg/kg/day.Of 138 patients, the first steady-state voriconazole troughs were supratherapeutic (>5 mg/L) in 65 (47%) patients, therapeutic (2-5 mg/L) in 57 (41%) patients and subtherapeutic (<2 mg/L) in 16 (12%) patients. Twenty-three patients had pre-steady

2017 Journal of Antimicrobial Chemotherapy

11. Combining Potent Statin Therapy with Other Drugs to Optimize Simultaneous Cardiovascular and Metabolic Benefits while Minimizing Adverse Events Full Text available with Trip Pro

Combining Potent Statin Therapy with Other Drugs to Optimize Simultaneous Cardiovascular and Metabolic Benefits while Minimizing Adverse Events Hypercholesterolemia and hypertension are among the most important risk factors for cardiovascular (CV) disease. They are also important contributors to metabolic diseases including diabetes that further increase CV risk. Updated guidelines emphasize targeted reduction of overall CV risks but do not explicitly incorporate potential adverse metabolic (...) ) inhibitor therapies demonstrate additive/synergistic beneficial effects on endothelial dysfunction, insulin resistance, and other metabolic parameters in addition to lowering both cholesterol levels and blood pressure. This combined therapy simultaneously reduces CV events when compared to either drug type used as monotherapy. This is mediated by both separate and interrelated mechanisms. Therefore, statin-based therapy combined with RAS inhibitors is important for developing optimal management

2017 Korean circulation journal

12. 'Forever Young'†-Testosterone replacement therapy: a blockbuster drug despite flabby evidence and broken promises. Full Text available with Trip Pro

'Forever Young'†-Testosterone replacement therapy: a blockbuster drug despite flabby evidence and broken promises. In the last decade, testosterone replacement therapy (TRT) has been increasingly prescribed to treat a controversial condition known as 'late-onset hypogonadism (LOH)'. This syndrome is diagnosed in men who, for no discernible reason other than older age, obesity or ill health have serum testosterone concentrations below the normal range for healthy young men and report one or more (...) , testosterone drugs have exhibited extraordinary commercial success and their pharmaceutical sales are steadily rising. Behind this apparently unjustifiable trend there are deliberate, well designed direct and indirect pharmaceutical marketing initiatives that exploit the conviction rooted in contemporary society that testosterone can reverse the effects of ageing and ensure social accomplishment. Commercial mechanisms have laid the foundation for disease mongering of LOH and also have resulted

2017 Human Reproduction

13. Efficacy and safety of initial combination therapy with gemigliptin and metformin compared with monotherapy with either drug in patients with type 2 diabetes: A double-blind randomized controlled trial (INICOM study) Full Text available with Trip Pro

of combination therapy. A significantly higher percentage of patients in the combination therapy group reached the target HbA1c level <7% (or <6.5%) compared with the monotherapy groups. No severe side effects were observed.In T2D patients, the initial combination of gemigliptin and metformin had superior efficacy without safety concerns compared with monotherapy with either drug.© 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. (...) Efficacy and safety of initial combination therapy with gemigliptin and metformin compared with monotherapy with either drug in patients with type 2 diabetes: A double-blind randomized controlled trial (INICOM study) Gemigliptin is a new dipeptidyl peptidase-IV inhibitor. We investigated the efficacy and safety of initial combination therapy with gemigliptin and metformin compared with monotherapy with either drug in patients with type 2 diabetes (T2D).A total of 433 T2D patients

2016 EvidenceUpdates

16. Gastrointestinal Traits: Individualizing Therapy for Obesity with Drugs and Devices. Full Text available with Trip Pro

Gastrointestinal Traits: Individualizing Therapy for Obesity with Drugs and Devices. The aims of this article were to review the discrepancy between numbers of people requiring weight loss treatment and results and to assess the potential effects of pharmacologic treatments (recently approved for obesity) and endoscopically deployed devices on quantitative GI traits in development for obesity treatment.We conducted a review of relevant literature to achieve our objectives.The 2013 guidelines (...) increased the number of adults recommended for weight loss treatment by 20.9% (116.0 million to 140.2 million). There is an imbalance between efficacy and costs of commercial weight loss programs and drug therapy (average weight loss about 5 kg). The number of bariatric procedures performed in the United States has doubled in the past decade. The efficacy of bariatric surgery is attributed to reduction in the volume of the stomach, nutrient malabsorption with some types of surgery, increased

2015 Gastrointestinal endoscopy

17. Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities. Full Text available with Trip Pro

Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities. The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment.Cohort study (...) with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.Primary

2018 JAMA

18. Development of Obesity Competencies for Medical Education: A Report from the Obesity Medicine Education Collaborative. Full Text available with Trip Pro

Development of Obesity Competencies for Medical Education: A Report from the Obesity Medicine Education Collaborative. Obesity Medicine Education Collaborative (OMEC) was formed to develop obesity-focused competencies and benchmarks that can be used by undergraduate and graduate medical education program directors. This article describes the developmental process used to create the competencies.Fifteen professional organizations with an interest in obesity collaborated to form OMEC. Using (...) contains five descriptive measurement benchmarks for evaluator rating.This set of OMEC obesity-focused competencies is the first evaluation tool developed to be used within undergraduate and graduate medical training programs for both formative and summative assessments. Routine and more robust assessment is expected to increase the competence of health care providers to assess, prevent, and treat obesity. In addition to dissemination, the competencies and benchmarks will need to undergo evaluation

2019 Obesity

19. The Perceptions of Medical School Students and Faculty Toward Obesity Medicine Education: Survey and Needs Analysis Full Text available with Trip Pro

The Perceptions of Medical School Students and Faculty Toward Obesity Medicine Education: Survey and Needs Analysis Recent trends in obesity show that over two-thirds of US adults are considered at least overweight (body mass index, BMI≥25 kg/m2) and of those, about one-third are categorized as obese (BMI≥30 kg/m2). Physicians can address the health impacts of obesity; yet research has suggested that physicians-in-training frequently fail to recognize obesity, are not properly educated (...) professionals to provide these interventions. Faculty rated the following topics as most important to supplement the curriculum: patient-centered treatment of weight, bringing up the topic of weight, discussing weight and well-being, discussing the relationship between weight and comorbidities, and physician role with overweight or obese patients.A review of the literature as well as surveyed medical students and faculty identified a need for supplementation of the current obesity medicine curriculum

2017 JMIR medical education

20. [Bariatric surgery versus medical therapy in the treatment of obesity]. (Abstract)

[Bariatric surgery versus medical therapy in the treatment of obesity]. 28421259 2018 09 06 2018 09 06 1433-0385 88 5 2017 May Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen Chirurg [Bariatric surgery versus medical therapy in the treatment of obesity]. 449-450 10.1007/s00104-017-0426-z Schröder W W Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. wolfgang.schroeder@uni-koeln.de. Bruns C C Klinik für (...) Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. ger Comparative Study Journal Article Randomized Controlled Trial Bariatrische Chirurgie versus medikamentöse Therapie in der Behandlung der Adipositas. Germany Chirurg 16140410R 0009-4722 0 Glycated Hemoglobin A 0 hemoglobin A1c protein, human IM Diabetes Complications blood surgery Follow-Up Studies Gastric Bypass methods Glycated Hemoglobin A metabolism Humans Obesity, Morbid blood surgery

2018 Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen Controlled trial quality: uncertain

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