Objectiv e: To evaluate clinical,Quality of Life (QoL) and medical cost outcomes in pati ents with symptomatic reflux esophagitis (RE) receiving different ″triple c ombin ation therapy″ . Methods: A multicent...Objectiv e: To evaluate clinical,Quality of Life (QoL) and medical cost outcomes in pati ents with symptomatic reflux esophagitis (RE) receiving different ″triple c ombin ation therapy″ . Methods: A multicenter medical effectiveness trial conducte d in 10 hospitals of 5 regions in Zhejiang Province. 248 patient-volunteers were ass ig ned to 8 weeks of ″ triple combination therapy″ with Lansoprazole plus Cisapri de and Sucralfate or Ranitidine plus Cisapride and Sucralfate. Main outcomes asses sment included symptoms scale scores,RE severity,QoL at baseline and 8 weeks. Medical cost data were collected with cost analysis questionnaire. Results: (1)M ore Lansoprazole group patients noted RE symptoms resolution than Ranitidine gro up(92.3% vs 78.4%,P<0.01). There was no striking difference between two gro ups in RE healing rate (90.8% vs 82.9%, P>0.05). (2)RE significantly impaire d QoL of patients(P<0.001).Compared with Ranitidine group,QoL in Lansoprazole group had significant improvement (rate of ″good″ QoL 64.5% vs 45.6%,P<0.01). (3)T here w as close correlation between symptomic effectiveness and QoL rating scale in bot h the Lansoprazole and Ranitidine group(P<0.01,r=0.235 and 0.353 respec tively). There were no statistical difference of medical cost between the two groups ( P> 0.05). Conclusion: RE significantly impaired QoL of patients. ″Triple combinati o n therapies″ can significantly improve RE symptoms and QoL. Lansoprazole combin ation therapy was more cost-effective than Ranitidine combination group.展开更多
AIM:To evaluate the effectiveness of the biological disease-modifying antirheumatic drugs(b DMARD) in the treatment of rheumatoid arthritis through a systematic review of observational studies.METHODS:The studies were...AIM:To evaluate the effectiveness of the biological disease-modifying antirheumatic drugs(b DMARD) in the treatment of rheumatoid arthritis through a systematic review of observational studies.METHODS:The studies were searched in the Pub Med,EMBASE,Cochrane Controlled Trials Register and LILACS databases(until August 2014),in the grey literature and conducted a manual search.The assessed criteria of effectiveness included the EULAR,the disease activity score(DAS),the Clinical Disease Activity Index,the Simplified Disease Activity Index,the American College of Rheumatology and the Health Assessment Questionnaire.The meta-analysis was performed with Review Manager 5.2 software using a random effects model.A total of 35 studies were included in this review.RESULTS:The participants anti-tumor necrosis factor inhibitors(TNF) nave,who used adalimumab(P = 0.0002) and etanercept(P = 0.0006) exhibited greater good EULAR response compared to the participants who used infliximab.No difference was detected between adalimumab and etanercept(P = 0.05).The participants who used etanercept exhibited greater remission according to DAS28 compared to the participants who used infliximab(P = 0.01).No differences were detected between adalimumab and infliximab(P = 0.12) or etanercept(P = 0.79).Better results were obtained with b DMARD associated with methotrexate than with b DMARD alone.The good EULAR response and DAS 28 was better for combination with methotrexate than b DMARD monotherapy(P = 0.03 e P < 0.00001).In cases of therapeutic failure,the participants who used rituximab exhibited greater DAS28 reduction compared to those who used anti-TNF agents(P = 0.0002).The participants who used etanercept achieved greater good EULAR response compared to those who did not use that drug(P = 0.007).Studies that assessed reduction of the CDAI score indicated the superiority of abatacept over rituximab(12.4 vs +1.7) and anti-TNF agents(7.6 vs 8.3).The present systematic review with meta-analysis found that relative to anti-TNF treatmentnave patients,adalimumab and etanercept were more effective when combined with methotrexate than when used alone.Furthermore,in case of therapeutic failure with anti-TNF agents;rituximab and abatacept(non anti-TNF) and etanercept(as second anti-TNF) were more effective.However,more studies of effectiveness were found for the rituximab.CONCLUSION:The best treatment for treatment-nave patients is adalimumab or etanercept combined with methotrexate.For anti-TNF therapeutic failure,the best choice is rituximab,abatacept or etanercept.展开更多
No one can pretend that nuclear engineering is simple.Far from it.But the next best thing is experience-lots of it-and no company can offermore experience or a more responsive service than BNFL Engineering Ltd.As the ...No one can pretend that nuclear engineering is simple.Far from it.But the next best thing is experience-lots of it-and no company can offermore experience or a more responsive service than BNFL Engineering Ltd.As the engineering arm of BNFL we are able to call on over 40 yearsof experience that provides our customers with valuable operational feedback,展开更多
文摘Objectiv e: To evaluate clinical,Quality of Life (QoL) and medical cost outcomes in pati ents with symptomatic reflux esophagitis (RE) receiving different ″triple c ombin ation therapy″ . Methods: A multicenter medical effectiveness trial conducte d in 10 hospitals of 5 regions in Zhejiang Province. 248 patient-volunteers were ass ig ned to 8 weeks of ″ triple combination therapy″ with Lansoprazole plus Cisapri de and Sucralfate or Ranitidine plus Cisapride and Sucralfate. Main outcomes asses sment included symptoms scale scores,RE severity,QoL at baseline and 8 weeks. Medical cost data were collected with cost analysis questionnaire. Results: (1)M ore Lansoprazole group patients noted RE symptoms resolution than Ranitidine gro up(92.3% vs 78.4%,P<0.01). There was no striking difference between two gro ups in RE healing rate (90.8% vs 82.9%, P>0.05). (2)RE significantly impaire d QoL of patients(P<0.001).Compared with Ranitidine group,QoL in Lansoprazole group had significant improvement (rate of ″good″ QoL 64.5% vs 45.6%,P<0.01). (3)T here w as close correlation between symptomic effectiveness and QoL rating scale in bot h the Lansoprazole and Ranitidine group(P<0.01,r=0.235 and 0.353 respec tively). There were no statistical difference of medical cost between the two groups ( P> 0.05). Conclusion: RE significantly impaired QoL of patients. ″Triple combinati o n therapies″ can significantly improve RE symptoms and QoL. Lansoprazole combin ation therapy was more cost-effective than Ranitidine combination group.
基金Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico,Brazil
文摘AIM:To evaluate the effectiveness of the biological disease-modifying antirheumatic drugs(b DMARD) in the treatment of rheumatoid arthritis through a systematic review of observational studies.METHODS:The studies were searched in the Pub Med,EMBASE,Cochrane Controlled Trials Register and LILACS databases(until August 2014),in the grey literature and conducted a manual search.The assessed criteria of effectiveness included the EULAR,the disease activity score(DAS),the Clinical Disease Activity Index,the Simplified Disease Activity Index,the American College of Rheumatology and the Health Assessment Questionnaire.The meta-analysis was performed with Review Manager 5.2 software using a random effects model.A total of 35 studies were included in this review.RESULTS:The participants anti-tumor necrosis factor inhibitors(TNF) nave,who used adalimumab(P = 0.0002) and etanercept(P = 0.0006) exhibited greater good EULAR response compared to the participants who used infliximab.No difference was detected between adalimumab and etanercept(P = 0.05).The participants who used etanercept exhibited greater remission according to DAS28 compared to the participants who used infliximab(P = 0.01).No differences were detected between adalimumab and infliximab(P = 0.12) or etanercept(P = 0.79).Better results were obtained with b DMARD associated with methotrexate than with b DMARD alone.The good EULAR response and DAS 28 was better for combination with methotrexate than b DMARD monotherapy(P = 0.03 e P < 0.00001).In cases of therapeutic failure,the participants who used rituximab exhibited greater DAS28 reduction compared to those who used anti-TNF agents(P = 0.0002).The participants who used etanercept achieved greater good EULAR response compared to those who did not use that drug(P = 0.007).Studies that assessed reduction of the CDAI score indicated the superiority of abatacept over rituximab(12.4 vs +1.7) and anti-TNF agents(7.6 vs 8.3).The present systematic review with meta-analysis found that relative to anti-TNF treatmentnave patients,adalimumab and etanercept were more effective when combined with methotrexate than when used alone.Furthermore,in case of therapeutic failure with anti-TNF agents;rituximab and abatacept(non anti-TNF) and etanercept(as second anti-TNF) were more effective.However,more studies of effectiveness were found for the rituximab.CONCLUSION:The best treatment for treatment-nave patients is adalimumab or etanercept combined with methotrexate.For anti-TNF therapeutic failure,the best choice is rituximab,abatacept or etanercept.
文摘No one can pretend that nuclear engineering is simple.Far from it.But the next best thing is experience-lots of it-and no company can offermore experience or a more responsive service than BNFL Engineering Ltd.As the engineering arm of BNFL we are able to call on over 40 yearsof experience that provides our customers with valuable operational feedback,
