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[PMID]:27775380
[Au] Autor:Banks HT; Banks JE; Everett RA; Stark JD
[Ad] Endereço:Center for Research in Scientific Computation, North Carolina State University, Raleigh, NC 27695-8212, United States. email: htbanks@eos.ncsu.edu.
[Ti] Título:An adaptive feedback methodology for determining information content in stable population studies.
[So] Source:Math Biosci Eng;13(4):653-671, 2016 08 01.
[Is] ISSN:1551-0018
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We develop statistical and mathematical based methodologies for determining (as the experiment progresses) the amount of information required to complete the estimation of stable population parameters with pre-specified levels of confidence. We do this in the context of life table models and data for growth/death for three species of Daphniids as investigated by J. Stark and J. Banks [17]. The ideas developed here also have wide application in the health and social sciences where experimental data are often expensive as well as difficult to obtain.
[Mh] Termos MeSH primário: Daphnia/fisiologia
Modelos Biológicos
[Mh] Termos MeSH secundário: Animais
Ecossistema
Tábuas de Vida
Dinâmica Populacional
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.3934/mbe.2016013


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[PMID]:29385364
[Au] Autor:Calderon-Margalit R; Golan E; Twig G; Leiba A; Tzur D; Afek A; Skorecki K; Vivante A
[Ad] Endereço:From Hadassah-Hebrew University Braun School of Public Health (R.C.-M.) and the Director's Office, Israel Ministry of Health (A.A.), Jerusalem, the Department of Nephrology and Hypertension, Meir Medical Center, Kfar-Saba, and the Israel Renal Registry, Tel Aviv (E.G.), the Sackler Faculty of Medici
[Ti] Título:History of Childhood Kidney Disease and Risk of Adult End-Stage Renal Disease.
[So] Source:N Engl J Med;378(5):428-438, 2018 02 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The long-term risk associated with childhood kidney disease that had not progressed to chronic kidney disease in childhood is unclear. We aimed to estimate the risk of future end-stage renal disease (ESRD) among adolescents who had normal renal function and a history of childhood kidney disease. METHODS: We conducted a nationwide, population-based, historical cohort study of 1,521,501 Israeli adolescents who were examined before compulsory military service in 1967 through 1997; data were linked to the Israeli ESRD registry. Kidney diseases in childhood included congenital anomalies of the kidney and urinary tract, pyelonephritis, and glomerular disease; all participants included in the primary analysis had normal renal function and no hypertension in adolescence. Cox proportional-hazards models were used to estimate the hazard ratio for ESRD associated with a history of childhood kidney disease. RESULTS: During 30 years of follow-up, ESRD developed in 2490 persons. A history of any childhood kidney disease was associated with a hazard ratio for ESRD of 4.19 (95% confidence interval [CI], 3.52 to 4.99). The associations between each diagnosis of kidney disease in childhood (congenital anomalies of the kidney and urinary tract, pyelonephritis, and glomerular disease) and the risk of ESRD in adulthood were similar in magnitude (multivariable-adjusted hazard ratios of 5.19 [95% CI, 3.41 to 7.90], 4.03 [95% CI, 3.16 to 5.14], and 3.85 [95% CI, 2.77 to 5.36], respectively). A history of kidney disease in childhood was associated with younger age at the onset of ESRD (hazard ratio for ESRD among adults <40 years of age, 10.40 [95% CI, 7.96 to 13.59]). CONCLUSIONS: A history of clinically evident kidney disease in childhood, even if renal function was apparently normal in adolescence, was associated with a significantly increased risk of ESRD, which suggests that kidney injury or structural abnormality in childhood has long-term consequences.
[Mh] Termos MeSH primário: Nefropatias/complicações
Falência Renal Crônica/etiologia
Sistema Urinário/anormalidades
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Incidência
Israel/epidemiologia
Rim/anormalidades
Falência Renal Crônica/epidemiologia
Tábuas de Vida
Masculino
Pielonefrite/complicações
Sistema de Registros
Risco
Sistema Urinário/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1700993


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[PMID]:28975207
[Au] Autor:Bano A; Dhana K; Chaker L; Kavousi M; Ikram MA; Mattace-Raso FUS; Peeters RP; Franco OH
[Ad] Endereço:Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.
[Ti] Título:Association of Thyroid Function With Life Expectancy With and Without Cardiovascular Disease: The Rotterdam Study.
[So] Source:JAMA Intern Med;177(11):1650-1657, 2017 Nov 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Variations in thyroid function within reference ranges are associated with an increased risk of cardiovascular disease (CVD) and mortality. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without CVD remains unknown. Objective: To investigate the association of thyroid function with total LE and LE with and without CVD among euthyroid individuals. Design, Setting, and Participants: The Rotterdam Study, a population-based, prospective cohort study. We included participants without known thyroid disease and with thyrotropin and free thyroxine (FT4) levels within the reference ranges. Main Outcomes and Measures: Multistate life tables were used to calculate total LE and LE with and without CVD among thyrotropin and FT4 tertiles. Life expectancy estimates in men and women aged 50 years and older were obtained using prevalence, incidence rates, and hazard ratios for 3 transitions (healthy to CVD, healthy to death, and CVD to death), adjusting for sociodemographic and cardiovascular risk factors. Results: The mean (SD) age of the 7785 participants was 64.7 (9.8) years, and 52.5% were women. Over a median follow-up of 8.1 (interquartile range, 2.7-9.9) years, we observed 789 incident CVD events and 1357 deaths. Compared with those in the lowest tertile, men and women in the highest thyrotropin tertile lived 2.0 (95% CI, 1.0 to 2.8) and 1.4 (95% CI, 0.2 to 2.4) years longer, respectively, of which, 1.5 (95% CI, 0.2 to 2.6) and 0.9 (95% CI, -0.2 to 2.0) years longer without CVD. Compared with those in the lowest tertile, the difference in life expectancy for men and women in the highest FT4 tertile was -3.2 (95% CI, -5.0 to -1.4) and -3.5 (95% CI, -5.6 to -1.5) years, respectively, of which, -3.1 (95% CI, -4.9 to -1.4) and -2.5 (95% CI, -4.4 to -0.7) years without CVD. Conclusions and Relevance: At the age of 50 years, participants with low-normal thyroid function live up to 3.5 years longer overall and up to 3.1 years longer without CVD than participants with high-normal thyroid function. These findings provide supporting evidence for a reevaluation of the current reference ranges of thyroid function and can help inform preventive and clinical care.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/mortalidade
Expectativa de Vida
Testes de Função Tireóidea
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Incidência
Tábuas de Vida
Masculino
Meia-Idade
Países Baixos/epidemiologia
Prevalência
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.4836


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[PMID]:28854665
[Au] Autor:Majd-Marani S; Naseri B; Nouri-Ganbalani G; Borzoui E
[Ad] Endereço:Department of Plant Protection, Faculty of Agriculture and Natural Resources, University of Mohaghegh Ardabili, Ardabil, Iran.
[Ti] Título:The Effect of Maize Hybrid on Biology and Life Table Parameters of the Trogoderma granarium (Coleoptera: Dermestidae).
[So] Source:J Econ Entomol;110(4):1916-1922, 2017 Aug 01.
[Is] ISSN:1938-291X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The khapra beetle, Trogoderma granarium Everts (Coleoptera: Dermestidae), is a polyphagous pest that infests many stored grains and products. The effect of nine maize hybrids including 704, AR 89, AS 71, AS 77, BC 678, KSC 703, PL 472, SC 704, and Simax was studied on biology and life table parameters of T. granarium at controlled conditions (33 ± 1 °C, 65 ± 5% RH, and a photoperiod of 14:10 [L:D] h). According to the results of this study, the immature period was the longest on BC 678 (56.79 ± SE: 1.51 d) and the shortest on PL 472 (39.90 ± 0.48 d). The highest values of fecundity and fertility were observed on PL 472 (67.95 ± 1.23 eggs and 74.81 ± 0.68%, respectively) and the lowest values were on BC 678 (40.00 ± 1.63 and 48.24 ± 1.35, respectively). The net reproductive rate (R0) of T. granarium ranged from 10.40 ± 0.11 offsprings on BC 678 to 30.43 ± 0.20 offsprings on KSC 703. The highest intrinsic rate of increase (rm) was for T. granarium reared on KSC 703 (0.0773 ± 0.0001 d-1), and the lowest was on BC 678 (0.0390 ± 0.0002 d-1). According to the obtained results, BC 678 is an unfavorable hybrid for population increase of T. granarium, which can be recommended to be grown in regions where the damage of T. granarium is considerable to minimize maize infestations by this pest.
[Mh] Termos MeSH primário: Coleópteros/fisiologia
Zea mays/fisiologia
[Mh] Termos MeSH secundário: Animais
Coleópteros/crescimento & desenvolvimento
Feminino
Cadeia Alimentar
Larva/crescimento & desenvolvimento
Larva/fisiologia
Traços de História de Vida
Tábuas de Vida
Masculino
Óvulo/crescimento & desenvolvimento
Pupa/crescimento & desenvolvimento
Pupa/fisiologia
Reprodução
Zea mays/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1093/jee/tox182


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[PMID]:28854663
[Au] Autor:Sugawara R; Ullah MS; Ho CC; Gökçe A; Chi H; Gotoh T
[Ad] Endereço:Laboratory of Applied Entomology and Zoology, Faculty of Agriculture, Ibaraki University, Ami, Ibaraki 300-0393, Japan.
[Ti] Título:Temperature-Dependent Demography of Two Closely Related Predatory Mites Neoseiulus womersleyi and N. longispinosus (Acari: Phytoseiidae).
[So] Source:J Econ Entomol;110(4):1533-1546, 2017 Aug 01.
[Is] ISSN:1938-291X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Temperature has significant effects on the development, survival, and reproduction of ectothermic organisms. In this study, we examined the effect of temperature on the demographic characteristics of two predatory mite species, Neosciulus womersleyi (Schicha) and N. longispinosus (Evans), reared on Tetranychus urticae Koch. The developmental and reproductive traits of both species were examined at 10 constant temperatures between 15 °C and 37.5 °C. The preadult development time of N. womersleyi and N. longispinosus decreased with increasing temperature until 32.5 °C and 35 °C, respectively. The lower developmental threshold (T0) and thermal constant (K) estimated by using a linear model were 11.61 °C and 69.36 DD for N. womersleyi and 11.92 °C and 61.5 DD for N. longispinosus, respectively. Total preoviposition period and total longevity of females and males of N. womersleyi and N. longispinosus decreased with increasing temperature. The mean generation time (T) first decreased with temperature until 32.5 and 35 °C for N. womersleyi and N. longispinosus, respectively, and then increased at higher temperatures. The R0 and r values first increased with temperature until 32.5 and 30 °C for N. womersleyi and N. longispinosus, respectively, and then decreased at higher temperatures. The R0 and r values for N. longispinosus at 37.5 °C were 0.3 offspring and -0.143 d-1, respectively. These results show that N. longispinosus is less fit than N. womersleyi at 37.5 °C.
[Mh] Termos MeSH primário: Tábuas de Vida
Longevidade
Ácaros/fisiologia
[Mh] Termos MeSH secundário: Animais
Feminino
Cadeia Alimentar
Larva/crescimento & desenvolvimento
Larva/fisiologia
Masculino
Ácaros/crescimento & desenvolvimento
Ninfa/crescimento & desenvolvimento
Ninfa/fisiologia
Óvulo/crescimento & desenvolvimento
Óvulo/fisiologia
Comportamento Predatório
Reprodução
Taiwan
Temperatura Ambiente
Tetranychidae
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1093/jee/tox177


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[PMID]:28854662
[Au] Autor:Atlihan R; Kasap I; Özgökçe MS; Polat-Akköprü E; Chi H
[Ad] Endereço:Department of Plant Protection, Faculty of Agriculture, University of Yuzuncu Yil, 65080 Van, Turkey.
[Ti] Título:Population Growth of Dysaphis pyri (Hemiptera: Aphididae) on Different Pear Cultivars With Discussion on Curve Fitting in Life Table Studies.
[So] Source:J Econ Entomol;110(4):1890-1898, 2017 Aug 01.
[Is] ISSN:1938-291X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Population growth parameters of the Dysaphis pyri (Boyer de Fonscolombe) (Hemiptera: Aphididae) were evaluated on four different cultivars (Coscia, Ankara, Williams, and Santa-Maria) of pear (Pyrus communis L.) under field conditions in the Van region of Turkey. Aphids were kept on leaves of 10-yr-old pear trees in Plexiglas clip-cells (20 mm in diameter and 10 mm in height, with the upper side covered with muslin). For the description of the stage differentiation during population growth, we analyzed raw data of developmental time, survival, and fecundity using the age-stage, two-sex life table to take the variable developmental rate among individuals into account. Results indicated that the Coscia and Ankara cultivars are less favorable hosts for D. pyri because of the longer preadult developmental time, higher preadult mortality rate, and lower total fecundity on these cultivars. The intrinsic rate of increase (r), the net reproduction rate (R0), and the finite rate of increase (λ) values were lower on the Coscia and Ankara cultivars. We discussed the application of the Weibull function, polynomial model, and Enkegaard model in life table studies. Because these models are often inaccurate in describing survival and reproduction parameters, we suggest that their application in life table research should be reevaluated.
[Mh] Termos MeSH primário: Afídeos/fisiologia
Cadeia Alimentar
Pyrus
[Mh] Termos MeSH secundário: Animais
Afídeos/crescimento & desenvolvimento
Feminino
Fertilidade
Tábuas de Vida
Longevidade
Masculino
Ninfa/crescimento & desenvolvimento
Ninfa/fisiologia
Crescimento Demográfico
Pyrus/genética
Pyrus/crescimento & desenvolvimento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1093/jee/tox174


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[PMID]:28854656
[Au] Autor:Riahi E; Fathipour Y; Talebi AA; Mehrabadi M
[Ti] Título:Attempt to Develop Cost-Effective Rearing of Amblyseius swirskii (Acari: Phytoseiidae): Assessment of Different Artificial Diets.
[So] Source:J Econ Entomol;110(4):1525-1532, 2017 Aug 01.
[Is] ISSN:1938-291X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Commercial production of Amblyseius swirskii Athias-Henriot based on storage mites needs both space and labor to maintain large cultures of these prey, and also may lead to health problems for workers. Therefore, the accessibility of a suitable artificial diet could eliminate the mentioned problems; however, the artificial diets must support the persistent production of high quality progeny. This study endeavored to find a more easily available and cheaper nutrient that may further reduce the cost of diet production for A. swirskii. The predator's performance was determined when it was fed on a basic artificial diet (AD1) composed of honey, sucrose, tryptone, yeast extract, and hen egg yolk, and on eight other artificial diets consisting of 80% AD1 enriched with different nutrients including maize pollen (AD2), hemolymph of Plusia gamma L. (AD3), Ephestia eggs (AD4), Artemis cysts (AD5), Ephestia last-instar larvae (AD6), multivitamin syrup (AD7), bovine serum albumin (AD8), and bull sperm (AD9). The lowest development time was on AD2. The highest value of fecundity and oviposition period were observed on AD5, followed by AD2 and AD4. The intrinsic rate of increase (r) and the finite rate of increase (λ) reached the maximal value on AD5. Feeding on AD2 and AD5 resulted in highest value of R0 (net reproductive rate). Our results indicated that Artemia cysts and maize pollen had better potential to be used as nutrient in artificial diet for mass production of A. swirskii. Overall, it seems that AD2 is the most cost effective than others.
[Mh] Termos MeSH primário: Ração Animal/análise
Ácaros/fisiologia
Controle Biológico de Vetores/métodos
[Mh] Termos MeSH secundário: Animais
Análise Custo-Benefício
Dieta
Feminino
Larva/crescimento & desenvolvimento
Tábuas de Vida
Masculino
Ácaros/crescimento & desenvolvimento
Valor Nutritivo
Ninfa/crescimento & desenvolvimento
Óvulo/crescimento & desenvolvimento
Controle Biológico de Vetores/economia
Reprodução
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1093/jee/tox172


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[PMID]:28817326
[Au] Autor:Perron L; Simard M; Brisson J; Hamel D; Lo E
[Ad] Endereço:Linda Perron, Marc Simard, Denis Hamel, and Ernest Lo are with the Institut national de santé publique du Québec, Quebec City, QC. Linda Perron and Jacques Brisson are with the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec City. Jacques Brisson is also
[Ti] Título:Standard Period Life Table Used to Compute the Life Expectancy of Diseased Subpopulations: More Confusing Than Helpful.
[So] Source:Am J Public Health;107(10):1615-1620, 2017 Oct.
[Is] ISSN:1541-0048
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Life expectancy (LE) based on a period life table (PLT) traditionally serves as a general population summary metric. It is, however, becoming more frequently reported for chronically afflicted subpopulations. In general populations, there is always an obvious real cohort sharing the hypothetical PLT cohort characteristics, and the LE estimate is intuitively understood as that real cohort mean survival time, assuming constancy of death risks. In diseased subpopulations, the correspondence between the hypothetical cohort and a real cohort is not straightforward. Furthermore, the excess mortality of chronic diseases usually changes according to age at onset and time since onset. The standard PLT method does not allow for proper control of these issues, so the LE estimate can only be deemed valid under specific assumptions. Without clear statements about the real cohort to whom the estimate is intended and the assumptions allowing disregard of the effect of age at onset and time since onset, LEs of afflicted subpopulations computed with the PLT are only abstract numbers summarizing mortality rates. If called "life expectancy," they can be seriously misleading. The same applies to health-adjusted LE.
[Mh] Termos MeSH primário: Doença Crônica/epidemiologia
Expectativa de Vida/tendências
Tábuas de Vida
[Mh] Termos MeSH secundário: Distribuição por Idade
Doença Crônica/mortalidade
Interpretação Estatística de Dados
Seres Humanos
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.2105/AJPH.2017.303932


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Registro de Ensaios Clínicos
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[PMID]:28564557
[Au] Autor:Metz LM; Li DKB; Traboulsee AL; Duquette P; Eliasziw M; Cerchiaro G; Greenfield J; Riddehough A; Yeung M; Kremenchutzky M; Vorobeychik G; Freedman MS; Bhan V; Blevins G; Marriott JJ; Grand'Maison F; Lee L; Thibault M; Hill MD; Yong VW; Minocycline in MS Study Team
[Ad] Endereço:From the Cumming School of Medicine and the Hotchkiss Brain Institute, Calgary, AB (L.M.M., G.C., J.G., M.Y., M.D.H., V.W.Y.), the University of British Columbia, Vancouver (D.K.B.L., A.L.T., A.R.), the University of Montreal, Montreal (P.D.), Western University, London, ON (M.K.), Fraser Health MS
[Ti] Título:Trial of Minocycline in a Clinically Isolated Syndrome of Multiple Sclerosis.
[So] Source:N Engl J Med;376(22):2122-2133, 2017 06 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: On the basis of encouraging preliminary results, we conducted a randomized, controlled trial to determine whether minocycline reduces the risk of conversion from a first demyelinating event (also known as a clinically isolated syndrome) to multiple sclerosis. METHODS: During the period from January 2009 through July 2013, we randomly assigned participants who had had their first demyelinating symptoms within the previous 180 days to receive either 100 mg of minocycline, administered orally twice daily, or placebo. Administration of minocycline or placebo was continued until a diagnosis of multiple sclerosis was established or until 24 months after randomization, whichever came first. The primary outcome was conversion to multiple sclerosis (diagnosed on the basis of the 2005 McDonald criteria) within 6 months after randomization. Secondary outcomes included conversion to multiple sclerosis within 24 months after randomization and changes on magnetic resonance imaging (MRI) at 6 months and 24 months (change in lesion volume on T -weighted MRI, cumulative number of new lesions enhanced on T -weighted MRI ["enhancing lesions"], and cumulative combined number of unique lesions [new enhancing lesions on T -weighted MRI plus new and newly enlarged lesions on T -weighted MRI]). RESULTS: A total of 142 eligible participants underwent randomization at 12 Canadian multiple sclerosis clinics; 72 participants were assigned to the minocycline group and 70 to the placebo group. The mean age of the participants was 35.8 years, and 68.3% were women. The unadjusted risk of conversion to multiple sclerosis within 6 months after randomization was 61.0% in the placebo group and 33.4% in the minocycline group, a difference of 27.6 percentage points (95% confidence interval [CI], 11.4 to 43.9; P=0.001). After adjustment for the number of enhancing lesions at baseline, the difference in the risk of conversion to multiple sclerosis within 6 months after randomization was 18.5 percentage points (95% CI, 3.7 to 33.3; P=0.01); the unadjusted risk difference was not significant at the 24-month secondary outcome time point (P=0.06). All secondary MRI outcomes favored minocycline over placebo at 6 months but not at 24 months. Trial withdrawals and adverse events of rash, dizziness, and dental discoloration were more frequent among participants who received minocycline than among those who received placebo. CONCLUSIONS: The risk of conversion from a clinically isolated syndrome to multiple sclerosis was significantly lower with minocycline than with placebo over 6 months but not over 24 months. (Funded by the Multiple Sclerosis Society of Canada; ClinicalTrials.gov number, NCT00666887 .).
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Doenças Desmielinizantes/tratamento farmacológico
Minociclina/uso terapêutico
Esclerose Múltipla/prevenção & controle
[Mh] Termos MeSH secundário: Análise Atuarial
Administração Oral
Adulto
Antibacterianos/efeitos adversos
Progressão da Doença
Tontura/induzido quimicamente
Método Duplo-Cego
Exantema/induzido quimicamente
Feminino
Seres Humanos
Análise de Intenção de Tratamento
Tábuas de Vida
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Minociclina/efeitos adversos
Esclerose Múltipla/diagnóstico por imagem
Risco
Descoloração de Dente/induzido quimicamente
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); FYY3R43WGO (Minocycline)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1608889


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[PMID]:28554192
[Au] Autor:Bansback N; Phibbs CS; Sun H; O'Dell JR; Brophy M; Keystone EC; Leatherman S; Mikuls TR; Anis AH; CSP 551 RACAT Investigators
[Ad] Endereço:From University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada; Palo Alto Veterans Affairs (VA) Health Care System, Palo Alto, and Stanford University School of Medicine, Stanford, California; VA Nebraska-Western Iowa Health Care Center and University of Nebraska Med
[Ti] Título:Triple Therapy Versus Biologic Therapy for Active Rheumatoid Arthritis: A Cost-Effectiveness Analysis.
[So] Source:Ann Intern Med;167(1):8-16, 2017 Jul 04.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: The RACAT (Rheumatoid Arthritis Comparison of Active Therapies) trial found triple therapy to be noninferior to etanercept-methotrexate in patients with active rheumatoid arthritis (RA). Objective: To determine the cost-effectiveness of etanercept-methotrexate versus triple therapy as a first-line strategy. Design: A within-trial analysis based on the 353 participants in the RACAT trial and a lifetime analysis that extrapolated costs and outcomes by using a decision analytic cohort model. Data Sources: The RACAT trial and sources from the literature. Target Population: Patients with active RA despite at least 12 weeks of methotrexate therapy. Time Horizon: 24 weeks and lifetime. Perspective: Societal and Medicare. Intervention: Etanercept-methotrexate first versus triple therapy first. Outcome Measures: Incremental costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Results of Base-Case Analysis: The within-trial analysis found that etanercept-methotrexate as first-line therapy provided marginally more QALYs but accumulated substantially higher drug costs. Differences in other costs between strategies were negligible. The ICERs for first-line etanercept-methotrexate and triple therapy were $2.7 million per QALY and $0.98 million per QALY over 24 and 48 weeks, respectively. The lifetime analysis suggested that first-line etanercept-methotrexate would result in 0.15 additional lifetime QALY, but this gain would cost an incremental $77 290, leading to an ICER of $521 520 per QALY per patient. Results of Sensitivity Analysis: Considering a long-term perspective, an initial strategy of etanercept-methotrexate and biologics with similar cost and efficacy is unlikely to be cost-effective compared with using triple therapy first, even under optimistic assumptions. Limitation: Data on the long-term benefit of triple therapy are uncertain. Conclusion: Initiating biologic therapy without trying triple therapy first increases costs while providing minimal incremental benefit. Primary Funding Source: The Cooperative Studies Program, Department of Veterans Affairs Office of Research and Development, Canadian Institutes for Health Research, and an interagency agreement with the National Institutes of Health-American Recovery and Reinvestment Act.
[Mh] Termos MeSH primário: Antirreumáticos/economia
Antirreumáticos/uso terapêutico
Artrite Reumatoide/tratamento farmacológico
Fatores Biológicos/economia
Fatores Biológicos/uso terapêutico
Análise Custo-Benefício
[Mh] Termos MeSH secundário: Quimioterapia Combinada
Etanercepte/uso terapêutico
Feminino
Seres Humanos
Tábuas de Vida
Masculino
Metotrexato/uso terapêutico
Meia-Idade
Anos de Vida Ajustados por Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antirheumatic Agents); 0 (Biological Factors); OP401G7OJC (Etanercept); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170530
[St] Status:MEDLINE
[do] DOI:10.7326/M16-0713



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