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1.
J Cardiovasc Pharmacol ; 83(1): 86-92, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38180456

RESUMO

ABSTRACT: This study aimed to compare the cost-effectiveness of the new quadruple therapy regimen of adding sodium-glucose-linked transporter 2 (SGLT2) inhibitors, with standard treatment for patients with heart failure (HF) in China. From the payer's perspective, the dates of cardiovascular event recurrences were extracted from a meta-analysis including 6 trials, combined with the treatment cost for patients with HF in China to construct a Markov model. The outcomes included per capita medical costs and incremental cost-effectiveness ratio, using quality-adjusted life years (QALYs) data. Single-factor, probability sensitivity analysis, and scenario analysis were used to explore the potential uncertainties of the model. The per capita costs of the new quadruple therapy regimen and standard treatment were $87441.26 and $87087.54, respectively. The new regimen was associated with a mean of 21.44 QALYs gained, compared with 18.60 QALYs gained with the standard treatment. The incremental cost-effectiveness ratio was $124.03 per QALY gained. The sensitivity analysis revealed that changes in the parameters within the set range did not affect the model results. In China, compared with standard treatment, the new quadruple therapy regimen with SGLT2 inhibitors reduce the frequency of cardiovascular events among patients with HF, and it has economic advantages.


Assuntos
Análise Custo-Benefício , Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , China , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Inibidores do Transportador 2 de Sódio-Glicose/economia
2.
Oncol Lett ; 25(3): 108, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36817048

RESUMO

The present review assessed the effectiveness of sacubitril/valsartan in patients with cancer therapy-related cardiac dysfunction (CTRCD). Studies that included patients with CTRCD treated with sacubitril/valsartan were retrieved from the Medline, Embase, Cochrane Library and ClinicalTrials databases. Only descriptive studies on sacubitril/valsartan for patients with CTRCD were included in this review; therefore, all variables were qualitatively analyzed. A total of five studies comprising 109 patients were included. The duration from anticancer therapy to heart failure (HF) or from HF to the use of sacubitril/valsartan exhibited interindividual variations. In patients with CTRCD who were treated with sacubitril/valsartan, the left ventricular ejection fraction improved, N-terminal pro-B-type natriuretic peptide levels decreased and exercise tolerance improved, as indicated by the change in the New York Heart Association functional class. These clinical, echocardiographic and biochemical improvements were found for different dosages or treatment durations of sacubitril/valsartan. No difference was found between the baseline and follow-up serum creatinine and potassium levels. These findings, which are limited to descriptive studies, support the effectiveness of sacubitril/valsartan in improving heart function following CTRCD.

3.
J Cardiovasc Med (Hagerstown) ; 24(2): 123-131, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36583980

RESUMO

The current review aimed to study the effectiveness and safety of angiotensin receptor-neprilysin inhibitor (ARNI) combined with sodium-glucose cotransporter-2 (SGLT2) inhibitors versus ARNI or SGLT2 inhibitors monotherapy in patients with heart failure with reduced ejection fraction (HFrEF). Studies containing patients with HFrEF who used ARNI combined with SGLT2 inhibitors versus ARNI or SGLT2 inhibitors alone were retrieved from the Medline, Embase, and Cochrane Library databases. From the selected studies, the pooled risk ratios with 95% confidence intervals of dichotomous outcomes were assessed by a random or fixed effects model in our meta-analysis. Compared with ARNI monotherapy, the reduction in ARNI combined with SGLT2 inhibitors in a composite of the first hospitalization for heart failure or cardiovascular death was 32%, hospitalization for heart failure was 35% and cardiovascular death was 35%; also all-cause death was 30%, worsening renal function was 35%, respectively, for patients with HFrEF. In addition, compared with SGLT2 inhibitors monotherapy, the reduction in ARNI combined with SGLT2 inhibitors in cardiovascular death was 36% and all-cause death was 28%, respectively, for patients with HFrEF. Although the estimated treatment effect is a 55% increase in volume depletion, overall, ARNI combined with SGLT2 inhibitors might be effective and safe for patients with HFrEF, and volume depletion should be given more attention.


Assuntos
Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Disfunção Ventricular Esquerda , Humanos , Antagonistas de Receptores de Angiotensina/efeitos adversos , Anti-Hipertensivos/farmacologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Neprilisina , Receptores de Angiotensina , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Volume Sistólico , Resultado do Tratamento
4.
J Cardiovasc Pharmacol ; 78(2): 202-210, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33929386

RESUMO

ABSTRACT: This review aimed to summarize the adverse events (AEs) reported during the use of sacubitril/valsartan versus angiotensin converting enzyme inhibitors (ACEI)/angiotensin II receptor blocker (ARB). Studies containing safety outcomes or AEs during the use of sacubitril/valsartan versus ACEI/ARB were retrieved from the MEDLINE, Embase, and Cochrane Library databases and clinical trials. From the selected studies, the pooled risk ratios with 95% confidence intervals of dichotomous outcomes were assessed by a random or fixed effects model in our meta-analysis. Fourteen studies involving 20,261 patients were included in this review. No significant differences were found in total AEs between the sacubitril/valsartan and ACEI/ARB groups. Compared with ACEI/ARB, sacubitril/valsartan decreased the risk of death, discontinuation due to AEs, and renal dysfunction, whereas it increased the risk of hypotension. Specifically, sacubitril/valsartan decreased the risk of death compared with ACEI/ARB, whereas it increased the risk of hypotension for patients with heart failure and decreased the risk of discontinuation due to AEs in White patients. It also increased the risk of dizziness in Asians and decreased the risk of hyperkalemia and renal dysfunction, whereas it increased the risk of hypotension when the study duration was ≥48 weeks. The available evidence showed that sacubitril/valsartan was associated with fewer side effects than ACEI/ARB, except for hypotension. Study duration, race, and patients with primary diseases affected the AEs of sacubitril/valsartan.


Assuntos
Aminobutiratos/efeitos adversos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Compostos de Bifenilo/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Insuficiência Cardíaca/tratamento farmacológico , Inibidores de Proteases/efeitos adversos , Valsartana/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Combinação de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/mortalidade , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipotensão/induzido quimicamente , Hipotensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neprilisina/antagonistas & inibidores , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
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