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- Mellström, Dan, 1945, et al.
(författare)
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Proportion and Characteristics of Patients in Sweden Remaining at High Risk of Fracture Despite Prior Treatment
- 2016
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Ingår i: Clinical Therapeutics. - : Elsevier BV. - 0149-2918. ; 38:7, s. 1686-1695
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Fragility fractures axe a clinical consequence of osteoporosis (OP). Evidence suggests however, current OP treatments may be inadequate in reducing fracture risk. The purpose of this study was to estimate the proportion and characteristics of Swedish patients who remain at high risk of fracture after 2 years of treatment, as evidenced by osteoporotic bone mineral density (BMD), a decrease in BMD, or the occurrence of new fractures. Methods: This was a retrospective, descriptive analysis of a subset of participants obtained from a Swedish osteoporosis patient registry from 1991 to 2009. Patients were required to be osteoporotic, to be treatment naive at baseline, to have returned for at least 1 follow-up visit, and to have reported osteoporosis treatment use for >= 2 years after the baseline visit with a BMD T score. Two overlapping cohorts remaining at high risk of fracture were defined using the BMD T score measured after 2 years of treatment from baseline. The osteoporosis cohort comprised patients who remained osteoporotic, whereas the BMD decrease cohort included patients whose total hip or lumbar spine T score decreased by >= 3%. Findings: A total of 3292 osteoporotic patients were identified in the registry, of whom 392 met the study inclusion criteria. The mean (SD) patient age was 68.3 (8.5) years, with most patients being female (92.3%). Among all patients, 297 (75.8%) remained osteoporotic after at least 2 years of treatment, 90 (23.0%) experienced a BMD decrease of >= 3%, and 23 (5.9%) reported an incident fracture between the baseline and first follow-up visit. More than three-quarters (76.8%) of all patients reported taking bisphosphonates, whereas only 72.4% and 47.8% reported this in the osteoporosis and BMD decrease cohorts, respectively. Raloxifene was the only nonbisphosphonate used, with 24.2% of all patients reportedly taking it. Implications: This study highlighted that despite 2 years of osteoporosis treatment, a high percentage of patients remain at high risk of fracture. There is a need for improved treatment strategies that reduce fracture risk and improve patient outcomes in the real-world setting.
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- Kasvayee, Keivan Amiri, 1986-, et al.
(författare)
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Strain localization and crack formation effects on stress-strain response of ductile iron
- 2017
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Ingår i: Materials Science & Engineering. - : Elsevier. - 0921-5093 .- 1873-4936. ; 702, s. 265-271
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Tidskriftsartikel (refereegranskat)abstract
- The strain localization and crack formation in ferritic-pearlitic ductile iron under tension was investigated by in-situ tensile tests. In-situ tensile tests under optical microscope were performed and the onset of the early ferrite-graphite decohesions and micro-cracks inside the matrix were studied. The results revealed that early ferrite-graphite decohesion and micro-cracks inside the ferrite were formed at the stress range of 280–330 MPa, where a kink occurred in the stress-strain response, suggesting the dissipation of energy in both plastic deformation and crack initiation. Some micro-cracks initiated and propagated inside the ferrite but were arrested within the ferrite zone before propagating in the pearlite. Digital Image Correlation (DIC) was used to measure local strains in the deformed micrographs obtained from the in-situ tensile test. Higher strain localization in the microstructure was measured for the areas in which the early ferrite-graphite decohesions occurred or the micro-cracks initiated. © 2017 Elsevier B.V.
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- Luttropp, K, et al.
(författare)
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Real-world treatment persistence of golimumab in the management of immune-mediated rheumatic diseases in Europe: a systematic literature review
- 2019
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:5, s. e027456-
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Tidskriftsartikel (refereegranskat)abstract
- To summarise real-world data from studies reporting golimumab persistence in European immune-mediated rheumatic disease (IMRD) populations and to report pooled estimates.DesignSystematic literature review.Data sourcesRelevant literature was identified through searching Medline and Embase via Ovid as well as the conference databases of European League Against Rheumatism and American College of Rheumatology—Association of Rheumatology Health Professionals.Eligibility criteriaWe screened records using predefined patients, interventions, comparators, outcomes and study design criteria. Eligible studies included reports of persistence among adult IMRD patients in Europe receiving treatment with subcutaneous golimumab. Clinical trials, randomised controlled trials, literature reviews, editorials, guidelines and studies with <20 patients receiving golimumab were excluded.Data extraction and synthesisFollowing double screening by two independent reviewers, 27 studies out of 578 identified records were selected for inclusion and subsequent data extraction. Persistence was most commonly reported at 12and 24 months; hence, pooled persistence estimates were calculated for these two time points and reported according to indication.ResultsPersistence ranged between 58.1% (psoriatic arthritis (PsA) patients regardless of treatment line) and 75.7% (biological-naïve rheumatoid arthritis patients) at 12 months; at 24 months, the range was 43% (axial spondyloarthritis (AxSpA) patients regardless of treatment line) and 69.6% (biological-naïve PsA patients). On the basis of data from 12 studies, persistence with golimumab treatment was either significantly higher or not significantly different from other tumour necrosis factor inhibitors (TNFi).ConclusionsGolimumab persistence at 24 months approximates 50%, with a lower persistence among AxSpA (43%) patients. However, as the number of studies in these populations was low, they warrant further research. In 12 studies comparing various TNFi treatments, golimumab was shown to have significantly better or equal persistence to its comparators.
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