BACKGROUND: Guidelines recommend primary prophylactic use of colony-stimulating factor (PP-CSF) when risk of febrile neutropenia (FN)-based on chemotherapy and patient risk factors-is high. Whether and how PP-CSF use may have changed over time (e.g., due to guideline revisions, increasing use of myelosuppressive regimens, controversy regarding inappropriate CSF use), and whether there has been a concomitant change in the incidence of FN, is unknown. METHODS: A
Pelton SI, Bornheimer R, Doroff R, Shea KM, Sato R, Weycker D. Decline in pneumococcal disease attenuated in older adults and those with comorbidities following universal childhood PCV13 immunization. Clin Infect Dis 2019;68(11):1831-8.
INTRODUCTION: Following introduction of PCV7 in the US, epidemiology of pneumococcal disease shifted such that disease incidence in the elderly exceeded that in children. We evaluated the impact of replacing PCV7 with PCV13 on disease burden in adults, and identified age/risk-specific subgroups with highest remaining disease burden. METHODS: A retrospective design and data from two US
Weycker D, Hanau A, Lonshteyn A, Bowers C, Garawin T, Bensink M, Chandler D. Risk of chemotherapy-induced febrile neutropenia with early discontinuation of pegfilgrastim prophylaxis: a retrospective evaluation using medicare claims. Curr Med Res Opin 2019;35(4):725-30.
BACKGROUND: Two recent evaluations reported that many cancer chemotherapy patients discontinue pegfilgrastim prophylaxis (PP) following the first cycle, and that these patients have a higher subsequent risk of febrile neutropenia (FN). Such evidence is based principally on the experience of younger adults with private healthcare coverage, and the generalizability of results to elderly Medicare patients
Vincent JL, Nielsen ND, Shapiro NI, Gerbasi ME, Grossman A, Doroff R, Zeng F, Young PJ, Russell JA.Mean arterial pressure and mortality in patients with distributive shock: a retrospective analysis of the MIMIC-III database. Ann Intensive Care 2018;8(1):107.
INTRODUCTION: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. METHODS: In this retrospective analysis of the
Spagnolo P, Kreuter M, Maher TM, Wuyts W, Bonella F, Corte TJ, Kopf S, Weycker D, Kirchgaessler KU, Ryerson CJ. Metformin does not affect clinically relevant outcomes in patients with idiopathic pulmonary fibrosis. Respiration 2018;96(4):314-22.
BACKGROUND: Diabetes mellitus is a possible risk factor for the development of idiopathic pulmonary fibrosis (IPF), yet the effect of antidiabetic therapy on the course of IPF is unknown. OBJECTIVES: This post hoc analysis assessed the effect of metformin on clinically relevant outcomes in patients with IPF. METHODS: For the primary analysis, patients randomized to
Weycker D, Li X, Wygant GD, Lee T, Hamilton M, Luo X, Vo L, Mardekian J, Pan X, Burns L, Atwood M, Hanau A, Cohen AT. Effectiveness and safety of apixaban versus warfarin as outpatient treatment of venous thromboembolism in U.S. clinical practice. Thromb Haemost 2018;118(11):1951-61.
In the AMPLIFY clinical trial, apixaban was non-inferior to warfarin plus subcutaneous enoxaparin bridge therapy in the treatment of acute venous thromboembolism (VTE) and was associated with significantly less bleeding. This study evaluated their comparative effectiveness and safety in routine clinical practice. A matched-cohort design and data from four U.S. private health care claims databases
Weycker D, Hanau A, Lonshteyn A, Bowers C, Bensink M, Garawin T, Chandler D. Risk of chemotherapy-induced febrile neutropenia with same-day versus next-day pegfilgrastim prophylaxis among patients aged ≥65 years: a retrospective evaluation using Medicare claims. Curr Med Res Opin 2018;34(9):1705-11.
BACKGROUND: Two recent evaluations reported that risk of febrile neutropenia (FN) may be higher when pegfilgrastim prophylaxis (PP) is administered on same day as chemotherapy rather than per recommendation (1-3 days following chemotherapy). Such evidence is based largely on the experience of younger privately insured adults and may not be generalizable to older patients in
Hagiwara M, Sharma A, Chung KC, Delea TE. Healthcare resource utilization and costs in patients with newly diagnosed acute myeloid leukemia. J Med Econ 2018;21(11):1119-30.
AIM: Acute myeloid leukemia (AML) is associated with high disease burden. This analysis estimated HRU and costs among newly diagnosed AML patients in a US commercially insured population. MATERIALS AND METHODS: This was a retrospective observational study using the IMS Health PharMetrics Plus and Hospital Charge Detail Master databases. Patients included adults who were newly
Marbaix S, Peetermans WE, Verhaegen J, Annemans L, Sato R, Mignon A, Atwood M, Weycker D. Cost-effectiveness of PCV13 vaccination in Belgian adults aged 65-84 years at elevated risk of pneumococcal infection. PLoS One 2018;13(7):e0199427.
BACKGROUND: The Belgian Superior Health Council (SHC) recently added a 13-valent pneumococcal conjugate vaccine (PCV13) to its recommendations for adult pneumococcal vaccination. This study addresses the policy question regarding whether a single dose of PCV13 should be reimbursed among Belgian adults aged 65-84 years with chronic comorbidities (“moderate-risk”) or immunosuppression (“high-risk”). METHODS: A cohort model
Atwood M, Beausoleil L, Breton MC, Laferriere C, Sato R, Weycker D. Cost-effectiveness of alternative strategies for use of 13-valent pneumococcal conjugate vaccine (PCV13) in Canadian adults. Can J Public Health 2018;109(5-6):756-68.
OBJECTIVES: The Canadian National Advisory Committee on Immunization (NACI) recommends use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine in a sequential schedule (PCV13 → PPV23) among adults aged ≥ 65 years and those aged ≥ 18 years who are immunocompromised. In light of recent PCV13 efficacy data from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA),
Kuchenbecker U, Chase D, Reichert A, Schiffner-Rohe J, Atwood M. Estimating the cost-effectiveness of a sequential pneumococcal vaccination program for adults in Germany. PLoS One 2018;13(5):e0197905.
INTRODUCTION: In Germany, a 23-valent polysaccharide pneumococcal vaccine (PPSV23) is recommended for elderly (60+) and patients 16+ with chronic diseases not associated with immune suppression. For all other patients at risk, sequential immunization with a 13-valent pneumococcal conjugate vaccine (PCV13) first, followed by PPSV23 is recommended. Repeated vaccination with PPSV23 is recommended every 6 years