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1.
Clin Drug Investig ; 23(11): 735-42, 2003.
Article in English | MEDLINE | ID: mdl-17536887

ABSTRACT

OBJECTIVE: To describe the effects of venlafaxine, fluoxetine and sertraline treatment on mood and behaviour patterns, physical functioning, and tolerability issues in a long-term care environment. DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort analysis of 257 elderly residents of three long-term care facilities in the US who used venlafaxine, fluoxetine or sertraline during a 3-month period. MAIN OUTCOME MEASURES: Indicators of depression, anxiety and sad mood, physical functioning, antidepressant-related adverse events, and the global impression of efficacy. RESULTS: The average age of the participants was 80.6 years. At the 3-month follow-up, more than 85% of the residents recorded no change in indicators of depression, anxiety and sad mood or physical functioning, and there were no statistically significant differences among the three antidepressant drug groups. A marginal improvement in the social interaction indicator was observed among residents who received venlafaxine (11%) compared with those receiving fluox-etine (3%) or sertraline (2%). Antidepressant-related adverse events were infrequent and similar in incidence across the three drug groups. CONCLUSIONS: Indicators of mood and functioning of most residents were stable over the 3-month period and similar among the venlafaxine, fluoxetine and sertraline groups, and no significant differences in the safety profiles of the three drugs were recorded.

2.
Am J Manag Care ; 8(3): 231-40, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11915973

ABSTRACT

OBJECTIVE: To document the burden of early rheumatoid arthritis (RA) on health-related quality of life (HQL) and compare changes in HQL across 2 treatments. STUDY DESIGN: Analysis of HQL scores among patients enrolled in a multicenter, double-blind, randomized control trial of early RA treatment. PATIENTS AND METHODS: A total of 424 patients with early RA were randomized to 1 of 2 treatment groups: etanercept or methotrexate. Patients were treated and followed for 52 weeks. Health-related quality of life was assessed before and throughout treatment using the Medical Outcomes Study Short Form 36 Health Survey (SF-36) and the Health Assessment Questionnaire (HAQ). The HQL burden of RA was established by comparing SF-36 scale scores to general US population norms. The impact of treatment on HQL was determined by comparing scores on both SF-36 and HAQ scales. RESULTS: Before treatment, RA patients showed significant decrements in scores on all SF-36 scales and summary measures in comparison with age- and sex-matched general US population norms, multivariate analysis of variance (MANOVA) F(8,2815) = 204.6, P < .0001. After 52 weeks of treatment, 7 of 8 SF-36 scales and the physical summary measure remained significantly below the general US population norm, MANOVA F(8,2815) = 41.9, P < .0001. Patients randomized to etanercept showed significantly better HQL improvement earlier in treatment than patients randomized to methotrexate on the SF-36 physical summary, MANOVA F(10,4230) = 6.1, P< .0001, the SF-36 arthritis-specific health index, MANOVA F(10,4230) = 8.5, P < .0001, and the HAQ, MANOVA F(10,4230) = 14.7, P < .0001. At 52 weeks, there were no significant differences between treatment groups. CONCLUSIONS: Rheumatoid arthritis places tremendous disease burden on patients' HQL. Successful treatment of early RA improved HQL. Etanercept showed a rapid HQL response.


Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/psychology , Cost of Illness , Immunoglobulin G/therapeutic use , Methotrexate/therapeutic use , Receptors, Tumor Necrosis Factor/therapeutic use , Sickness Impact Profile , Adult , Aged , Etanercept , Female , Humans , Male , Middle Aged , Pain Measurement , Surveys and Questionnaires , Treatment Outcome , United States
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