ABSTRACT
BACKGROUND: The purpose of this study was to investigate the risk of death among elderly outpatients (>65 years) with a dementia diagnosis treated with atypical antipsychotics. METHODS: We conducted a cohort study of 696 patients who entered the Unit of Alzheimer Evaluation (UVA) of Teramo Hospital in Central Italy, during a 3-year period (January 2007-December 2009). Among these patients, 375 were treated with atypical antipsychotics (quetiapine, risperidone and olanzapine). Data were collected from record files sent to the pharmaceutical service of the hospital. RESULTS: Patients taking atypical antipsychotic medication were associated with a significantly higher mortality rate than patients not taking antipsychotics. The relative risk of death in patients treated with antipsychotics compared to control patients was 2.354 (95% CI 1.704-3.279). The greatest increases in mortality rate occurred close to the last drug supply, and declined exponentially as time passed from the last drug supply in patients who stopped drug assumption. Quetiapine was the most commonly prescribed drug and higher doses of this drug were associated with higher mortality rates. CONCLUSIONS: These results are in line with the April 2005 warning of the Food and Drug Administration (FDA) that among elderly patients with dementia, the treatment of behavioural disorders with atypical antipsychotics is associated with a higher mortality rate. Given the potential risks of mortality with antipsychotics, and since antipsychotic medications may benefit only a minority of patients, new approaches are clearly needed to manage the neuropsychiatric symptoms of dementia.
Subject(s)
Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Dementia/drug therapy , Dibenzothiazepines/therapeutic use , Risperidone/therapeutic use , Aged , Aged, 80 and over , Alzheimer Disease/drug therapy , Alzheimer Disease/mortality , Antipsychotic Agents/adverse effects , Benzodiazepines/adverse effects , Causality , Cholinesterase Inhibitors/adverse effects , Cholinesterase Inhibitors/therapeutic use , Dementia/mortality , Dibenzothiazepines/adverse effects , Female , Humans , Italy/epidemiology , Kaplan-Meier Estimate , Male , Olanzapine , Outpatients/statistics & numerical data , Quetiapine Fumarate , Risk , Risperidone/adverse effectsABSTRACT
INTRODUCTION: The unmet therapeutic needs lead to accelerated registration of new oncology drugs, even with incomplete information of the benefit-risk ratio. METHODS: In Italy the Onco-AIFA Register was established to monitor oncology drugs when used according to authorized indications and to assure their appropriate use in clinical practice. In the Abruzzo region, an observational longitudinal study (ProMoFIA_Oncologici) was performed to evaluate in standard clinical practice all patients treated with these new oncology drugs for any indication. RESULTS: During the period 2008-2011, 3435 patients were observed: in 62.2% of patients, the use of these drugs was eligible also for the Onco-AIFA Register; in 22.7% it was in-label but not monitored in the Onco-AIFA; in 15.1% the use was off-label. DISCUSSION: The study findings showed a widespread use of the new oncology drugs beyond the Onco-AIFA indications, as well as their off-label use.
Subject(s)
Antineoplastic Agents/therapeutic use , Neoplasms/drug therapy , Registries , Adult , Humans , ItalyABSTRACT
Analizou-se dentre outras enzimas, a atividade de L-gama-glutamil-transferase sérica em 30 pacientes com Distrofia Miotônica e verificaram atividade elevada em 20 pacientes (66,66%)
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , gamma-Glutamyltransferase/blood , Myotonic Dystrophy/metabolismABSTRACT
Os autores analisaram, dentre outras enzimas, a atividades de L-gama-glutamil-tranferase serica em 30 pacientes com Distrofia Miotonica e vericaram atividade elevada em 20 pacientes (66,66 por cento).
Subject(s)
Muscular Atrophy , Muscular AtrophyABSTRACT
Estudou-se o grupo sanguíneo ABO e o fator Rh de 23 doentes com distrofia miotônica (DM), originados de 11 famílias, e dois irmäos com miotonia congênita (MC). Entre os doentes com DM, 10 pertenciam ao grupo 0 e 13 ao A, todos eram Rh positivo. Os dois irmäos com MC pertenciam ao grupo 0, Rh positivo
Subject(s)
Humans , Male , Female , Myotonia Congenita/etiology , Myotonic Dystrophy/genetics , ABO Blood-Group System/genetics , Rh-Hr Blood-Group System/geneticsABSTRACT
Os autores estudaram o grupo sanguineo ABO e o fator de 23 doentes com distrofia miotonica (DM), originados de 11 familias, e dois irmaos com miotonia congenita (MC). Entre os doentes com DM, 10 pertenciam ao grupo O a 13 ao A, todos eram Rh positivo. Os dois irmaos com MC pertenciam ao grupo O, Rh positivo.
