RESUMO
STUDY OBJECTIVE: To assess the lipid-lowering efficacy, safety, and costs of a large-scale statin formulary conversion program. DESIGN: Prospective, observational study. SETTING: Tertiary academic medical center. PATIENTS: A total of 980 patients consented to participate; 942 patients completed the study. INTERVENTION: Patients were converted from their current statin therapy to either cerivastatin 0.4 or 0.8 mg/day, or simvastatin 80 mg/day, using a conversion algorithm. MEASUREMENTS AND MAIN RESULTS: Efficacy and safety were evaluated at baseline and after 6 weeks of therapy; costs were also measured. Overall attainment of the National Cholesterol Education Program (NCEP) goal for low-density lipoprotein cholesterol (LDL) increased from 64.8% to 74.5% of patients (p<0.001); mean LDL decreased from 115+/-30 mg/dl to 106+/-25 mg/dl (p<0.001). Adverse events occurred in 3% of patients, and included myositis (0.6%) and increased hepatic transaminases (0.1%). Overall costs were reduced by $115/patient treatment-year. CONCLUSION: Statin therapeutic interchange can improve lipid control at reduced costs. The possibility of uncommon but potentially serious adverse effects suggests that these programs require appropriate monitoring.
Assuntos
Anticolesterolemiantes/uso terapêutico , Lipídeos/sangue , Piridinas/uso terapêutico , Sinvastatina/uso terapêutico , Idoso , Algoritmos , Anticolesterolemiantes/efeitos adversos , Anticolesterolemiantes/economia , LDL-Colesterol/sangue , Estudos de Coortes , Custos e Análise de Custo , Relação Dose-Resposta a Droga , Formulários de Hospitais como Assunto , Hospitais Militares/economia , Humanos , Masculino , Pessoa de Meia-Idade , Piridinas/efeitos adversos , Piridinas/economia , Sinvastatina/efeitos adversos , Sinvastatina/economiaRESUMO
In 971 patients with squamous cell carcinoma of supraglottic larynx several clinical and physical prognostic factors were evaluated. There were 55% of patients with advanced primary tumours and 71% of patients with no regional neck metastases. All patients were irradiated radically using external megavoltage beam. The total dose was in range 60-70 Gy for 95% of patients. The 3-year local control rate and 3-year overall in whole group were 41% and 50% respectively. Clinical stage, haemoglobin level at the end of treatment, overall treatment time, sex and total dose were estimated as an independent and important prognostic factors for the outcome in radiotherapy of supraglottic larynx cancer.
