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Kopel H, Nguyen VH, Boileau C, Bogdanov A, Winer I, Ducruet T, Zeng N, Bonafede M, Esposito DB, Martin D, Rosen A, Van de Velde N, Vermund SH, Gravenstein S, Mansi JA. Comparative Effectiveness of Bivalent (Original/Omicron BA.4/BA.5) COVID-19 Vaccines in Adults. Vaccines (Basel) 2023; 11:1711. [PMID: 38006043 PMCID: PMC10675676 DOI: 10.3390/vaccines11111711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
The emergence of Omicron variants coincided with declining vaccine-induced protection against SARS-CoV-2. Two bivalent mRNA vaccines, mRNA-1273.222 (Moderna) and BNT162b2 Bivalent (Pfizer-BioNTech), were developed to provide greater protection against the predominate circulating variants by including mRNA that encodes both the ancestral (original) strain and BA.4/BA.5. We estimated their relative vaccine effectiveness (rVE) in preventing COVID-19-related outcomes in the US using a nationwide dataset linking primary care electronic health records and pharmacy/medical claims data. The study population (aged ≥18 years) received either vaccine between 31 August 2022 and 28 February 2023. We used propensity score weighting to adjust for baseline differences between groups. We estimated the rVE against COVID-19-related hospitalizations (primary outcome) and outpatient visits (secondary) for 1,034,538 mRNA-1273.222 and 1,670,666 BNT162b2 Bivalent vaccine recipients, with an adjusted rVE of 9.8% (95% confidence interval: 2.6-16.4%) and 5.1% (95% CI: 3.2-6.9%), respectively, for mRNA-1273.222 versus BNT162b2 Bivalent. The incremental relative effectiveness was greater among adults ≥ 65; the rVE against COVID-19-related hospitalizations and outpatient visits in these patients was 13.5% (95% CI: 5.5-20.8%) and 10.7% (8.2-13.1%), respectively. Overall, we found greater effectiveness of mRNA-1273.222 compared with the BNT162b2 Bivalent vaccine in preventing COVID-19-related hospitalizations and outpatient visits, with increased benefits in older adults.
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Affiliation(s)
- Hagit Kopel
- Moderna, Inc., Cambridge, MA 02139, USA (D.B.E.); (A.R.)
| | | | | | | | | | | | - Ni Zeng
- Veradigm, Chicago, IL 60654, USA
| | | | | | - David Martin
- Moderna, Inc., Cambridge, MA 02139, USA (D.B.E.); (A.R.)
| | - Andrew Rosen
- Moderna, Inc., Cambridge, MA 02139, USA (D.B.E.); (A.R.)
| | | | - Sten H. Vermund
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA;
| | - Stefan Gravenstein
- Alpert Medical School and School of Public Health, Brown University, Providence, RI 02903, USA
| | - James A. Mansi
- Moderna, Inc., Cambridge, MA 02139, USA (D.B.E.); (A.R.)
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Hung Nguyen V, Boileau C, Bogdanov A, Sredl M, Bonafede M, Ducruet T, Chavers S, Rosen A, Martin D, Buck P, Esposito D, Van de Velde N, Mansi JA. Relative Effectiveness of BNT162b2, mRNA-1273, and Ad26.COV2.S Vaccines and Homologous Boosting in Preventing COVID-19 in Adults in the US. Open Forum Infect Dis 2023; 10:ofad288. [PMID: 37496607 PMCID: PMC10368199 DOI: 10.1093/ofid/ofad288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 07/28/2023] Open
Abstract
Background Few head-to-head comparisons have been performed on the real-world effectiveness of coronavirus disease 2019 (COVID-19) booster vaccines. We evaluated the relative effectiveness (rVE) of a primary series of mRNA-1273 vs BNT162b2 and Ad26.COV2.S and a homologous mRNA booster against any medically attended, outpatient, and hospitalized COVID-19. Methods A data set linking primary care electronic medical records with medical claims data was used for this retrospective cohort study of US patients age ≥18 years vaccinated with a primary series between February and October 2021 (Part 1) and a homologous mRNA booster between October 2021 and January 2022 (Part 2). Adjusted hazard ratios (HRs) were derived from 1:1 matching adjusted across potential covariates. rVE was (1 - HRadjusted) × 100. Additional analysis was performed across regions and age groups. Results Following adjustment, Part 1 rVE for mRNA-1273 vs BNT162b2 was 23% (95% CI, 22%-25%), 23% (95% CI, 22%-25%), and 19% (95% CI, 14%-24%), while the rVE for mRNA-1273 vs Ad26.COV2.S was 50% (95% CI, 48%-51%), 50% (95% CI, 48%-52%), and 57% (95% CI, 53%-61%) against any medically attended, outpatient, and hospitalized COVID-19, respectively. The adjusted rVE in Part 2 for mRNA-1273 vs BNT162b2 was 14% (95% CI, 10%-18%), 13% (95% CI, 8%-17%), and 19% (95% CI, 1%-34%) against any medically attended, outpatient, and hospitalized COVID-19, respectively. rVE against medically attended COVID-19 was higher in adults age ≥65 years (35%; 95% CI, 24%-47%) than in those age 18-64 years (13%; 95% CI, 9%-17%) after the booster. Conclusions In this study, mRNA-1273 was more effective than BNT162b2 or Ad26.COV2.S following a primary series during the Delta-dominant period and more effective than BNT162b2 as a booster during the Omicron-dominant period.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Nicolas Van de Velde
- Correspondence: James A. Mansi, 5 Vaughn Drive, Princeton, NJ, 08540 (); or Nicolas Van de Velde, 5 Vaughn Drive, Princeton, NJ, 08540 ()
| | - James A Mansi
- Correspondence: James A. Mansi, 5 Vaughn Drive, Princeton, NJ, 08540 (); or Nicolas Van de Velde, 5 Vaughn Drive, Princeton, NJ, 08540 ()
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Ward A, Sarraju A, Lee D, Bhasin K, Gad S, Beetel R, Chang S, Bonafede M, Rodriguez F, Dash R. COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort. PLoS One 2022; 17:e0261786. [PMID: 35020742 PMCID: PMC8754296 DOI: 10.1371/journal.pone.0261786] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/09/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. Methods We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT); arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. Results There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38–1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95–1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98–1.25) and MI (HR 0.93, 95% CI 0.85–1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19–1.56) and PE (HR 1.82, 95% CI 1.57–2.10) in patients with COVID-19. Conclusion In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19.
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Affiliation(s)
- Andrew Ward
- HealthPals Inc., Redwood City, California, United States of America
| | - Ashish Sarraju
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University, Stanford, California, United States of America
- * E-mail:
| | - Donghyun Lee
- HealthPals Inc., Redwood City, California, United States of America
| | - Kanchan Bhasin
- HealthPals Inc., Redwood City, California, United States of America
| | - Sanchit Gad
- HealthPals Inc., Redwood City, California, United States of America
| | - Rob Beetel
- HealthPals Inc., Redwood City, California, United States of America
| | - Stella Chang
- Veradigm, Chicago, Illinois, United States of America
| | - Mac Bonafede
- Veradigm, Chicago, Illinois, United States of America
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University, Stanford, California, United States of America
| | - Rajesh Dash
- HealthPals Inc., Redwood City, California, United States of America
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University, Stanford, California, United States of America
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Ward A, Sarraju A, Lee D, Bhasin K, Gad S, Beetel R, Chang S, Bonafede M, Rodriguez F, Dash R. COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort. medRxiv 2021. [PMID: 34704094 PMCID: PMC8547526 DOI: 10.1101/2021.10.15.21264137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. Methods We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT); arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. Results There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38–1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95–1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98–1.25) and MI (HR 0.93, 95% CI 0.85–1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19–1.56) and PE (HR 1.82, 95% CI 1.57–2.10) in patients with COVID-19. Conclusion In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19.
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Thorat T, Hassan M, Bonafede M, Limone B, McGarry L, Rubin J. P067 Hospitalisations among children with cystic fibrosis aged <6 years. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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D’Ovidio MC, de’ Donato F, Ariano R, Bonini M, Moscato G, De Gironimo V, Di Renzi S, Bonafede M, Grandi C, Marinaccio A, Michelozzi P. 1576 Networks for pollen and fungal spores monitoring: integrated approach to support health surveillance with regard to occupational allergies in italy. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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7
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Soliman A, Surrey E, Bonafede M, Nelson J, Vora J, Agarwal S. Direct healthcare utilization and costs associated with endometriosis among women with medicaid insurance. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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8
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Fonseca R, Abouzaid S, Bonafede M, Cai Q, Parikh K, Cosler L, Richardson P. Trends in overall survival and costs of multiple myeloma, 2000-2014. Leukemia 2017; 31:1915-1921. [PMID: 28008176 PMCID: PMC5596206 DOI: 10.1038/leu.2016.380] [Citation(s) in RCA: 226] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 12/11/2022]
Abstract
Little real-world evidence is available to describe the recent trends in treatment costs and outcomes for patients with multiple myeloma (MM). Using the Truven Health MarketScan Research Databases linked with social security administration death records, this study found that the percentage of MM patients using novel therapy continuously increased from 8.7% in 2000 to 61.3% in 2014. Compared with MM patients diagnosed in earlier years, those diagnosed after 2010 had higher rates of novel therapy use and better survival outcomes; patients diagnosed in 2012 were 1.25 times more likely to survive 2 years than those diagnosed in 2006. MM patients showed improved survival over the study period, with the 2-year survival gap between MM patients and matched controls decreasing at a rate of 3% per year. Total costs among MM patients have increased in all healthcare services over the years; however, the relative contribution of drug costs has remained fairly stable since 2009 despite new novel therapies coming to market. Findings from this study corroborate clinical data, suggesting a paradigm shift in MM treatment over the past decade that is associated with substantial survival gains. Future studies should focus on the impact on specific novel agents on patients' outcomes.
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Affiliation(s)
| | | | - M Bonafede
- Health Economics and Outcomes Research, Truven Health Analytics Inc., an IBM company, Cambridge, MA, USA
| | - Q Cai
- Health Economics and Outcomes Research, Truven Health Analytics Inc., an IBM company, Cambridge, MA, USA
| | - K Parikh
- Celgene Corporation, Summit, NJ, USA
| | - L Cosler
- Binghamton University, Binghamton, NY, USA
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Rubin J, Bonafede M, Sikirica S, Limone B, Adolph N, Konstan M. P183 Burden of illness in school-aged patients with cystic fibrosis (CF) in the united states. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Bonafede M, Troeger K, Riehle E, Adolph N, Pohlman S. Healthcare Costs Associated with Surgical Interventions for Uterine Fibroids. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Bonafede M, Pohlman S, Riehle E, Adolph N, Troeger K. Surgical Treatment Patterns for Women with Newly Diagnosed Uterine Fibroids: Trends from 2010-2014. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Soliman A, Surrey E, Bonafede M, Nelson J, Castelli-Haley J, Winkel C. Incremental costs of healthcare and work loss attributed to endometriosis in a cohort of commercially insured women. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE Ivacaftor was approved in 2012 to treat patients with cystic fibrosis (CF) with specific CFTR gene mutations. The objective of this analysis was to analyze the impact of ivacaftor on health resource utilization through analysis of claims data. METHODS Patients diagnosed with CF aged ≥6 years prescribed ivacaftor between January 1, 2012 and July 31, 2014 with ≥12 months of continuous insurance coverage prior to and following the prescription were identified. All-cause and CF-specific healthcare resource utilization during the pre- and post-prescription periods and ivacaftor adherence levels were studied. RESULTS The 79 identified patients had a mean age of 20.8 years, and 54% were female. The proportion of patients with inpatient admissions (all-cause and CF-related) was significantly higher in the pre index compared to post index period (p ≤ 0.05). Mean ivacaftor medication possession ratio was 0.8 (SD = 0.3), and 73% of patients had a medication possession ratio >0.80. LIMITATIONS Only a small number of patients met the inclusion criteria. Additionally, claims data may contain errors or inconsistencies and cannot be used to determine if medications were taken as prescribed. CONCLUSIONS Ivacaftor therapy was associated with significant reductions in hospitalizations along with high rates of adherence to treatment over 12 months.
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Affiliation(s)
| | - Mac Bonafede
- b Truven Health Analytics , Cambridge , MA , USA
| | | | | | - Gregory S Sawicki
- c Division of Respiratory Diseases , Boston Children's Hospital , Boston , MA , USA
| | - Jeffrey S Wagener
- d Department of Pediatrics , University of Colorado Medical School , Aurora , CO , USA
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Soliman A, Taylor H, Bonafede M, Nelson J, Castelli-Haley J, Winkel C. Direct and indirect costs associated with endometriosis-related surgery among employed women in the US. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Bonafede M, Curtis J, McMorrow D, Mahajan P, Chen C. AB0359 Treatment Effectiveness for Rheumatoid Arthritis after Switching from A Tumor Necrosis Factor Inhibitor to Another Agent:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bonafede M, Shi N, Barron R, Li X, Crittenden D, Chandler D. Predicting imminent risk for fracture in patients aged 50 or older with osteoporosis using US claims data. Arch Osteoporos 2016; 11:26. [PMID: 27475642 PMCID: PMC4967418 DOI: 10.1007/s11657-016-0280-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/07/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED Patient characteristics contributing to imminent risk for fracture, defined as risk of near-term fracture within the next 12 to 24 months, have not been well defined. In patients without recent fracture, we identified factors predicting imminent risk for vertebral/nonvertebral fracture, including falls, age, comorbidities, and other potential fall risk factors. PURPOSE Several factors contribute to long-term fracture risk in patients with osteoporosis, including age, bone mineral density, and fracture history. Some patients may be at imminent risk for fracture, defined here as a risk of near-term fracture within 12-24 months. Many patient characteristics contributing to imminent risk for fracture have not been well defined. This case-control study used US commercial and Medicare supplemental insured data for women and men without recent fracture to identify factors associated with imminent risk for fracture. METHODS Patients included were aged ≥50 with osteoporosis, had a vertebral or nonvertebral fracture claim (index date; fracture group) or no fracture claim (control group) from January 1, 2006, to September 30, 2012, continuously enrolled and without fracture in the 24 months before index. Potential risk factors during the period before fracture were assessed. RESULTS Using data from 12 months before fracture, factors significantly associated with imminent risk for fracture were previous falls, older age, poorer health status, specific comorbidities (psychosis, Alzheimer's disease, central nervous system disease), and other fall risk factors (wheelchair use, psychoactive medication use, mobility impairment). Similar findings were observed with data from 24 months before fracture. CONCLUSIONS In patients with osteoporosis and no recent fracture, falls, older age, poorer health status, comorbidities, and other potential fall risk factors were predictive of imminent risk for fracture. Identification of factors associated with imminent risk for vertebral/nonvertebral fracture may help identify and risk stratify those patients most in need of immediate and appropriate treatment to decrease fracture risk.
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Affiliation(s)
| | - N. Shi
- Truven Health Analytics, Cambridge, MA USA
| | - R. Barron
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA USA
| | - X. Li
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA USA
| | | | - D. Chandler
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA USA
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Paoli CJ, Bonafede M, Gandra S, Cappell K, Simpson RJ. Trends in Treatment Patterns of First Statin and Ezetimibe Use in the United States from 2007-2012. J Clin Lipidol 2015. [DOI: 10.1016/j.jacl.2015.03.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Bonafede M, Johnson B, Tang D, Shah N, Harrison D, Collier D. THU0441 Adherence and Persistence with Triple Non-Biologic Disease Modifying Antirheumatic Drug Therapy and Etanercept-Methotrexate Combination Therapy in US Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Accortt N, Bonafede M, Collier D, Iles J, Anthony M, Curtis J. FRI0257 A Retrospective Database Analysis Describing Recurrent Infection Risk among Patients Using Tnf-Inhibitors, Other Biologic DMARDS and Non-Biologic Dmards. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bonafede M, Johnson B, Princic N, Shah N, Harrison D. SAT0076 Effectiveness of RA BIOLOGICS in the Two Years following Initiation Using A Validated Claims-Based Algorithm. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Bonafede M, Joseph GJ, Princic N, Harrison DJ. THU0521 Comparison of Biologic Cost Per Treated Patient with Rheumatoid Arthrits (RA) in US Patients with Employer Provided Health Insurance. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Bonafede M, Joseph GJ, Princic N, Shah NA, Harrison DJ. AB0767 Biologic treatment patterns in us managed care patients with employer provided health insurance treated for rheumatoid arthritis (ra). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gerson LB, Bonafede M, Princic N, Gregory C, Farr A, Balu S. Development of a refractory gastro-oesophageal reflux score using an administrative claims database. Aliment Pharmacol Ther 2011; 34:555-67. [PMID: 21714794 DOI: 10.1111/j.1365-2036.2011.04755.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Approximately one-third of gastro-oesophageal reflux disease (GERD) patients demonstrate refractory symptoms following treatment with proton pump inhibitor (PPI) therapy. AIM To develop a refractory GERD score that can be applied to predict patients' healthcare utilisation. METHODS We enrolled adults (≥18 years) with a diagnosis of GERD. Refractory GERD was evaluated on an 8-point scale where 1 point was given for each of the following criteria: doubling, addition, or switching of GERD medication dose, receipt of a GERD-related endoscopic procedure or surgery, or ≥3 GERD-related outpatient visits. Refractory GERD was defined as the presence of two or more points. RESULTS A total of 135,139 GERD patients (44% male) were analysed with a mean (±s.d.) age of 52.9 ± 15 years. The mean overall refractory GERD score was 1.12 ± 1.2 (range 0-8 on an 8-point scale); 31% of patients had refractory GERD with a mean score of 2.56 ± 0.82. Among patients with refractory GERD, 31% doubled their GERD medication, 28% added a new GERD medication, 60% switched GERD medications, 54% had a GERD-related procedure and 1% had a GERD-related surgery. Patients with refractory GERD were more likely to be female (59% vs. 55%, P < 0.001) and had a higher co-morbidity score (0.78 vs. 0.56, P < 0.001). The overall mean costs for refractory patients during the study period were significantly higher compared with treatment-responsive patients ($18,088 ± $36,220 vs. $11,044 ± $22,955, P < 0.001). CONCLUSIONS Refractory GERD was present in approximately one-third of the GERD patients. We created a GERD refractory score that could define need for increased anti-reflux therapy and predict higher healthcare resource utilisation.
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Affiliation(s)
- L B Gerson
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, CA, USA.
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Yan L, Fu D, Li C, Blechl A, Tranquilli G, Bonafede M, Sanchez A, Valarik M, Yasuda S, Dubcovsky J. The wheat and barley vernalization gene VRN3 is an orthologue of FT. Proc Natl Acad Sci U S A 2006; 103:19581-6. [PMID: 17158798 PMCID: PMC1748268 DOI: 10.1073/pnas.0607142103] [Citation(s) in RCA: 582] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Winter wheat and barley varieties require an extended exposure to low temperatures to accelerate flowering (vernalization), whereas spring varieties do not have this requirement. In this study, we show that in these species, the vernalization gene VRN3 is linked completely to a gene similar to Arabidopsis FLOWERING LOCUS T (FT). FT induction in the leaves results in a transmissible signal that promotes flowering. Transcript levels of the barley and wheat orthologues, designated as HvFT and TaFT, respectively, are significantly higher in plants homozygous for the dominant Vrn3 alleles (early flowering) than in plants homozygous for the recessive vrn3 alleles (late flowering). In wheat, the dominant Vrn3 allele is associated with the insertion of a retroelement in the TaFT promoter, whereas in barley, mutations in the HvFT first intron differentiate plants with dominant and recessive VRN3 alleles. Winter wheat plants transformed with the TaFT allele carrying the promoter retroelement insertion flowered significantly earlier than nontransgenic plants, supporting the identity between TaFT and VRN-B3. Statistical analyses of flowering times confirmed the presence of significant interactions between vernalization and FT allelic classes in both wheat and barley (P < 0.0001). These interactions were supported further by the observed up-regulation of HvFT transcript levels by vernalization in barley winter plants (P = 0.002). These results confirmed that the wheat and barley FT genes are responsible for natural allelic variation in vernalization requirement, providing additional sources of adaptive diversity to these economically important crops.
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Affiliation(s)
- L. Yan
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - D. Fu
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - C. Li
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - A. Blechl
- U.S. Department of Agriculture–Agricultural Research Service, Western Regional Research Center, Albany, CA 94710; and
| | - G. Tranquilli
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - M. Bonafede
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - A. Sanchez
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - M. Valarik
- *Department of Plant Sciences, University of California, Davis, CA 95616
| | - S. Yasuda
- Research Institute for Bioresources, Okayama University, Kurashiki 710-0046, Japan
| | - J. Dubcovsky
- *Department of Plant Sciences, University of California, Davis, CA 95616
- To whom correspondence should be addressed. E-mail:
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Fiorentini S, Licenziati S, Alessandri G, Castelli F, Caligaris S, Bonafede M, Grassi M, Garrafa E, Balsari A, Turano A, Caruso A. CD11b expression identifies CD8+CD28+ T lymphocytes with phenotype and function of both naive/memory and effector cells. J Immunol 2001; 166:900-7. [PMID: 11145666 DOI: 10.4049/jimmunol.166.2.900] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A previously unreported CD8(+)CD28(+)CD11b(+) T cell subset occurs in healthy individuals and expands in patients suffering from primary viral infections. In functional terms, these cells share the features of naive/memory CD8(+)CD28(+)CD11b(-) and terminally differentiated effector CD8(+)CD28(-)CD11b(+) subpopulations. Like CD28(-) cells, CD28(+)CD11b(+) lymphocytes have the ability to produce IFN-gamma, to express perforin granules in vivo, and to exert a potent cytolytic activity. Moreover, these cells can respond to chemotactic stimuli and can efficiently cross the endothelial barrier. In contrast, like their CD11b(-) counterpart, they still produce IL-2 and retain the ability to proliferate following mitogenic stimuli. The same CD28(+)CD11b(+) subpopulation detected in vivo could be generated by culturing naive CD28(+)CD11b(-) cells in the presence of mitogenic stimuli following the acquisition of a CD45RO(+) memory phenotype. Considering both phenotypic and functional properties, we argue that this subset may therefore constitute an intermediate phenotype in the process of CD8(+) T cell differentiation and that the CD11b marker expression can distinguish between memory- and effector-type T cells in the human CD8(+)CD28(+) T cell subset.
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Affiliation(s)
- S Fiorentini
- Institute of Microbiology and Department of Infectious Diseases, University of Brescia Medical School, Brescia, Italy
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Rice LB, Carias LL, Hujer AM, Bonafede M, Hutton R, Hoyen C, Bonomo RA. High-level expression of chromosomally encoded SHV-1 beta-lactamase and an outer membrane protein change confer resistance to ceftazidime and piperacillin-tazobactam in a clinical isolate of Klebsiella pneumoniae. Antimicrob Agents Chemother 2000; 44:362-7. [PMID: 10639363 PMCID: PMC89684 DOI: 10.1128/aac.44.2.362-367.2000] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/1999] [Accepted: 11/09/1999] [Indexed: 11/20/2022] Open
Abstract
We describe Klebsiella pneumoniae 15571, a clinical isolate resistant to ceftazidime MIC = 32 microg/ml) and piperacillin-tazobactam (MICs = 1,024 and 128 microg/ml). K. pneumoniae 15571 expresses a single beta-lactamase with a pI of 7.6. However, when cloned in a high-copy-number vector in Escherichia coli, this bla(SHV-1) gene did not confer resistance to ceftazidime, a spectrum consistent with the nucleotide sequence, which was nearly identical to those of previously described bla(SHV-1) genes. Outer membrane protein (OMP) analysis of K. pneumoniae 15571 revealed a decrease in the quantity of a minor 45-kDa OMP in comparison to that in K. pneumoniae 44NR, a low-level ampicillin-resistant strain that also expresses a chromosomally determined bla(SHV-1). Crude beta-lactamase enzyme extracts from K. pneumoniae 15571 produced roughly 200-fold more beta-lactamase activity than K. pneumoniae 44NR. Northern hybridization analysis revealed that this difference was explainable by quantifiable differences in transcription of the bla(SHV-1) gene in the two strains. Primer extension analysis of bla(SHV-1) mRNA from K. pneumoniae 15571 and 44NR indicated that the transcriptional start sites were identical in the two strains. DNA sequencing of the promoter regions upstream of the of bla(SHV-1) open reading frames in the two K. pneumoniae strains revealed an A-->C change in the second position of the -10 region in K. pneumoniae 44NR compared to that in 15571. Site-directed mutagenesis of the cloned K. pneumoniae 15571 bla(SHV-1), in which the A in the second position of the 15571 -10 region was changed to a C, resulted in a substantial lowering of the MIC of ampicillin. When the levels of beta-lactamase enzyme expression in E. coli were compared, the bla(SHV-1) downstream of the altered -10 region produced 17-fold less beta-lactamase enzyme. These results indicate that elevated levels of ceftazidime resistance can result from a combination of increased enzyme production and minor OMP changes and that levels of chromosomally encoded SHV-1 beta-lactamase production can vary substantially with a single-base-pair change in promoter sequence.
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Affiliation(s)
- L B Rice
- Medical Service, Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA.
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Affiliation(s)
- M Bonafede
- Cleveland Veterans Affairs Medical Center, and the Department of Medicine, Case Western Reserve University School of Medicine, OH 44106, USA
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Bonafede M, Boschi E, Dragoni M. Viscoelastic stress relaxation on deep fault sections as a possible source of very long period elastic waves. ACTA ACUST UNITED AC 1983. [DOI: 10.1029/jb088ib03p02251] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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