FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1996993842> ?p ?o ?g. }

• W1996993842 abstract "Objective To evaluate the cost-effectiveness of high-dose statins (atorvastatin 80 mg/day, rosuvastatin 40 mg/day and simvastatin 80 mg/day) versus simvastatin 40 mg/day in individuals with acute coronary syndrome (ACS). Data sources Eleven bibliographic databases, including MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, DARE and NHS EED, were searched from inception to 2008. Review methods Data relating to study design, baseline patient characteristics, clinical or surrogate outcome, and adverse events were abstracted, and methodological quality was assessed according to standard methods. A synthesis of the available evidence was performed using a Bayesian mixed treatment meta-analysis using both direct and indirect evidence. An existing Markov model was modified to explore the costs and benefits associated with a lifetime of the differing treatment regimens. Results A total of 3345 titles and abstracts were screened for inclusion in the review of clinical effectiveness and 125 full papers retrieved and assessed in detail. Of these, 30 papers met the inclusion criteria for the review, describing 28 trials. The Bayesian mixed treatment meta-analysis demonstrated a clear dose–response relationship in terms of reductions in low-density lipoprotein cholesterol (LDL-c), with rosuvastatin 40 mg/day achieving the greatest percentage reduction (56%) from baseline, followed by atorvastatin 80 mg/day (52%), simvastatin 80 mg/day (45%) and simvastatin 40 mg/day (37%). Although serious adverse events with statins are rare, their incidence is likely to be greater with higher doses. Several clinical scenarios were used to explore the effect of adherence on the cost-effectiveness of the treatment regimens. Using a threshold of £20,000 per quality-adjusted life-year (QALY) and assuming that the benefits and adherence rates observed in the clinical trials are generalisable to a clinical setting and that individuals who do not tolerate the higher-dose statins are prescribed simvastatin 40 mg/day, then simvastatin 80 mg/day, atorvastatin 80 mg/day and rosuvastatin 40 mg/day would be considered cost-effective compared with simvastatin 40 mg/day in individuals with ACS. Simvastatin 80 mg/day is not well tolerated because of the high incidence rates of less severe adverse events such as myopathy (26-fold higher than rates in those receiving simvastatin 20 mg/day), which are likely to affect adherence levels in clinical practice. The reference case shows that rosuvastatin is the optimal treatment for individuals with a recent history of ACS using a threshold of £20,000 per QALY. However, this is based on the assumption that the additional incremental reductions in LDL-c observed in patients treated with rosuvastatin 40 mg/day compared with atorvastatin will transfer into corresponding changes in relative risks of cardiovascular events. Conclusions Simvastatin 80 mg/day cannot be recommended because of the high incidence rates of adverse events. If the cost of atorvastatin decreases in line with that observed for simvastatin when the patent ends in 2011, atorvastatin 80 mg/day will be the most cost-effective treatment for all thresholds; if the cost reduces to 25% of the current value, atorvastatin 80 mg/day will be the most cost-effective treatment for thresholds between £5000 and £30,000 per QALY. Large long-term RCTs reporting effects in terms of clinical events are required to determine the optimum statin use for subgroups." @default.
• W1996993842 created "2016-06-24" @default.
• W1996993842 creator A5043750952 @default.
• W1996993842 creator A5049040242 @default.
• W1996993842 creator A5051652828 @default.
• W1996993842 creator A5070119593 @default.
• W1996993842 creator A5075563674 @default.
• W1996993842 date "2009-07-01" @default.
• W1996993842 modified "2023-10-16" @default.
• W1996993842 title "Early high-dose lipid-lowering therapy to avoid cardiac events: a systematic review and economic evaluation" @default.
• W1996993842 cites W116577846 @default.
• W1996993842 cites W131464745 @default.
• W1996993842 cites W14052386 @default.
• W1996993842 cites W141766886 @default.
• W1996993842 cites W142764086 @default.
• W1996993842 cites W1488603340 @default.
• W1996993842 cites W1502524639 @default.
• W1996993842 cites W1510386142 @default.
• W1996993842 cites W1517555081 @default.
• W1996993842 cites W1521266957 @default.
• W1996993842 cites W1524299374 @default.
• W1996993842 cites W1524506629 @default.
• W1996993842 cites W1533985811 @default.
• W1996993842 cites W1541080151 @default.
• W1996993842 cites W1559018917 @default.
• W1996993842 cites W1566978789 @default.
• W1996993842 cites W1604547439 @default.
• W1996993842 cites W1642866390 @default.
• W1996993842 cites W1839390453 @default.
• W1996993842 cites W1922625321 @default.
• W1996993842 cites W1933463071 @default.
• W1996993842 cites W195680707 @default.
• W1996993842 cites W1963791423 @default.
• W1996993842 cites W1964054283 @default.
• W1996993842 cites W1964729842 @default.
• W1996993842 cites W1965201020 @default.
• W1996993842 cites W1966000886 @default.
• W1996993842 cites W1966427471 @default.
• W1996993842 cites W1966444218 @default.
• W1996993842 cites W1966817707 @default.
• W1996993842 cites W1966897685 @default.
• W1996993842 cites W1969006368 @default.
• W1996993842 cites W1969825830 @default.
• W1996993842 cites W1970616811 @default.
• W1996993842 cites W1972203198 @default.
• W1996993842 cites W1973185874 @default.
• W1996993842 cites W1973885488 @default.
• W1996993842 cites W1977192972 @default.
• W1996993842 cites W1979038033 @default.
• W1996993842 cites W1981501248 @default.
• W1996993842 cites W1983634599 @default.
• W1996993842 cites W1984386330 @default.
• W1996993842 cites W1984603222 @default.
• W1996993842 cites W1986348763 @default.
• W1996993842 cites W1987478572 @default.
• W1996993842 cites W1988516867 @default.
• W1996993842 cites W1989133590 @default.
• W1996993842 cites W1991216993 @default.
• W1996993842 cites W1992254924 @default.
• W1996993842 cites W1992287929 @default.
• W1996993842 cites W1993251788 @default.
• W1996993842 cites W1993282245 @default.
• W1996993842 cites W1993553202 @default.
• W1996993842 cites W1994032445 @default.
• W1996993842 cites W1994394357 @default.
• W1996993842 cites W1995067043 @default.
• W1996993842 cites W1996151477 @default.
• W1996993842 cites W1996607042 @default.
• W1996993842 cites W1996784517 @default.
• W1996993842 cites W1998094270 @default.
• W1996993842 cites W1998391689 @default.
• W1996993842 cites W2000967295 @default.
• W1996993842 cites W2001597243 @default.
• W1996993842 cites W2001774934 @default.
• W1996993842 cites W2002600726 @default.
• W1996993842 cites W2003307830 @default.
• W1996993842 cites W2003533903 @default.
• W1996993842 cites W2004539225 @default.
• W1996993842 cites W2004732013 @default.
• W1996993842 cites W2006312678 @default.
• W1996993842 cites W2007476930 @default.
• W1996993842 cites W2009054630 @default.
• W1996993842 cites W2010109270 @default.
• W1996993842 cites W2011277263 @default.
• W1996993842 cites W2013467349 @default.
• W1996993842 cites W2013504325 @default.
• W1996993842 cites W2014979672 @default.
• W1996993842 cites W2015323294 @default.
• W1996993842 cites W2016253197 @default.
• W1996993842 cites W2017494355 @default.
• W1996993842 cites W2017920919 @default.
• W1996993842 cites W2018711158 @default.
• W1996993842 cites W2018715171 @default.
• W1996993842 cites W2018938059 @default.
• W1996993842 cites W2019171200 @default.
• W1996993842 cites W2019219799 @default.
• W1996993842 cites W2019513999 @default.
• W1996993842 cites W2020628724 @default.
• W1996993842 cites W2021042232 @default.
• W1996993842 cites W2022555391 @default.

• next