Skip header and navigation

Refine By

69 records – page 1 of 7.

11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).

https://arctichealth.org/en/permalink/ahliterature149701
Source
Lancet. 2009 Aug 22;374(9690):620-7
Publication Type
Article
Date
Aug-22-2009
Author
Jari Tiihonen
Jouko Lönnqvist
Kristian Wahlbeck
Timo Klaukka
Leo Niskanen
Antti Tanskanen
Jari Haukka
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio and Niuvanniemi Hospital, Department of Clinical Physiology, Kuopio University Hospital, Kuopio, Finland. jari.tiihonen@niuva.fi
Source
Lancet. 2009 Aug 22;374(9690):620-7
Date
Aug-22-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Antipsychotic Agents - adverse effects
Case-Control Studies
Cause of Death
Clozapine - adverse effects
Dibenzothiazepines - adverse effects
Drug Utilization - trends
Female
Finland - epidemiology
Follow-Up Studies
Health Status Disparities
Humans
Life expectancy
Male
Middle Aged
Patient Readmission - statistics & numerical data
Perphenazine - adverse effects
Proportional Hazards Models
Registries
Risk factors
Schizophrenia - drug therapy - mortality
Sex Distribution
Time Factors
Abstract
The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.
Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5.2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.
Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up, the gap in life expectancy between patients with schizophrenia and the general population did not widen between 1996 (25 years), and 2006 (22.5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1.41, 95% CI 1.09-1.82), and the lowest risk for clozapine (0.74, 0.60-0.91; p=0.0045 for the difference between clozapine vs perphenazine, and p
Notes
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897117
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897118
Comment In: Lancet. 2009 Aug 22;374(9690):590-219595448
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897121
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897120
PubMed ID
19595447 View in PubMed
Less detail
Source
Psychother Psychosom. 2011;80(6):359-64
Publication Type
Article
Date
2011
Author
Kirsi Honkalampi
Soili M Lehto
Heli Koivumaa-Honkanen
Jukka Hintikka
Leo Niskanen
Minna Valkonen-Korhonen
Heimo Viinamäki
Author Affiliation
Kuopio Psychiatric Center, Kuopio, Finland. kirsi.honkalampi @ kuh.fi
Source
Psychother Psychosom. 2011;80(6):359-64
Date
2011
Language
English
Publication Type
Article
Keywords
Affective Symptoms - diagnosis - immunology - pathology
Biological Markers - blood
C-Reactive Protein - metabolism
Cluster analysis
Depression - immunology - pathology
Female
Finland
Health Surveys
Humans
Inflammation - diagnosis - immunology - pathology
Interleukin-6 - blood
Logistic Models
Male
Middle Aged
Psychiatric Status Rating Scales
Registries
Abstract
Altered immune responses are seen in depression, and recent data suggest that similar changes could also be observable in alexithymia. We examined whether the inflammatory markers high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 are independently related to alexithymia or its factors in a population-based sample.
This study formed a clinical part of the Kuopio Depression (KUDEP) general population study focusing on the mental health of a general population of adults aged 25-64 years (n = 308). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20), and depressive symptoms were assessed using the Beck Depression Inventory (BDI-21).
The levels of IL-6 (in picograms per milliliter) and hs-CRP (in milligrams per liter) were significantly higher in alexithymic than in nonalexithymic subjects (IL-6 effect size, ES: 0.50; hs-CRP ES: 0.27). The BDI scores, hs-CRP and IL-6 explained 33.5% of the variation in TAS scores in the whole study population. According to logistic regression analysis, hs-CRP but not IL-6 increased the likelihood of belonging to the alexithymic group. This observation remained unaltered after additional adjustments for chronic inflammation-related disorders, the use of inflammation-modulating medications and depressive symptoms.
Our findings suggest that the association between hs-CRP and alexithymia resembles that observed in depressed patients. It is, however, independent of depressive symptoms. These findings widen our view on the stress-alexithymia concept.
PubMed ID
21829048 View in PubMed
Less detail

Anthropometry, bioelectrical impedance and dual-energy X-ray absorptiometry in the assessment of body composition in elderly Finnish women.

https://arctichealth.org/en/permalink/ahliterature187518
Source
Clin Physiol Funct Imaging. 2002 Nov;22(6):383-91
Publication Type
Article
Date
Nov-2002
Author
Irja Haapala
Anu Hirvonen
Leo Niskanen
Matti Uusitupa
Heikki Kröger
Esko Alhava
Aulikki Nissinen
Author Affiliation
Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland. irja.haapala@uku.fi
Source
Clin Physiol Funct Imaging. 2002 Nov;22(6):383-91
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Aged
Body Composition
Body Weight
Electric Impedance
Epidemiologic Methods
Female
Finland
Humans
Middle Aged
Predictive value of tests
Abstract
In this study, the bioelectrical impedance analysis (BIA), skinfold thickness measurement (STM) and dual-energy X-ray absorptiometry (DXA), as a reference method, were compared with each other in the assessment of body composition in elderly (62-72-year-old) Finnish women (n=93). BIA had better agreement with DXA in the assessment of fat free mass (FFM, R2=0.70, Sres=2.1) and fat mass (FM, R2=0.93, Sres=2.3) than the STM (FFM, R2=0.62, Sres=2.4; FM, R2=0.89,Sres=2.8). There was quite a large variation in the estimates when different BIA prediction equations were used. The equation developed in this study, FFM (kg)=-128.06 + 1.85 x BMI-0.63 x weight + 1.07 x height - 0.03 x resistance +10.0 x waist-hip ratio, yielded a small and unbiased error (0.5 +/- 1.6 kg), with a small residual standard deviation (R2=0.83, Sres=1.6). However, error associated with the estimate of FM was positively related to the degree of FM. BIA(Heitmann) equation yielded unbiased estimates of both FFM and FM (FFM, R2=0.77, Sres=1.8; FM, R2=0.95, Sres=1.9). Both the STM and BIA (manufacturer's equation) resulted in error which was statistically significant and positively correlated with FFM and FM. These results indicate that BIA prediction equations, chosen with care, can improve the performance of equations based upon anthropometric measurements alone in the assessment of body composition in elderly women.
PubMed ID
12464142 View in PubMed
Less detail

Association of follicle-stimulating hormone levels and risk of type 2 diabetes in older postmenopausal women.

https://arctichealth.org/en/permalink/ahliterature291332
Source
Menopause. 2017 Jul; 24(7):796-802
Publication Type
Journal Article
Date
Jul-2017
Author
Elizabeth R Bertone-Johnson
Jyrki K Virtanen
Leo Niskanen
Tarja Nurmi
Kimmo Ronkainen
Sari Voutilainen
Jaakko Mursu
Jussi Kauhanen
Tomi-Pekka Tuomainen
Author Affiliation
1Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 2Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland 3Department of Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland 4Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Source
Menopause. 2017 Jul; 24(7):796-802
Date
Jul-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Blood Glucose - analysis
Diabetes Mellitus, Type 2 - epidemiology - etiology
Female
Finland - epidemiology
Follicle Stimulating Hormone - blood
Follow-Up Studies
Humans
Incidence
Insulin - blood
Insulin Resistance
Middle Aged
Odds Ratio
Postmenopause - blood
Prevalence
Prospective Studies
Risk factors
Abstract
Recent studies of perimenopausal women have observed associations of follicle-stimulating hormone (FSH) levels with markers of insulin resistance, independent of estradiol. Whether FSH is related to type 2 diabetes (T2D) in older women who have completed the menopause transition remains unknown. We assessed the association of FSH levels with diabetes and measures of insulin resistance among 588 postmenopausal Finnish women.
Study participants were aged 53 to 73 years and not using hormone therapy at baseline (1998-2001) when FSH was measured. Prevalence of T2D was assessed at baseline, along with fasting insulin and glucose levels. Incident T2D, and insulin and glucose levels were assessed 7 to 9 years later at follow-up examination.
After adjustment for age, estradiol, body mass index, smoking, lipids levels, and other factors, women with higher FSH (>50?IU/L) had a lower prevalence of T2D (odds ratio 0.49, 95% confidence interval [CI] 0.28-0.86) than women with lower FSH. Each 1 unit increase in FSH level was associated with a significant 1.9% lower risk of T2D (95% CI 0.966-0.997, P?=?0.02). Higher FSH was associated with marginally significant lower incidence of T2D at follow-up (hazard ratio 0.53, 95% CI 0.27-1.02). Baseline FSH levels were inversely correlated with fasting insulin and glucose levels at both baseline and follow-up visits (all P?
PubMed ID
28141661 View in PubMed
Less detail

Association of serum 25-hydroxyvitamin D with lifestyle factors and metabolic and cardiovascular disease markers: population-based cross-sectional study (FIN-D2D).

https://arctichealth.org/en/permalink/ahliterature260969
Source
PLoS One. 2014;9(7):e100235
Publication Type
Article
Date
2014
Author
Maija E Miettinen
Leena Kinnunen
Jaana Leiviskä
Sirkka Keinänen-Kiukaanniemi
Eeva Korpi-Hyövälti
Leo Niskanen
Heikki Oksa
Timo Saaristo
Jaakko Tuomilehto
Mauno Vanhala
Matti Uusitupa
Markku Peltonen
Source
PLoS One. 2014;9(7):e100235
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Biological Markers - metabolism
Cardiovascular Diseases - blood - epidemiology - metabolism
Cross-Sectional Studies
Female
Finland - epidemiology
Glucose - metabolism
Humans
Life Style
Male
Metabolic Syndrome X - blood - epidemiology - metabolism
Middle Aged
Vitamin D - analogs & derivatives - blood
Abstract
Low serum 25-hydroxyvitamin D (25OHD) level has been associated with an increased risk of several chronic diseases. Our aim was to determine lifestyle and clinical factors that are associated with 25OHD level and to investigate connection of 25OHD level with metabolic and cardiovascular disease markers.
In total, 2868 Finnish men and women aged 45-74 years participated in FIN-D2D population-based health survey in 2007. Participants that had a serum sample available (98.4%; n?=?2822) were included in this study. 25OHD was measured with chemiluminescent microparticle immunoassay method.
The mean 25OHD level was 58.2 nmol/l in men (n?=?1348) and 57.1 nmol/l in women (n?=?1474). Mean 25OHD level was lower in the younger age groups than in the older ones (p
Notes
Cites: Diabetologia. 2012 Aug;55(8):2173-8222526608
Cites: Eur Biophys J. 2009 Feb;38(2):145-5818797861
Cites: Br J Nutr. 2012 Nov 14;108(9):1557-6122264449
Cites: Atherosclerosis. 2013 Jan;226(1):245-5123159013
Cites: PLoS Med. 2013;10(2):e100138323393431
Cites: Eur J Nutr. 2013 Mar;52(2):513-2522538929
Cites: Pediatr Nephrol. 2013 Apr;28(4):605-1023239393
Cites: Clin Chem. 2013 May;59(5):771-8023503722
Cites: J Clin Endocrinol Metab. 2013 Jul;98(7):3001-923666975
Cites: Endocrinology. 2013 Sep;154(9):3022-3023825120
Cites: Eur J Nutr. 2014;53(2):367-7424292820
Cites: Clin Endocrinol (Oxf). 2014 Apr;80(4):502-723452164
Cites: J Steroid Biochem Mol Biol. 2014 Oct;144 Pt A:232-624189546
Cites: FASEB J. 2008 Dec;22(12):4044-5418716026
Cites: N Z Med J. 2007;120(1262):U273017891218
Cites: Osteoporos Int. 2009 Mar;20(3):417-2518629568
Cites: Eur Heart J. 2009 Mar;30(6):710-718676970
Cites: Clin Endocrinol (Oxf). 2009 Jun;70(6):870-518771560
Cites: Circulation. 2009 Oct 20;120(16):1640-519805654
Cites: J Am Coll Nutr. 2009 Jun;28(3):252-620150598
Cites: J Nutr. 2010 May;140(5):987-9120237070
Cites: J Intern Med. 2010 May;267(5):462-7220141565
Cites: PLoS One. 2010;5(5):e1080120520739
Cites: Curr Opin Pharmacol. 2010 Aug;10(4):482-9620427238
Cites: Nutr Clin Pract. 2010 Aug;25(4):340-620702838
Cites: Diabetes Care. 2010 Sep;33(9):2021-320805275
Cites: Eur J Nutr. 2010 Oct;49(7):401-720204652
Cites: Diabetes Care. 2010 Oct;33(10):2146-5120664020
Cites: Joint Bone Spine. 2010 Dec;77(6):552-721067953
Cites: J Nutr Health Aging. 2011 May;15(5):349-5421528160
Cites: J Clin Endocrinol Metab. 2011 Sep;96(9):2851-6021715529
Cites: Prog Lipid Res. 2011 Oct;50(4):303-1221640757
Cites: J Clin Endocrinol Metab. 2011 Oct;96(10):2997-300621795448
Cites: Diabetes Metab Res Rev. 2012 Jul;28(5):418-2322318870
Cites: Calcif Tissue Int. 1988 Oct;43(4):199-2013145124
Cites: Stroke. 2004 Oct;35(10):2248-5215345795
Cites: Eur J Clin Nutr. 1999 Dec;53(12):920-610602348
Cites: J Immunol. 2000 Mar 1;164(5):2405-1110679076
Cites: Am J Clin Nutr. 2000 Sep;72(3):690-310966885
Cites: Am J Clin Nutr. 2004 May;79(5):820-515113720
Cites: J Clin Invest. 1985 Oct;76(4):1536-82997282
Cites: Circulation. 1990 Aug;82(2):495-5062372896
Cites: Circulation. 1991 Jan;83(1):356-621984895
Cites: Diabetes. 2008 Feb;57(2):298-30518003755
Cites: Nutr J. 2008;7:418226257
Cites: J Am Coll Cardiol. 2008 Jul 22;52(4):293-918634985
Cites: Lancet. 2008 Jul 19;372(9634):224-3318640459
Cites: Am J Clin Nutr. 2008 Aug;88(2):582S-586S18689406
Cites: Arch Intern Med. 2008 Aug 11;168(15):1629-3718695076
Cites: Ann Epidemiol. 1992 Sep;2(5):697-7031342321
Cites: Eur J Endocrinol. 1997 Nov;137(5):495-5029405029
Cites: Am J Clin Nutr. 2005 Sep;82(3):517-2216155262
Cites: Am J Clin Nutr. 2006 Jul;84(1):18-2816825677
Cites: Am J Clin Nutr. 2007 Jan;85(1):6-1817209171
Cites: J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):786-9217215122
Cites: J Epidemiol Community Health. 2007 May;61(5):449-5417435214
Cites: Int J Circumpolar Health. 2007 Apr;66(2):101-1217515250
Cites: J Clin Endocrinol Metab. 2007 Jun;92(6):2058-6517341569
Cites: N Engl J Med. 2007 Jul 19;357(3):266-8117634462
Cites: Am J Clin Nutr. 2007 Sep;86(3):714-717823437
Cites: Int J Cancer. 2012 Dec 15;131(12):2754-6222961494
PubMed ID
25000408 View in PubMed
Less detail

Berries reduce postprandial insulin responses to wheat and rye breads in healthy women.

https://arctichealth.org/en/permalink/ahliterature116740
Source
J Nutr. 2013 Apr;143(4):430-6
Publication Type
Article
Date
Apr-2013
Author
Riitta Törrönen
Marjukka Kolehmainen
Essi Sarkkinen
Kaisa Poutanen
Hannu Mykkänen
Leo Niskanen
Author Affiliation
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Source
J Nutr. 2013 Apr;143(4):430-6
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Bread
Cross-Over Studies
Diet
Dietary Carbohydrates - administration & dosage
Female
Finland
Fragaria
Fruit
Humans
Insulin - blood
Middle Aged
Photinia
Postprandial Period - physiology
Ribes
Secale cereale
Single-Blind Method
Starch - administration & dosage
Triticum
Vaccinium macrocarpon
Vaccinium myrtillus
Vaccinium vitis-idaea
Abstract
Starch in white wheat bread (WB) induces high postprandial glucose and insulin responses. For rye bread (RB), the glucose response is similar, whereas the insulin response is lower. In vitro studies suggest that polyphenol-rich berries may reduce digestion and absorption of starch and thereby suppress postprandial glycemia, but the evidence in humans is limited. We investigated the effects of berries consumed with WB or RB on postprandial glucose and insulin responses. Healthy females (n = 13-20) participated in 3 randomized, controlled, crossover, 2-h meal studies. They consumed WB or RB, both equal to 50 g available starch, with 150 g whole-berry purée or the same amount of bread without berries as reference. In study 1, WB was served with strawberries, bilberries, or lingonberries and in study 2 with raspberries, cloudberries, or chokeberries. In study 3, WB or RB was served with a mixture of berries consisting of equal amounts of strawberries, bilberries, cranberries, and blackcurrants. Strawberries, bilberries, lingonberries, and chokeberries consumed with WB and the berry mixture consumed with WB or RB significantly reduced the postprandial insulin response. Only strawberries (36%) and the berry mixture (with WB, 38%; with RB, 19%) significantly improved the glycemic profile of the breads. These results suggest than when WB is consumed with berries, less insulin is needed for maintenance of normal or slightly improved postprandial glucose metabolism. The lower insulin response to RB compared with WB can also be further reduced by berries.
PubMed ID
23365108 View in PubMed
Less detail

Body mass index and bone loss among postmenopausal women: the 10-year follow-up of the OSTPRE cohort.

https://arctichealth.org/en/permalink/ahliterature131092
Source
J Bone Miner Metab. 2012 Mar;30(2):208-16
Publication Type
Article
Date
Mar-2012
Author
Jarmo Saarelainen
Vesa Kiviniemi
Heikki Kröger
Marjo Tuppurainen
Leo Niskanen
Jukka Jurvelin
Risto Honkanen
Author Affiliation
Bone and Cartilage Research Unit, Clinical Research Center, University of Eastern Finland, P. O. Box 1627, 70211, Kuopio, Finland. jtsaarel@hytti.uku.fi
Source
J Bone Miner Metab. 2012 Mar;30(2):208-16
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Body Height - physiology
Body mass index
Body Weight - physiology
Bone Density - physiology
Bone Resorption - physiopathology
Cohort Studies
Female
Finland - epidemiology
Follow-Up Studies
Humans
Linear Models
Middle Aged
Osteoporosis, Postmenopausal - epidemiology - physiopathology - prevention & control
Postmenopause - physiology
Reference Values
Risk factors
Time Factors
Abstract
Obesity protects against osteoporosis, but the magnitude of this association has been difficult to assess from cross-sectional or short term studies. We examined the time course of bone loss as a function of body mass index (BMI) in early and late postmenopausal women. Our study population (n = 300) was a random sample of the population-based Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study, Finland. We excluded women without complete BMD results, premenopausal women during the second bone densitometry and women who had used hormone replacement therapy, bisphosphonates or calcitonin. BMI along with femoral neck and spinal bone mineral density (BMD) were assessed three times by dual-energy X-ray absorptiometry during a mean follow-up of 10.5 years (SD 0.5). The mean baseline age was 53.6 years (SD 2.8), time since menopause 2.9 years (SD 4.3) and BMI 27.3 kg/m(2) (SD 4.4). The data was analyzed by linear mixed models. Thus, we were able to approximate the bone loss up to 20 postmenopausal years. To illustrate, a woman with a baseline BMI of 20 kg/m(2) became osteopenic 2 (spine) and 4 (femoral neck) years after menopause, while obesity (BMI of 30 kg/m(2)) delayed the incidence of osteopenia by 5 (spine) and 9 (femoral neck) years, respectively. The delay was due to high baseline BMD of the obese, while bone loss rate was similar for both lean and obese subjects. This lean versus obese difference may also be partly due to altered X-ray attenuation due to fat mass.
PubMed ID
21938384 View in PubMed
Less detail

Cardiometabolic profile of people screened for high risk of type 2 diabetes in a national diabetes prevention programme (FIN-D2D).

https://arctichealth.org/en/permalink/ahliterature138828
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Publication Type
Article
Date
Dec-2010
Author
Timo Saaristo
Leena Moilanen
Jari Jokelainen
Eeva Korpi-Hyövälti
Mauno Vanhala
Juha Saltevo
Leo Niskanen
Markku Peltonen
Heikki Oksa
Henna Cederberg
Jaakko Tuomilehto
Matti Uusitupa
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Pirkanmaa Hospital District, Tampere, Finland. timo.saaristo@pshp.fi
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Blood Glucose - analysis
Cardiovascular Diseases - epidemiology
Chi-Square Distribution
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology - prevention & control
Diabetes, Gestational - blood - epidemiology
Female
Finland
Glucose Intolerance - blood - epidemiology
Glucose Tolerance Test
Humans
Male
Mass Screening - methods
Middle Aged
National Health Programs
Predictive value of tests
Pregnancy
Primary Health Care
Risk assessment
Risk factors
Abstract
To study screening of high-risk individuals as part of a national diabetes prevention programme in primary health care settings in Finland between 2003 and 2007, and evaluate the cardiometabolic risk profile of persons identified for intervention.
High-risk individuals were identified by the Finnish Diabetes Risk Score (FINDRISC), history of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), cardiovascular disease (CVD), or gestational diabetes. Participants subsequently underwent an oral glucose tolerance test. CVD morbidity risk was estimated by the Framingham Study Risk Equation and CVD mortality risk by the Systematic Coronary Risk Evaluation Formula (SCORE).
A high-risk cohort of 10,149 (of whom 30.3% men) was identified (mean age 54.7 for men, 53.0 for women). Altogether 18.8% of men and 11.5% of women had screen-detected diabetes. In total 68.1% of men and 49.4% of women had abnormal glucose tolerance (IFG, IGT or screen-detected diabetes). Furthermore, 43.2% and 41.5% of men, and 13.3% and 11.3% of women, respectively, had a high predicted risk of CVD morbidity or mortality.
Prevalence of dysglycemia including undiagnosed diabetes and the predicted risk for CVD was alarmly high in the identified high-risk cohort, particularly in men.
PubMed ID
21134669 View in PubMed
Less detail

Cost-effectiveness of insulin detemir compared with NPH insulin in people with type 2 diabetes in Denmark, Finland, Norway, and Sweden.

https://arctichealth.org/en/permalink/ahliterature116567
Source
J Med Econ. 2013;16(4):468-78
Publication Type
Article
Date
2013
Author
Martin Ridderstråle
Marie Markert Jensen
Rasmus Prior Gjesing
Leo Niskanen
Author Affiliation
Department of Endocrinology, Skåne University Hospital, Malmö, Sweden. martin.ridderstrale@med.lu.se
Source
J Med Econ. 2013;16(4):468-78
Date
2013
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - drug therapy - economics
Finland
Humans
Hypoglycemia - chemically induced - economics
Hypoglycemic Agents - economics - therapeutic use
Insulin, Isophane - economics - therapeutic use
Insulin, Long-Acting - economics - therapeutic use
Models, Economic
Quality-Adjusted Life Years
Reproducibility of Results
Scandinavia
Weight Gain
Abstract
To assess the cost-effectiveness of insulin detemir compared with Neutral Protamine Hagedorn (NPH) insulin when initiating insulin treatment in people with type 2 diabetes mellitus (T2DM) in Denmark, Finland, Norway, and Sweden.
Efficacy and safety data were derived from a 20-week multi-centre randomized controlled head-to-head clinical trial comparing insulin detemir and NPH insulin in insulin naïve people with T2DM, and short-term (1-year) cost effectiveness analyses were performed. As no significant differences in HbA1c were observed between the two treatment arms, the model was based on significant differences in favour of insulin detemir in frequency of hypoglycaemia (Rate-Ratio?=?0.52; CI?=?0.44-0.61) and weight gain (??=?0.9?kg). Model outcomes were measured in Quality Adjusted Life Years (QALYs) using published utility estimates. Acquisition costs for insulin and direct healthcare costs associated with non-severe hypoglycaemic events were obtained from National Health Service public sources. One-way and probabilistic sensitivity analyses were performed.
Based on lower incidence of non-severe hypoglycaemic events and less weight gain, the QALY gain from initiating treatment with insulin detemir compared with NPH insulin was 0.01 per patient per year. Incremental cost-effectiveness ratios for the individual countries were: Denmark, Danish Kroner 170,852 (€22,933); Finland, €28,349; Norway, Norwegian Kroner 169,789 (€21,768); and Sweden, Swedish Krona 226,622 (€25,097) per QALY gained. Possible limitations of the study are that data on hypoglycaemia and relative weight benefits from a clinical trial were combined with hypoglycaemia incidence data from observational studies. These populations may have slightly different patient characteristics.
The lower risk of non-severe hypoglycaemia and less weight gain associated with using insulin detemir compared with NPH insulin when initiating insulin treatment in insulin naïve patients with type 2 diabetes provide economic benefits in the short-term. Based on cost/QALY threshold values, this represents good value for money in the Nordic countries. Using a short-term modelling approach may be conservative, as reduced frequency of hypoglycaemia and less weight gain may also have positive long-term health-related implications.
PubMed ID
23384160 View in PubMed
Less detail

Cost-effectiveness of statins in the prevention of coronary heart disease events in middle-aged Finnish men.

https://arctichealth.org/en/permalink/ahliterature157163
Source
Curr Med Res Opin. 2008 Jun;24(6):1823-32
Publication Type
Article
Date
Jun-2008
Author
Piia Peura
Janne Martikainen
Erkki Soini
Taru Hallinen
Leo Niskanen
Author Affiliation
Department of Social Pharmacy, Center for Pharmaceutical Policy and Economics (CEPPE), University of Kuopio, Kuopio, Finland. Piia.Peura@uku.fi
Source
Curr Med Res Opin. 2008 Jun;24(6):1823-32
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Cohort Studies
Coronary Disease - prevention & control
Cost-Benefit Analysis
Finland
Fluorobenzenes - economics - therapeutic use
Heptanoic Acids - economics - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - economics - therapeutic use
Life expectancy
Male
Markov Chains
Middle Aged
Pyrimidines - economics - therapeutic use
Pyrroles - economics - therapeutic use
Quality-Adjusted Life Years
Simvastatin - economics - therapeutic use
Sulfonamides - economics - therapeutic use
Abstract
This study evaluated the long-term cost-effectiveness of atorvastatin 20 mg, rosuvastatin 10 mg and simvastatin 40 mg in primary and secondary prevention of CHD in Finland.
The effect of statin therapy on the incidence of CHD and the expected total costs of the disease were described using a Markov state transition model. Due to the limited amount of evidence concerning mortality and morbidity for rosuvastatin, the model was used to transmute the efficiency data of all statins (decrease in total cholesterol) into long-term endpoints (myocardial infarction, death) using risk functions of the FINRISK and 4S studies. The study followed a characterized cohort of 55-year-old Finnish men with an average 3.3-6.6% baseline risk of dying from cardiovascular disease within a 10-year period.
Incremental cost-effectiveness ratios (ICERs) for atorvastatin and rosuvastatin, compared with simvastatin, measured as cost of life years gained (euro/LYG) and cost of quality adjusted life years gained (euro/QALY).
The use of rosuvastatin increased the life expectancy by 0.27 years on average (LYG) compared with simvastatin, producing additional 0.08 quality-adjusted life-years (QALYs). Compared with simvastatin, the cost of one LYG with rosuvastatin was euro10 834 and the cost of one QALY gained was euro36 548 (discount rate 5% per annum). Corresponding figures for atorvastatin were euro31 286/LYG and euro105 599/QALY.
If the decision makers' willingness to pay for a QALY gained is around euro40 000 there is a high probability (>50%) that rosuvastatin represents a cost-effective form of therapy in the prevention of CHD in middle-aged men with an average 3.3-6.6% risk of dying within 10 years from cardiovascular disease. However, the true clinical impact of these results needs confirmation from on-going clinical trials, as the role of rosuvastatin in reducing clinical events is pending, but for simvastatin and atorvastatin established.
PubMed ID
18485270 View in PubMed
Less detail

69 records – page 1 of 7.