Biomedical subjects

F Pelagotti

Publications and source records attributed to F Pelagotti.

2 recordsLinked to original sources

PubMed2003

Dropout rates with olanzapine or risperidone: a multi-centre observational study.

OBJECTIVE: In patients with schizophrenia, risperidone and olanzapine are the two most commonly used atypical anti-psychotics. A recent meta-analysis based on randomized trials suggests that, in the long term, olanzapine can have a lower frequency of treatment discontinuation (or dropout) in comparison with risperidone. To better test this hypothesis, our observational study was aimed at assessing whether or not this advantage of olanzapine versus risperidone could be confirmed in a patient series examined in an observational setting. METHODS: Our study was based on a retrospective multi-centre observational design. We collected the following information from each patient: demographic characteristics; current anti-psychotic treatment (olanzapine or risperidone, under the condition of a stable therapy over months -1 to -4); cumulative dose of the drug; previous anti-psychotic treatment (during months -5, -6, -7 and/or, when available, also before month -7); daily dose and treatment duration. Our primary analysis traced back the patient's history from the date of enrollment retrospectively up to month -7. The secondary analysis followed-up the patient's history prior to month -7, thus extending this retrospective recording as long as possible (depending on what information was actually available for individual patients). RESULTS: The patients were enrolled from 31 institutions. In our primary analysis (months -1 to -7), a total of 144 patients were included; in this subgroup treated with olanzapine or risperidone as initial drug ( n=94), we observed 4 of 54 switches from olanzapine to risperidone and 11 of 40 switches from risperidone to olanzapine ( P=0.01). A total of 454 patients were enrolled in our secondary analysis (from month -1 up to month -73); the same comparison showed 9 of 236 switches from olanzapine to risperidone and 17 of 150 switches from risperidone to olanzapine ( P=0.004). CONCLUSION: Our analysis confirms the results of a recent meta-analysis and shows that olanzapine might imply a lower risk of dropout than risperidone.

Adult↗

PubMed2003

Use of gabexate mesylate in Italian hospitals: a multicentre observational study.

INTRODUCTION: Gabexate mesylate has been proposed as a therapeutic or prophylactic agent in a variety of diseases (e.g. disseminated intravascular coagulation, prophylaxis of pancreatic damage and acute pancreatitis), but its clinical effectiveness is still unclear. As the drug is widely used in Italy, we conducted an observational study to determine the pattern of prescription of gabexate in Italian hospitals and to assess the outcome of patients with acute pancreatitis when this treatment is given. An updated meta-analysis of the use of the drug is also presented. MATERIALS AND METHODS: From 20 May to 20 July 2001, all consecutive patients admitted to 13 Italian hospitals were enrolled. The following information was recorded from each patient: indication for the use of gabexate, total dose and duration of gabexate administration, need for surgical treatment and outcome of hospitalization (alive or dead). In the patient subgroup with acute pancreatitis, the outcome data of our observational study were compared with those reported by the randomized trials (RCTs) previously published. For this purpose, the survival data of the RCTs were summarized in an updated meta-analysis. RESULTS: A total of 170 patients were enrolled in the study. The main clinical indications were acute pancreatitis in 88 cases (52%) and prophylaxis of pancreatic damage in 62 cases (36%). At the end of the study, 80 of the 88 patients treated for acute pancreatitis (91%) were alive and eight (9%) had died. In the subgroup of patients with necrotic-haemorrhagic pancreatitis (n = 10), six died during the observation period. Our meta-analysis showed that gabexate mesylate did not improve survival in comparison with placebo. The meta-analytic odds ratio was 0.70 (95% CI: 0.45-1.09). DISCUSSION: The study described the pattern of use of gabexate mesylate in Italian hospitals and provided information on the outcome of the subgroup treated for acute pancreatitis. A meta-analysis of current data from RCTs, together with our findings, indicates that gabexate mesylate does not significantly improve survival in acute pancreatitis.

Acute Disease↗