Publications by authors named "Judith van Dalem"

5 Publications

  • Page 1 of 1

Thiazolidinediones and Glucagon-like Peptide-1 Receptor Agonists and the Risk of Nonalcoholic Fatty Liver Disease: A Cohort Study.

Hepatology 2021 Jun 15. Epub 2021 Jun 15.

CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands.

Thiazolidinediones (TZDs) and glucagon-like peptide-1 (GLP-1) receptor agonists are potential pharmacological treatment options for patients at risk of nonalcoholic fatty liver disease (NAFLD). Therefore, we examined the association between the risk of NAFLD and the use of thiazolidinediones and GLP-1 receptor agonists compared with the use of sulfonylureas (SUs) and insulins. Additionally, we calculated the incidence of hepatocellular carcinoma (HCC) in users of TZDs and GLP-1 receptor agonists. We conducted a population-based cohort study using primary care data from the Clinical Practice Research Datalink (CPRD) database (2007-2018). All patients aged ≥18 with a prescription of an oral glucose-lowering agent or GLP-1 receptor agonist were included. The first prescription defined the start of follow-up. The primary outcome was a new diagnosis of NAFLD. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the primary outcome. Incidence rates of HCC were determined per 1,000 person-years for all exposures. The study identified 207,367 adults with a prescription for a glucose-lowering agent. The risk of NAFLD was lower in patients prescribed a thiazolidinedione than in those prescribed a SU (adjusted HR [aHR], 0.32; 95% CI, 0.20-0.51). No difference in risk of NAFLD was observed comparing GLP-1 receptor agonist use with insulin use (aHR, 1.22; 95% CI, 0.91-1.63). Conclusion: Results of our study endorse the use of TZDs for selected patients at risk of NAFLD but do not support previous findings regarding the beneficial effect of GLP-1 receptor agonists. The low number of events in several subgroups may affect the generalizability of the current findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hep.32012DOI Listing
June 2021

Determinants of treatment modification before and after implementation of the updated 2015 NICE guideline on type 2 diabetes: A retrospective cohort study.

Diabetes Res Clin Pract 2021 Jun 21;176:108828. Epub 2021 Apr 21.

Department of Clinical Pharmacy, Maastricht University Medical Centre+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, the Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.

Aims: To identify patient-specific factors associated with early metformin treatment modification among type 2 diabetes patients before and after implementation of the updated 2015 NICE (National Institute for Health and Care Excellence) guideline.

Methods: We conducted a population-based cohort study using data from the Clinical Practice Research Datalink GOLD database (2009-2016). Patients ≥ 18 years, newly treated with metformin only, during the period of valid data collection were included. The first prescription defined start of follow-up. Determinants of treatment modification in two cohorts (before and after implementation of the updated guideline) were studied by time-dependent Cox proportional hazards regression.

Results: After implementation of the updated guideline, patients were less likely to receive sulphonylureas (62.3% vs 41.3%) or thiazolidediones (4.7% vs 2.2%) and more likely to receive dipeptidyl peptidase-4 inhibitors (15.8% vs 27.1%) or sodium-glucose cotransporter-2 inhibitors (0.8% vs 9.9%). Some determinants influenced general practitioners' prescribing differently after implementation of the updated guideline compared to before, including a high body mass index and heart failure.

Conclusions: Our results indicate that a first step towards tailored prescribing has been made. However, not all determinants that are important to consider when prescribing second-line glucose-lowering agents were of influence on general practitioners' prescribing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.diabres.2021.108828DOI Listing
June 2021

Risk of a first-ever acute myocardial infarction and all-cause mortality with sulphonylurea treatment: A population-based cohort study.

Diabetes Obes Metab 2018 04 27;20(4):1056-1060. Epub 2017 Dec 27.

Department of Clinical Pharmacy, Maastricht University Medical Centre+, Maastricht, The Netherlands.

We investigated the association between the current use of individual sulphonylureas and the risk of a first-ever acute myocardial infarction (AMI) and all-cause mortality, in a population-based cohort study, using primary care data from the Clinical Practice Research Datalink database (2004-2012). New users (N = 121 869), aged ≥18 years, with at least one prescription for a non-insulin antidiabetic agent were included. The first prescription defined start of follow-up. Time-dependent Cox proportional hazard models were used to estimate the risk of a first-ever AMI and all-cause mortality associated with the use of individual sulphonylureas, and other non-insulin glucose-lowering drugs. No differences in risk of a first-ever AMI (adjusted hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.70-1.50) or all-cause mortality (adjusted HR 0.97, 95% CI 0.80-1.17) were observed when comparing gliclazide use with non-gliclazide sulphonylurea use. Similar results were found for each individual sulphonylurea. As evidence is accumulating that gliclazide is no safer than other sulphonylureas, current guidelines suggesting superiority should be carefully evaluated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dom.13168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873381PMC
April 2018

Risk of hypoglycaemia in users of sulphonylureas compared with metformin in relation to renal function and sulphonylurea metabolite group: population based cohort study.

BMJ 2016 Jul 13;354:i3625. Epub 2016 Jul 13.

Department of Clinical Pharmacy, Maastricht University Medical Centre, Maastricht, Netherlands Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences Utrecht University, PO Box 80082, 3508 TB Utrecht, Netherlands.

Objective:  To determine the association between use of sulphonylureas and risk of hypoglycaemia in relation to renal function and sulphonylurea metabolic group compared with use of metformin.

Design:  Population based cohort study using routinely collected data from general practices in England.

Setting:  Clinical Practice Research Datalink (CPRD) database, 2004-12.

Participants:  120 803 new users of a non-insulin antidiabetic agent with at least one prescription and aged 18 years or more. The first prescription defined start of follow-up. Patients were followed until the end of data collection, a record for hypoglycaemia, or a blood glucose level of less than 3.0 mmol/L.

Main Outcome Measures:  Associations between sulphonylurea dose, renal impairment, type of sulphonylurea used, and risk of hypoglycaemia, were determined using Cox proportional hazard models. Adjustments were made for age, sex, lifestyle, comorbidity, and drug use.

Results:  The risk of hypoglycaemia in current users of sulphonylureas only was significantly increased compared with current users of metformin only (adjusted hazard ratio 2.50, 95% confidence interval 2.23 to 2.82). The higher risk in current users of sulphonylureas only was further increased in patients with an estimated glomerular filtration rate of less than 30 mL/min/1.73 m(2) (4.96, 3.76 to 6.55). The risk of hypoglycaemia was also significantly higher in patients with a high sulphonylurea dose (3.12, 2.68 to 3.62) and in current users of glibenclamide (7.48, 4.89 to 11.44). Gliclazide, the sulphonylurea of first choice, showed a similar risk of hypoglycaemia compared with other sulphonylureas.

Conclusions:  Sulphonylurea treatment in patients with a renal function of less than 30 mL/min/1.73 m(2) should be considered with caution. Moreover, an increased risk of hypoglycaemic events was observed among all users of sulphonylureas. This contrasts with several guidelines that recommend gliclazide as first choice sulphonylurea, and therefore requires further investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948031PMC
http://dx.doi.org/10.1136/bmj.i3625DOI Listing
July 2016

Interventions promoting adherence to cardiovascular medicines.

Int J Clin Pharm 2012 Apr 24;34(2):295-311. Epub 2012 Jan 24.

Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, FAFC Wentgebouw, Sorbonnelaan 16, 3584 CA, Utrecht, The Netherlands.

Background: Cardiovascular diseases (CVDs) are a large burden on the healthcare system. Medicines are the primary treatment for these diseases; however, adherence to therapy is low. To optimise treatment and health outcomes for patients, it is important that adherence to cardiovascular medicines is maintained at an optimal level. Therefore, identifying effective interventions to improve adherence and persistence to cardiovascular therapy is of great significance.

Aim Of The Review: This paper presents a review of the literature on interventions used in the community setting which aim to improve adherence to cardiovascular medicines in patients with hypertension, dyslipidaemia, congestive heart failure or ischaemic heart disease.

Methods: Several databases (Medline, EMBASE, PsychINFO, IPA, CINAHL, Pubmed, Cochrane) were searched for studies which were published from 1979-2009, evaluated interventions intended to improve adherence to cardiovascular medicines in the community setting, had at least one measure of adherence, and consisted of an intervention and comparison/control group.

Results: Among 36 eligible studies (consisting of 7 informational, 15 behavioural, 1 social, and 13 combined strategy interventions), 17 (1 informational, 10 behavioural, and 6 combined) reported a significant improvement in adherence and/or persistence. Behavioural interventions were the most successful. Twenty-one studies (4 informational, 9 behavioural, and 8 combined) also demonstrated improvements in clinical outcomes, though, effects were frequently variable, contradictory and not related to changes in adherence.

Conclusion: Several types of interventions are effective in improving adherence and/or persistence within the CVD area and in the community setting. Behavioural interventions have shown the greatest success (compared to other types of interventions); and adding informational strategies has not resulted in further improvements in adherence. Improving adherence and persistence to cardiovascular medicines is a dynamic process that is influenced by many factors, and one which requires long term multiple interventions to promote medicine taking in patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11096-012-9607-5DOI Listing
April 2012
-->