+publisher:"University of Illinois – Chicago" +contributor:("Calip, Gregory S")

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University of Illinois – Chicago

1. Lee, Wan-Ju. Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults.

Degree: 2016, University of Illinois – Chicago

URL: http://hdl.handle.net/10027/21614

► This dissertation examined use of tumor necrosis factor-alpha inhibitors (TNFI) and risk of TNFI-associated serious infection compared to oral immunosuppressants in children and young adults… (more)

▼ This dissertation examined use of tumor necrosis factor-alpha inhibitors (TNFI) and risk of TNFI-associated serious infection compared to oral immunosuppressants in children and young adults with juvenile idiopathic arthritis (JIA)/rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). Four retrospective cohort studies were conducted using the Truven Health MarketScan Research Database (2009-2013). TNFI treatment patterns, early TNFI therapy rates, and time to TNFI initiation were examined in incident JIA/RA and IBD cohorts. Serious infections were defined as those requiring hospitalization. Cox proportional hazard models were used to estimate the risk of serious infection associated with TNFIs in JIA and IBD cohorts. High-dimensional propensity score models were used to control for potential confounding. In two studies examining treatment patterns, 18.6% of the incident JIA/RA cohort initiated TNFIs, and etanercept was most commonly used, while in the incident IBD cohort, 27.6% initiated TNFIs, and infliximab was most commonly used. In both cohorts, time from new diagnosis to first TNFI prescription was shorter in more recent years. Specifically, early TNFI therapy increased over time in the IBD cohort. In a third study, 2,495 JIA patients were followed for 1,810 person-years. Serious infection rates were 2.7/100 person-years for TNFIs and 1.28/100 person-years for disease-modifying antirheumatic drugs (DMARD). TNFI monotherapy posed a 2.7-fold increase in risk of serious infection compared to DMARDs alone. In the fourth study, 10,838 IBD patients were followed for 9,849 person-years. Serious infection rates were 5.25/100 person-years for TNFIs and 3.59/100 person-years for immunomodulators (methotrexate and thiopurines). New use of TNFI monotherapy was associated with a 1.36-fold higher risk of serious infection compared to immunomodulator initiation. The risk of serious infection differed by individual TNFIs and route of administration. This dissertation characterized the utilization of TNFIs and indicated that a more aggressive treatment approach has emerged for children and young adults with JIA/RA and IBD despite an FDA warning about TNFI-associated serious infections. However, study findings support the warning for children with JIA and IBD. This dissertation provides insights into how TNFIs are being used and informs decision-making about use of these drugs–particularly regarding balancing the benefits and risks of TNFIs. Advisors/Committee Members: Schumock, Glen T (advisor), Lee, Todd A (committee member), Calip, Gregory S (committee member), Suda, Katie J (committee member), Briars, Leslie (committee member), Schumock, Glen T (chair).

Subjects/Keywords: TNF inhibitors; infections

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APA (6^th Edition):

Lee, W. (2016). Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults. (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/21614

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Lee, Wan-Ju. “Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults.” 2016. Thesis, University of Illinois – Chicago. Accessed March 04, 2021. http://hdl.handle.net/10027/21614.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Lee, Wan-Ju. “Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults.” 2016. Web. 04 Mar 2021.

Vancouver:

Lee W. Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults. [Internet] [Thesis]. University of Illinois – Chicago; 2016. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/10027/21614.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Lee W. Utilization and Risk of Serious Infection Associated with TNF-α Inhibitors in Children and Young Adults. [Thesis]. University of Illinois – Chicago; 2016. Available from: http://hdl.handle.net/10027/21614

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

University of Illinois – Chicago

2. Samp, Jennifer C. Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease.

Degree: 2017, University of Illinois – Chicago

URL: http://hdl.handle.net/10027/21925

► Background: Treatment with a long-acting beta2-agonist (LABA) is an integral part of the guidelines for management of chronic obstructive pulmonary disease (COPD). Concurrent use of… (more)

▼ Background: Treatment with a long-acting beta2-agonist (LABA) is an integral part of the guidelines for management of chronic obstructive pulmonary disease (COPD). Concurrent use of a LABA and a long-acting muscarinic antagonist (LAMA) are believed to enhance bronchodilation due to the synergistic mechanisms of action. Only recently have fixed dose combination LABA/LAMA agents been developed which has resulted in a vast amount of efficacy and safety data from clinical trials. However, data remains lacking on the effectiveness and safety of LABA/LAMA in a broader population of COPD patients. Objectives: The aims of this research were to examine real-world effectiveness and safety of LABA/LAMA compared to LABA/inhaled corticosteroid (LABA/ICS) combination treatment. A secondary goal was to develop a predictive model to identify those at risk for COPD exacerbations among patients treated with LABA/LAMA or LABA/ICS. Methods: This was a retrospective, observational study utilizing administrative claims data among COPD patients initiating LABA/LAMA or LABA/ICS. Effectiveness was measured by comparing COPD exacerbation rates using Poisson regression models adjusted for baseline covariates. We examined cardiovascular and cerebrovascular safety outcomes by measuring hospitalizations with a primary diagnosis for acute coronary syndrome, heart failure, cardiac dysrhythmia, stroke, or transient ischemic attack. Time to event was compared using Cox proportional hazards models after matching patients 1 LABA/LAMA user to 4 LABA/ICS users) on propensity score. A predictive model of COPD exacerbations among LABA/LAMA or LABA/ICS users was developed using stepwise logistic regression in a training set of the original cohort. The test characteristics of the model were evaluated in the training set and validation set of patients. Results: Patients treated with the LABA/LAMA combination had similar exacerbation rates compared to those treated with LABA/ICS (adjusted incidence rate ratio of 0.98 [95% CI: 0.95 – 1.01]). Cardiovascular events in the LABA/LAMA cohort were lower than LABA/ICS (hazard ratio [HR]=0.794 [95% CI: 0.623-0.997]) but there was no significant difference in the risk of cerebrovascular events (HR=1.166 [95% CI 0.653-1.959]). The base predictive model resulted in a sensitivity of 41.6% and specificity of 85.5%. Other exploratory models resulted in similar test characteristics. Conclusions: In this real-world, observational study, exacerbations rates and cerebrovascular events were similar among patients treated with LABA/LAMA and LABA/ICS. Patients treated with LABA/LAMA had slightly lower risk of cardiovascular events. Further studies are recommended to confirm these findings. Finally, we were not able to develop a predictive model that identified patients at high risk for COPD exacerbations among patients treated with LABA/LAMA or LABA/ICS. Advisors/Committee Members: Lee, Todd A (advisor), Joo, Min J (committee member), Schumock, Glen T (committee member), Pickard, A S (committee member), Calip, Gregory S (committee member), Lee, Todd A (chair).

Subjects/Keywords: Chronic obstructive pulmonary disease

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Samp, J. C. (2017). Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease. (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/21925

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Samp, Jennifer C. “Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease.” 2017. Thesis, University of Illinois – Chicago. Accessed March 04, 2021. http://hdl.handle.net/10027/21925.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Samp, Jennifer C. “Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease.” 2017. Web. 04 Mar 2021.

Vancouver:

Samp JC. Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease. [Internet] [Thesis]. University of Illinois – Chicago; 2017. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/10027/21925.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Samp JC. Comparative Efficacy and Safety of Combination Treatments for Chronic Obstructive Pulmonary Disease. [Thesis]. University of Illinois – Chicago; 2017. Available from: http://hdl.handle.net/10027/21925

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

University of Illinois – Chicago

3. Xing, Shan. Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes.

Degree: 2017, University of Illinois – Chicago

URL: http://hdl.handle.net/10027/22207

► This dissertation evaluated the use of and comparative effects of second generation antipsychotics (SGAs) and non-SGA depression pharmacotherapies [bupropion, lithium, mirtazapine, tricyclic antidepressants (TCAs) and… (more)

▼ This dissertation evaluated the use of and comparative effects of second generation antipsychotics (SGAs) and non-SGA depression pharmacotherapies [bupropion, lithium, mirtazapine, tricyclic antidepressants (TCAs) and thyroid hormone] on diabetes outcomes in patients with pre-existing diabetes and depression who previously used a selective serotonin reuptake inhibitor or selective norepinephrine reuptake inhibitor. Three clinical studies compared 1) non-adherence and non-persistence to SGA versus non-SGA depression therapies, 2) non-adherence and non-persistence to oral antidiabetic drugs (OAD) between SGA and non-SGA users, and 3) SGA and non-SGA users on the risk of diabetes-related hospitalization or diabetes drug intensification. Use of SGAs was associated with a 1.8 times higher odds of non-adherence and a 1.4 times higher risk of non-persistence to therapy compared to non-SGA use. Also, SGA users had a 30-40% higher odds of a 10% or greater decline in OAD adherence compared to non-SGA users, while persistence to OAD therapy was similar between groups. Risk of diabetes of diabetes-related hospitalization or diabetes drug intensification was no different comparing SGA versus non-SGA users; however, there were differences when comparing specific treatment subgroups: bupropion was associated with a 15% reduced risk of diabetes-related hospitalization or treatment intensification compared to TCAs, quetiapine was associated with a 18% reduced risk of events compared to mirtazapine, and quetiapine was associated with a 16% reduced risk of events compared to TCAs. Differences for other subgroup comparisons between aripiprazole, quetiapine, bupropion, mirtazapine and TCAs were small and non-significant. Future studies are needed to access the impact of SGA and non-SGA therapies on other diabetes outcomes, including hemoglobin A1c, diabetic complications, and mortality. A fourth methodological study assessed the performance of full-cohort high dimensional propensity score (HDPS) matching approaches versus subgroup-specific HDPS approaches. The full-cohort HDPS matching approaches sometimes resulted in non-overlapping propensity score distributions, more imbalance in potential confounders, and greater than 10% change in effect estimates compared to the subgroup-specific approach. Therefore, examining covariate balance after matching to ensure that patient subgroups are balanced with respect to potential confounders is recommended if one of the full-cohort HDPS approaches are used. Advisors/Committee Members: Lee, Todd A (advisor), Calip, Gregory S (committee member), Leow, Alex D (committee member), Kim, Shiyun (committee member), Schumock, Glen T (committee member), Touchette, Daniel R (committee member), Lee, Todd A (chair).

Subjects/Keywords: Antipsychotic Agents High dimensional propensity score Depression Diabetes Comorbidity Pharmacoepidemiology

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Xing, S. (2017). Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes. (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/22207

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Xing, Shan. “Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes.” 2017. Thesis, University of Illinois – Chicago. Accessed March 04, 2021. http://hdl.handle.net/10027/22207.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Xing, Shan. “Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes.” 2017. Web. 04 Mar 2021.

Vancouver:

Xing S. Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes. [Internet] [Thesis]. University of Illinois – Chicago; 2017. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/10027/22207.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Xing S. Second Generation Antipsychotics and Diabetes Outcomes in Patients with Depression and Diabetes. [Thesis]. University of Illinois – Chicago; 2017. Available from: http://hdl.handle.net/10027/22207

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

University of Illinois – Chicago

4. Zueger, Patrick M. Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med).

Degree: 2018, University of Illinois – Chicago

URL: http://hdl.handle.net/10027/22618

► Hospice was founded with the primary goal of eliminating aggressive treatment measures and providing holistic, end of life palliative care aimed at relieving pain and… (more)

▼ Hospice was founded with the primary goal of eliminating aggressive treatment measures and providing holistic, end of life palliative care aimed at relieving pain and symptoms and maximizing quality of life. This includes the discontinuation of limited benefit medications (LBMs) which may no longer provide a patient benefit in the context of limited life expectancy. The continued use of LBMs in the hospice population was poorly characterized in the literature, and evidence was needed to inform providers and policy makers regarding the scope of suboptimal medication use in this vulnerable patient group. This dissertation aimed to broadly characterize LBM use and continuation and identify factors associated with LBM continuation after admission among patients admitted to hospice for cancer and non-cancer causes. Our research aims were accomplished via a series of retrospective cross-sectional and cohort studies in the Medicare hospice population using patient-level administrative claims data from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database between 2007 and 2013. LBMs for the purposes of this research consisted of anti-hyperlipidemics, antihypertensives, oral antidiabetics, antiplatelets, anti-dementia and anti-osteoporotic medications, and proton pump inhibitors, with medication use measured via Medicare Part D dispensing claims. We found that the prevalence of LBM use after hospice admission was high, differed by primary hospice admission diagnosis and LBM class, and was relatively stable among patient cohorts defined by hospice admission year. After hospice enrollment, approximately 30% of patients continued at least one LBM that had been used prior to hospice admission. Anti-dementia medications were the most frequently continued LBM class while anti-osteoporotic medications were continued least often. In adjusted analysis, the likelihood of continuing at least one LBM after hospice admission was significantly greater in older patients, patients admitted to hospice in a nursing or assisted-living facility (compared to home hospice), and patients with longer hospice stays. Patients experiencing a care transition from a hospice to a non-hospice setting after hospice admission, particularly those experiencing hospitalizations, were also at an increased risk of continuing LBMs. Despite hospice care principles, use and continuation of LBMs in the hospice population is common. This work provides critical evidence on the scope of problematic medication use at the end of life and will ideally be used to promote the development of tailored medication management strategies that minimize burden without impacting quality of life during the patient’s final weeks and months. Until then, a more careful review of patients’ drug regimens at the time of hospice enrollment is warranted, including thoughtful consideration of the need to continue each medication in the context of its risks, benefits and the patient’s preferences and care goals. Advisors/Committee Members: Lee, Todd A (advisor), Holmes, Holly M (committee member), Calip, Gregory S (committee member), Qato, Dima M (committee member), Pickard, Simon (committee member), Lee, Todd A (chair).

Subjects/Keywords: hospice; deprescribing; end of life; geriatrics; palliative care; Medicare Part D; medication use

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Zueger, P. M. (2018). Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med). (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/22618

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Zueger, Patrick M. “Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med).” 2018. Thesis, University of Illinois – Chicago. Accessed March 04, 2021. http://hdl.handle.net/10027/22618.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Zueger, Patrick M. “Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med).” 2018. Web. 04 Mar 2021.

Vancouver:

Zueger PM. Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med). [Internet] [Thesis]. University of Illinois – Chicago; 2018. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/10027/22618.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Zueger PM. Study of Trends and Outcomes of Prescription Medications Continued During Hospice Care (STOP Med). [Thesis]. University of Illinois – Chicago; 2018. Available from: http://hdl.handle.net/10027/22618

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

University of Illinois – Chicago

5. Adimadhyam, Sruthi. Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors.

Degree: 2018, University of Illinois – Chicago

URL: http://hdl.handle.net/10027/23328

► More than 30 million people living in the US have diabetes. Over time, increased concentrations of glucose in the blood lead to cellular damage and… (more)

▼ More than 30 million people living in the US have diabetes. Over time, increased concentrations of glucose in the blood lead to cellular damage and cause a variety of serious complications in these individuals. Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2i) are the latest class of oral antidiabetic medications approved for use in the US. They work by blocking the resorption of glucose in the kidney thereby increasing urinary glucose excretion. Due to their distinct mechanism of action, these drugs demonstrate cardio- and reno-protective effects in addition to their antihyperglycemic effect. However, clinical trials report an increased risk for adverse events such as amputations, fractures, and mycotic infections raising concerns about their safety. The objective of this dissertation was to evaluate the comparative safety of these drugs in a real-world setting outside of clinical trials. Three observational studies were conducted using prescription and medical insurance data from Truven Health MarketScan Databases (2009-2015). The first study investigated the association between SGLT2i and amputations and concluded that the potential for harm cannot be ruled out. While there was a 38% increase in risk for amputations following initiation of treatment with SGLT2i, the 95% confidence interval included the null. The second study investigated the association between SGLT2i and fractures. There was an 82% increase in risk for fractures early in treatment with SGLT2i. Beyond the initial 2-week treatment period, there was no apparent effect on fracture risk. The third study investigated the association between SGLT2i and mycotic infections. There was a 53% increase in risk for mycotic infections within the first 90 days of treatment with SGLT2i. This dissertation evaluated the post-marketing safety of this new class of antidiabetic medications in a real-world setting. Evidence from such observational studies can supplement that from clinical trials to more thoroughly inform decision-making. Findings from this research can help clinicians understand patients at high-risk for experiencing these events and devise remedial measures in anticipation. Advisors/Committee Members: Schumock, Glen T (advisor), Lee, Todd A (committee member), Calip, Gregory S (committee member), Smith Marsh, Daphne E (committee member), Layden, Brian T (committee member), Schumock, Glen T (chair).

Subjects/Keywords: pharmacoepidemiology; drug safety; SGLT2 inhibitors; type 2 diabetes; amputations; fractures; mycotic infections

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Adimadhyam, S. (2018). Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors. (Thesis). University of Illinois – Chicago. Retrieved from http://hdl.handle.net/10027/23328

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Adimadhyam, Sruthi. “Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors.” 2018. Thesis, University of Illinois – Chicago. Accessed March 04, 2021. http://hdl.handle.net/10027/23328.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Adimadhyam, Sruthi. “Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors.” 2018. Web. 04 Mar 2021.

Vancouver:

Adimadhyam S. Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors. [Internet] [Thesis]. University of Illinois – Chicago; 2018. [cited 2021 Mar 04]. Available from: http://hdl.handle.net/10027/23328.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Adimadhyam S. Comparative Safety of Sodium-Glucose Co-Transporter 2 Inhibitors. [Thesis]. University of Illinois – Chicago; 2018. Available from: http://hdl.handle.net/10027/23328

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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