Trends in utilization of non‐first‐line topical acne medications among children, adolescents, and adults in the United States, 2012‐2016

2021 ◽  
Author(s):  
Mohsen Afarideh ◽  
Katinna E. Rodriguez Baisi ◽  
Dawn M.R. Davis ◽  
Jennifer L. Hand ◽  
Megha M. Tollefson
Keyword(s):  
United States ◽  
The United States ◽  
First Line ◽  
Adolescents And Adults

James Angleton and the Church Committee

2013 ◽  
Vol 15 (4) ◽  
pp. 128-147
Author(s):  
Loch K. Johnson
Keyword(s):  
United States ◽  
The United States ◽  
Central Intelligence Agency ◽  
First Line ◽  
Intelligence Agency ◽  
Public Defense ◽  
Intelligence Operations ◽  
The Cold War ◽  
The Church ◽  
Extreme View

James J. Angleton, who served as chief of counterintelligence for the U.S. Central Intelligence Agency (CIA) from 1954 to 1974, was an important figure in the Cold War and, in a sense, the first line of defense against clandestine Soviet intelligence operations directed against the United States and its allies. In 1975 a U.S. Senate investigative committee—informally known as the Church Committee and led by Senator Frank Church—called Angleton to testify in public on his approach to counterintelligence, especially how he had become involved in illegal domestic operations in the United States. His testimony to committee staff investigators preceding the hearing, along with his public statements to senators during the hearing, displayed an extreme view of the global Communist threat. Amid ongoing revelations in the mid-1970s of illegal CIA actions, Angleton proved unable to mount an effective public defense of his approach.

scholarly journals 524. Understanding the Treatment of Carbapenem-Resistant Enterobacteriaceae (CRE) Infections in the United States (US): Insights from a Survey of Hospital-Based Pharmacists

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S252-S252 ◽  
Author(s):  
Brian Potoski ◽  
Deanna Buehrle ◽  
Minh-Hong Nguyen ◽  
Cornelius J Clancy
Keyword(s):  
United States ◽  
Rank Order ◽  
Polymyxin B ◽  
The United States ◽  
Academic Community ◽  
First Line ◽  
New Agents ◽  
Carbapenem Resistant ◽  
Urinary Infections ◽  
Improved Outcomes

Abstract Background New anti-CRE antibiotics (ceftazidime–avibactam, C-A; meropenem-vaborbactam, M-V; plazomicin, PLZ) are associated with improved outcomes and lower toxicity than polymixins (PMs; colistin; polymyxin B) in treating CRE infections. We previously demonstrated that ~40% (range: 28–71%) and ~23% (16–41%) of CRE infections in the United States were treated with PMs or new agents, respectively, as of 1/19. Methods To understand formulary status, availability and positioning of new anti-CRE agents and PMs, we surveyed hospital-based Society of ID Pharmacists (SIDP) members (11–12/18; Qualtrics). Results There were 218 respondents from 41 states. Mean CRE infections encountered were 2.7/mo (0–36). C-A, M-V, PLZ were formulary restricted or non-formulary but available at 84%, 68% and 31% of hospitals, respectively; agents were stocked at 80%, 37% and 4%. In 33% of instances, C-A was presented to P&T a second time prior to approval. In rank order, reasons for adding a new agent to formulary were improved outcomes/efficacy, safety/toxicity, and local stewardship (ASP) opinion. Ranked reasons for not adding a new agent were infrequency of CRE, cost, concern for misuse, and limited data. A new agent was positioned as first-line against CRE pneumonia (PNA), bacteremia (BSI), abdominal (IAI) and urinary infections by 87%, 90%, 83% and 56% of respondents [Table]. Smaller hospitals (stratified as ≤200, 201–400, >400 beds) were more likely to have not made a formulary decision or have new agents as no buy (P = 0.0005), and less likely to have a new agent stocked (P = 7e-8) or to position a new agent as first line against CRE PNA, BSI and IAI (P = 0.009). Similar associations were not evident by hospital type (academic, community teaching, or non-teaching). Conclusion New agents are positioned as the first line against CRE PNA, BSI and IAI at most US hospitals with an SIDP member pharmacist, but they are still prescribed less against CRE infections than PMs nationally. Smaller hospitals are less likely to have mechanisms for using new agents or to position them as the first line. Discrepancies between positioning and use of new agents may reflect a bias in SIDP membership toward larger hospitals with ASP, lags between endorsing a first-line agent and incorporating it into care, and/or conservative ASP approval of agents in individual cases. Disclosures All authors: No reported disclosures.

scholarly journals Lenalidomide in follicular lymphoma

Blood ◽  
2020 ◽  
Vol 135 (24) ◽  
pp. 2133-2136 ◽  
Author(s):  
Christopher R. Flowers ◽  
John P. Leonard ◽  
Nathan H. Fowler
Keyword(s):  
United States ◽  
Follicular Lymphoma ◽  
Single Agent ◽  
The United States ◽  
First Line ◽  
Safety And Efficacy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Immunomodulatory Drug

Abstract Lenalidomide is an immunomodulatory drug approved in the United States for use with rituximab in patients with relapsed/refractory follicular lymphoma. We reviewed data from trials addressing the safety and efficacy of lenalidomide alone and in combination with rituximab as a first-line therapy and as a treatment of patients with relapsed/refractory follicular lymphoma. Lenalidomide-rituximab has been demonstrated to be an effective chemotherapy-free therapy that improves upon single-agent rituximab and may become an alternative to chemoimmunotherapy.

How Many Life Years Have Been Saved In The United States From Using Rituximab Plus Chemotherapy Compared To Chemotherapy Alone From 1998-2013

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2937-2937
Author(s):  
Mark Danese ◽  
Michelle Gleeson ◽  
Marc Halperin ◽  
Sandra Skettino ◽  
Carolina Reyes
Keyword(s):  
United States ◽  
Research Funding ◽  
B Cell Lymphoma ◽  
The United States ◽  
Incidence Rates ◽  
Lymphocytic Leukemia ◽  
Age Group ◽  
First Line ◽  
Medicare Data ◽  
Life Years

Abstract Introduction Rituximab was approved in December 1997 and has since become the standard of care in diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and chronic lymphocytic leukemia (CLL). Clinical trials have shown statistically significant improvements in progression-free and overall survival. The objective of this study was to estimate the real-world effectiveness of first-line rituximab plus chemotherapy (R+Chemo) relative to chemotherapy alone (Chemo Alone) in the United States (US) from 1998 to 2013. Methods For each cancer, we constructed a population effectiveness model from 1998-2013 comprised of 3 modules: epidemiology, utilization and survival. The epidemiology module included age group, gender, and year-specific incidence rates for each cancer from the Surveillance, Epidemiology, and End Results (SEER) program from 2000-2010. Published SEER-based join-point estimates were used to extrapolate to other years. Census population data using the same age group, gender, and year strata were combined with incidence rates to project total diagnosed patient counts. The utilization module was based on SEER-Medicare linked data from 1999-2009. Drug utilization (defined as first infusion within 180 days of diagnosis for each cancer) for R+Chemo and for Chemo Alone was estimated as a proportion of all diagnosed patients, and stratified by age group, gender, and calendar year of diagnosis in the SEER-Medicare data. Utilization proportions were then multiplied by the diagnosed population counts to estimate treated patient counts for each cancer, by age group, gender, and calendar year. The survival module was calculated using SEER-Medicare data, starting from 30-days after first infusion, with follow up through 12/31/2010. For each cancer, flexible parametric (Royston-Parmar) survival models were applied to estimate restricted (10-year) mean survival times for each person, adjusted for individual patient covariates. These estimates were averaged across patients within strata defined by age group, gender and treatment. Life years lived were estimated for patients receiving R+Chemo, first by using mean survival for treatment with R+Chemo, and then by using mean survival estimates for Chemo Alone. The incremental life years saved were calculated as the difference between the projected survival from using R+Chemo and from using Chemo Alone. These differences were summed over age group, gender, and calendar year for each cancer. Monte Carlo sampling was used to estimate the 95% uncertainty intervals (UI). Results Across all three cancers, there were 289,793 cumulative life years saved (95% UI, 248,300-330,618; see Figure) from 1998 to 2013. For DLBCL, an estimated 177,952 patients were treated with R+Chemo. In these patients, an estimated 199,323 (95% UI 169,534-231,214) additional life years were lived compared to what might have occurred if Chemo Alone had been used instead. For FL, an estimated 84,303 patients were treated with R+Chemo, and an additional 80,338 (95% UI 53,876-106,709) life years were lived compared to Chemo Alone. For CLL, an estimated 14,398 patients were treated with R+Chemo, and an additional 10,132 (95% UI 4,469-15,998) life years were lived compared to Chemo Alone. Conclusions For DLBCL, FL and CLL patients treated with first-line therapy within 180 days of diagnosis in the US, approximately 290,000 cumulative life years were saved by adding rituximab to chemotherapy between 1998 and 2013. Next generation therapies may be able to extend these survival gains for patients with CLL, FL and DLBCL. Disclosures: Danese: Amgen: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; Medimmune: Consultancy, Research Funding. Gleeson:Amgen, Inc.: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; MedImmune: Consultancy, Research Funding. Halperin:Genentech: Consultancy, Research Funding; Medimmune: Consultancy, Research Funding; Amgen: Consultancy, Research Funding. Skettino:Genentech: Employment, stock Other. Reyes:Genentech, inc: Employment, Equity Ownership.

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