Digital Commons Network^™

Combination Thyroid Hormone Therapy In The Treatment Of Hypothyroidism, Jessica Johnson

Physician Assistant Scholarly Project Papers

The nature of this systemic literature review and research is to explore the use of thyroxine (T4) monotherapy versus T4 and triiodothyronine (T3) (combination) therapy for the treatment of hypothyroidism. A literature review was conducted using electronic search databases which included PubMed, CINHAL, and Clinical Key. Mesh terms included hypothyroidism/drug therapy, hypothyroidism/diagnosis, thyroid hormones/physiology, and thyroxine. Filters applied to the search included clinical study, clinical trial, guideline, journal article, meta-analysis, randomized controlled study, and systematic review. The search was tapered by limiting results to the last ten years, human species, and adults 19+. The articles were further narrowed by excluding …

How Does Access To Primary Care Affect The Latino Population, Brandon Harthan

Physician Assistant Scholarly Project Papers

Healthcare disparities by race or ethnicity across the United States are becoming more evident as the population continues to grow, none being more evident than that of the Latino population. The purpose of this research is to determine the effects that access to primary healthcare has on the comorbidity and mortality of the Latino population. Much of the research supports the theory that Latino’s are at greater risk of comorbidity and mortality from diabetes, chronic liver disease, and cirrhosis due to their decreased access to primary healthcare services. However, evidence also supports the “Hispanic Mortality Paradox” in which Latinos have …

The Impact Of Continuous Glucose Monitoring In The Management Of Type Ii Diabetes, Benjamin Graf

Physician Assistant Scholarly Project Papers

According to the American Diabetes Association (ADA), approximately 36 million Americans have a diagnosis of type II diabetes (T2D). Among these patients with T2D, nearly forty percent have glycated hemoglobin A1c (Hgb A1c) values above the target goal of 7%. Many patients with T2D utilize self-monitoring blood glucose (SMBG) systems to monitor day-to-day fluctuations in blood glucose values. However, SMBG systems can be cumbersome and may result in lower patient compliance. With many patients struggling to achieve their target Hgb A1c, methods to improve glycemic control are needed to prevent long-term diabetes-related complications. This literature review aims to investigate the …

The Role Of Ketamine In The Management Of Chronic Pain, Hugh W. Cline Iii

Physician Assistant Scholarly Project Papers

Chronic pain diagnoses are on the rise amongst people within the United States and thought to be an epidemic. It is estimated to affect millions of patients who have suffered trauma, injury, or complications from surgical procedures. The treatment of chronic pain, defined as pain lasting longer than 3 months, can be complicated. There are no definitive treatment options that have garnered a consensus among medical professionals. Treatment usually involves several medical specialties and pharmacological options. Reliance on the use of multiple pharmacological options can cause patients increased hospitalizations, and a reliance on opioids can potentially cause other illnesses due …

Long Term Outcomes Of Anti-Retroviral Treatment Vs. Additional Nutritional Supplementation For Hiv Patients, Michael P. Gillispie

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is not to determine the best treatment for human immunodeficiency virus HIV but to analyze additional supplementation that can prolong the progression of the disease process. Zinc, vitamin A, D, and E will be evaluated additionally with the antiretroviral treatment ART. The cost of an ART Regimen can be very expensive and challenging for patients to afford. The goal is to find an acceptable option to complement ART with a sensible cost to prolong disease progression and minimize additional costs of health care. With the advances of ART, more and more patients can …

Migraine With Aura Versus Seizure: Diagnosis And Treatment, Jessica Gifford

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if obtaining an electroencephalogram (EEG) in patients presenting with migraine with aura would result in better and/or more prompt symptom management compared to empiric migraine treatment. In this review, the electronic databases; CINAHL, PubMed, Clinical Key, Cochrane Library and Dynamed Plus were used. Both keyword and mesh terms were used related to the pathophysiology of migraines and seizures along with guidelines for work-up and treatment of migraines and seizures. All articles chosen for review were published after 1999, except one. All articles were peer reviewed, and include randomized …

Breast Conserving Therapy Vs Mastectomy In Treatment Of Early Breast Cancer Patients. Does Brca1/Brca2 Status Change Treatment Recommendations?, Kylie Engebretson

Physician Assistant Scholarly Project Papers

In the United States, breast cancer is the second most common cancer, represents 30% of total cancer cases and 14% of deaths in the United States in 2019. BRCA1 and BRCA2 are genetic mutations that increase the likelihood of developing breast cancer by 57% and 49%, respectfully. Several surgical options are available for those with newly diagnosed early-stage breast cancer. The purpose of this systemic literature review is to evaluation the safety and efficacy of breast conserving therapy versus mastectomy for surgical intervention of early-stage breast cancer patients and evaluate if possessing a BRCA positive mutation changes the recommendation for …

Is Mdma A Safe And Effective Adjunct For Treatment Of Posttraumatic Stress Disorder, Angela Emerson

Physician Assistant Scholarly Project Papers

Background: Post-traumatic stress disorder (PTSD) is a common mental health disorder that affects many Americans and leads to considerable morbidity and mortality. While there are a range of therapies to treat PTSD, treatment resistance is high, leading to a chronic condition in many patients. In recent years, attention has been turned to the use of novel drugs, such as 3,4,- methylenedioxymethamphetamine (MDMA) as a treatment for PTSD.

Aim: The purpose of this literature review was to assess the safety and efficacy of MDMA use in the treatment of PTSD.

Results: MDMA is a schedule I drug, therefore research into its …

In Adults With Gastroesophageal Reflux Disease, What Is The Efficacy Of Surgical Versus Pharmacotherapy In Reducing Symptoms?, Travis Cook

Physician Assistant Scholarly Project Papers

The purpose of this systematic review is to explore the efficacy of pharmacotherapeutics and surgical interventions for the treatment of gastroesophageal reflux disease (GERD). In this systematic review, five electronic databases were used including AccessMedicine, PubMed, Cochrane library, Dynamed, and Clinical Key. Research criteria included work after 2010, peer reviewed, and only randomized control trials, systematic reviews, and meta-analyses were considered. Studies that were excluded included any that were before 2010, poor study design, and those that looked at other conditions or treatments outside of the research question in study. A total of 9 studies were selected for this systematic …

An Overview Of Mrna Vaccine Technology, Rachel N. Bruening

Physician Assistant Scholarly Project Papers

This project will serve to analyze the mechanism, efficacy, and adverse effects of mRNA technology in detail while also comparing it with a previous recombinant Influenza vaccine trial. In this systematic literature review, three library data bases were searched including Pub Med, Clinical Key, and Ebsco Megafile. Search criteria included the key terms: mRNA vaccines, vaccines, and COVID-19. Additional phrases used included: mechanism, history, and efficacy. Each key word was entered as it appears in the databases with additional phrases used to narrow down the research. The search was limited to the last five years to ensure up to date …

Hepatitis C Treatment For Substance Users In North Dakota, Janae Arnold

Physician Assistant Scholarly Project Papers

In the 1960’s, the hepatitis C virus (HCV) epidemic began mainly through the transmission of blood transfusions. By the time screening was implemented, millions had already become infected worldwide. After a decade of declining infection rates, a second wave started in the midst of the opioid epidemic in 2010. Prior to 2014 and the application of curative direct-acting antivirals, treatment was expensive, had low efficacy, many side effects, and long treatment durations. Advances in medicine have allowed for HCV elimination with shorter treatment durations, less side effects, and higher treatment rates. Unfortunately, treatment is not offered to all HCV patients …

Best Second Oral Agent To Metformin To Manage Type 2 Diabetes, Dhana Acharya

Physician Assistant Scholarly Project Papers

Diabetes is a major health concern in the United States with many long-term complications, such as heart disease, stroke, kidney failure, blindness, and amputation. According to the Center for Disease Control, as of 2020, 34.1 million of US adult had diabetes and 88 million were prediabetic. Due to the severe complications, it is important to manage diabetes with lifestyle changes and pharmacotherapies. Many oral agents such as metformin, sodium glucose transporter 2 inhibitors (SGLT2i), and sulfonylureas are used in the management of type II diabetes. Metformin is typically the first line pharmacotherapy. However, when metformin alone is not enough to …

Dietary Iron And The Elite Dancer, Caitlin Attwell, Cory Dugan, Alannah K. A. Mckay, Joanna Nicholas, Luke Hopper, Peter Peeling

Research outputs 2022 to 2026

Dancers are an athlete population at high risk of developing iron deficiency (ID). The aesthetic nature of the discipline means dancers potentially utilise dietary restriction to meet physique goals. In combination with high training demands, this means dancers are susceptible to problems related to low energy availability (LEA), which impacts nutrient intake. In the presence of LEA, ID is common because of a reduced mineral content within the low energy diet. Left untreated, ID becomes an issue that results in fatigue, reduced aerobic work capacity, and ultimately, iron deficient anaemia (IDA). Such progression can be detrimental to a dancer’s capacity …

A Cohort Comparison Study On Women In Threatened Preterm Labor Given Nifedipine Or Nifedipine And Salbutamol Tocolysis In Air Medical Retrieval, Breeanna Spring Walsh, Fergus W. Gardiner, Dianne Bloxsome, David Ford, Brennen W. Mills, Simon M. Laws

Research outputs 2022 to 2026

Objective: Women with threatened preterm labor in remote Australia often require tocolysis in the prevention of in-flight birth during air medical retrieval. However, debate exists over the tocolytic choice. Methods: A retrospective analysis was undertaken on data containing women who required air medical retrieval for threatened preterm labor within Western Australia between the years 2013 and 2018. Results: A total number of 236 air medical retrievals were deemed suitable for inclusion; 141 received nifedipine, and 95 women received salbutamol + nifedipine. Tocolytic efficaciousness was reported in 151 cases, proportionally more (P < .05) from the women who received salbutamol + nifedipine (n = 68, 71.6%) compared with the women who received nifedipine only (n = 83, 58.9%). Those receiving salbutamol + nifedipine were more likely to suffer maternal tachycardia (n = 87 [91.6%] vs. n = 62 [44.0%]), fetal tachycardia (n = 26 [27.4%] vs. n = 13 [9.2%]), nausea (n = 17 [17.9] vs. n = 5 [3.55%]), and vomiting (n = 12 [12.6%] vs. n = 2 [1.4%]). Three women who received salbutamol + nifedipine had serious side effects including echocardiographic changes, chest pain, and metabolic and lactic acidosis. Conclusion: Salbutamol + nifedipine tocolysis was proven to be more effective than nifedipine only. Although salbutamol + nifedipine had increased temporary side effects, most were nonsevere and managed in-flight.

A Psychoeducational Support Group Intervention For People Who Have Attempted Suicide: An Open Trial With Promising Preliminary Findings, Myfanwy Maple, Sarah Wayland, Tania Pearce, Rebecca Sanford, Navjot Bhullar

Research outputs 2022 to 2026

Psychoeducational groups have been used to address many health needs. Yet, there are few such options available for people who have attempted suicide. This study presents preliminary findings from an open trial of Eclipse, an 8-week closed, psychoeducational group for people who have attempted suicide. It examined the effectiveness of the Eclipse program in reducing suicidal ideation, depressive symptoms, perceived burdensomeness and thwarted belongingness, and increasing resilience and help-seeking. Results showed statistically significant improvements in depressive symptoms, perceived burdensomeness, resilience and help-seeking from baseline (T1) to immediate post-test (T2), and in perceived burdensomeness from T1 to 1-month follow-up (T3). A …

Characterization Of Retinal Drusen In Subjects At High Genetic Risk Of Developing Sporadic Alzheimer’S Disease: An Exploratory Analysis, Inés López-Cuenca, Elena Salobrar-García, Inés Gil-Salgado, Lidia Sánchez-Puebla, Lorena Elvira-Hurtado, José A. Fernández-Albarral, Federico Ramírez-Toraño, Ana Barabash, Jaisalmer De Frutos-Lucas, Juan J. Salazar, José M. Ramírez, Ana I. Ramírez, Rosa De Hoz

Research outputs 2022 to 2026

Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ε4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH-or FH+) and …

Diet And Exercise Advice And Referrals For Cancer Survivors: An Integrative Review Of Medical And Nursing Perspectives, Ria Joseph, Nicolas H. Hart, Natalie Bradford, Oluwaseyifunmi Andi Agbejule, Bogda Koczwara, Alexandre Chan, Matthew P. Wallen, Raymond J. Chan

Research outputs 2022 to 2026

Purpose:

To examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals.

Methods:

An integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators.

Results:

Twenty-one studies involving 3401 …

Movement Quantity And Quality: How Do They Relate To Pain And Disability In Dancers?, Danica Hendry, Amity Campbell, Anne Smith, Luke Hopper, Leon Straker, Peter O’Sullivan

Research outputs 2022 to 2026

Objective This field-based study aimed to determine the association between pre-professional student dancers’ movement quantity and quality with (i) pain severity and (ii) pain related disability. Methods Pre-professional female ballet and contemporary dance students (n = 52) participated in 4 time points of data collection over a 12-week university semester. At each time point dancers provided self-reported pain outcomes (Numerical Rating Scale as a measure of pain severity and Patient Specific Functional Scale as a measure of pain related disability) and wore a wearable sensor system. This system combined wearable sensors with previously developed machine learning models capable of capturing …

Re-Imagining The Data Collection And Analysis Research Process By Proposing A Rapid Qualitative Data Collection And Analytic Roadmap Applied To The Dynamic Context Of Precision Medicine, James Smith, Jeffrey Braithwaite, Tracey A. O’Brien, Stephanie Smith, Vanessa J. Tyrrell, Emily V. A. Mould, Janet C. Long, Frances Rapport

Research outputs 2022 to 2026

Our implementation science study focuses on implementing a new way of practice and offers methodological specificity about how to rapidly investigate an individually tailored precision medicine intervention. A qualitative study advancing a new methodology for speedily identifying barriers and enablers to implementation in the context of childhood cancer. Data were collected through rapid ethnography, coded using the Consolidated Framework for Implementation Research, and analysed by Sentiment Analysis. Thirty-eight data collection events occurred during 14 multidisciplinary tumour board meetings, 14 curation meetings, and 10 informal conversations. Sentiment Analysis distilled Consolidated Framework for Implementation Research codes to reveal key barriers and enablers …

Shorter Constant Work Rate Cycling Tests As Proxies For Longer Tests In Highly Trained Cyclists, Chantelle Du Plessis, Mark Andrews, Lachlan J. G. Mitchell, Jodie Cochrane Wilkie, Trish King, Anthony J. Blazevich

Research outputs 2022 to 2026

Severe-intensity constant work rate (CWR) cycling tests simulate the high-intensity competition environment and are useful for monitoring training progression and adaptation, yet impose significant physiological and psychological strain, require substantial recovery, and may disrupt athlete training or competition preparation. A brief, minimally fatiguing test providing comparable information is desirable.

Purpose

To determine whether physiological variables measured during, and functional decline in maximal power output immediately after, a 2-min CWR test can act as a proxy for 4-min test outcomes.

Methods

Physiological stress (VO _2 kinetics, heart rate, blood lactate concentrations ([La-]b)) was monitored and performance fatigability was estimated (as pre-to-post-CWR …

Effects Of Reciprocal Inhibition And Whole-Body Relaxation On Persistent Inward Currents Estimated By Two Different Methods, Ricardo N.O. Mesquita, Janet L. Taylor, Gabriel S. Trajano, Jakob Škarabot, Aleš Holobar, Basílio A. M. Gonçalves, Anthony J. Blazevich

Research outputs 2022 to 2026

Persistent inward currents (PICs) are crucial for initiation, acceleration, and maintenance of motoneuron firing. As PICs are highly sensitive to synaptic inhibition and facilitated by serotonin and noradrenaline, we hypothesised that both reciprocal inhibition (RI) induced by antagonist nerve stimulation and whole-bodyrelaxation (WBR) would reduce PICs in humans. To test this, we estimated PICs using the well-established paired motor unit (MU) technique. High-density surface electromyograms were recorded from gastrocnemius medialis during voluntary, isometric 20-s ramp, plantarflexor contractions and decomposed into MU discharges to calculate delta frequency (ΔF). Moreover, another technique (VibStim), which evokes involuntary contractions proposed to result from PIC …

A Most Unusual Tail: Scoliosis In A Wild Australian Skink, And Reported Incidences And Suggested Causes Of Similar Malformations Amongst Squamates, Philip W. Bateman, Robyn Benken, Ryan Glowacki, Robert A. Davis

Research outputs 2022 to 2026

Malformations of vertebrae potentially occur across many taxa, particularly in Testudines, which are susceptible to kyphosis (dorsoventral curvature of the spine). Such malformations may stem from either genetic or environmental origins, and their prevalence and associated impacts on survival remain poorly understood. However, scoliosis (sideways curvature of the spine) is rarely reported and especially so in wild lizards. We report here on the first known case of scoliosis in a wild Australian lizard, the skink Ctenotus fallens, from Perth, Western Australia. This occurrence is the first of 805 individuals captured in a natural population monitored annually for the past 11 …

Resistance Training Effectiveness On Body Composition And Body Weight Outcomes In Individuals With Overweight And Obesity Across The Lifespan: A Systematic Review And Meta-Analysis, Pedro Lopez, Dennis R. Taaffe, Daniel A. Galvão, Robert U. Newton, Elisa R. Nonemacher, Victória M. Wendt, Renata N. Bassanesi, Douglas J. P. Turella, Anderson Rech

Research outputs 2022 to 2026

To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = −3.8%, 95% CI: −4.7 to −2.9%, p < 0.001) and whole-body fat mass (ES = −5.3 kg, 95% CI: −7.2 to −3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = −2.3% and −1.4 kg, p < 0.001) and resistance training alone (ES = −1.6% and −1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ − 0.3 kg, p = 0.550–0.727). Results were consistently observed across age and sex groups (p = 0.001–0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.

Cerebrospinal Fluid Neurofilament Light Predicts Risk Of Dementia Onset In Cognitively Healthy Iindividuals And Rate Of Cognitive Decline In Mild Cognitive Impairment: A Prospective Longitudinal Study, Kunal Dhiman, Victor L. Villemagne, Christopher Fowler, Pierrick Bourgeat, Qiao Xin Li, Steven Collins, Ashley I. Bush, Christopher C. Rowe, Colin L. Masters, David Ames, Kaj Blennow, Henrik Zetterberg, Ralph N. Martins, Veer Gupta

Research outputs 2022 to 2026

Background: Biomarkers that are indicative of early biochemical aberrations are needed to predict the risk of dementia onset and progression in Alzheimer’s disease (AD). We assessed the utility of cerebrospinal fluid (CSF) neurofilament light (NfL) chain for screening preclinical AD, predicting dementia onset among cognitively healthy (CH) individuals, and the rate of cognitive decline amongst individuals with mild cognitive impairment (MCI). Methods: Neurofilament light levels were measured in CSF samples of participants (CH, n = 154 and MCI, n = 32) from the Australian Imaging, Biomarkers and Lifestyle study of ageing (AIBL). Cases of preclinical AD were identified using biomarker-guided …

Chronic Obstructive Pulmonary Disease Exacerbations: Do All Roads Lead To Rome?, Sanjay Ramakrishnan, Iwein Gyselinck, Mona Bafadhel, Wim Janssens

Research outputs 2022 to 2026

To the Editor: The Rome chronic obstructive pulmonary disease (COPD) exacerbation proposal is a welcome step forward (1). Celli and colleagues have attempted to revise the definition and propose a new severity classification, based on measurable clinical and laboratory variables instead. The central role of healthcare use when defining exacerbations has held us back from a better understanding of these critical events. ...

Climate Anxiety Does Not Need A Diagnosis Of A Mental Health Disorder, Navjot Bhullar, Melissa Davis, Roselyn Kumar, Patrick Nunn, Debra Rickwood

Research outputs 2022 to 2026

In a recent Correspondence in The Lancet Planetary Health, Sampaio and Sequeria1 state that “climate anxiety is not yet considered a mental health disorder” and might be a risk factor for mental disorders, which is something that we contest. The authors further claim that “climate anxiety occurs mainly in lower-income countries located in areas that are more directly affected by climate change”,1 which we regard as doubly incorrect: first, there are no substantial differences in climate anxiety between countries with different average incomes,2 and second, it is misleading to aver that lower income countries are more directly affected by climate …

Biomarkers And Factors Related To Risk Of Acute Kidney Injury, Mary Ann David

Dissertations

Background: Acute kidney injury (AKI) is associated with increased mortality, morbidity, length of hospital stay, and in-hospital cost. Timely intervention is needed to prevent disease progression, but the delay in diagnostic process often results in delayed treatment. Recent studies show a significant increase in novel urine biomarkers (UB), TIMP-2 and IGFBP7, has been linked to an increased risk of AKI.

Objectives: The purpose of this study was to examine the relationships among participants’ sociodemographic and clinical characteristics, including select biomarkers, care management processes, treatments, and patient outcomes in a sample of hospitalized critically ill patients in southern California.

Findings: Study …

Multiple Metals In Children’S Deciduous Teeth: Results From A Community-Initiated Pilot Study, Alexa Friedman, Julia Anglen Bauer, Christine Austin, Timothy Downs, Yorghos Tripodis, Wendy Heiger-Bernays, Roberta White, Manish Arora, Birgit Claus Henn

Sustainability and Social Justice

Background: Characterizing retrospective exposure to toxicants during multiple early-life developmental periods is challenging, yet critical for understanding developmental effects. Objective: To characterize early-life metal exposure using deciduous teeth in a community concerned about past exposures. Methods: Naturally shed teeth were collected from 30 children ages 5–13 years who resided in Holliston, Massachusetts since conception. We estimated weekly prenatal and postnatal (up to 1 year of age) exposure to 12 metals by measuring dentine concentrations using laser ablation-inductively coupled plasma-mass spectrometry. Multivariable linear mixed models were used to explore sociodemographic, dietary, and behavioral correlates of dentine metal concentrations. Results: Temporal trends …

The Potentials And Challenges Of Zoom Live Theatre During Coronavirus Lockdown: Pandemic Therapy And Corona Chicken (Part Two), Khaled Mostafa Karam

Faculty Scholarship

This study discusses the potentials and challenges of Zoom theatre performances during the lockdown caused by the Covid-19 pandemic. It examines the utilization and applicability of videoconferencing software Zoom, and other streaming software compatible with it, in creating a viable performance option for theatre practitioners and audiences during mandatory social distancing. Such software can be a strategy for social inclusion, alleviating the adverse effects of extended quarantine. The article also discusses the technical and performative aspects of Zoom theatre, pointing out its pros and cons. It uses a critical and analytical approach to performances of two Zoom plays, Pandemic Therapy …

The Time-Varying Cardiovascular Benefits Of Glucagon-Like Peptide-1 Receptor Agonist Therapy In Patients With Type 2 Diabetes Mellitus: Evidence From Large Multinational Trials, Salil V. Deo, Yakov Elgudin

Faculty Scholarship

Aims: To evaluate the time-varying cardio-protective effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) using pooled data from eight contemporary cardiovascular outcome trials using the difference in the restricted mean survival time (ΔRMST) as the effect estimate. Material and Methods: Data from eight multinational cardiovascular outcome randomized controlled trials of GLP-1RAs for type 2 diabetes mellitus were pooled. Flexible parametric survival models were fit from published Kaplan-Meier plots. The differences between arms in RMST (ΔRMST) were calculated at 12, 24, 36 and 48 months. ΔRMST values were pooled using an inverse variance-weighted random-effects model; heterogeneity was tested with Cochran's Q statistic. …