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Start Over Author "Mantovani, Lorenzo G" Publisher elsevier
16 results on '"Mantovani, Lorenzo G"'

1. Predictors of NOAC versus VKA use for stroke prevention in patients with newly diagnosed atrial fibrillation: Results from GARFIELD-AF

Author

Haas, Sylvia, Camm, A John, Bassand, Jean-Pierre, Angchaisuksiri, Pantep, Cools, Frank, Corbalan, Ramon, Gibbs, Harry, Jacobson, Barry, Koretsune, Yukihiro, Mantovani, Lorenzo G, Misselwitz, Frank, Panchenko, Elizaveta, Ragy, Hany Ibrahim, Stepinska, Janina, Turpie, Alexander Gg, Sawhney, Jitendra Ps, Steffel, Jan, Lim, Toon Wei, Pieper, Karen S, Virdone, Saverio, Verheugt, Freek Wa, Kakkar, Ajay K, GARFIELD-AF Investigators, Haas, Sylvia, Camm, A John, Bassand, Jean-Pierre, Angchaisuksiri, Pantep, Cools, Frank, Corbalan, Ramon, Gibbs, Harry, Jacobson, Barry, Koretsune, Yukihiro, Mantovani, Lorenzo G, Misselwitz, Frank, Panchenko, Elizaveta, Ragy, Hany Ibrahim, Stepinska, Janina, Turpie, Alexander Gg, Sawhney, Jitendra Ps, Steffel, Jan, Lim, Toon Wei, Pieper, Karen S, Virdone, Saverio, Verheugt, Freek Wa, Kakkar, Ajay K, and GARFIELD-AF Investigators

Abstract

INTRODUCTION A principal aim of the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) was to document changes in treatment practice for patients with newly diagnosed atrial fibrillation during an era when non-vitamin K antagonist oral anticoagulants (NOACs) were becoming more widely adopted. In these analyses, the key factors which determined the choice between NOACs and vitamin K antagonists (VKAs) are explored. METHODS Logistic least absolute shrinkage and selection operator regression determined predictors of NOAC and VKA use. Data were collected from 24,137 patients who were initiated on AC ± antiplatelet (AP) therapy (NOAC [51.4%] or VKA [48.6%]) between April 2013 and August 2016. RESULTS The most significant predictors of AC therapy were country, enrolment year, care setting at diagnosis, AF type, concomitant AP, and kidney disease. Patients enrolled in emergency care or in the outpatient setting were more likely to receive a NOAC than those enrolled in hospital (OR 1.16 [95% CI: 1.04-1.30], OR: 1.15 [95% CI: 1.05-1.25], respectively). NOAC prescribing seemed to be favored in lower-risk groups, namely, patients with paroxysmal AF, normotensive patients, and those with moderate alcohol consumption, but also the elderly and patients with acute coronary syndrome. By contrast, VKAs were preferentially used in patients with permanent AF, moderate to severe kidney disease, heart failure, vascular disease, and diabetes and with concomitant AP. CONCLUSION GARFIELD-AF data highlight marked heterogeneity in stroke prevention strategies globally. Physicians are adopting an individualized approach to stroke prevention where NOACs are favored in patients with a lower stroke risk but also in the elderly and patients with acute coronary syndrome.

Published
2019

2. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Hay, Simon I, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Ahmed, Muktar Beshir, Aichour, Miloud Taki Eddine, Aichour, Amani Nidhal, Aichour, Ibtihel, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Béjot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bicer, Burcu Kucuk, Bienhoff, Kelly, Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert R A, Brainin, Michael, Brayne, Carol, Brazinova, Alexandra, Breitborde, Nicholas J K, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair R, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Campos-Nonato, Ismael Ricardo, Carabin, Hélène, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castañeda-Orjuela, Carlos A, Castle, Chris D, Catalá-López, Ferrán, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, Cyrus, Cortesi, Paolo Angelo, Cortinovis, Monica, Criqui, Michael H, Cromwell, Elizabeth A, Cross, Marita, Crump, John A, Dadi, Abel Fekadu, Dalal, Koustuv, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, das Neves, José, Davitoiu, Dragos V, Davletov, Kairat, de Courten, Barbora, De Leo, Diego, De Steur, Hans, Defo, Barthelemy Kuate, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Dicker, Daniel, Djalainia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E Ray, dos Santos, Kadine Priscila Bender, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E, Echko, Michelle, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshetie, Setegn, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fanuel, Fanuel Belayneh Bekele, Farag, Tamer, Farinha, Carla Sofia e Sa, Faro, André, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, João C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Franklin, Richard C, Frostad, Joseph J, Fullman, Nancy, Fürst, Thomas, Furtado, Joao M, Futran, Neal D, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M, Geleto, Ayele, Gemechu, Bikila Lencha, Gesesew, Hailay Abrha, Gething, Peter W, Ghajar, Alireza, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W, Goel, Kashish, Goenka, Shifalika, Goldberg, Ellen M, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Goulart, Alessandra Carvalho, Graetz, Nicholas, Gugnani, Harish Chander, Gupta, Prakash C, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Gupta, Rahul, Gutiérrez, Reyna A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Hareri, Habtamu Abera, Haro, Josep Maria, Harun, Kimani M, Harvey, James, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Hay, Roderick J, Hedayati, Mohammad T, Hendrie, Delia, Henry, Nathaniel J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Hoffman, Howard J, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, John J, Huynh, Chantal, Iburg, Kim Moesgaard, Igumbor, Ehimario Uche, Ikeda, Chad, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jassal, Simerjot K, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Kar, Chittaranjan, Karam, Nadim E, Karch, André, Karema, Corine Kakizi, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassa, Getachew Mullu, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Kastor, Anshul, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah T, Khosravi, Ardeshir, Khubchandani, Jagdish, Kiadaliri, Aliasghar Ahmad, Kieling, Christian, Kim, Yun Jin, Kim, Daniel, Kimokoti, Ruth W, Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna A, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krohn, Kristopher J, Kumar, G Anil, Kumar, Pushpendra, Kyu, Hmwe H, Lager, Anton Carl Jonas, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lambert, Nkurunziza, Lan, Qing, Lansingh, Van C, Larsson, Anders, Leasher, Janet L, Lee, Paul H, Leigh, James, Leshargie, Cheru Tesema, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S, Linn, Shai, Liu, Patrick Y, Liu, Angela, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Looker, Katharine J, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Timothy C D, Lunevicius, Raimundas, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Maddison, Emilie R, Magdy Abd El Razek, Hassan Magdy Abd, Magdy Abd El Razek, Mohammed, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Mamun, Abdullah A, Manguerra, Helena, Manhertz, Treh, Mantovani, Lorenzo G, Mapoma, Chabila C, March, Lyn M, Marczak, Laurie B, Martinez-Raga, Jose, Martins, Paulo Henrique Viegas, Martins-Melo, Francisco Rogerlândio, Martopullo, Ira, März, Winfried, Mathur, Manu Raj, Mazidi, Mohsen, McAlinden, Colm, McGaughey, Madeline, McGrath, John J, McKee, Martin, Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mengesha, Melkamu Merid, Mengistie, Mubarek Abera, Mengistu, Desalegn Tadese, Mensah, George A, Meretoja, Tuomo J, Meretoja, Atte, Mezgebe, Haftay Berhane, Micha, Renata, Millear, Anoushka, Miller, Ted R, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke, Mishra, Shiva Raj, Mitchell, Philip B, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Muktar Sano Kedir, Mohammed, Kedir Endris, Mohammed, Shafiu, Mohan, Murali B V, Mokdad, Ali H, Mollenkopf, Sarah K, Monasta, Lorenzo, Montañez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Mori, Rintaro, Morrison, Shane D, Moses, Mark, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Mueller, Ulrich O, Muller, Kate, Murdoch, Michele E, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Naidoo, Kovin S, Nangia, Vinay, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negasa, Dumessa Edessa, Negoi, Ruxandra Irina, Negoi, Ionut, Newton, Charles R, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Trang Huyen, Nguyen, Grant, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Norheim, Ole F, Norrving, Bo, Noubiap, Jean Jacques N, Nyandwi, Alypio, Obermeyer, Carla Makhlouf, O'Donnell, Martin J, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olagunju, Tinuke Oluwasefunmi, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Osgood-Zimmerman, Aaron, Osman, Majdi, Ota, Erika, Owolabi, Mayowa O, PA, Mahesh, Pacella, Rosana E, Panda, Basant Kumar, Pandian, Jeyaraj Durai, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Parsaeian, Mahboubeh, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pearce, Neil, Pereira, David M, Perez, Krystle Marie, Perico, Norberto, Pesudovs, Konrad, Peterson, Carrie Beth, Petri, William Arthur, Petzold, Max, Phillips, Michael Robert, Phipps, Geoffrey, Pigott, David M, Pillay, Julian David, Pinho, Christine, Piradov, Michael A, Plass, Dietrich, Pletcher, Martin A, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Narayan, Purcell, Carrie, Purwar, Manorama, Qorbani, Mostafa, Quintanilla, Beatriz Paulina Ayala, Rabiee, Rynaz H S, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rahman, Mahfuzar, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rankin, Zane, Rao, Paturi Vishnupriya, Rao, Puja C, Rawaf, Salman, Ray, Sarah E, Reiner, Robert C, Reinig, Nikolas, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre M N, Resnikoff, Serge, Rezaei, Satar, Ribeiro, Antonio L, Rivas, Jacqueline Castillo, Roba, Hirbo Shore, Robinson, Stephen R, Rojas-Rueda, David, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Ruhago, George Mugambage, Saadat, Soheil, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salama, Joseph, Saleh, Muhammad Muhammad, Salomon, Joshua A, Salvi, Sundeep Santosh, Samy, Abdallah M, Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolores, Santomauro, Damian, Santos, João Vasco, Santos, Itamar S, Santric Milicevic, Milena M, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Saxena, Sonia, Schelonka, Kathryn, Schmidt, Maria Inês, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shaheen, Amira, Shaikh, Masood Ali, Shamsipour, Mansour, Sharma, Rajesh, Sharma, Jayendra, She, Jun, Shi, Peilin, Shibuya, Kenji, Shields, Chloe, Shifa, Girma Temam, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shirude, Shreya, Shishani, Kawkab, Shoman, Haitham, Siabani, Soraya, Sibai, Abla Mehio, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santos, Silva, João Pedro, Silveira, Dayane Gabriele Alves, Singh, Jasvinder A, Singh, Om Prakash, Singh, Narinder Pal, Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Slepak, Erica Leigh, Smith, David L, Smith, Mari, Sobaih, Badr H A, Sobngwi, Eugene, Soljak, Michael, Sorensen, Reed J D, Sousa, Tatiane Cristina Moraes, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steel, Nicholas, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Stovner, Lars Jacob, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Sylte, Dillon, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Taffere, Getachew Redae, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tarekegn, Yihunie L, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Terkawi, Abdullah Sulieman, Tesfaye, Dawit Jember, Tesssema, Belay, Thakur, JS, Thamsuwan, Ornwipa, Theadom, Alice M, Theis, Andrew M, Thomas, Katie E, Thomas, Nihal, Thompson, Robert, Thrift, Amanda G, Tobe-Gai, Ruoyan, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Touvier, Mathilde, Traebert, Jefferson, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thomas, Tsoi, Derrick, Tuzcu, Emin Murat, Tymeson, Hayley, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J, Venkatesh, S, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Violante, Francesco S, Vishnu, Abhishek, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wijeratne, Tissa, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Woolf, Anthony D, Workicho, Abdulhalik, Xavier, Denis, Xu, Gelin, Yadgir, Simon, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Ye, Pengpeng, Yihdego, Mahari Gidey, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zhang, Xueying, Zheng, Yingfeng, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, and Murray, Christopher J L

Subjects
1. No poverty, 3. Good health

3. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Hay, Simon I, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abebo, Teshome Abuka, Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J, Ackerman, Ilana N, Adedeji, Isaac A, Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Sutapa, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Aiyar, Sneha, Akinyemiju, Tomi F, Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alasfoor, Deena, Alene, Kefyalew Addis, Ali, Raghib, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Maskari, Fatma, AlMazroa, Mohammad AbdulAziz, Al-Raddadi, Rajaa, Alsharif, Ubai, Alsowaidi, Shirina, Althouse, Benjamin M, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Ampem, Yaw Amoako, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlov, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asgedom, Solomon W, Atey, Tesfay Mehari, Atnafu, Niguse Tadele, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Awasthi, Shally, Quintanilla, Beatriz Paulina Ayala, Azarpazhooh, Mahmoud Reza, Azzopardi, Peter, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S, Barac, Aleksandra, Barker-Collo, Suzanne L, Barnighausen, Till, Barquera, Simon, Barrero, Lope H, Basu, Sanjay, Battista, Robert, Battle, Katherine E, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Bejot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabe, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A, Biadgilign, Sibhatu, Bienhoff, Kelly, Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Blyth, Fiona M, Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R, Bourne, Rupert RA, Brainin, Michael, Brayne, Carol EG, Brazinova, Alexandra, Breitborde, Nicholas JK, Briant, Paul S, Britton, Gabrielle, Brugha, Traolach S, Buchbinder, Rachelle, Bulto, Lemma Negesa Bulto, Bumgarner, Blair, Butt, Zahid A, Cahuana-Hurtado, Lucero, Cameron, Ewan, Ricardo Campos-Nonato, Ismael, Carabin, Helene, Cardenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Carter, Austin, Carvalho, Felix, Casey, Daniel, Castaneda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Castle, Chris D, Catala-Lopez, Ferran, Chang, Jung-Chen, Charlson, Fiona J, Chaturvedi, Pankaj, Chen, Honglei, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A, Chowdhury, Rajiv, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Colombara, Danny, Cooper, Leslie Trumbull, Cooper, Cyrus, Cortesi, Paolo Angelo, Cortinovis, Monica, Criqui, Michael H, Cromwell, Elizabeth A, Cross, Marita, Crump, John A, Dadi, Abel Fekadu, Dalal, Koustuv, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, Das Neves, Jose, Davitoiu, Dragos V, Davletov, Kairat, De Courten, Barbora, De Leo, Diego, De Steur, Hans, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Dicker, Daniel, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E Ray, Bender Dos Santos, Kadine Priscila, Driscoll, Tim R, Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E, Echko, Michelle, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshetie, Setegn, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Fanuel, Fanuel Belayneh Bekele, Farag, Tamer, Sofia, Carla, Farinha, Sa, Faro, Andre, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, Joao C, Ferrari, Alize J, Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Franklin, Richard C, Frostad, Joseph J, Fullman, Nancy, Furst, Thomas, Furtado, Joao M, Futran, Neal D, Gakidou, Emmanuela, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M, Geleto, Ayele, Gemechu, Bikila Lencha, Gesesew, Hailay Abrha, Gething, Peter W, Ghajar, Alireza, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William W, Goel, Kashish, Goenka, Shifalika, Goldberg, Ellen M, Gona, Philimon N, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Goulart, Alessandra Carvalho, Graetz, Nicholas, Gugnani, Harish Chander, Gupta, Rajeev, Gupta, Prakash C, Gupta, Tanush, Gupta, Vipin, Gupta, Rahul, Gutierrez, Reyna A, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Hareri, Habtamu Abera, Haro, Josep Maria, Harun, Kimani M, Harvey, James, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Hay, Roderick J, Hedayati, Mohammad T, Hendrie, Delia, Henry, Nathaniel J, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hoek, Hans W, Hoffman, Howard J, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Hotez, Peter J, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, John J, Huynh, Chantal, Iburg, Kim Moesgaard, Igumbor, Ehimario Uche, Ikeda, Chad, Irvine, Caleb Mackay Salpeter, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jassal, Simerjot K, Javanbakht, Mehdi, Jayaraman, Sudha P, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, John, Denny, Johnson, Catherine O, Johnson, Sarah Charlotte, Jonas, Jost B, Jurisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kamal, Ritul, Kar, Chittaranjan, Karam, Nadim E, Karch, Andre, Karema, Corine Kakizi, Karimi, Seyed M, Karimkhani, Chante, Kasaeian, Amir, Kassa, Getachew Mullu, Kassebaum, Nicholas J, Kassaw, Nigussie Assefa, Kastor, Anshul, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Keiyoro, Peter Njenga, Kemmer, Laura, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Ejaz Ahmad, Khang, Young-Ho, Khoja, Abdullah T, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Yun Jin, Kim, Daniel, Kimokoti, Ruth W, Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna A, Kissoon, Niranjan, Kivimaki, Mika, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krohn, Kristopher J, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kumar, G Anil, Kumar, Pushpendra, Kyu, Hmwe H, Lager, Anton Carl Jonas, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lambert, Nkurunziza, Lan, Qing, Lansingh, Van C, Larsson, Anders, Leasher, Janet L, Lee, Paul H, Leigh, James, Leshargie, Cheru Tesema, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Xiaofeng, Liben, Misgan Legesse, Lim, Stephen S, Linn, Shai, Liu, Angela, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lodha, Rakesh, Logroscino, Giancarlo, Looker, Katharine J, Lopez, Alan D, Lorkowski, Stefan, Lotufo, Paulo A, Lozano, Rafael, Lucas, Timothy CD, Lunevicius, Raimundas, Lyons, Ronan A, Macarayan, Erlyn Rachelle King, Maddison, Emilie R, Abd El Razek, Hassan Magdy, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malhotra, Rajesh, Malta, Deborah Carvalho, Mamun, Abdullah A, Manguerra, Helena, Manhertz, Treh, Mantovani, Lorenzo G, Mapoma, Chabila C, March, Lyn M, Marczak, Laurie B, Martinez-Raga, Jose, Henrique, Paulo, Martins, Viegas, Martins-Melo, Francisco Rogerlndio, Martopullo, Ira, Marz, Winfried, Mathur, Manu Raj, Mazidi, Mohsen, McAlinden, Colm, McGaughey, Madeline, McGrath, John J, Mckee, Martin, Mehata, Suresh, Meier, Toni, Meles, Kidanu Gebremariam, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mengesha, Melkamu Merid, Mengistie, Mubarek Abera, Mengistu, Desalegn Tadese, Mensah, George A, Meretoja, Atte, Meretoja, Tuomo J, Mezgebe, Haftay Berhane, Micha, Renata, Millear, Anoushka, Miller, Ted R, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Misganaw, Awoke, Mishra, Shiva Raj, Mitchell, Philip B, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mohammed, Kedir Endris, Mohammed, Muktar Sano Kedir, Mohan, Murali BV, Mokdad, Ali H, Mollenkopf, Sarah K, Monasta, Lorenzo, Montanez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Moraga, Paula, Morawska, Lidia, Mori, Rintaro, Morrison, Shane D, Moses, Mark, Mountjoy-Venning, Cliff, Mruts, Kalayu Birhane, Mueller, Ulrich O, Muller, Kate, Mudoch, Michele E, Murthy, Srinivas, Murthy, Gudlavalleti Venkata Satyanarayana, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naghavi, Mohsen, Naheed, Aliya, Naidoo, Kovin S, Nangia, Vinay, Nasher, Jamal T, Natarajan, Gopalakrishnan, Negasa, Dumessa Edessa, Negoi, Ionut, Negoi, Ruxandra Irina, Newton, Charles R, Ngunjiri, Josephine Wanjiku, Nguyen, Cuong Tat, Nguyen, Quyen Le, Nguyen, Grant, Nguyen, Trang Huyen, Nguyen, Minh, Nichols, Emma, Ningrum, Dina Nur Anggraini, Nong, Vuong Minh, Norheim, Ole F, Norrving, Bo, Noubiap, Jean Jacques N, Nyandwi, Alypio, Obermeyer, Carla Makhlouf, O'Donnell, Martin J, Ogbo, Felix Akpojene, Oh, In-Hwan, Okoro, Anselm, Oladimeji, Olanrewaju, Olagunju, Andrew Toyin, Olagunju, Tinuke Oluwasefunmi, Olsen, Helen E, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Osgood-Zimmerman, Aaron, Osman, Majdi, Ota, Erika, Owolabi, Mayowa O, Pa, Mahesh, Pacella, Rosana E, Panda, Basant Kumar, Pandian, Jeyaraj D, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Parsaeian, Mahboubeh, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Paulson, Katherine, Pearce, Neil, Pereira, David M, Perez, Krystle Marie, Perico, Norberto, Pesudovs, Konrad, Peterson, Carrie Beth, Petri, William Arthur, Petzold, Max, Phillips, Michael Robert, Phipps, Geoffrey, Pigott, David M, Pillay, Julian David, Pinho, Christine, Piradov, Michael A, Plass, Dietrich, Pletcher, Martin A, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Prasad, Narayan, Purcell, Carrie, Purwar, Manorama, Qorbani, Mostafa, Rabiee, Rynaz HS, Radfar, Amir, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Muhammad Aziz, Rahman, Mohammad Hifz Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Ranabhat, Chhabi Lal, Rangaswamy, Thara, Rankin, Zane, Rao, Paturi Vishnupriya, Rao, Puja C, Rawaf, Salman, Ray, Sarah E, Reiner, Robert C, Reinig, Nikolas, Reitsma, Marissa, Remuzzi, Giuseppe, Renzaho, Andre MN, Resnikoff, Serge, Rezaei, Satar, Ribeiro, Antonio L, Roba, Hirbo Shore, Robinson, Stephen R, Rojas-Rueda, David, Rokni, Mohammad Bagher, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Rubagotti, Enrico, Ruhago, George Mugambage, Saadat, Soheil, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salama, Joseph, Saleh, Muhammad Muhammad, Salomon, Joshua A, Salvi, Sundeep Santosh, Samy, Abdallah M, Sanabria, Juan Ramon, Dolores Sanchez-Nino, Maria, Santomauro, Damian, Santos, Joao Vasco, Santos, Itamar S, Milicevic, Milena M Santric, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Saxena, Sonia, Schelonka, Kathryn, Schmidt, Maria Ines, Schneider, Ione JC, Schottker, Ben, Schutte, Aletta E, Schwebel, David C, Schwendicke, Falk, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shaheen, Amira, Shaikh, Masood Ali, Shamsipour, Mansour, Islam, Sheikh Mohammed Shariful, Sharma, Rajesh, Sharma, Jayendra, She, Jun, Shi, Peilin, Shibuya, Kenji, Shields, Chloe, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shiri, Rahman, Shirkoohi, Reza, Shirude, Shreya, Shishani, Kawkab, Shoman, Haitham, Siabani, Soraya, Sibai, Abla Mehio, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Joao Pedro, Santos Silva, Diego Augusto, Alves Silveira, Dayane Gabriele, Singh, Jasvinder A, Singh, Virendra, Singh, Om Prakash, Singh, Narinder Pal, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Skirbekk, Vegard, Slepak, Erica Leigh, Smith, David L, Smith, Mari, Sobaih, Badr HA, Sobngwi, Eugene, Soljak, Michael, Sorensen, Reed JD, Moraes Sousa, Tatiane Cristina, Sposato, Luciano A, Sufiyan, Muawiyyah Babale, Abdulkader, Rizwan Suliankatchi, Sunguya, Bruno F, Sur, Patrick J, Swaminathan, Soumya, Sykes, Bryan L, Sylte, Dillon, Szoeke, Cassandra EI, Tabares-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Taffere, Getachew Redae, Takala, Jukka S, Tandon, Nikhil, Tanne, David, Tarekegn, Yihunie L, Tavakkoli, Mohammad, Taveira, Nuno, Taylor, Hugh R, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Tekelab, Tesfalidet, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tesfaye, Dawit Jember, Tesssema, Belay, Thakur, JS, Thamsuwan, Ornwipa, Theadom, Alice M, Theis, Andrew M, Thomas, Katie E, Thomas, Nihal, Thompson, Robert, Thrift, Amanda G, Tobe-Gai, Ruoyan, Tobollik, Myriam, Tonelli, Marcello, Topor-Madry, Roman, Tortajada, Miguel, Touvier, Mathilde, Traebert, Jefferson, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thomas, Tsoi, Derrick, Tuzcu, Emin Murat, Tymeson, Hayley, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, Van Boven, Job FM, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J, Venkatesh, S, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Violante, Francesco S, Vishnu, Abhishek, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T, Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wijeratne, Tissa, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles DA, Woodbrook, Rachel, Woolf, Anthony D, Workicho, Abdulhalik, Xavier, Denis, Xu, Gelin, Yadgir, Simon, Yaghoubi, Mohsen, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Ye, Pengpeng, Yihdego, Mahari Gidey, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zegeye, Elias Asfaw, Zenebe, Zerihun Menlkalew, Zhang, Xueying, Zheng, Yingfeng, Zhou, Maigeng, Zipkin, Ben, Zodpey, Sanjay, Zoeckler, Leo, Zuhlke, Liesl Joanna, Murray, Christopher JL, and Collaborators, GBD DALYs HALE

Subjects
Adult, Aged, 80 and over, Male, 1. No poverty, Middle Aged, Global Health, Communicable Diseases, 3. Good health, Global Burden of Disease, Age Distribution, Life Expectancy, Residence Characteristics, Cause of Death, Humans, Wounds and Injuries, Disabled Persons, Female, sense organs, Quality-Adjusted Life Years, Sex Distribution, Noncommunicable Diseases, Aged
Abstract

Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI).

4. Multiple Sclerosis Progressive Courses: A Clinical Cohort Long-Term Disability Progression Study.

Author

Cortesi PA, Fornari C, Capra R, Cozzolino P, Patti F, and Mantovani LG

Subjects
Cohort Studies, Disability Evaluation, Disease Progression, Humans, Longitudinal Studies, Recurrence, Multiple Sclerosis epidemiology, Multiple Sclerosis, Chronic Progressive epidemiology
Abstract

Objectives: Improving the understanding of multiple sclerosis (MS) mechanism and disability progression over time is essential to assess the value of healthcare interventions. Poor or no data on disability progression are available for progressive courses. This study aims to fill this gap., Methods: An observational cohort study of patients with primary MS (PPMS) and secondary progressive MS (SPMS) was conducted on 2 Italian MS centers disease registries over an observational time of 34 years. Annual transition probabilities among Expanded Disability Status Scale (EDSS) states were estimated using continuous Markov models. A sensitivity analysis was performed in relation to clinical characteristic associated to disability progression., Results: The study cohort included 758 patients (274 PPMS and 434 SPMS) with a median follow-up of 8.2 years. Annual transition probability matrices of SPMS and PPMS reported different annual probabilities to move within EDSS levels. Excluding EDSS associated to relapse events or patient with relapses, the annual probability of staying stable in an EDSS level increased in both disease courses even not significantly., Conclusions: This study provides estimates of annual disability progression as EDSS changes for PPMS and SPMS. These estimates could be a useful tool for healthcare decision makers and clinicians to properly assess impact of clinical interventions., (Copyright © 2022. Published by Elsevier Inc.)

Published
2022
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5. Management strategies and clinical outcomes in patients with inferior vena cava thrombosis: Data from GARFIELD-VTE.

Author

Cohen O, Ageno W, Farjat AE, Turpie AGG, Weitz JI, Haas S, Goto S, Goldhaber SZ, Angchaisuksiri P, Gibbs H, MacCallum P, Kayani G, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, and Kakkar AK

Subjects
Humans, Prospective Studies, Vena Cava, Inferior, Pulmonary Embolism epidemiology, Venous Thromboembolism epidemiology, Venous Thrombosis diagnosis, Venous Thrombosis drug therapy
Abstract

Background: Inferior vena cava (IVC) thrombosis is a rare form of venous thromboembolism (VTE). The optimal treatment strategies and outcomes are unclear in patients with this presentation., Objective: We aimed to compare baseline characteristics, treatment patterns and 24-month outcomes in IVC thrombosis patients (n = 100) with lower extremity deep vein thrombosis (LEDVT) patients (n = 7629)., Methods: GARFIELD-VTE is a prospective, observational registry of 10 868 patients with objectively diagnosed VTE from 415 sites in 28 countries., Results: IVC thrombosis patients were younger (51.9 vs. 59.8 years), more frequently had active cancer (26.0% vs. 8.9%) or history of cancer (21.0% vs. 12.2%), and less frequently had recent trauma or surgery than LEDVT patients. IVC thrombosis was more frequently treated with parenteral anticoagulants alone (35.1% vs. 15.9%), whereas patients with LEDVT more commonly received vitamin K antagonists (32.0% vs. 25.8%) or direct oral anticoagulants (49.0% vs. 35.1%). Thrombolysis (11.0% vs. 3.6%) and surgical/mechanical interventions (4.0% vs. 1.4%) were more frequent in IVC thrombosis. At 24-months, the rate per 100 person-years (95% confidence interval) of all-cause mortality was higher in patients with IVC thrombosis than LEDVT (13.28 [8.57-20.58] vs. 4.91 [4.55-5.3]); the incidence of cancer-associated mortality was comparable as was the incidence of VTE recurrence (4.11 [1.85-9.15] vs. 4.18 [3.84-4.55]). Major bleeding was slightly higher in IVC thrombosis (2.03 [0.66-6.31] vs. 1.66 [1.45-1.89])., Conclusion: In summary, IVC thrombosis patients have higher all-cause mortality rates than those with LEDVT, a finding only partly attributable to malignancy., (© 2021 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.)

Published
2022
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6. Influence of body mass index on clinical outcomes in venous thromboembolism: Insights from GARFIELD-VTE.

Author

Weitz JI, Farjat AE, Ageno W, Turpie AGG, Haas S, Goto S, Goldhaber SZ, Angchaisuksiri P, Gibbs H, MacCallum P, Carrier M, Kayani G, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, and Kakkar AK

Subjects
Anticoagulants therapeutic use, Body Mass Index, Hemorrhage, Humans, Prospective Studies, Venous Thromboembolism diagnosis
Abstract

Background: There is limited information on the influence of body mass index (BMI) on clinical outcomes in patients with venous thromboembolism (VTE)., Objectives: Investigate the influence of BMI on baseline characteristics, treatment patterns, and 24-month outcomes in VTE patients., Methods: GARFIELD-VTE is a prospective, non-interventional study of 10 869 patients with objectively confirmed VTE. Patients were grouped according to BMI: <18.5 (underweight; n = 214); 18.5-24.9 (normal; n = 2866); 25.0-29.9 (overweight; n = 3326); ≥30 (obese; n = 3073)., Results: Compared with patients with a normal BMI, obese patients were more frequently Caucasian (77.4% vs. 57.9%), treated in the outpatient setting (30.4% vs. 23.1%), and had previous VTE (17.5% vs. 11.7%). Active cancer was associated with lower BMI (underweight: 30.4%, normal: 13.5%, overweight: 9.4%, obese: 7.0%). At baseline, overweight and obese patients less often received parenteral therapy alone (16.7% and 14.4%) compared with those with an underweight or normal BMI (30.8% and 21.6%). Obese patients more commonly remained on anticoagulants for ≥2-years compared to those with a normal BMI (52.3% vs. 37.7%). After 24-months, the risk of all-cause mortality was lower in overweight and obese patients than in those with normal BMI (adjusted hazard ratio [95% CI]; 0.75 [0.63-0.89] and 0.59 [0.49-0.72], respectively). Underweight patients more often experienced major bleeding (2.45 [1.41-4.26]) and all-cause mortality (1.90 [1.43-2.53]) than patients with a normal BMI. Recurrent VTE was comparable among groups., Conclusion: Underweight VTE patients have the highest risk of mortality and major bleeding. The risk of mortality in obese VTE patients is lower than that in VTE patients with a normal BMI., (© 2021 International Society on Thrombosis and Haemostasis.)

Published
2021
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7. Cancer-Associated ThrOmboSIs - Patient-Reported OutcoMes With RivarOxaban (COSIMO) - Baseline characteristics and clinical outcomes.

Author

Maraveyas A, Beyer-Westendorf J, Lee AY, Mantovani LG, De Sanctis Y, Abdelgawwad K, Fatoba S, Bach M, and Cohen AT

Abstract

Background: Patients with cancer-associated thrombosis (CAT) have a high risk of recurrent venous thromboembolic events, which contribute to significant morbidity and mortality. Direct oral anticoagulants may provide a convenient treatment option for these patients., Objectives: To assess clinical characteristics and outcomes of patients with active cancer changing to rivaroxaban after ≥4 weeks of standard therapy for the treatment of venous thromboembolism (VTE) in clinical practice. This analysis focused on secondary outcomes of Cancer-associated thrOmboSIs - Patient-reported outcoMes with rivarOxaban (COSIMO)., Patients: COSIMO was a multinational, prospective, noninterventional, single-arm cohort study. Overall, 505 patients received at least one dose of rivaroxaban; 96.6% changing from low-molecular-weight heparin, 1.6% from a vitamin K antagonist, and 1.8% from fondaparinux., Results: Most patients had solid tumors (n = 449; 88.9%) and approximately half of these patients had metastases. The qualifying venous thromboembolic event was deep vein thrombosis (DVT) in 45.3% of patients, pulmonary embolism (PE) in 37.2% of patients, DVT with PE in 9.7% of patients, and catheter-associated DVT in 7.5% of patients. Approximately 75.1% of patients received rivaroxaban for at least 3 months; 150 (29.7%) patients received concomitant chemotherapy during the study. VTE recurrence, major bleeding, nonmajor bleeding, and major adverse cardiovascular events occurred in 18 (3.6%), 18 (3.6%), 81 (16.0%), and 12 (2.4%) patients, respectively., Conclusions: In patients with CAT who changed to rivaroxaban treatment after ≥4 weeks of standard therapy, the observed incidence proportions of recurrent VTE and bleeding events were in keeping with the recognized effectiveness and safety profile of rivaroxaban for the treatment of CAT., (© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).)

Published
2021
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8. Anticoagulant treatment for venous thromboembolism: A pooled analysis and additional results of the XALIA and XALIA-LEA noninterventional studies.

Author

Haas S, Mantovani LG, Kreutz R, Monje D, Schneider J, Zell ER, Tamm M, Gebel M, Bugge JP, Ageno W, and Turpie AGG

Abstract

Background: The XALIA and XALIA-LEA prospective, noninterventional studies investigated the safety and effectiveness of rivaroxaban versus standard anticoagulation for venous thromboembolism (VTE) treatment in routine clinical practice across global regions., Objectives: This pooled analysis combined their data to determine the incidence of thromboembolic and bleeding events in both treatment groups and addressed specific bleeding patterns in a broad range of patients., Methods: Patients with objectively confirmed VTE and an indication for ≥3 months' anticoagulation treatment received rivaroxaban or standard anticoagulation (eg, initial treatment with heparin/fondaparinux, followed by a vitamin K antagonist [VKA]). Treatment choice, dose, management, and duration were at the physician's discretion. Primary outcomes (major bleeding, recurrent VTE, and all-cause mortality) were compared between the two treatment groups. Propensity score stratification, and matching were used to reduce bias due to confounding variables., Results: Overall, 7129 patients were enrolled from 36 countries; 6445 and 2714 patients were included in the propensity score-stratified and -matched analyses, respectively. Major bleeding and incidences of recurrent VTE were similar between treatment groups; all-cause mortality was lower with rivaroxaban than with standard anticoagulation. The incidences of genitourinary bleeding were higher with rivaroxaban than with standard anticoagulation therapy (46 and 23 events in the matched analysis, respectively). VKA management in real-world practice was suboptimal., Conclusion: XALIA and XALIA-LEA show similar safety and effectiveness profiles of rivaroxaban and standard anticoagulation for VTE treatment in routine practice in many parts of the world. The observations are consistent with results from the phase III EINSTEIN randomized controlled trials., (© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).)

Published
2021
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9. Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE.

Author

Ageno W, Farjat A, Haas S, Weitz JI, Goldhaber SZ, Turpie AGG, Goto S, Angchaisuksiri P, Dalsgaard Nielsen J, Kayani G, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, and Kakkar AK

Abstract

Introduction: Venous thromboembolism (VTE) has a long-term risk of recurrence, dependent on the presence or absence of provoking risk factors at the time of the event., Objective: To compare clinical characteristics, anticoagulant patterns, and 12-month outcomes in patients with transient provoking factors, active cancer, and unprovoked VTE., Methods: The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE is a prospective, observational study that enrolled 10 207 patients with objectively diagnosed VTE from 415 sites in 28 countries., Results: Patients with transient provoking factors were younger (53.0 years) and more frequently women (61.2%) than patients with unprovoked VTE (60.3 years; 43.0% women) or active cancer (63.6 years; 51.7% women). After 6 months, 59.1% of patients with transient provoking factors remained on anticoagulation, compared to 71.3% with unprovoked VTE and 47.3% with active cancer. At 12 months, this decreased to 36.7%, 51.5%, and 25.4%, respectively. The risk of mortality (hazard ratio [HR], 1.21; 95% confidence interval [CI], 0.90-1.62), recurrent VTE (HR, 0.84; 95% CI, 0.62-1.14), and major bleeding (HR, 1.26; 95% CI, 0.86-1.85) was comparable in patients with transient provoking factors and unprovoked VTE. Patients with minor and major transient provoking factors had a similar risk of recurrent VTE (HR, 0.99; 95% CI, 0.59-1.66), but those with major transient risk factors had a lower risk of death (HR, 0.61; 95% CI, 0.38-0.98)., Conclusion: At 1 year, nearly 40% of patients with transient provoking factors and slightly over half of patients with unprovoked VTE were on anticoagulant treatment. Event rates were comparable between the two groups. Risk of death was higher in patients with minor transient factors than in those with major transient factors., (© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).)

Published
2021
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10. A review of global health technology assessments of non-VKA oral anticoagulants in non-valvular atrial fibrillation.

Author

Lopes RD, Berger SE, Di Fusco M, Kang A, Russ C, Afriyie A, Earley A, Deshpande S, and Mantovani LG

Subjects
Administration, Oral, Anticoagulants adverse effects, Dabigatran therapeutic use, Humans, Pyridones therapeutic use, Rivaroxaban therapeutic use, Stroke drug therapy, Stroke epidemiology, Stroke prevention & control, Technology Assessment, Biomedical, Atrial Fibrillation diagnosis, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology
Abstract

Background: This review assessed global health technology assessment (HTA) reports and recommendations of non-vitamin K oral anticoagulants (NOACs) in non-valvular atrial fibrillation (NVAF)., Methods: NHTA agency websites were searched for HTA reports evaluating NOACs versus NOACs or vitamin K antagonists. HTA methods and information on patient involvement/access were collected and empirically analyzed., Results: The review identified 38 unique HTA reports published between 2012 and 2017 in 16 countries including 11 in Europe. NOACs that were cost-effective per local willingness-to-pay (WTP) thresholds were positively recommended for the treatment of NVAF. WTP thresholds ranged from €20,000 to 69,000. Apixaban was recommended in 10/12 (83%) countries, dabigatran in 9/13 (69%) countries, and rivaroxaban in 10/13 (76%) over warfarin. Edoxaban was recommended in 5/7 (71%) countries. Economic evaluations and recommendations comparing NOACs were sparse (two or three countries per NOAC) and generally favored apixaban and edoxaban, followed by dabigatran. Eleven HTA reports from four countries considered the patient voice (Canada [n = 3], Scotland [n = 3], England [n = 4], Brazil [n = 1]); however, only 2/11 (18%) developed recommendations based on this. Among the reports with a positive recommendation, 26/30 (87%) featured a decision that aligned with the approved regulatory label., Conclusions: Most agencies recommended NOACs over warfarin for patients with NVAF. Few countries made statements recommending one NOAC over another. Given different WTP thresholds, a drug that is cost-effective in one market may not be in another. Therefore, the various NOAC recommendations from HTA agencies cannot be generalized across different countries., Competing Interests: Declaration of competing interest RDL received research support and consulting fees from Bristol-Myers Squibb and Pfizer. MDF and CR are employees of Pfizer, Inc. AK is an employee of Bristol-Myers Squibb Company. SB, AA, SD and AE are employees of Evidera, a research and consulting company which was paid by Pfizer and Bristol-Myers Squibb for collaboration on this project and manuscript. LGM received research support and fees from Pfizer., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2020
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11. Anticoagulation therapy patterns for acute treatment of venous thromboembolism in GARFIELD-VTE patients.

Author

Haas S, Ageno W, Weitz JI, Goldhaber SZ, Turpie AGG, Goto S, Angchaisuksiri P, Dalsgaard Nielsen J, Kayani G, Zaghdoun A, Farjat AE, Schellong S, Bounameaux H, Mantovani LG, Prandoni P, and Kakkar AK

Subjects
Aged, Aged, 80 and over, Anticoagulants adverse effects, Drug Utilization trends, Female, Guideline Adherence trends, Humans, Male, Middle Aged, Practice Guidelines as Topic, Pregnancy, Pulmonary Embolism blood, Pulmonary Embolism diagnosis, Pulmonary Embolism epidemiology, Registries, Time Factors, Treatment Outcome, Venous Thromboembolism blood, Venous Thromboembolism diagnosis, Venous Thromboembolism epidemiology, Venous Thrombosis blood, Venous Thrombosis diagnosis, Venous Thrombosis epidemiology, Anticoagulants administration & dosage, Blood Coagulation drug effects, Healthcare Disparities trends, Practice Patterns, Physicians' trends, Pulmonary Embolism drug therapy, Venous Thromboembolism drug therapy, Venous Thrombosis drug therapy
Abstract

Background: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices., Objectives: Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis., Methods: VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only., Results: A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC)., Conclusion: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to., (© 2019 International Society on Thrombosis and Haemostasis.)

Published
2019
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12. Cost-Effectiveness and Cost-Utility Analysis of Spinal Cord Stimulation in Patients With Failed Back Surgery Syndrome: Results From the PRECISE Study.

Author

Zucco F, Ciampichini R, Lavano A, Costantini A, De Rose M, Poli P, Fortini G, Demartini L, De Simone E, Menardo V, Cisotto P, Meglio M, Scalone L, and Mantovani LG

Subjects
Aged, Disability Evaluation, Failed Back Surgery Syndrome etiology, Failed Back Surgery Syndrome psychology, Female, Humans, Longitudinal Studies, Male, Middle Aged, Quality of Life, Quality-Adjusted Life Years, Retrospective Studies, Severity of Illness Index, Surveys and Questionnaires, Cost-Benefit Analysis, Failed Back Surgery Syndrome therapy, Spinal Cord Stimulation economics, Spinal Cord Stimulation methods
Abstract

Objective: To assess the cost-effectiveness and cost-utility of Spinal Cord Stimulation (SCS) in patients with failed back surgery syndrome (FBSS) refractory to conventional medical management (CMM)., Materials and Methods: We conducted an observational, multicenter, longitudinal ambispective study, where patients with predominant leg pain refractory to CMM expecting to receive SCS+CMM were recruited in 9 Italian centers and followed up to 24 months after SCS. We collected data on clinical status (pain intensity, disability), Health-Related Quality-of-Life (HRQoL) and on direct and indirect costs before (pre-SCS) and after (post-SCS) the SCS intervention. Costs were quantified in € 2009, adopting the National Health Service's (NHS), patient and societal perspectives. Benefits and costs pre-SCS versus post-SCS were compared to estimate the incremental cost-effectiveness and cost utility ratios., Results: 80 patients (40% male, mean age 58 years) were recruited. Between baseline and 24 months post-SCS, clinical outcomes and HRQoL significantly improved. The EQ-5D utility index increased from 0.421 to 0.630 (p < 0.0001). Statistically significant improvement was first observed six months post-SCS. Societal costs increased from €6600 (pre-SCS) to €13,200 (post-SCS) per patient per year. Accordingly, the cost-utility acceptability curve suggested that if decision makers' willingness to pay per Quality-Adjusted-Life-Years (QALYs) was €60,000, SCS implantation would be cost-effective in 80% and 85% of cases, according to the NHS's and societal point of views, respectively., Conclusions: Our results suggest that in clinical practice, SCS+CMM treatment of FBSS patients refractory to CMM provides good value for money. Further research is encouraged in the form of larger, long-term studies., (© 2015 International Neuromodulation Society.)

Published
2015
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13. Italian population-based values of EQ-5D health states.

Author

Scalone L, Cortesi PA, Ciampichini R, Belisari A, D'Angiolella LS, Cesana G, and Mantovani LG

Subjects
Adolescent, Adult, Age Factors, Aged, Attitude to Health, Cost-Benefit Analysis, Female, Humans, Italy, Male, Middle Aged, Psychometrics, Quality of Life, Sex Factors, Socioeconomic Factors, Time Factors, Young Adult, Health Status, Quality-Adjusted Life Years
Abstract

Objective: To estimate a value set for the calculation of Italian-specific quality-adjusted life years (QALYs), based on preferences elicited on EuroQol five-dimensional (EQ-5D) questionnaire health states using the time trade-off technique., Methods: The revised standard Measurement and Valuation of Health protocol was followed. Twenty-five health states, divided into three groups and given to 450 subjects, were selected to obtain 300 observations per state. Subjects aged 18 to 75 years were recruited to be representative of the Italian general adult population for age, sex, and geographical distribution. To improve efficiency, face-to-face interviews were conducted by using the Computer Assisted Personal Interviewing approach. Several random effects regression models were tested to predict the full set of EQ-5D questionnaire health states. Model selection was based on logical consistency of the estimates, sign and magnitude of the regression coefficients, goodness of fit, and parsimony., Results: The model that satisfied the criteria of logical consistency and was more efficient includes 10 main effect dummy variables for the EQ-5D questionnaire domain levels and the D1 interaction term, which accounts for the number of dimensions at levels 2 or 3 beyond the first. This model has an R(2) of 0.389 and a mean absolute error of 0.03, which are comparable to or better than those of models used in other countries. The utility estimates after state 11111 range from 0.92 (21111) to -0.38 (33333). Italian utility estimates are higher than those estimated in the United Kingdom and Spain and used so far to assess QALYs and conduct cost-utility evaluations in Italy., Conclusions: A specific value set is now available to calculate QALYs for the conduction of health economic studies targeted at the Italian health care system., (Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.)

Published
2013
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14. Burden of acute myocardial infarction.

Author

Mantovani LG, Fornari C, Madotto F, Riva MA, Merlino L, Ferrario MM, Chiodini V, Zocchetti A, Corrao G, and Cesana G

Subjects
Follow-Up Studies, Humans, Italy epidemiology, National Health Programs economics, Cost of Illness, Myocardial Infarction economics, Myocardial Infarction epidemiology
Published
2011
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16. Cost of care and quality of life for patients with hemophilia complicated by inhibitors: the COCIS Study Group.

Author

Gringeri A, Mantovani LG, Scalone L, and Mannucci PM

Subjects
Adult, Antibodies, Factor IX economics, Factor IX immunology, Factor IX therapeutic use, Factor VIII economics, Factor VIII immunology, Factor VIII therapeutic use, Financing, Personal, Hemophilia A drug therapy, Hemophilia A epidemiology, Hemophilia B drug therapy, Hemophilia B epidemiology, Humans, Longitudinal Studies, Middle Aged, Prevalence, Prospective Studies, Surveys and Questionnaires, Cost of Illness, Health Care Costs, Hemophilia A economics, Hemophilia B economics, Quality of Life
Abstract

Inhibitors in patients with hemophilia are a rare complication of a rare disease causing pain and disability in patients and impairment to the quality of their lives. Recent advances in treatment have brought improvements, but they have done so by absorbing larger amounts of financial resources. This study involved 52 Italian patients with hemophilia with high-responding inhibitors who were longitudinally observed for 18 months to evaluate concomitantly cost of care and quality of life. Overall, 0.6 bleeding episodes per patient per month were recorded. This frequency of events was lower than that reported in other cohorts of patients with hemophilia who were not taking inhibitors. The average monthly cost of care was, in euros, 18,000 (18,000 US dollars) per patient, mainly because of treatment products. Recombinant activated factor VII, mostly used for orthopedic surgery, represented 50% of the expenses. Quality of life, measured through validated questionnaires, was similar to that of patients with severe hemophilia without inhibitors. In particular, physical quality of life was similar to that in patients with diabetes and on dialysis, whereas mental quality of life was comparable to that in the general population. This study shows that hemophilia complicated by inhibitors, a prototype of rare disease, requires high amounts of resources for management that provides a satisfactory quality of life.

Published
2003
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