Search

Your search keyword '"Rivera, Adovich S."' showing total 156 results
Start Over Author "Rivera, Adovich S."
156 results on '"Rivera, Adovich S."'

11. Designing target trials using electronic health records: A case study of second-line disease-modifying anti-rheumatic drugs and cardiovascular disease outcomes in patients with rheumatoid arthritis.

Author

Rivera, Adovich S., Pierce, Jacob B., Sinha, Arjun, Pawlowski, Anna E., Lloyd-Jones, Donald M., Lee, Yvonne C., Feinstein, Matthew J., and Petito, Lucia C.

Subjects
*ANTIRHEUMATIC agents, *ELECTRONIC health records, *PRAGMATICS, *CARDIOVASCULAR agents, *RHEUMATOID arthritis, *CARDIOVASCULAR diseases, *DISCRIMINATION against overweight persons
Abstract

Background: Emulation of the "target trial" (TT), a hypothetical pragmatic randomized controlled trial (RCT), using observational data can be used to mitigate issues commonly encountered in comparative effectiveness research (CER) when randomized trials are not logistically, ethically, or financially feasible. However, cardiovascular (CV) health research has been slow to adopt TT emulation. Here, we demonstrate the design and analysis of a TT emulation using electronic health records to study the comparative effectiveness of the addition of a disease-modifying anti-rheumatic drug (DMARD) to a regimen of methotrexate on CV events among rheumatoid arthritis (RA) patients. Methods: We used data from an electronic medical records-based cohort of RA patients from Northwestern Medicine to emulate the TT. Follow-up began 3 months after initial prescription of MTX (2000–2020) and included all available follow-up through June 30, 2020. Weighted pooled logistic regression was used to estimate differences in CVD risk and survival. Cloning was used to handle immortal time bias and weights to improve baseline and time-varying covariate imbalance. Results: We identified 659 eligible people with RA with average follow-up of 46 months and 31 MACE events. The month 24 adjusted risk difference for MACE comparing initiation vs non-initiation of a DMARD was -1.47% (95% confidence interval [CI]: -4.74, 1.95%), and the marginal hazard ratio (HR) was 0.72 (95% CI: 0.71, 1.23). In analyses subject to immortal time bias, the HR was 0.62 (95% CI: 0.29–1.44). Conclusion: In this sample, we did not observe evidence of differences in risk of MACE, a finding that is compatible with previously published meta-analyses of RCTs. Thoughtful application of the TT framework provides opportunities to conduct CER in observational data. Benchmarking results of observational analyses to previously published RCTs can lend credibility to interpretation. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

17. Changes in Glomerular Filtration Rate After Switching From Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide Fumarate for Human Immunodeficiency Virus Preexposure Prophylaxis.

Author

Rivera, Adovich S, Pak, Katherine, Mefford, Matthew T, and Hechter, Rulin C

Subjects
*HIV, *GLOMERULAR filtration rate, *TENOFOVIR, *PROPENSITY score matching, *ELECTRONIC health records
Abstract

Background Tenofovir alafenamide fumarate (TAF) was promoted as a safer alternative to tenofovir disoproxil fumarate (TDF) for human immunodeficiency virus oral preexposure prophylaxis (PrEP). It is unknown if switching from TDF to TAF translates to improved renal function. We used electronic health record (EHR) data to assess changes in creatinine-estimated glomerular filtration rate (eGFR) after switching from TDF to TAF. Methods We conducted a retrospective cohort study using EHR data from Kaiser Permanente Southern California. We identified individuals who switched from TDF to TAF between October 2019 and May 2022 and used time-varying propensity score matching to identify controls who were on TDF ("nonswitchers"). We then used Bayesian longitudinal modeling to compare differences in eGFR between switching and nonswitching scenarios. Results Among 5246 eligible individuals, we included 118 TDF to TAF switchers and 114 nonswitchers. Compared to nonswitchers, switchers had older age of starting TDF but similar body weights at index date. A higher proportion of switchers were White, on Medicare or Medicaid, and had dyslipidemia at index date. Switching to TAF was associated with a higher eGFR compared to staying on TDF in 3–15 months post-switch, but the differences were not statistically significant (eg, month 9 difference: 1.27 [95% credible interval, −1.35 to 3.89]). While most of the estimated changes showed eGFR increase associated with switching, most were <2 eGFR units. Sensitivity analyses to address missingness or nonadherence showed similar results. Conclusions Switching from TDF to TAF for PrEP was associated with a nonsignificant increase in eGFR. Findings need to be confirmed using larger cohorts. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

18. Renal outcomes in adults with HBV, HIV and HBV/HIV coinfection after 3 years of antiviral therapy in urban Tanzania.

Author

Wu, En-Ling, Christian, Beatrice, Rivera, Adovich S, Fabian, Emanuel, Macha, Irene, Aris, Eric, Mpangala, Shida, Ulenga, Nzovu, Mugusi, Ferdinand, Murphy, Robert L, and Hawkins, Claudia A

Subjects
HEPATITIS B virus, HEPATITIS associated antigen, MIXED infections, HIV, GLOMERULAR filtration rate, CHRONIC kidney failure
Abstract

Background An enhanced understanding of renal outcomes in persons with chronic HBV, HIV, and HBV/HIV coinfection is needed to mitigate chronic kidney disease in regions where HBV and HIV are endemic. Objectives To investigate changes in estimated glomerular filtration rate (eGFR) in adults with HBV, HIV or HBV/HIV enrolled in a 3 year prospective cohort study of liver outcomes in Dar es Salaam, Tanzania and initiated on antiviral therapy. Methods We compared eGFR between and within groups over time using mixed-effects models. Results Four hundred and ninety-nine participants were included in the analysis (HBV: 164; HIV: 271; HBV/HIV: 64). Mean baseline eGFRs were 106.88, 106.03 and 107.18 mL/min/1.73 m2, respectively. From baseline to Year 3, mean eGFR declined by 4.3 mL/min/1.73 m2 (95% CI −9.3 to 0.7) and 3.7 (−7.8 to 0.5) in participants with HBV and HIV, respectively, and increased by 5.1 (−4.7 to 14.9) in those with HBV/HIV. In multivariable models, participants with HBV had lower eGFRs compared with those with HIV or HBV/HIV and, after adjusting for HBV DNA level and hepatitis B e antigen (HBeAg) status, significantly lower eGFRs than those with HBV/HIV at all follow-up visits. Conclusions In this Tanzanian cohort, coinfection with HBV/HIV did not appear to exacerbate renal dysfunction compared with those with either infection alone. Although overall changes in eGFR were small, persons with HBV experienced lower eGFRs throughout follow-up despite their younger age and similar baseline values. Longer-term studies are needed to evaluate continuing changes in eGFR and contributions from infection duration and other comorbidities. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

26. Additional file 1 of Analyses of Kaposi Sarcoma trends among adults establishing initial outpatient HIV care in Nigeria: 2006���2017

Author

Akanbi, Maxwell O., Bilaver, Lucy A., Achenbach, Chad, Hirschhorn, Lisa R., Rivera, Adovich S., Silas, Olugbenga A., Agaba, Patricia A., Agbaji, Oche, Shehu, Nathan Y., Sagay, Solomon A., Hou, Lifang, and Murphy, Robert L.

Abstract

Additional file 1: Figure 1. Kaposi Sarcoma prevalence among adults who initiated HIV care from 2006-2017 in Jos, Nigeria. (Model adjusted for year of enrollment, age, and sex. Year and age were expressed using restricted cubic splines with knots at years 2007, 2008 and 2011, and at ages 28, 34, and 40). HIV: Human Immunodeficiency Virus; Figure 2. Trends in CD4 T-cell count among adults who initiated HIV care from 2006-2017 in Jos, Nigeria. (Model adjusted for year of enrollment, age, and sex. Year and age were expressed using restricted cubic splines with knots at years 2007, 2008 and 2011, and at ages 28, 34, and 40). HIV: Human Immunodeficiency Virus.

Published
2022
Full Text
View/download PDF

27. Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Author

Sinha, Arjun, primary, Rivera, Adovich S., additional, Chadha, Simran A., additional, Prasada, Sameer, additional, Pawlowski, Anna E., additional, Thorp, Edward, additional, DeBerge, Matthew, additional, Ramsey-Goldman, Rosalind, additional, Lee, Yvonne C., additional, Achenbach, Chad J., additional, Lloyd-Jones, Donald M., additional, and Feinstein, Matthew J., additional

Published
2021
Full Text
View/download PDF

28. HBV co-infection is associated with persistently elevated liver stiffness measurement in HIV-positive adults: A 6-year single-centre cohort study in Nigeria

Author

Rivera, Adovich S, primary, Machenry, Stephen, additional, Okpokwu, Jonathan, additional, Olatunde, Bola, additional, Ugoagwu, Placid, additional, Auwal, Muazu, additional, Sule, Halima, additional, Agaba, Patricia, additional, Agbaji, Oche O, additional, Thio, Chloe L, additional, Murphy, Robert Leo, additional, and Hawkins, Claudia, additional

Published
2021
Full Text
View/download PDF

32. Association of immune cell subsets with cardiac mechanics in the Multi-Ethnic Study of Atherosclerosis

Author

Sinha, Arjun, primary, Rivera, Adovich S., additional, Doyle, Margaret F., additional, Sitlani, Colleen, additional, Fohner, Alison, additional, Huber, Sally A., additional, Olson, Nels C., additional, Lima, Joao A.C., additional, Delaney, Joseph A., additional, Feinstein, Matthew J., additional, Shah, Sanjiv J., additional, Tracy, Russel P., additional, and Psaty, Bruce M., additional

Published
2021
Full Text
View/download PDF

33. Association between Ambient Temperature and Severe Diarrhoea in the National Capital Region, Philippines

Author

Chua, Paul L. C., Ng, Chris Fook Sheng, Rivera, Adovich S., Salva, Eumelia P., Salazar, Miguel Antonio, Huber, Veronika, Hashizume, Masahiro, Chua, Paul L. C., Ng, Chris Fook Sheng, Rivera, Adovich S., Salva, Eumelia P., Salazar, Miguel Antonio, Huber, Veronika, and Hashizume, Masahiro

Abstract

Epidemiological studies have quantified the association between ambient temperature and diarrhoea. However, to our knowledge, no study has quantified the temperature association for severe diarrhoea cases. In this study, we quantified the association between mean temperature and two severe diarrhoea outcomes, which were mortality and hospital admissions accompanied with dehydration and/or co-morbidities. Using a 12-year dataset of three urban districts of the National Capital Region, Philippines, we modelled the non-linear association between weekly temperatures and weekly severe diarrhoea cases using a two-stage time series analysis. We computed the relative risks at the 95th (30.4 °C) and 5th percentiles (25.8 °C) of temperatures using minimum risk temperatures (MRTs) as the reference to quantify the association with high- and low-temperatures, respectively. The shapes of the cumulative associations were generally J-shaped with greater associations towards high temperatures. Mortality risks were found to increase by 53.3% [95% confidence interval (CI): 29.4%; 81.7%)] at 95th percentile of weekly mean temperatures compared with the MRT (28.2 °C). Similarly, the risk of hospitalised severe diarrhoea increased by 27.1% (95% CI: 0.7%; 60.4%) at 95th percentile in mean weekly temperatures compared with the MRT (28.6 °C). With the increased risk of severe diarrhoea cases under high ambient temperature, there may be a need to strengthen primary healthcare services and sustain the improvements made in water, sanitation, and hygiene, particularly in poor communities., International Journal of Environmental Research and Public Health, 18(15), art. no. 8191; 2021

Published
2021

45. PW 2524 Determining availability, accessibility, affordabilty, and acceptability of child restraints to support legislation on mandatory child restraint use in philippines

Author

Lam, Hilton, primary, Atienza, Wilfrido A, additional, Rivera, Adovich S, additional, Miguel, Red Thaddeus DP, additional, Go, John Juliard L, additional, Quintana, Ronaldo O, additional, Jason, Kent, additional, Mamporte, Amelyn A, additional, and Candelaria, Maria Eleanor L, additional

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results