scholarly journals Preimplantation Genetic Testing for Polygenic Disease Relative Risk Reduction: Evaluation of Genomic Index Performance in 11,883 Adult Sibling Pairs

Genes ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 648 ◽  
Author(s):  
Nathan R. Treff ◽  
Jennifer Eccles ◽  
Diego Marin ◽  
Edward Messick ◽  
Louis Lello ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
Embryo Selection ◽  
Type I ◽  
Preimplantation Genetic Testing ◽  
Sibling Pairs ◽  
Polygenic Disease ◽  
Diabetes Status

Preimplantation genetic testing for polygenic disease risk (PGT-P) represents a new tool to aid in embryo selection. Previous studies demonstrated the ability to obtain necessary genotypes in the embryo with accuracy equivalent to in adults. When applied to select adult siblings with known type I diabetes status, a reduction in disease incidence of 45–72% compared to random selection was achieved. This study extends analysis to 11,883 sibling pairs to evaluate clinical utility of embryo selection with PGT-P. Results demonstrate simultaneous relative risk reduction of all diseases tested in parallel, which included diabetes, cancer, and heart disease, and indicate applicability beyond patients with a known family history of disease.

Lipid Management with Statins in Type 2 Diabetes Mellitus

2005 ◽  
Vol 39 (10) ◽  
pp. 1714-1719 ◽  
Author(s):  
Brian K Irons ◽  
Lisa A Kroon
Keyword(s):  
Cardiovascular Disease ◽  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
Data Extraction ◽  
Density Lipoprotein ◽  
Coronary Event ◽  
Lipid Management ◽  
Medline Search ◽  
Patients With Diabetes

OBJECTIVE: To provide an update on lipid management and recent modifications in cholesterol guidelines for use of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), specifically in patients with diabetes. DATA SOURCES: Studies and guidelines were identified through a MEDLINE search (1996–April 2005). STUDY SELECTION AND DATA EXTRACTION: Studies were selected for review if the primary treatment intervention was a statin, at least 4% of the study population held a diagnosis of diabetes, and diabetes subgroup analysis was available. DATA SYNTHESIS: The Heart Protection Study demonstrated an approximately 25% relative risk reduction of a first coronary event in patients with diabetes, a reduction similar to those without diabetes. In subjects with diabetes, a significant reduction in coronary events was noted regardless of the baseline cholesterol level. The Collaborative Atorvastatin Diabetes Study demonstrated a 37% relative risk reduction in the primary prevention of cardiovascular morbidity in patients with diabetes. CONCLUSIONS: Based on the current literature, a low-density lipoprotein cholesterol (LDL-C) level <100 mg/dL remains an appropriate goal for patients with diabetes in the absence of established cardiovascular disease. For higher-risk patients, such as those with diabetes and a history of cardiovascular disease, a more stringent LDL-C goal of <70 mg/dL is an option according to current clinical trial evidence. At least a 30–40% reduction in the LDL-C level is advisable when initiating statin therapy.

Absolute v relative risk reduction

BMJ ◽  
2010 ◽  
Vol 341 (nov16 4) ◽  
pp. c6333-c6333
Author(s):  
P. E. Norman
Keyword(s):  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction

scholarly journals Effects of semaglutide on risk of cardiovascular events across a continuum of cardiovascular risk: combined post hoc analysis of the SUSTAIN and PIONEER trials

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Mansoor Husain ◽  
Stephen C. Bain ◽  
Anders Gaarsdal Holst ◽  
Thomas Mark ◽  
Søren Rasmussen ◽  
...  
Keyword(s):  
Relative Risk ◽  
High Risk ◽  
Prediction Model ◽  
Risk Reduction ◽  
Risk Prediction ◽  
Risk Score ◽  
Relative Risk Reduction ◽  
Absolute Risk ◽  
Post Hoc Analysis ◽  
Post Hoc

Abstract Background Semaglutide is a glucagon-like peptide-1 (GLP-1) analog treatment for type 2 diabetes (T2D) available in subcutaneous (s.c.) and oral formulations. Two cardiovascular (CV) outcomes trials showed that in subjects with T2D at high risk of CV events there were fewer major adverse CV events (MACE; defined as CV death, non-fatal stroke, non-fatal myocardial infarction) with semaglutide than with placebo (hazard ratio [95% CI]: 0.74 [0.58;0.95] for once-weekly s.c. semaglutide and 0.79 [0.57;1.11] for once-daily oral semaglutide). However, there is little evidence for an effect of semaglutide on MACE in subjects not at high risk of CV events. This post hoc analysis examined CV effects of semaglutide in subjects across a continuum of baseline CV risk. Methods Data from the s.c. (SUSTAIN) and oral (PIONEER) semaglutide phase 3a clinical trial programs were combined according to randomized treatment (semaglutide or comparators) and analyzed to assess time to first MACE and its individual components. A CV risk model was developed with independent data from the LEADER trial (liraglutide vs placebo), considering baseline variables common to all datasets. Semaglutide data were analyzed to assess effects of treatment as a function of CV risk predicted using the CV risk prediction model. Results The CV risk prediction model performed satisfactorily when applied to the semaglutide data set (area under the curve: 0.77). There was a reduced relative and absolute risk of MACE for semaglutide vs comparators across the entire continuum of CV risk. While the relative risk reduction tended to be largest with low CV risk score, the largest absolute risk reduction was for intermediate to high CV risk score. Similar results were seen for relative risk reduction of the individual MACE components and also when only placebo comparator data were included. Conclusion Semaglutide reduced the risk of MACE vs comparators across the continuum of baseline CV risk in a broad T2D population. Trial registrations ClinicalTrials.gov identifiers: NCT02054897, NCT01930188, NCT01885208, NCT02128932, NCT02305381, NCT01720446, NCT02207374, NCT02254291, NCT02906930, NCT02863328, NCT02607865, NCT02863419, NCT02827708, NCT02692716, NCT02849080, NCT03021187, NCT03018028, NCT03015220.

scholarly journals PMDI: A NEW METHOD FOR TIME ADJUSTMENT OF THE NUMBER NEEDED TO TREAT REGARDING VARIABLE RELATIVE RISK REDUCTION

2003 ◽  
Vol 6 (3) ◽  
pp. 291
Author(s):  
H Aino ◽  
S Yanagisawa ◽  
L Cai ◽  
H Inoue ◽  
K Nakajo ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
New Method ◽  
Number Needed To Treat

Radiation Therapy Plus Tamoxifen Versus Tamoxifen Alone After Breast-Conserving Surgery in Postmenopausal Women With Stage I Breast Cancer: A Decision Analysis

2003 ◽  
Vol 21 (12) ◽  
pp. 2260-2267 ◽  
Author(s):  
Rinaa S. Punglia ◽  
Karen M. Kuntz ◽  
Jason H. Lee ◽  
Abram Recht
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
Breast Conserving Surgery ◽  
Sensitivity Analyses ◽  
Recurrence Free Survival ◽  
Health States ◽  
Free Survival

Purpose: To compare outcomes for hypothetical cohorts of postmenopausal patients with estrogen receptor–positive tumors that are ≤ 2 cm in size, with pathologically uninvolved axillary nodes, treated with radiation therapy plus tamoxifen versus tamoxifen alone after breast-conserving surgery. Methods: A Markov model was used to simulate patients’ clinical course and estimate overall survival, recurrence-free survival, time with an intact breast, and death from breast cancer. Probabilities were derived from randomized trials and retrospective studies. Analyses were performed separately by age of diagnosis in 5-year increments from 50 to 80 years. Sensitivity analyses tested the stability of radiation benefit. Results: The modeled recurrence-free survival benefit of giving radiation therapy was 3.35 years for women who were 50 years of age at diagnosis, versus 0.61 years for women who were 80 years of age. In the 50-year-old cohort, radiation therapy resulted in additional 0.60 years survival, compared with 0.04 years among 80-year-olds. A 50-year-old woman who received radiation therapy plus tamoxifen was less likely to die from breast cancer than if she received tamoxifen alone (2.43% v 5.29%; relative-risk reduction, 54%). An 80-year-old woman had a 1.17% chance of dying from breast cancer if she received radiation therapy plus tamoxifen, versus 2.02% with tamoxifen alone (relative-risk reduction, 42%). Sensitivity analyses showed that the magnitude of benefit was strongly influenced by including unequal rates of developing distant disease after breast recurrence between the treatment arms and varying rates of local recurrence. Conclusion: The absolute and relative benefits of radiation therapy and individual patient preferences for different health states should be considered when selecting treatment.

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