Using Registers to Study Effectiveness and Safety of Drugs
https://doi.org/10.17650/1818-8338-2012-3-4-4-9
Abstract
The article discusses the main aspects of registers use to evaluate the effectiveness and safety of drugs. It is noted that the results of the randomized clinical trials are currently constitute the highest level of evidence in medicine, but they have several limitations. Besides, in many
cases evidence based on the results of the randomized clinical trials (RCTs) is simply missing. In this connection need for observational studies that, despite some limitations often supplement the information obtained in the RCT is discussed. Registers as the way to study the effectiveness and safety of drugs could help overcome some limitations of observational studies. The examples of both Russian and foreign studies held within registers in order to study the effectiveness of drugs in cardiology are provided. The framework for RCTs and registries contribution in studying effectiveness and safety of a drug is proposed.
About the Authors
L. Yu. DrozdovaRussian Federation
N. P. Kutishenko
Russian Federation
M. L. Ginzburg
Russian Federation
References
1. Гланц С. Медико-биологическая статистика. Пер. с англ. М.: Практика, 1998.
2. Флетчер Р., Флетчер С., Вагнер Э. Клиническая эпидемиология: Основы доказательной медицины. М.: Медиа Сфера, 1998.
3. Stanley K. Evaluation of randomized controlled trials. Circulation 2007;115(13):1819–22.
4. Эффективность и безопасность лекарственной терапии при первичной и вторичной профилактике сердечно-сосудистых заболеваний. Рекомендации ВНОК, 2011. Рационал фармакотер в кардиол 2011;7(5 приложение):2–72.
5. Strom B.L., Kimmel S.E., Hennessy S. Pharmacoepidemiology. 5th Edition New York: John Wiley & Sons Ltd., 2012.
6. Chen Z.M., Pan H.C., Chen Y.P. et al. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005;366(9497):1622–32.
7. Avorn J. In defense of pharmacoepidemiologyembracing the yin and yang of drug research. N Engl J Med 2007;357(22):2219–21.
8. Rawlins M. De testimonio: on the evidence for decisions about the use of therapeutic interventions. Lancet 2008;372(9656):2152–61.
9. Norris S., Atkins D., Bruening W. et al. Selecting Observational Studies for Comparing Medical Interventions. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/196/454/
10. MethodsGuideNorris_06042010.pdf.
11. Gliklich R.E. Registries for Evaluating Patient Outcomes: A User’s Guide. Available at: http://effectivehealthcare.ahrq.gov/ehc/products/74/531/Registries%202nd%20ed%20final%20to%20Eisenberg%209-15-10.pdf.
12. Tricoci P., Allen J.M., Kramer J.M. et al. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA 2009;301(8):831–41.
13. Flint A.C., Kamel H., Navi B.B. et al. Inpatient statin use predicts improved ischemic stroke discharge disposition. Neurology 2012;78(21):1678–83.
14. Horinaka S., Yabe A., Yagi H. et al. Effects of nicorandil on cardiovascular events in patients with coronary artery disease in the Japanese Coronary Artery Disease (JCAD) study. CircJ 2010;74(3):503–9.
15. Stauffer J.C., Goy J.J., Duvoisin N. et al.; AMIS group. Dramatic effect of early clopidogrel administration in reducing mortality and MACE rates in ACS patients. Data from the Swiss registry AMIS-Plus. Swiss Med Wkly 2012;142:w13573.
16. Callahan A., Amarenco P., Goldstein L.B. et al. Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Arch Neurol 2011;68(10):1245–51.
17. Марцевич С.Ю., Гинзбург М.Л., Кутишенко Н.П. и др. Исследование ЛИС (Люберецкое исследование смертности больных, перенесших острый инфаркт миокарда): портрет заболевшего. Кардиоваскул тер и профил 2011;10(6):89–93.
18. Марцевич С.Ю., Гинзбург М.Л., Кутишенко Н.П. и др. Люберецкое исследование по изучению смертности больных, перенесших острый инфаркт миокарда. Первые результаты исследования «ЛИС». Клиницист 2011;(2):24–7.
19. Марцевич С.Ю., Гинзбург М.Л., Кутишенко Н.П. и др. Исследование ЛИС (Люберецкое исследование смертности больных, перенесших острый инфаркт миокарда). Оценка лекарственной терапии. Часть 1. Как лечатся больные перед инфарктом миокарда и как это влияет на смертность в стационаре. Рационал фармакотер в кардиол 2012;8(5):681–84.
20. Yang Y., West-Strum D. Understanding Pharmacoepidemiology. NY: McGraw-Hill Medical, 2010.
Review
For citations:
Drozdova L.Yu., Kutishenko N.P., Ginzburg M.L. Using Registers to Study Effectiveness and Safety of Drugs. The Clinician. 2012;6(3-4):4-9. (In Russ.) https://doi.org/10.17650/1818-8338-2012-3-4-4-9