Treatments success rates

Recently, results from a 14-week study, with HbAlc at baseline of approximately 8.5%, have demonstrated an HbAlc reduction of 1.75% in the absence of any cases of minor or major hypogly-caemia [6]. Treatment success rate, defined as the proportion of patients achieving HbAlc of 7% or less in the absence of hypoglycaemia during the preceding 12 weeks, was 50% and thus exceeds that reported for other diabetes drug classes at this baseline HbAlc. 

VD as monotherapy had a satisfactory resporrse rate between 22 and 96% and a treatment success rate ranging from 4 to 40%. VDS had a satisfactory response rate between 35 and 53%. A meta-analysis found a probability of success twice higher with VDS than with VD in adult plaque psoriasis, while the cost/efficacy ratio was evaluated as 1.2 to 1.8 times higher for VDS than for VD. In conclusion VDS is twice more effective than VD, although additional studies are needed to clarify maintenance treatment, impact on quality of life and treatment of non-plaque psoriasis. It will be important to harmonise outcome measures in future studies with topical agents in psoriasis to better appraise their efficacy. 

The factors that correlate with treatment success do not clearly apply to success after detoxification from methadone maintenance. Correlates of successful detoxification include 1) less criminal behavior 2) more stable family 3) more stable employment 4) shorter drug history 5) long maintenance with lower dosage and 6) discharge status, with patient and staff consensus as opposed to unilateral discharge from treatment (Dole and Joseph 1978). In one study, addicts were followed an average of 2 years after detoxification (Stim-mel et al. 1977). Although only 28% of the total sample remained abstinent, 83% of those who had fully completed treatment remained abstinent. Another study of 105 patients detoxified after methadone maintenance treatment documented an 82% relapse rate within 12 months (Ball and Ross 1991). These... 

With few exceptions, models find in favour of newer compounds Qonsson and Bebbington, 1994 Le Pen et al, 1994 McFarland, 1994 Stewart, 1994 Einarson et al, 1995 Lapierre et al, 1995 Nuitjen et al, 1995 Montgomeiy et al, 1996). One study (CCOHTA, 1997) did make allowances for variations in practice and patient behaviour. The results indicated that in the short term treatment was likely to be more successful with an SSRI than with a TCA, but at a higher cost. However, when treatment dropout rates found in naturalistic studies were substituted for drop-out rates found in controlled trials, the cost differences became smaller. When cost-utility analysis was applied, this increased cost was offset by improvements in quality of life for the patients. 

Initiation of a second HP treatment regimen after failure of the initial treatment regimen is usually associated with a lower success rate. Reasons for failure are often the same as those reported with failure of the initial regimen patient non-compliance and/or... 

VEDs are one of the most effective treatment modalities for ED. They have a success rate of greater than 90% in obtaining an erection sufficient for coitus and are considered a first-line non-invasive therapy.13 Rigidity may be improved by using a double pump technique in which the vacuum is applied for a couple of minutes, removed, then reapplied for another few minutes. Higher efficacy rates can also be achieved by combining VEDs with other therapies. 

The use of vincristine to treat thrombotic thrombocytopenic purpura has also been reported to be successful 14,18). This rare disease of sporadic thrombosis of small vessels with consequent intravascular hemolysis has been successfully treated recently with both plasma exchange and plasma infusion. However, there are obvious disadvantages to plasma infusion, including volume overload, transmission of infection, and cost and scarcity of plasma. Several patients have been successfully treated with vincristine alone or in association with plasma therapy. At present, however, this treatment should probably not be used alone because of the high success rate of plasma infusion and/or exchange. 

Elderly In the two phase 3 clinical studies in patients with complicated skin and skin structure infections (cSSSI), lower clinical success rates were seen in patients 65 years of age and older compared with those younger than 65 years of age. In addition, treatment-emergent adverse events were more common in patients 65 years of age and older than in patients younger than 65 years of age in both cSSSI studies. 

In a parallel group, placebo-controlled trial in acute stroke the primary endpoint is success on the Barthel index at month 3. Previous data suggests that the success rate on placebo will be 35 per cent and it is required to detect an improvement in the active treatment group to 50 per cent. How many patients are needed for 90 per cent power ... 

Follow-up of depressed youth and adults has shown that, despite successful acute psychotherapy or pharmacological treatment, the rate of relapse or recurrence at 6 to 12 months is about 40% to 60%, particularly in those who discontinue treatment (Vostanis et ah. 

Discontinuation trials, either controlled or open, usually are not likely to have any direct benefit and may well have real risks, such as relapse, suicide, and loss of employment. Such studies need additional scrutiny and safeguards to minimize risk and to strengthen consent procedures. There are some situations in which a discontinuation study may be considered. For example, to determine whether long-term treatment is needed, a study design might randomly assign patients who have responded successfully to a particular treatment to either a continuation or discontinuation of that treatment. Relapse rates across these two conditions could... 

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