324 |
Lazarus G., Suhardi I.P., Wiyarta E., Rasyidah R.A., Barliana J.D. |
57214599425;57222253831;57221521342;57222252100;57200964187; |
Is there a need to reconsider the use of metformin in COVID-19 patients with type 2 diabetes mellitus? |
2021 |
International Journal of Diabetes in Developing Countries |
41 |
3 |
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377 |
382 |
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3 |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102035672&doi=10.1007%2fs13410-021-00924-w&partnerID=40&md5=6553878fa250ce9823f68e0c2659a9ff |
Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia; Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia |
Lazarus, G., Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia; Suhardi, I.P., Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia; Wiyarta, E., Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia; Rasyidah, R.A., Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No. 6, RW 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Jakarta, 10430, Indonesia; Barliana, J.D., Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia |
Introduction: Diabetes has been linked with poorer outcomes in coronavirus disease (COVID-19) patients. However, the question to whether continue or withdraw metformin therapy in COVID-19 patients with type 2 diabetes mellitus remains contentious. This study aims to investigate the association between metformin and poor COVID-19 outcomes. Methods: Eligible studies published up to 21 October 2020 were included and appraised for validity, importance, and applicability. The included studies were further ranked according to the level of evidence (LOE). Results: Nine studies were included for further assessments, of which seven studies stated that metformin was not associated with poor COVID-19 outcomes (LOE II-V), while the other two with poorer designs stated otherwise (LOE V). Although metformin may increase the risk of developing acidosis and lactic acidosis (LOE IV), the observed risks were more accentuated in patients with severe COVID-19 disease or kidney impairment and in patients with > 2 daily metformin doses. Interestingly, one study revealed that metformin may even yield therapeutic role in reducing the risk of COVID-19 mortality (LOE II), although further studies are required to confirm these findings. Conclusions: Our findings indicated that metformin may be safely continued in COVID-19 patients. The benefit of metformin therapy with simultaneous continuous monitoring of COVID-19 severity and kidney function may outweigh the risks of lactic acidosis, of which incidence is relatively rare. © 2021, Research Society for Study of Diabetes in India. |
COVID-19; Metformin; Prognosis; Type 2 diabetes mellitus |
hemoglobin A1c; metformin; acidosis; adult; Article; case report; clinical article; coronavirus disease 2019; diabetic patient; disease course; disease severity; drug safety; estimated glomerular filtration rate; glycemic control; human; kidney failure; kidney function; lactic acidosis; male; middle aged; mortality; mortality risk; non insulin dependent diabetes mellitus; prognosis; systematic review |
Springer |
09733930 |
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Article |
Q3 |
205 |
19024 |
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433 |
Jiamsakul A., Azwa I., Zhang F., Yunihastuti E., Ditangco R., Kumarasamy N., Ng O.T., Chan Y.-J., Ly P.S., Choi J.Y., Lee M.-P., Pujari S., Kiertiburanakul S., Chaiwarith R., Merati T.P., Sangle S., Khusuwan S., Sim B.L.H., Avihingsanon A., Do C.D., Tanuma J., Ross J., Law M., the TREAT Asia HIV Observational Database of IeDEA Asia-Pacific |
55285745500;55553159100;55503803800;57221273925;55406840800;7003549856;57203665233;33667461800;9743902800;48761023600;56143671100;57205894660;6506539792;57203665049;57203678680;6602877716;56166613100;9242778900;57200282477;56658396600;57208428839;57193109926;57222965808; |
Treatment modification after second-line failure among people living with HIV in Asia-Pacific |
2021 |
Antiviral Therapy |
25 |
7 |
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377 |
387 |
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85106544855&doi=10.3851%2fIMP3388&partnerID=40&md5=485e6ef464b90e2346135f1d92ba9394 |
The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; University of Malaya Medical Centre, Kuala Lumpur, Malaysia; Beijing Ditan Hospital, Capital Medical University, Beijing, China; Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Research Institute for Tropical Medicine, Manila, Philippines; Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), The Voluntary Health Services (VHS), Chennai, India; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Taipei Veterans General Hospital, Taipei, Taiwan; National Center for HIV/AIDS, Dermatology and STDs, University of Health Sciences, Phnom Penh, Cambodia; Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, South Korea; Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong; Institute of Infectious Diseases, Pune, India; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Research Institute for Health Sciences, Chiang Mai, Thailand; Faculty of Medicine, Udayana University, Sanglah Hospital, Bali, Indonesia; BJ Government Medical College, Sassoon General Hospital, Pune, India; Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; Hospital Sungai Buloh, Sungai Buloh, Malaysia; HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; Bach Mai Hospital, Hanoi, Viet Nam; National Center for Global Health and Medicine, Tokyo, Japan; TREAT Asia, AmfAR, The Foundation for AIDS Research, Bangkok, Thailand |
Jiamsakul, A., The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Azwa, I., University of Malaya Medical Centre, Kuala Lumpur, Malaysia; Zhang, F., Beijing Ditan Hospital, Capital Medical University, Beijing, China; Yunihastuti, E., Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Ditangco, R., Research Institute for Tropical Medicine, Manila, Philippines; Kumarasamy, N., Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), The Voluntary Health Services (VHS), Chennai, India; Ng, O.T., Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Chan, Y.-J., Taipei Veterans General Hospital, Taipei, Taiwan; Ly, P.S., National Center for HIV/AIDS, Dermatology and STDs, University of Health Sciences, Phnom Penh, Cambodia; Choi, J.Y., Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, College of Medicine, Seoul, South Korea; Lee, M.-P., Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong; Pujari, S., Institute of Infectious Diseases, Pune, India; Kiertiburanakul, S., Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Chaiwarith, R., Research Institute for Health Sciences, Chiang Mai, Thailand; Merati, T.P., Faculty of Medicine, Udayana University, Sanglah Hospital, Bali, Indonesia; Sangle, S., BJ Government Medical College, Sassoon General Hospital, Pune, India; Khusuwan, S., Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; Sim, B.L.H., Hospital Sungai Buloh, Sungai Buloh, Malaysia; Avihingsanon, A., HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; Do, C.D., Bach Mai Hospital, Hanoi, Viet Nam; Tanuma, J., National Center for Global Health and Medicine, Tokyo, Japan; Ross, J., TREAT Asia, AmfAR, The Foundation for AIDS Research, Bangkok, Thailand; Law, M., The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; the TREAT Asia HIV Observational Database of IeDEA Asia-Pacific |
Background: The World Health Organization recommends continuation with the failing second-line regimen if third-line option is not available. We investigated treatment outcomes among people living with HIV in Asia who continued with failing second-line regimens compared with those who had treatment modifications after failure. Methods: Treatment modification was defined as a change of two antiretrovirals, a drug class change or treatment interruption (TI), all for >14 days. We assessed factors associated with CD4 changes and undetectable viral load (UVL <1,000 copies/ml) at 1 year after second-line failure using linear and logistic regression, respectively. Survival time was analysed using competing risk regression. Results: Of the 328 patients who failed second-line ART in our cohorts, 208 (63%) had a subsequent treatment modification. Compared with those who continued the failing regimen, the average CD4 cell increase was higher in patients who had a modification without TI (difference =77.5, 95% CI 35.3, 119.7) while no difference was observed among those with TI (difference =-5.3, 95% CI -67.3, 56.8). Compared with those who continued the failing regimen, the odds of achieving UVL was lower in patients with TI (OR=0.18, 95% CI 0.06, 0.60) and similar among those who had a modification without TI (OR=1.97, 95% CI 0.95, 4.10), with proportions of UVL 60%, 22% and 75%, respectively. Survival time was not affected by treatment modifications. Conclusions: CD4 cell improvements were observed in those who had treatment modification without TI compared with those on the failing regimen. When no other options are available, maintaining the same failing ART combination provided better VL control than interrupting treatment. © 2020 International Medical Press |
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Human immunodeficiency virus proteinase inhibitor; nonnucleoside reverse transcriptase inhibitor; RNA directed DNA polymerase inhibitor; adult; antiretroviral therapy; Article; Asia; CD4 lymphocyte count; clinical outcome; cohort analysis; confidence interval; controlled study; female; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; linear regression analysis; logistic regression analysis; major clinical study; male; odds ratio; survival time; treatment duration; treatment modification; undetectable virus load; virus load |
International Medical Press Ltd |
13596535 |
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33843656 |
Article |
Q2 |
747 |
6553 |
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