The Comparative Effectiveness and Safety of Second-line Therapy in Patients with Type 2 Diabetes

2 型糖尿病患者二线治疗的有效性和安全性比较

基本信息

批准号：
9805224
负责人：
Jung-Im Shin
金额：
$ 15.85万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9805224
关键词：
Address Age Agonist Agreement American American College of Physicians Amputation Antidiabetic Drugs Benefits and Risks Blood Pressure Body mass index Cardiovascular Diseases Caring Characteristics Chronic Kidney Failure Clinical Consensus Creatinine Decision Making Diabetes Mellitus Dipeptidyl Peptidases Doctor of Philosophy Educational Curriculum Effectiveness End stage renal failure Endocrinologist Epidemiology Event Five-Year Plans Foundations Fracture GLP-I receptor General Population Glucose Glycosylated hemoglobin A Goals Guidelines Health Health system Healthcare Heart failure Hyperglycemia Hypoglycemia Incidence Infection Insulin International Israel Knowledge Lead Measurement Mediating Mentored Research Scientist Development Award Mentors Mentorship Metformin Methods Morbidity - disease rate Non-Insulin-Dependent Diabetes Mellitus Obesity Oral Outcome Participant Patient-Focused Outcomes Patients Pattern Pharmaceutical Preparations Pharmacoepidemiology Pharmacology Public Health Public Health Schools Race Recommendation Renal function Research Research Proposals Resources Risk Risk Assessment Robin bird Safety Scientist Socioeconomic Status Sodium Subgroup Sulfonylurea Compounds Sweden Therapeutic Thiazolidinediones Time Training Uncertainty Weight Gain World Health Organization adverse event risk cardiovascular disorder risk career clinical practice cohort comparative effectiveness cost diabetes management experience glycemic control improved individual patient inhibitor/antagonist mortality novel novel therapeutics optimal treatments programs sex side effect skills

项目摘要

PROJECT SUMMARY/ABSTRACT Jung-Im Shin, MD, PhD, is an Assistant Scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. She seeks a K01 Mentored Research Scientist Development Award in order to obtain essential skills and mentored research experience for an independent career as a research scientist in the field of pharmacoepidemiology and diabetes. The research proposal details a five-year plan consisting of in-depth training in novel causal inference methods, mentorship by Dr. Morgan Grams, MD, PhD, and Dr. Elizabeth Selvin, PhD, MPH, and pharmacoepidemiologic research in utilization, effectiveness, and safety of second-line therapy in patients with type 2 diabetes. The specific aims of the research agenda are to: 1) Describe the real-world epidemiology of second-line therapy among people with diabetes after metformin monotherapy; 2) Evaluate real-world effectiveness of 5 classes of second-line therapy for hyperglycemia management among similar people with diabetes after metformin monotherapy; and 3) Evaluate real-world risks of adverse events and benefits on long-term clinical outcomes of 5 classes of second- line therapy among similar people with diabetes after metformin monotherapy. Immediate career goals include the mastery of applying target trial emulation and estimating the effect of a dynamic treatment regime with Robin’s g-methods through an academic curriculum integrated with the research plan. Long-term, Dr. Shin aims to lead independent research programs investigating optimal treatment and decision-making to improve health outcomes of patients with type 2 diabetes. Completion of the proposed aims will provide vital information relevant to the approximately thirty million U.S. patients with type 2 diabetes. Type 2 diabetes is associated with high levels of morbidity and mortality. Although consensus exists around first-line therapy, there remains great uncertainty regarding the optimal choice of a second-line therapy, with inconsistent recommendations across guidelines. A better understanding of the risks and benefits of different classes of second-line antidiabetic drugs would greatly help clinical practice in patients with type 2 diabetes.

项目摘要/摘要 Jung-im Shin，医学博士，博士是约翰·霍普金斯（Johns Hopkins）流行病学系的助理科学家彭博公共卫生学院。她寻求K01指导的研究科学家发展奖为了获得基本技能并为研究的独立职业提供研究经验药物epidemiology和糖尿病领域的科学家。研究建议详细介绍了一个五年计划包括新的因果推理方法中的深入培训，Morgan Grams，MD的Mentalship，MD，博士学位和伊丽莎白·塞尔文（Elizabeth Selvin）博士，博士，MPH和Pharmacooepidemiologic in Plistization，Esivealive， 2型糖尿病患者的二线治疗的安全性。研究议程的具体目的为：1）描述糖尿病患者二线治疗的现实世界流行病学之后二甲双胍单一疗法； 2）评估5种二线治疗的现实世界有效性二甲双胍单一疗法后类似糖尿病患者的高血糖管理； 3）评估现实世界中不良事件的风险，并在5类第二类的临床结果上评估二甲双胍单一疗法后，类似糖尿病患者的线疗法。直接的职业目标包括应用目标试验仿真并估算动态治疗方案的效果的掌握罗宾（Robin）通过与研究计划相结合的学术课程的G-Methods。长期，Shin博士旨在领导独立研究计划调查最佳治疗和决策以改善 2型糖尿病患者的健康结果。拟议目标的完成将提供重要信息与大约300万美国2型糖尿病患者有关。 2型糖尿病是相关的具有高水平的发病率和死亡率。尽管在一线疗法周围存在共识，但仍有关于二线疗法的最佳选择的极大不确定性，建议不一致跨指南。更好地理解不同类别的二线类别的风险和好处抗糖尿病药物将极大地帮助2型糖尿病患者的临床实践。