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47 results on '"Mazzaglia, G"'

1. Treatment patterns in essential tremor: Real-world evidence from a United Kingdom and France primary care database

Author: Antonazzo, I, Rozza, D, Conti, S, Fornari, C, Cortesi, P, Eteve-Pitsaer, C, Paris, C, Gantzer, L, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo IC, Rozza D, Conti S, Fornari C, Cortesi PA, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, Mazzaglia G, Antonazzo, I, Rozza, D, Conti, S, Fornari, C, Cortesi, P, Eteve-Pitsaer, C, Paris, C, Gantzer, L, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo IC, Rozza D, Conti S, Fornari C, Cortesi PA, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, and Mazzaglia G
Abstract: Background and purpose: Essential tremor (ET) is one of the most common neurological disorders, but information on treatment pattern is still scant. The aim of this study was to describe the demographic and clinical characteristics, treatment patterns, and determinants of drug use in patients with newly diagnosed ET in France and the United Kingdom. Methods: Incident cases of ET diagnosed between January 1, 2015 and December 31, 2018 with 2 years of follow-up were identified by using The Health Improvement Network (THIN®) general practice database. During the follow-up, we assessed the daily prevalence of use and potential switches from first-line to second-line treatment or other lines of treatment. Logistic regression models were conducted to assess the effect of demographic and clinical characteristics on the likelihood of receiving ET treatment. Results: A total of 2957 and 3249 patients were selected in the United Kingdom and France, respectively. Among ET patients, drug use increased from 12 months to 1 month prior the date of index diagnosis (ID). After ID, nearly 40% of patients received at least one ET treatment, but during follow-up drug use decreased and at the end of the follow-up approximately 20% of patients were still on treatment. Among treated patients, ≤10% maintained the same treatment throughout the entire follow-up, nearly 20% switched, and 40%–75% interrupted any treatment. Results from the multivariate analysis revealed that, both in France and the United Kingdom, patients receiving multiple concomitant therapies and affected by psychiatric conditions were more likely to receive an ET medication. Conclusion: This study shows that ET is an undertreated disease with a lower-than-expected number of patients receiving and maintaining pharmacological treatment. Misclassification of ET diagnosis should be acknowledged; thus, results require cautious interpretation.
Published: 2024

2. Burden of Stroke in Europe: An Analysis of the Global Burden of Disease Study Findings from 2010 to 2019

Author: Prendes, C, Rantner, B, Hamwi, T, Stana, J, Feigin, V, Stavroulakis, K, Tsilimparis, N, Fernandez Prendes, C, Aboyans, P, Olusola Akinyemi, R, Al-Shahi Salman, R, Artamonov, A, Aujayeb, A, Baldereschi, M, Basu, S, Bejot, Y, Belo, L, Bennett, D, Srikanth Bhagavathula, A, Bikbov, B, Brenner, H, Dos Santos, F, Carrero, J, Carvalho, F, Catapano, A, Charalampous, P, Christensen, H, Chung, S, Angelo Cortesi, P, Marisa Costa, V, Cyganska, M, D'Amico, E, Davletov, K, Georgieva Dokova, K, Douiri, A, Francis Fagbamigbe, A, Fischer, F, Ghith, N, Giampaoli, S, Singh Gill, P, Gnedovskaya, E, Havmoeller, R, Hostiuc, S, Iavicoli, I, Ilic, M, Isola, G, Jerzy Jozwiak, J, Jurisson, M, Kayode, G, Khan, M, Khatab, K, Kisa, A, Kivimaki, M, Koyanagi, A, Kulimbet, M, Kusuma, D, La Vecchia, C, Lacey, B, Lallukka, T, Lorkowski, S, Majeed, P, Giovanni Mantovani, L, Mazzaglia, G, Mentis, A, Meretoja, A, Miao Jonasson, J, Mirica, A, Mirrakhimov, E, Mohammed, S, Molokhia, M, Monasta, L, Mons, U, Morze, J, Irina Negoi, R, Norrving, B, Oancea, B, O'Caoimh, R, Orru, H, Padron-Monedero, A, Pedersini, P, Perico, N, Polibin, R, Polinder, S, Raggi, A, Rawaf, S, Remuzzi, G, Romoli, M, Sacco, P, Reza Saeb, P, Vasco Santos, J, Santric-Milicevic, M, Aleksandrovna Skryabina, A, Smith, L, Starodubova, A, Stevanovic, A, Stranges, P, Teuschl, Y, Topor-Madry, R, Touvier, M, Tovani-Palone, M, Unim, B, Juhani Vasankari, T, Volovici, V, Wafa, H, Wang, Y, Westerman, R, Wolfe, P, Yesiltepe, M, Zanghi, A, Sergeevich Zastrozhin, M, Prendes C. F., Rantner B., Hamwi T., Stana J., Feigin V. L., Stavroulakis K., Tsilimparis N., Fernandez Prendes C., Aboyans P. V., Olusola Akinyemi R., Al-Shahi Salman R., Artamonov A. A., Aujayeb A., Baldereschi M., Basu S., Bejot Y., Belo L., Bennett D. A., Srikanth Bhagavathula A., Bikbov B., Brenner H., Dos Santos F., Carrero J. J., Carvalho F., Catapano A. L., Charalampous P., Christensen H., Chung S. -C., Angelo Cortesi P., Marisa Costa V., Cyganska M., D'Amico E., Davletov K., Georgieva Dokova K., Douiri A., Francis Fagbamigbe A., Fischer F., Ghith N., Giampaoli S., Singh Gill P., Gnedovskaya E. V., Havmoeller R. J., Hostiuc S., Iavicoli I., Ilic M. D., Isola G., Jerzy Jozwiak J., Jurisson M., Kayode G. A., Khan M. A. B., Khatab K., Kisa A., Kivimaki M., Koyanagi A., Kulimbet M., Kusuma D., La Vecchia C., Lacey B., Lallukka T., Lorkowski S., Majeed P. A., Giovanni Mantovani L., Mazzaglia G., Mentis A. -F. A., Meretoja A., Miao Jonasson J., Mirica A., Mirrakhimov E. M., Mohammed S., Molokhia M., Monasta L., Mons U., Morze J., Irina Negoi R., Norrving B., Oancea B., O'Caoimh R., Orru H., Padron-Monedero A., Pedersini P., Perico N., Polibin R. V., Polinder S., Raggi A., Rawaf S., Remuzzi G., Romoli M., Sacco P. S., Reza Saeb P. M., Vasco Santos J., Santric-Milicevic M. M., Aleksandrovna Skryabina A., Smith L., Starodubova A. V., Stevanovic A., Stranges P. S., Teuschl Y., Topor-Madry R., Touvier M., Tovani-Palone M. R., Unim B., Juhani Vasankari T., Volovici V., Wafa H. A., Wang Y., Westerman R., Wolfe P. C. D. A., Yesiltepe M., Zanghi A., Sergeevich Zastrozhin M., Prendes, C, Rantner, B, Hamwi, T, Stana, J, Feigin, V, Stavroulakis, K, Tsilimparis, N, Fernandez Prendes, C, Aboyans, P, Olusola Akinyemi, R, Al-Shahi Salman, R, Artamonov, A, Aujayeb, A, Baldereschi, M, Basu, S, Bejot, Y, Belo, L, Bennett, D, Srikanth Bhagavathula, A, Bikbov, B, Brenner, H, Dos Santos, F, Carrero, J, Carvalho, F, Catapano, A, Charalampous, P, Christensen, H, Chung, S, Angelo Cortesi, P, Marisa Costa, V, Cyganska, M, D'Amico, E, Davletov, K, Georgieva Dokova, K, Douiri, A, Francis Fagbamigbe, A, Fischer, F, Ghith, N, Giampaoli, S, Singh Gill, P, Gnedovskaya, E, Havmoeller, R, Hostiuc, S, Iavicoli, I, Ilic, M, Isola, G, Jerzy Jozwiak, J, Jurisson, M, Kayode, G, Khan, M, Khatab, K, Kisa, A, Kivimaki, M, Koyanagi, A, Kulimbet, M, Kusuma, D, La Vecchia, C, Lacey, B, Lallukka, T, Lorkowski, S, Majeed, P, Giovanni Mantovani, L, Mazzaglia, G, Mentis, A, Meretoja, A, Miao Jonasson, J, Mirica, A, Mirrakhimov, E, Mohammed, S, Molokhia, M, Monasta, L, Mons, U, Morze, J, Irina Negoi, R, Norrving, B, Oancea, B, O'Caoimh, R, Orru, H, Padron-Monedero, A, Pedersini, P, Perico, N, Polibin, R, Polinder, S, Raggi, A, Rawaf, S, Remuzzi, G, Romoli, M, Sacco, P, Reza Saeb, P, Vasco Santos, J, Santric-Milicevic, M, Aleksandrovna Skryabina, A, Smith, L, Starodubova, A, Stevanovic, A, Stranges, P, Teuschl, Y, Topor-Madry, R, Touvier, M, Tovani-Palone, M, Unim, B, Juhani Vasankari, T, Volovici, V, Wafa, H, Wang, Y, Westerman, R, Wolfe, P, Yesiltepe, M, Zanghi, A, Sergeevich Zastrozhin, M, Prendes C. F., Rantner B., Hamwi T., Stana J., Feigin V. L., Stavroulakis K., Tsilimparis N., Fernandez Prendes C., Aboyans P. V., Olusola Akinyemi R., Al-Shahi Salman R., Artamonov A. A., Aujayeb A., Baldereschi M., Basu S., Bejot Y., Belo L., Bennett D. A., Srikanth Bhagavathula A., Bikbov B., Brenner H., Dos Santos F., Carrero J. J., Carvalho F., Catapano A. L., Charalampous P., Christensen H., Chung S. -C., Angelo Cortesi P., Marisa Costa V., Cyganska M., D'Amico E., Davletov K., Georgieva Dokova K., Douiri A., Francis Fagbamigbe A., Fischer F., Ghith N., Giampaoli S., Singh Gill P., Gnedovskaya E. V., Havmoeller R. J., Hostiuc S., Iavicoli I., Ilic M. D., Isola G., Jerzy Jozwiak J., Jurisson M., Kayode G. A., Khan M. A. B., Khatab K., Kisa A., Kivimaki M., Koyanagi A., Kulimbet M., Kusuma D., La Vecchia C., Lacey B., Lallukka T., Lorkowski S., Majeed P. A., Giovanni Mantovani L., Mazzaglia G., Mentis A. -F. A., Meretoja A., Miao Jonasson J., Mirica A., Mirrakhimov E. M., Mohammed S., Molokhia M., Monasta L., Mons U., Morze J., Irina Negoi R., Norrving B., Oancea B., O'Caoimh R., Orru H., Padron-Monedero A., Pedersini P., Perico N., Polibin R. V., Polinder S., Raggi A., Rawaf S., Remuzzi G., Romoli M., Sacco P. S., Reza Saeb P. M., Vasco Santos J., Santric-Milicevic M. M., Aleksandrovna Skryabina A., Smith L., Starodubova A. V., Stevanovic A., Stranges P. S., Teuschl Y., Topor-Madry R., Touvier M., Tovani-Palone M. R., Unim B., Juhani Vasankari T., Volovici V., Wafa H. A., Wang Y., Westerman R., Wolfe P. C. D. A., Yesiltepe M., Zanghi A., and Sergeevich Zastrozhin M.
Abstract: BACKGROUND: While most European Regions perform well in global comparisons, large discrepancies within stroke epidemiological parameters exist across Europe. The objective of this analysis was to evaluate the stroke burden across European regions and countries in 2019 and its difference to 2010. METHODS: The GBD 2019 analytical tools were used to evaluate regional and country-specific estimates of incidence, prevalence, deaths, and disability-adjusted life years of stroke for the European Region as defined by the World Health Organization, with its 53 member countries (EU-53) and for European Union as defined in 2019, with its 28 member countries (EU-28), between 2010 and 2019. Results were analyzed at a regional, subregional, and country level. RESULTS: In EU-53, the absolute number of incident and prevalent strokes increased by 2% (uncertainty interval [UI], 0%-4%), from 1 767 280 to 1 802 559 new cases, and by 4% (UI, 3%-5%) between 2010 and 2019, respectively. In EU-28, the absolute number of prevalent strokes and stroke-related deaths increased by 4% (UI, 2%-5%) and by 6% (UI, 1%-10%), respectively. All-stroke age-standardized mortality rates, however, decreased by 18% (UI, -22% to -14%), from 82 to 67 per 100 000 people in the EU-53, and by 15% (UI, -18% to -11%), from 49.3 to 42.0 per 100 000 people in EU-28. Despite most countries presenting reductions in age-adjusted incidence, prevalence, mortality, and disability-adjusted life year rates, these rates remained 1.4×, 1.2×, 1.6×, and 1.7× higher in EU-53 in comparison to the EU-28. CONCLUSIONS: EU-53 showed a 2% increase in incident strokes, while they remained stable in EU-28. Age-standardized rates were consistently lower for all-stroke burden parameters in EU-28 in comparison to EU-53, and huge discrepancies in incidence, prevalence, mortality, and disability-adjusted life-year rates were observed between individual countries.
Published: 2024

3. Health and economic impact of dapagliflozin for type 2 diabetes patients who had or were at risk for atherosclerotic cardiovascular disease in the Italian general practitioners setting: a budget impact analysis

Author: Cortesi, P, Antonazzo, I, Palladino, P, Gnesi, M, Mele, S, D’Amelio, M, Zanzottera Ferrari, E, Mazzaglia, G, Mantovani, L, Cortesi, Paolo Angelo, Antonazzo, Ippazio Cosimo, Palladino, Pasquale, Gnesi, Marco, Mele, Silvia, D’Amelio, Marco, Zanzottera Ferrari, Elena, Mazzaglia, Giampiero, Mantovani, Lorenzo Giovanni, Cortesi, P, Antonazzo, I, Palladino, P, Gnesi, M, Mele, S, D’Amelio, M, Zanzottera Ferrari, E, Mazzaglia, G, Mantovani, L, Cortesi, Paolo Angelo, Antonazzo, Ippazio Cosimo, Palladino, Pasquale, Gnesi, Marco, Mele, Silvia, D’Amelio, Marco, Zanzottera Ferrari, Elena, Mazzaglia, Giampiero, and Mantovani, Lorenzo Giovanni
Abstract: Aim In 2022, in Italy, general practitioners (GPs) have been allowed to prescribe SGLT2i in Type 2 Diabetes (T2D) under National Health Service (NHS) reimbursement. In the pivotal clinical trial named DECLARE-TIMI 58, dapagliflozin reduced the risk of hospitalization for heart failure, CV death and kidney disease progression compared to placebo in a population of T2D patients. This study evaluated the health and economic impact of dapagliflozin for T2D patients who had or were at risk for atherosclerotic cardiovascular disease in the Italian GPs setting.Methods A budget impact model was developed to assess the health and economic impact of introducing dapagliflozin in GPs setting. The analysis was conducted by adopting the Italian NHS perspective and a 3-year time horizon. The model estimated and compared the health outcomes and direct medical costs associated with a scenario with dapagliflozin and other antidiabetic therapies available for GPs prescription (scenario B) and a scenario where only other antidiabetic therapies are available (scenario A). Rates of occurrence of cardiovascular and renal complications as well as adverse events were captured from DECLARE-TIMI 58 trial and the literature, while cost data were retrieved from the Italian tariff and the literature. One-way sensitivity analyses were conducted to test the impact of model parameters on the budget impact.Results The model estimated around 442.000 patients eligible for the treatment with dapagliflozin in the GPs setting for each simulated year. The scenario B compared to scenario A was associated with a reduction in the occurrence of cardiovascular and renal complication (-1.83%) over the 3 years simulated. Furthermore, the scenario A allowed for an overall cost saving of 102,692,305euro: 14,521,464euro in the first year, 33,007,064euro in the second and 55,163,777euro in the third. The cost of cost of drug acquisition, the probability of cardiovascular events and the percentage of patients potenti
Published: 2024

4. Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression

Author: Losa, L, Antonazzo, I, Di Martino, G, Mazzaglia, G, Tafuri, S, Mantovani, L, Ferrara, P, Losa, Lorenzo, Antonazzo, Ippazio Cosimo, Di Martino, Giuseppe, Mazzaglia, Giampiero, Tafuri, Silvio, Mantovani, Lorenzo Giovanni, Ferrara, Pietro, Losa, L, Antonazzo, I, Di Martino, G, Mazzaglia, G, Tafuri, S, Mantovani, L, Ferrara, P, Losa, Lorenzo, Antonazzo, Ippazio Cosimo, Di Martino, Giuseppe, Mazzaglia, Giampiero, Tafuri, Silvio, Mantovani, Lorenzo Giovanni, and Ferrara, Pietro
Abstract: Background: The adjuvanted recombinant zoster vaccine (RZV), consisting of varicella-zoster virus glycoprotein E (gE) and the AS01B adjuvant system, effectively prevents herpes zoster (HZ). In the absence of a well-defined correlate of protection, it is important to monitor the RZV immune response, as a proxy of clinical effectiveness. Methods: This systematic review examined post-vaccination parameters: humoral and cell-mediated immunity, avidity index, geometric mean concentration of antibody (GMC), and immunity persistence. The meta-analysis used a random-effects model, and subgroup and meta-regression analyses were conducted. Results: Among 37 included articles, after one month from RZV-dose 2, the pooled response rate for anti-gE humoral immunity was 95.2% (95%CI 91.9–97.2), dropping to 77.6% (95%CI 64.7–86.8) during immunosuppression. The anti-gE cell-mediated immunity-specific response reached 84.6% (95%CI 75.2–90.9). Varying factors, such as age, sex, coadministration with other vaccines, prior HZ, or live-attenuated zoster vaccine, did not significantly affect response rates. RZV induced a substantial increase in gE avidity. Immunity persistence was confirmed, with more rapid waning in the very elderly. Conclusions: This systematic review indicates that RZV elicits robust immunogenicity and overcomes immunocompromising conditions. The findings underscore the need for further research, particularly on long-term immunity, and have the potential to support HZ vaccination policies and programs.
Published: 2024

5. Epidemiology of SLE in Italy: an observational study using a primary care database

Author: Ferrara, P, Antonazzo, I, Zamparini, M, Fornari, C, Borrelli, C, Boarino, S, Bettiol, A, Mattioli, I, Palladino, P, Zanzottera Ferrari, E, Emmi, G, Mantovani, L, Mazzaglia, G, Ferrara, Pietro, Antonazzo, Ippazio C, Zamparini, Manuel, Fornari, Carla, Borrelli, Cristiana, Boarino, Silvia, Bettiol, Alessandra, Mattioli, Irene, Palladino, Pasquale, Zanzottera Ferrari, Elena, Emmi, Giacomo, Mantovani, Lorenzo G, Mazzaglia, Giampiero, Ferrara, P, Antonazzo, I, Zamparini, M, Fornari, C, Borrelli, C, Boarino, S, Bettiol, A, Mattioli, I, Palladino, P, Zanzottera Ferrari, E, Emmi, G, Mantovani, L, Mazzaglia, G, Ferrara, Pietro, Antonazzo, Ippazio C, Zamparini, Manuel, Fornari, Carla, Borrelli, Cristiana, Boarino, Silvia, Bettiol, Alessandra, Mattioli, Irene, Palladino, Pasquale, Zanzottera Ferrari, Elena, Emmi, Giacomo, Mantovani, Lorenzo G, and Mazzaglia, Giampiero
Abstract: Objectives To estimate the incidence and prevalence of SLE in Italy, and to describe the demographic and clinical characteristics of patients with newly diagnosed SLE. Methods A retrospective cohort study was conducted using The Health Improvement Network general practice database in Italy, encompassing data from 634 753 people. SLE cases were identified over the period 2017-2022, employing three alternative definitions to provide a more detailed understanding of SLE characteristics. Incidence rates were expressed as cases per 100 000 person-years and prevalence as cases per 100 000 people. Demographic and clinical characteristics of incident SLE cases were also studied. Results From 2017 to 2022, a total of 191 incident and 1385 prevalent cases were identified under our first definition. In 2022, the incidence rate was 6.51 cases (95% CI 6.29 to 6.74) per 100 000 person-years, and the prevalence 60.57 (95% CI 59.89 to 61.25) per 100 000 people, being the prevalence five times higher in women compared with men. Both estimates have trended upwards since 2017. A geographical variation across the country was also seen. The demographic and clinical characteristics of incident SLE cases were described, while the potential associations of SLE incidence with some pre-existing conditions were observed, such as chronic kidney disease, chronic hepatic disease, rheumatoid arthritis and Sjogren's syndrome. Conclusions The results of this nationwide study, the first conducted in Italy, showed that the incidence of SLE has increased in Italy in recent years. Age, sex, and area of residence strongly correlate with the epidemiology of this condition.
Published: 2024

6. Hepatitis B and C in Europe: an update from the Global Burden of Disease Study 2019

Author: Cortesi, P, Fornari, C, Conti, S, Antonazzo, I, Ferrara, P, Ahmed, A, Andrei, C, Andrei, T, Artamonov, A, Banach, M, Baravelli, C, Barnighausen, T, Bhagavathula, A, Briko, N, Calina, D, Carreras, G, Chung, S, Dianatinasab, M, Dubljanin, E, Durojaiye, O, Ezeonwumelu, I, Fagbamigbe, A, Fischer, F, Gallus, S, Glushkova, E, Golinelli, D, Gorini, G, Hassan, S, Hay, S, Hostiuc, M, Ilic, I, Ilic, M, Jakovljevic, M, Jamshidi, E, Jozwiak, J, Kabir, Z, Kauppila, J, Khalilov, R, Khan, M, Khatab, K, Koyanagi, A, La Vecchia, C, Lazarus, J, Ledda, C, Levi, M, Lopukhov, P, Loureiro, J, Matthews, P, Mentis, A, Mestrovic, T, Moazen, B, Mohammed, S, Monasta, L, Mulita, F, Murray, C, Negoi, I, Oancea, B, Palladino, C, Patel, J, Petcu, I, Postma, M, Rawaf, D, Rawaf, S, Romero-Rodriguez, E, Santric-Milicevic, M, Skryabin, V, Skryabina, A, Tabares-Seisdedos, R, Tampa, M, Taveira, N, Thiyagarajan, A, Tovani-Palone, M, Westerman, R, Zastrozhin, M, Mazzaglia, G, Mantovani, L, Cortesi P. A., Fornari C., Conti S., Antonazzo I. C., Ferrara P., Ahmed A., Andrei C. L., Andrei T., Artamonov A. A., Banach M., Baravelli C. M., Barnighausen T. W., Bhagavathula A. S., Briko N. I., Calina D., Carreras G., Chung S. -C., Dianatinasab M., Dubljanin E., Durojaiye O. C., Ezeonwumelu I. J., Fagbamigbe A. F., Fischer F., Gallus S., Glushkova E. V., Golinelli D., Gorini G., Hassan S., Hay S. I., Hostiuc M., Ilic I. M., Ilic M. D., Jakovljevic M., Jamshidi E., Jozwiak J. J., Kabir Z., Kauppila J. H., Khalilov R., Khan M. A., Khatab K., Koyanagi A., La Vecchia C., Lazarus J. V., Ledda C., Levi M., Lopukhov P. D., Loureiro J. A., Matthews P. C., Mentis A. -F. A., Mestrovic T., Moazen B., Mohammed S., Monasta L., Mulita F., Murray C. J. L., Negoi I., Oancea B., Palladino C., Patel J., Petcu I. -R., Postma M. J., Rawaf D. L., Rawaf S., Romero-Rodriguez E., Santric-Milicevic M. M., Skryabin V. Y., Skryabina A. A., Tabares-Seisdedos R., Tampa M., Taveira N., Thiyagarajan A., Tovani-Palone M. R., Westerman R., Zastrozhin M. S., Mazzaglia G., Mantovani L. G., Cortesi, P, Fornari, C, Conti, S, Antonazzo, I, Ferrara, P, Ahmed, A, Andrei, C, Andrei, T, Artamonov, A, Banach, M, Baravelli, C, Barnighausen, T, Bhagavathula, A, Briko, N, Calina, D, Carreras, G, Chung, S, Dianatinasab, M, Dubljanin, E, Durojaiye, O, Ezeonwumelu, I, Fagbamigbe, A, Fischer, F, Gallus, S, Glushkova, E, Golinelli, D, Gorini, G, Hassan, S, Hay, S, Hostiuc, M, Ilic, I, Ilic, M, Jakovljevic, M, Jamshidi, E, Jozwiak, J, Kabir, Z, Kauppila, J, Khalilov, R, Khan, M, Khatab, K, Koyanagi, A, La Vecchia, C, Lazarus, J, Ledda, C, Levi, M, Lopukhov, P, Loureiro, J, Matthews, P, Mentis, A, Mestrovic, T, Moazen, B, Mohammed, S, Monasta, L, Mulita, F, Murray, C, Negoi, I, Oancea, B, Palladino, C, Patel, J, Petcu, I, Postma, M, Rawaf, D, Rawaf, S, Romero-Rodriguez, E, Santric-Milicevic, M, Skryabin, V, Skryabina, A, Tabares-Seisdedos, R, Tampa, M, Taveira, N, Thiyagarajan, A, Tovani-Palone, M, Westerman, R, Zastrozhin, M, Mazzaglia, G, Mantovani, L, Cortesi P. A., Fornari C., Conti S., Antonazzo I. C., Ferrara P., Ahmed A., Andrei C. L., Andrei T., Artamonov A. A., Banach M., Baravelli C. M., Barnighausen T. W., Bhagavathula A. S., Briko N. I., Calina D., Carreras G., Chung S. -C., Dianatinasab M., Dubljanin E., Durojaiye O. C., Ezeonwumelu I. J., Fagbamigbe A. F., Fischer F., Gallus S., Glushkova E. V., Golinelli D., Gorini G., Hassan S., Hay S. I., Hostiuc M., Ilic I. M., Ilic M. D., Jakovljevic M., Jamshidi E., Jozwiak J. J., Kabir Z., Kauppila J. H., Khalilov R., Khan M. A., Khatab K., Koyanagi A., La Vecchia C., Lazarus J. V., Ledda C., Levi M., Lopukhov P. D., Loureiro J. A., Matthews P. C., Mentis A. -F. A., Mestrovic T., Moazen B., Mohammed S., Monasta L., Mulita F., Murray C. J. L., Negoi I., Oancea B., Palladino C., Patel J., Petcu I. -R., Postma M. J., Rawaf D. L., Rawaf S., Romero-Rodriguez E., Santric-Milicevic M. M., Skryabin V. Y., Skryabina A. A., Tabares-Seisdedos R., Tampa M., Taveira N., Thiyagarajan A., Tovani-Palone M. R., Westerman R., Zastrozhin M. S., Mazzaglia G., and Mantovani L. G.
Abstract: Background: In 2016, the World Health Assembly adopted the resolution to eliminate viral hepatitis by 2030. This study aims to provide an overview of the burdens of hepatitis B virus (HBV) and hepatitis C virus (HCV) in Europe and their changes from 2010 to 2019 using estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used GBD 2019 estimates of the burden associated with HBV-related and HCV-related diseases: acute hepatitis, cirrhosis and other chronic liver diseases, and liver cancer. We report total numbers and age-standardised rates per 100 000 for mortality, prevalence, incidence, and disability-adjusted life-years (DALYs) from 2010 to 2019. For each HBV-related and HCV-related disease and each measure, we analysed temporal changes and percentage changes for the 2010–19 period. Findings: In 2019, across all age groups, there were an estimated 2·08 million (95% uncertainty interval [UI] 1·66 to 2·54) incident cases of acute hepatitis B and 0·49 million (0·42 to 0·57) of hepatitis C in Europe. There were an estimated 8·24 million (7·56 to 8·88) prevalent cases of HBV-related cirrhosis and 11·87 million (9·77 to 14·41) of HCV-related cirrhosis, with 24·92 thousand (19·86 to 31·03) deaths due to HBV-related cirrhosis and 36·89 thousand (29·94 to 45·56) deaths due to HCV-related cirrhosis. Deaths were estimated at 9·00 thousand (6·88 to 11·62) due to HBV-related liver cancer and 23·07 thousand (18·95 to 27·31) due to HCV-related liver cancer. Between 2010 and 2019, the age-standardised incidence rate of acute hepatitis B decreased (–22·14% [95% UI –35·44 to –5·98]) as did its age-standardised mortality rate (–33·27% [–43·03 to –25·49]); the age-standardised prevalence rate (–20·60% [–22·09 to –19·10]) and mortality rate (–33·19% [–37·82 to –28·13]) of HBV-related cirrhosis also decreased in this time period. The age-standardised incidence rate of acute hepatitis C decreased by 3·24% (1·17 to 5·02) and its age-standa
Published: 2023

7. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Author: Ong, K, Stafford, L, Mclaughlin, S, Boyko, E, Vollset, S, Smith, A, Dalton, B, Duprey, J, Cruz, J, Hagins, H, Lindstedt, P, Aali, A, Abate, Y, Abate, M, Abbasian, M, Abbasi-Kangevari, Z, Abbasi-Kangevari, M, Abd ElHafeez, S, Abd-Rabu, R, Abdulah, D, Abdullah, A, Abedi, V, Abidi, H, Aboagye, R, Abolhassani, H, Abu-Gharbieh, E, Abu-Zaid, A, Adane, T, Adane, D, Addo, I, Adegboye, O, Adekanmbi, V, Adepoju, A, Adnani, Q, Afolabi, R, Agarwal, G, Aghdam, Z, Agudelo-Botero, M, Aguilera Arriagada, C, Agyemang-Duah, W, Ahinkorah, B, Ahmad, D, Ahmad, R, Ahmad, S, Ahmad, A, Ahmadi, A, Ahmadi, K, Ahmed, A, Ahmed, L, Ahmed, S, Ajami, M, Akinyemi, R, Al Hamad, H, Al Hasan, S, AL-Ahdal, T, Alalwan, T, Al-Aly, Z, Albataineh, M, Alcalde-Rabanal, J, Alemi, S, Ali, H, Alinia, T, Aljunid, S, Almustanyir, S, Al-Raddadi, R, Alvis-Guzman, N, Amare, F, Ameyaw, E, Amiri, S, Amusa, G, Andrei, C, Anjana, R, Ansar, A, Ansari, G, Ansari-Moghaddam, A, Anyasodor, A, Arabloo, J, Aravkin, A, Areda, D, Arifin, H, Arkew, M, Armocida, B, Arnlov, J, Artamonov, A, Arulappan, J, Aruleba, R, Arumugam, A, Aryan, Z, Asemu, M, Asghari-Jafarabadi, M, Askari, E, Asmelash, D, Astell-Burt, T, Athar, M, Athari, S, Atout, M, Avila-Burgos, L, Awaisu, A, Azadnajafabad, S, B, D, Babamohamadi, H, Badar, M, Badawi, A, Badiye, A, Baghcheghi, N, Bagheri, N, Bagherieh, S, Bah, S, Bahadory, S, Bai, R, Baig, A, Baltatu, O, Baradaran, H, Barchitta, M, Bardhan, M, Barengo, N, Barnighausen, T, Barone, M, Barone-Adesi, F, Barrow, A, Bashiri, H, Basiru, A, Basu, S, Batiha, A, Batra, K, Bayih, M, Bayileyegn, N, Behnoush, A, Bekele, A, Belete, M, Belgaumi, U, Belo, L, Bennett, D, Bensenor, I, Berhe, K, Berhie, A, Bhaskar, S, Bhat, A, Bhatti, J, Bikbov, B, Bilal, F, Bintoro, B, Bitaraf, S, Bitra, V, Bjegovic-Mikanovic, V, Bodolica, V, Boloor, A, Brauer, M, Brazo-Sayavera, J, Brenner, H, Butt, Z, Calina, D, Campos, L, Campos-Nonato, I, Cao, Y, Cao, C, Car, J, Carvalho, M, Castaneda-Orjuela, C, Catala-Lopez, F, Cerin, E, Chadwick, J, Chandrasekar, E, Chanie, G, Charan, J, Chattu, V, Chauhan, K, Cheema, H, Chekol Abebe, E, Chen, S, Cherbuin, N, Chichagi, F, Chidambaram, S, Cho, W, Choudhari, S, Chowdhury, R, Chowdhury, E, Chu, D, Chukwu, I, Chung, S, Coberly, K, Columbus, A, Contreras, D, Cousin, E, Criqui, M, Cruz-Martins, N, Cuschieri, S, Dabo, B, Dadras, O, Dai, X, Damasceno, A, Dandona, R, Dandona, L, Das, S, Dascalu, A, Dash, N, Dashti, M, Davila-Cervantes, C, De la Cruz-Gongora, V, Debele, G, Delpasand, K, Demisse, F, Demissie, G, Deng, X, Denova-Gutierrez, E, Deo, S, Dervisevic, E, Desai, H, Desale, A, Dessie, A, Desta, F, Dewan, S, Dey, S, Dhama, K, Dhimal, M, Diao, N, Diaz, D, Dinu, M, Diress, M, Djalalinia, S, Doan, L, Dongarwar, D, dos Santos Figueiredo, F, Duncan, B, Dutta, S, Dziedzic, A, Edinur, H, Ekholuenetale, M, Ekundayo, T, Elgendy, I, Elhadi, M, El-Huneidi, W, Elmeligy, O, Elmonem, M, Endeshaw, D, Esayas, H, Eshetu, H, Etaee, F, Fadhil, I, Fagbamigbe, A, Fahim, A, Falahi, S, Faris, M, Farrokhpour, H, Farzadfar, F, Fatehizadeh, A, Fazli, G, Feng, X, Ferede, T, Fischer, F, Flood, D, Forouhari, A, Foroumadi, R, Foroutan Koudehi, M, Gaidhane, A, Gaihre, S, Gaipov, A, Galali, Y, Ganesan, B, Garcia-Gordillo, M, Gautam, R, Gebrehiwot, M, Gebrekidan, K, Gebremeskel, T, Getacher, L, Ghadirian, F, Ghamari, S, Ghasemi Nour, M, Ghassemi, F, Golechha, M, Goleij, P, Golinelli, D, Gopalani, S, Guadie, H, Guan, S, Gudayu, T, Guimaraes, R, Guled, R, Gupta, R, Gupta, K, Gupta, V, Gyawali, B, Haddadi, R, Hadi, N, Haile, T, Hajibeygi, R, Haj-Mirzaian, A, Halwani, R, Hamidi, S, Hankey, G, Hannan, M, Haque, S, Harandi, H, Harlianto, N, Hasan, S, Hasani, H, Hassanipour, S, Hassen, M, Haubold, J, Hayat, K, Heidari, G, Heidari, M, Hessami, K, Hiraike, Y, Holla, R, Hossain, S, Hossain, M, Hosseini, M, Hosseinzadeh, M, Hosseinzadeh, H, Huang, J, Huda, M, Hussain, S, Huynh, H, Hwang, B, Ibitoye, S, Ikeda, N, Ilic, I, Ilic, M, Inbaraj, L, Iqbal, A, Islam, S, Islam, R, Ismail, N, Iso, H, Isola, G, Itumalla, R, Iwagami, M, Iwu, C, Iyamu, I, Iyasu, A, Jacob, L, Jafarzadeh, A, Jahrami, H, Jain, R, Jaja, C, Jamalpoor, Z, Jamshidi, E, Janakiraman, B, Jayanna, K, Jayapal, S, Jayaram, S, Jayawardena, R, Jebai, R, Jeong, W, Jin, Y, Jokar, M, Jonas, J, Joseph, N, Joseph, A, Joshua, C, Joukar, F, Jozwiak, J, Kaambwa, B, Kabir, A, Kabthymer, R, Kadashetti, V, Kahe, F, Kalhor, R, Kandel, H, Karanth, S, Karaye, I, Karkhah, S, Katoto, P, Kaur, N, Kazemian, S, Kebede, S, Khader, Y, Khajuria, H, Khalaji, A, Khan, M, Khan, A, Khanal, S, Khatatbeh, M, Khater, A, Khateri, S, Khorashadizadeh, F, Khubchandani, J, Kibret, B, Kim, M, Kimokoti, R, Kisa, A, Kivimaki, M, Kolahi, A, Komaki, S, Kompani, F, Koohestani, H, Korzh, O, Kostev, K, Kothari, N, Koyanagi, A, Krishan, K, Krishnamoorthy, Y, Kuate Defo, B, Kuddus, M, Kumar, R, Kumar, H, Kundu, S, Kurniasari, M, Kuttikkattu, A, La Vecchia, C, Lallukka, T, Larijani, B, Larsson, A, Latief, K, Lawal, B, Le, T, Lee, S, Lee, M, Lee, W, Lee, P, Legesse, S, Lenzi, J, Li, Y, Li, M, Lim, S, Lim, L, Liu, X, Liu, C, Lo, C, Lopes, G, Lorkowski, S, Lozano, R, Lucchetti, G, Maghazachi, A, Mahasha, P, Mahjoub, S, Mahmoud, M, Mahmoudi, R, Mahmoudimanesh, M, Mai, A, Majeed, A, Majma Sanaye, P, Makris, K, Malhotra, K, Malik, A, Malik, I, Mallhi, T, Malta, D, Mamun, A, Mansouri, B, Marateb, H, Mardi, P, Martini, S, Martorell, M, Marzo, R, Masoudi, R, Masoudi, S, Mathews, E, Maugeri, A, Mazzaglia, G, Mekonnen, T, Meshkat, M, Mestrovic, T, Miao Jonasson, J, Miazgowski, T, Michalek, I, Minh, L, Mini, G, Miranda, J, Mirfakhraie, R, Mirrakhimov, E, Mirza-Aghazadeh-Attari, M, Misganaw, A, Misgina, K, Mishra, M, Moazen, B, Mohamed, N, Mohammadi, E, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammadshahi, M, Mohseni, A, Mojiri-forushani, H, Mokdad, A, Momtazmanesh, S, Monasta, L, Moniruzzaman, M, Mons, U, Montazeri, F, Moodi Ghalibaf, A, Moradi, Y, Moradi, M, Moradi Sarabi, M, Morovatdar, N, Morrison, S, Morze, J, Mossialos, E, Mostafavi, E, 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L., Stafford L. K., McLaughlin S. A., Boyko E. J., Vollset S. E., Smith A. E., Dalton B. E., Duprey J., Cruz J. A., Hagins H., Lindstedt P. A., Aali A., Abate Y. H., Abate M. D., Abbasian M., Abbasi-Kangevari Z., Abbasi-Kangevari M., Abd ElHafeez S., Abd-Rabu R., Abdulah D. M., Abdullah A. Y. M., Abedi V., Abidi H., Aboagye R. G., Abolhassani H., Abu-Gharbieh E., Abu-Zaid A., Adane T. D., Adane D. E., Addo I. Y., Adegboye O. A., Adekanmbi V., Adepoju A. V., Adnani Q. E. S., Afolabi R. F., Agarwal G., Aghdam Z. B., Agudelo-Botero M., Aguilera Arriagada C. E., Agyemang-Duah W., Ahinkorah B. O., Ahmad D., Ahmad R., Ahmad S., Ahmad A., Ahmadi A., Ahmadi K., Ahmed A., Ahmed L. A., Ahmed S. A., Ajami M., Akinyemi R. O., Al Hamad H., Al Hasan S. M., AL-Ahdal T. M. A., Alalwan T. A., Al-Aly Z., AlBataineh M. T., Alcalde-Rabanal J. E., Alemi S., Ali H., Alinia T., Aljunid S. M., Almustanyir S., Al-Raddadi R. M., Alvis-Guzman N., Amare F., Ameyaw E. K., Amiri S., Amusa G. A., Andrei C. L., Anjana R. M., Ansar A., Ansari G., Ansari-Moghaddam A., Anyasodor A. E., Arabloo J., Aravkin A. Y., Areda D., Arifin H., Arkew M., Armocida B., Arnlov J., Artamonov A. A., Arulappan J., Aruleba R. T., Arumugam A., Aryan Z., Asemu M. T., Asghari-Jafarabadi M., Askari E., Asmelash D., Astell-Burt T., Athar M., Athari S. S., Atout M. M. W., Avila-Burgos L., Awaisu A., Azadnajafabad S., B D. B., Babamohamadi H., Badar M., Badawi A., Badiye A. D., Baghcheghi N., Bagheri N., Bagherieh S., Bah S., Bahadory S., Bai R., Baig A. A., Baltatu O. C., Baradaran H. R., Barchitta M., Bardhan M., Barengo N. C., Barnighausen T. W., Barone M. T. U., Barone-Adesi F., Barrow A., Bashiri H., Basiru A., Basu S., Batiha A. -M. M., Batra K., Bayih M. T., Bayileyegn N. S., Behnoush A. H., Bekele A. B., Belete M. A., Belgaumi U. I., Belo L., Bennett D. A., Bensenor I. M., Berhe K., Berhie A. Y., Bhaskar S., Bhat A. N., Bhatti J. S., Bikbov B., Bilal F., Bintoro B. S., Bitaraf S., Bitra V. R., Bjegovic-Mikanovic V., Bodolica V., Boloor A., Brauer M., Brazo-Sayavera J., Brenner H., Butt Z. A., Calina D., Campos L. A., Campos-Nonato I. R., Cao Y., Cao C., Car J., Carvalho M., Castaneda-Orjuela C. A., Catala-Lopez F., Cerin E., Chadwick J., Chandrasekar E. K., Chanie G. S., Charan J., Chattu V. K., Chauhan K., Cheema H. A., Chekol Abebe E., Chen S., Cherbuin N., Chichagi F., Chidambaram S. B., Cho W. C. S., Choudhari S. G., Chowdhury R., Chowdhury E. K., Chu D. -T., Chukwu I. S., Chung S. -C., Coberly K., Columbus A., Contreras D., Cousin E., Criqui M. H., Cruz-Martins N., Cuschieri S., Dabo B., Dadras O., Dai X., Damasceno A. A. M., Dandona R., Dandona L., Das S., Dascalu A. M., Dash N. R., Dashti M., Davila-Cervantes C. A., De la Cruz-Gongora V., Debele G. R., Delpasand K., Demisse F. W., Demissie G. D., Deng X., Denova-Gutierrez E., Deo S. V., Dervisevic E., Desai H. D., Desale A. T., Dessie A. M., Desta F., Dewan S. M. R., Dey S., Dhama K., Dhimal M., Diao N., Diaz D., Dinu M., Diress M., Djalalinia S., Doan L. P., Dongarwar D., dos Santos Figueiredo F. W., Duncan B. B., Dutta S., Dziedzic A. M., Edinur H. A., Ekholuenetale M., Ekundayo T. C., Elgendy I. Y., Elhadi M., El-Huneidi W., Elmeligy O. A. A., Elmonem M. A., Endeshaw D., Esayas H. L., Eshetu H. B., Etaee F., Fadhil I., Fagbamigbe A. F., Fahim A., Falahi S., Faris M. E. M., Farrokhpour H., Farzadfar F., Fatehizadeh A., Fazli G., Feng X., Ferede T. Y., Fischer F., Flood D., Forouhari A., Foroumadi R., Foroutan Koudehi M., Gaidhane A. M., Gaihre S., Gaipov A., Galali Y., Ganesan B., Garcia-Gordillo M. A., Gautam R. K., Gebrehiwot M., Gebrekidan K. G., Gebremeskel T. G., Getacher L., Ghadirian F., Ghamari S. -H., Ghasemi Nour M., Ghassemi F., Golechha M., Goleij P., Golinelli D., Gopalani S. V., Guadie H. A., Guan S. -Y., Gudayu T. W., Guimaraes R. A., Guled R. A., Gupta R., Gupta K., Gupta V. B., Gupta V. K., Gyawali B., Haddadi R., Hadi N. R., Haile T. G., Hajibeygi R., Haj-Mirzaian A., Halwani R., Hamidi S., Hankey G. J., Hannan M. A., Haque S., Harandi H., Harlianto N. I., Hasan S. M. M., Hasan S. S., Hasani H., Hassanipour S., Hassen M. B., Haubold J., Hayat K., Heidari G., Heidari M., Hessami K., Hiraike Y., Holla R., Hossain S., Hossain M. S., Hosseini M. -S., Hosseinzadeh M., Hosseinzadeh H., Huang J., Huda M. N., Hussain S., Huynh H. -H., Hwang B. -F., Ibitoye S. E., Ikeda N., Ilic I. M., Ilic M. D., Inbaraj L. R., Iqbal A., Islam S. M. S., Islam R. M., Ismail N. E., Iso H., Isola G., Itumalla R., Iwagami M., Iwu C. C. D., Iyamu I. O., Iyasu A. N., Jacob L., Jafarzadeh A., Jahrami H., Jain R., Jaja C., Jamalpoor Z., Jamshidi E., Janakiraman B., Jayanna K., Jayapal S. K., Jayaram S., Jayawardena R., Jebai R., Jeong W., Jin Y., Jokar M., Jonas J. B., Joseph N., Joseph A., Joshua C. E., Joukar F., Jozwiak J. J., Kaambwa B., Kabir A., Kabthymer R. H., Kadashetti V., Kahe F., Kalhor R., Kandel H., Karanth S. D., Karaye I. M., Karkhah S., Katoto P. D., Kaur N., Kazemian S., Kebede S. A., Khader Y. S., Khajuria H., Khalaji A., Khan M. A., Khan M., Khan A., Khanal S., Khatatbeh M. M., Khater A. M., Khateri S., khorashadizadeh F., Khubchandani J., Kibret B. G., Kim M. S., Kimokoti R. W., Kisa A., Kivimaki M., Kolahi A. -A., Komaki S., Kompani F., Koohestani H. R., Korzh O., Kostev K., Kothari N., Koyanagi A., Krishan K., Krishnamoorthy Y., Kuate Defo B., Kuddus M., Kuddus M. A., Kumar R., Kumar H., Kundu S., Kurniasari M. D., Kuttikkattu A., La Vecchia C., Lallukka T., Larijani B., Larsson A. O., Latief K., Lawal B. K., Le T. T. T., Le T. T. B., Lee S. W. H., Lee M., Lee W. -C., Lee P. H., Lee S. -W., Lee S. W., Legesse S. M., Lenzi J., Li Y., Li M. -C., Lim S. S., Lim L. -L., Liu X., Liu C., Lo C. -H., Lopes G., Lorkowski S., Lozano R., Lucchetti G., Maghazachi A. A., Mahasha P. W., Mahjoub S., Mahmoud M. A., Mahmoudi R., Mahmoudimanesh M., Mai A. T., Majeed A., Majma Sanaye P., Makris K. 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D., Karaye I. M., Karkhah S., Katoto P. D., Kaur N., Kazemian S., Kebede S. A., Khader Y. S., Khajuria H., Khalaji A., Khan M. A., Khan M., Khan A., Khanal S., Khatatbeh M. M., Khater A. M., Khateri S., khorashadizadeh F., Khubchandani J., Kibret B. G., Kim M. S., Kimokoti R. W., Kisa A., Kivimaki M., Kolahi A. -A., Komaki S., Kompani F., Koohestani H. R., Korzh O., Kostev K., Kothari N., Koyanagi A., Krishan K., Krishnamoorthy Y., Kuate Defo B., Kuddus M., Kuddus M. A., Kumar R., Kumar H., Kundu S., Kurniasari M. D., Kuttikkattu A., La Vecchia C., Lallukka T., Larijani B., Larsson A. O., Latief K., Lawal B. K., Le T. T. T., Le T. T. B., Lee S. W. H., Lee M., Lee W. -C., Lee P. H., Lee S. -W., Lee S. W., Legesse S. M., Lenzi J., Li Y., Li M. -C., Lim S. S., Lim L. -L., Liu X., Liu C., Lo C. -H., Lopes G., Lorkowski S., Lozano R., Lucchetti G., Maghazachi A. A., Mahasha P. W., Mahjoub S., Mahmoud M. A., Mahmoudi R., Mahmoudimanesh M., Mai A. T., Majeed A., Majma Sanaye P., Makris K. C., Malhotra K., Malik A. A., Malik I., Mallhi T. H., Malta D. C., Mamun A. A., Mansouri B., Marateb H. R., Mardi P., Martini S., Martorell M., Marzo R. R., Masoudi R., Masoudi S., Mathews E., Maugeri A., Mazzaglia G., Mekonnen T., Meshkat M., Mestrovic T., Miao Jonasson J., Miazgowski T., Michalek I. M., Minh L. H. N., Mini G. K., Miranda J. J., Mirfakhraie R., Mirrakhimov E. M., Mirza-Aghazadeh-Attari M., Misganaw A., Misgina K. H., Mishra M., Moazen B., Mohamed N. S., Mohammadi E., Mohammadi M., Mohammadian-Hafshejani A., Mohammadshahi M., Mohseni A., Mojiri-forushani H., Mokdad A. H., Momtazmanesh S., Monasta L., Moniruzzaman M., Mons U., Montazeri F., Moodi Ghalibaf A., Moradi Y., Moradi M., Moradi Sarabi M., Morovatdar N., Morrison S. D., Morze J., Mossialos E., Mostafavi E., Mueller U. O., Mulita F., Mulita A., Murillo-Zamora E., Musa K. I., Mwita J. C., Nagaraju S. P., Naghavi M., Nainu F., Nair T. S., Najmuldeen H. H. R., Nangia V., Nargus S., Naser A. 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A., Rahman M. H. U., Rahman M., Rahman M. M., Rahmani M., Rahmani S., Rahmanian V., Rahmawaty S., Rahnavard N., Rajbhandari B., Ram P., Ramazanu S., Rana J., Rancic N., Ranjha M. M. A. N., Rao C. R., Rapaka D., Rasali D. P., Rashedi S., Rashedi V., Rashid A. M., Rashidi M. -M., Ratan Z. A., Rawaf S., Rawal L., Redwan E. M. M., Remuzzi G., Rengasamy K. R., Renzaho A. M. N., Reyes L. F., Rezaei N., Rezaeian M., Rezazadeh H., Riahi S. M., Rias Y. A., Riaz M., Ribeiro D., Rodrigues M., Rodriguez J. A. B., Roever L., Rohloff P., Roshandel G., Roustazadeh A., Rwegerera G. M., Saad A. M. A., Saber-Ayad M. M., Sabour S., Sabzmakan L., Saddik B., Sadeghi E., Saeed U., Saeedi Moghaddam S., Safi S., Safi S. Z., Saghazadeh A., Saheb Sharif-Askari N., Saheb Sharif-Askari F., Sahebkar A., Sahoo S. S., Sahoo H., Saif-Ur-Rahman K. M., Sajid M. R., Salahi S., Saleh M. A., Salehi M. A., Salomon J. A., Sanabria J., Sanjeev R. K., Sanmarchi F., Santric-Milicevic M. M., Sarasmita M. A., Sargazi S., Sathian B., Sathish T., Sawhney M., Schlaich M. P., Schmidt M. I., Schuermans A., Seidu A. -A., Senthil Kumar N., Sepanlou S. G., Sethi Y., Seylani A., Shabany M., Shafaghat T., Shafeghat M., Shafie M., Shah N. S., Shahid S., Shaikh M. A., Shanawaz M., Shannawaz M., Sharfaei S., Shashamo B. B., Shiri R., Shittu A., Shivakumar K. M., Shivalli S., Shobeiri P., Shokri F., Shuval K., Sibhat M. M., Silva L. M. L. R., Simpson C. R., Singh J. A., Singh P., Singh S., Siraj M. S., Skryabina A. A., Sohag A. A. M., Soleimani H., Solikhah S., Soltani-Zangbar M. S., Somayaji R., Sorensen R. J. D., Starodubova A. V., Sujata S., Suleman M., Sun J., Sundstrom J., Tabares-Seisdedos R., Tabatabaei S. M., Tabatabaeizadeh S. -A., Tabish M., Taheri M., Taheri E., Taki E., Tamuzi J. J. L., Tan K. -K., Tat N. Y., Taye B. T., Temesgen W. A., Temsah M. -H., Tesler R., Thangaraju P., Thankappan K. R., Thapa R., Tharwat S., Thomas N., Ticoalu J. H. V., Tiyuri A., Tonelli M., Tovani-Palone M. R., Trico D., Trihandini I., Tripathy J. P., Tromans S. J., Tsegay G. M., Tualeka A. R., Tufa D. G., Tyrovolas S., Ullah S., Upadhyay E., Vahabi S. M., Govindaraj Vaithinathan A., Valizadeh R., van Daalen K. R., Vart P., Varthya S. B., Vasankari T. J., Vaziri S., Verma M. V., Verras G. -I., Vo D. C., Wagaye B., Waheed Y., Wang Z., Wang Y., Wang C., Wang F., Wassie G. T., Wei M. Y. W., Weldemariam A. H., Westerman R., Wickramasinghe N. D., Wu Y., Wulandari R. D., Xia J., Xiao H., Xu S., Xu X., Yada D. Y., Yang L., Yatsuya H., Yesiltepe M., Yi S., Yohannis H. K., Yonemoto N., You Y., Zaman S. B., Zamora N., Zare I., Zarea K., Zarrintan A., Zastrozhin M. S., Zeru N. G., Zhang Z. -J., Zhong C., Zhou J., Zielinska M., Zikarg Y. T., Zodpey S., Zoladl M., Zou Z., Zumla A., Zuniga Y. M. H., Magliano D. J., Murray C. J. L., Hay S. I., and Vos T.
Abstract: Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparativ
Published: 2023

8. Long COVID Syndrome: Lesson Learned and Future Implications

Author: Mazzaglia, G, Mazzaglia G, Mazzaglia, G, and Mazzaglia G
Published: 2023

9. Azithromycin use and covid-19: a real-world observational study.

Author: Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Mantovani LG, Mazzaglia G., Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Mantovani LG, and Mazzaglia G.
Published: 2023

10. The Value of Tucatinib in Metastatic HER2-Positive Breast Cancer Patients: An Italian Cost-Effectiveness Analysis

Author: Antonazzo, I, Cortesi, P, Miceli Sopo, G, Mazzaglia, G, Conte, P, Mantovani, L, Antonazzo I. C., Cortesi P. A., Miceli Sopo G., Mazzaglia G., Conte P., Mantovani L. G., Antonazzo, I, Cortesi, P, Miceli Sopo, G, Mazzaglia, G, Conte, P, Mantovani, L, Antonazzo I. C., Cortesi P. A., Miceli Sopo G., Mazzaglia G., Conte P., and Mantovani L. G.
Abstract: Background: This study was aimed at estimating the appropriate price of tucatinib plus trastuzumab and capecitabine (TXC), as third-line treatment, in HER2+ breast cancer (BC) patients from the Italian National Health System (NHS) perspective. Methods: A partitioned survival model with three mutually exclusive health states (i.e., progression-free survival (PFS), progressive disease (PD), and death) was used to estimate the price of tucatinib vs trastuzumab emtansine (TDM-1), considering a willingness to pay (WTP) of 60,000 EUR. Data from the HER2CLIMB trial, the Italian population, and the literature were used as input. The model also estimated the total costs and the life-years (LY) of TXC and TDM1. Deterministic and probabilistic (PSA) sensitivity analyses were conducted to evaluate the robustness of the model. Results: In the base case scenario, the appropriate price of tucatinib was 4828.44 EUR per cycle. The TXC resulted in +0.28 LYs and +16,628 EUR compared with TDM-1. Results were mainly sensitive to therapy intensity variation. In PSA analysis, TXC resulted cost-effective in 53% of the simulations. Assuming a WTP ranging 20,000–80,000 EUR, the tucatinib price ranged from 4090.60 to 5197.41 EUR. Conclusions: This study estimated the appropriate price for tucatinib according to different WTP in order to help healthcare decision makers to better understand the treatment value.
Published: 2023

11. Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study

Author: Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Di Pasquale R, Cortesi PA, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, Mazzaglia G, Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Di Pasquale R, Cortesi PA, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, and Mazzaglia G
Abstract: Background: The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis. Methods: Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models. Results: Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38-2.67), ICU access (OR: 0.54; 95% CI: 0.22-1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16-1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18-0.85) was observed in statins-users compared with non-LLT users. Conclusions: These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.
Published: 2022

12. Azithromycin use and outcomes in patients with COVID-19: an observational real-world study

Author: Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Di Pasquale R, Cortesi PA, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, Mazzaglia G, Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, Mazzaglia, G, Antonazzo IC, Fornari C, Rozza D, Conti S, Di Pasquale R, Cortesi PA, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, and Mazzaglia G
Abstract: Objectives: Previous studies ruled out the benefits of azithromycin for treatment of patients with COVID-19 who are hospitalized. However, the effects of azithromycin for treatment of patients with positive SARS-CoV-2 test results in the community remains a matter of debate. This study aimed to assess whether azithromycin, when used in subjects with positive test results for SARS-CoV-2, is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death. Methods: Two study cohorts were selected. Cohort A included subjects with positive test results for SARS-CoV-2 between February 20, 2020 and December 10, 2020; cohort B included subjects infected with SARS-CoV-2 and hospitalized between February 20, 2020 and December 31, 2020. We compared the risk of hospitalization, intensive care unit access, need for mechanical ventilation, and death in azithromycin users versus nonusers. A clustered Fine-Gray analysis was employed to assess the risk of hospitalization; logistic and Cox regressions were performed to assess the risk of intensive care unit access, mechanical ventilation, and death. Results: In cohort A, among 4861 azithromycin users and 4861 propensity-matched nonusers, azithromycin use was associated with higher risk of hospitalization (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.45-1.75) compared with nonuse. In cohort B, among 997 subjects selected in both groups, azithromycin use was not significantly associated with intensive care unit access (odds ratio [OR] 1.22, 95% CI 0.93-1.56), mechanical ventilation (OR 1.30, 95% CI 0.99-1.70), 14-day mortality (HR0.88, 95% CI 0.74-1.05), or 30-day mortality (HR 0.89, 95% CI 0.77-1.03). Conclusion: Our findings confirm the lack of benefits of azithromycin treatment among community patients infected with SARS-CoV-2, raising concern on potential risks associated with its inappropriate use.
Published: 2022

13. Time trends in the incidence of essential tremor: Evidences from UK and France primary care data

Author: Antonazzo, I, Conti, S, Rozza, D, Fornari, C, Eteve-Pitsaer, C, Paris, C, Gantzer, L, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo IC, Conti S, Rozza D, Fornari C, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, Mazzaglia G, Antonazzo, I, Conti, S, Rozza, D, Fornari, C, Eteve-Pitsaer, C, Paris, C, Gantzer, L, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo IC, Conti S, Rozza D, Fornari C, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, and Mazzaglia G
Abstract: Introduction: Although essential tremor (ET) is considered a common adult movement disorder, evidence on its incidence is still scant. This study aims at estimating ET incidence in two European countries, namely, the UK and France. Methods: Incident cases of ET were identified within the Health Improvement Network (THIN®) database between 1st January 2014 and 31 December 2019. Yearly crude and standardized incidence rates (IR) were estimated across the study period for both countries. Poisson regression models were built to assess temporal trends in IRs and differences between sexes and age classes. Results: In total, 4,970 and 4,905 incident cases of ET were identified in the UK and France, respectively. The yearly average crude IR (per 100,000 person-years) was 18.20 (95%CI: 15.09-21.32) in UK and 21.42 (17.83-25.00) in France, whereas standardized ones were 19.51 (18.97-20.01) and 19.50 (18.97-20.05). Regression analyses showed slightly increasing trends in both countries, higher incidence among males, and a significant increase with age. Yearly average IR increased from 3.96 (0.95-6.97) and 5.28 (1.12-9.44) in subjects aged <20 years to 49.27 (26.29-72.24) and 51.52 (30.19-72.86) in those aged >80 year in UK and France. Conclusions: Standardized ET incidence was comparable in the UK and France, showing a slight increase in both countries, reporting a higher value among people aged 60 years and older. This study outlines the need to conduct future studies to estimate the burden of ET in terms of disease control and healthcare resource utilization.
Published: 2022

14. I servizi sanitari. Elementi di organizzazione, legislazione sanitaria ed economia sanitaria

Author: Auxilia, F, Castaldi, S, Mantovani, L, Mazzaglia, G, Mazzaglia G, Auxilia, F, Castaldi, S, Mantovani, L, Mazzaglia, G, and Mazzaglia G
Published: 2022

15. Increased Risk of Stroke Due to Non-adherence and Non-persistence with Direct Oral Anticoagulants (DOACs): Real-World Analyses Using a Nested Case-Control Study from The Netherlands, Italy and Germany

Author: Holthuis, E, Smits, E, Spentzouris, G, Beier, D, Enders, D, Gini, R, Bartolini, C, Mazzaglia, G, Penning-van Beest, F, Herings, R, Holthuis E, Smits E, Spentzouris G, Beier D, Enders D, Gini R, Bartolini C, Mazzaglia G, Penning-van Beest F, Herings R, Holthuis, E, Smits, E, Spentzouris, G, Beier, D, Enders, D, Gini, R, Bartolini, C, Mazzaglia, G, Penning-van Beest, F, Herings, R, Holthuis E, Smits E, Spentzouris G, Beier D, Enders D, Gini R, Bartolini C, Mazzaglia G, Penning-van Beest F, and Herings R
Abstract: Background: A high degree of adherence to direct oral anticoagulants is essential for reducing the risk of ischaemic stroke and systemic embolism in patients with atrial fibrillation, owing to the rapid decline in anticoagulation activity when doses are omitted (i.e. rebound effect). Objective: We aimed to assess the relationship between non-adherence and non-persistence with direct oral anticoagulants and the incidence of ischaemic stroke in patients with atrial fibrillation. Methods: A nested case–control study was conducted in the Netherlands, Italy and Germany among patients with atrial fibrillation starting direct oral anticoagulants between the drug approval date and the end of database availability. Patients with an ischaemic stroke during the follow-up were selected as cases and compared with matched controls (matched on age ± 5 years, sex, year of cohort entry date and CHA2DS2-VASc-score at cohort entry date). The cohort entry date was the first dispensing date. Study patients were those aged ≥ 45 years, with ≥ 1 year database history, ≥ 1 year follow-up and at least two direct oral anticoagulant dispensings after the cohort entry date. Adherence and persistence to direct oral anticoagulant treatment were defined as the proportion of days covered ≥ 80% or direct oral anticoagulant continuous use between the cohort entry date and the index date (i.e. date of ischaemic stroke), respectively. Results: In The Netherlands, Italy and Germany, 105 cases and 395 controls, 1580 cases and 6248 controls, and 900 cases and 3570 controls were included, respectively. Odds ratios (ORs) for stroke among current users who were non-adherent compared to adherent users were 0.43 (95% confidence interval [CI] 0.09–1.96) in The Netherlands, 1.11 (95% CI 0.98–1.26) in Italy and 1.21 (95% CI 1.01–1.45) in Germany. The risk of stroke was significantly higher among non-persistent users compared with persistent users in all three databases [OR 1.56 (95% CI 1.00–2.44), OR 1.48 (1.32–1
Published: 2022

16. Antidepressants Drug Use during COVID-19 Waves in the Tuscan General Population: An Interrupted Time-Series Analysis

Author: Antonazzo, I, Fornari, C, Maumus-Robert, S, Cei, E, Paoletti, O, Ferrara, P, Conti, S, Cortesi, P, Mantovani, L, Gini, R, Mazzaglia, G, Antonazzo IC, Fornari C, Maumus-Robert S, Cei E, Paoletti O, Ferrara P, Conti S, Cortesi PA, Mantovani LG, Gini R, Mazzaglia G, Antonazzo, I, Fornari, C, Maumus-Robert, S, Cei, E, Paoletti, O, Ferrara, P, Conti, S, Cortesi, P, Mantovani, L, Gini, R, Mazzaglia, G, Antonazzo IC, Fornari C, Maumus-Robert S, Cei E, Paoletti O, Ferrara P, Conti S, Cortesi PA, Mantovani LG, Gini R, and Mazzaglia G
Abstract: In Italy, during the COVID-19 waves two lockdowns were implemented to prevent virus diffusion in the general population. Data on antidepressant (AD) use in these periods are still scarce. This study aimed at exploring the impact of COVID-19 lockdowns on prevalence and incidence of antidepressant drug use in the general population. A population-based study using the healthcare administrative database of Tuscany was performed. We selected a dynamic cohort of subjects with at least one ADs dispensing from 1 January 2018 to 27 December 2020. The weekly prevalence and incidence of drug use were estimated across different segments: pre-lockdown (1 January 2018–8 March 2020), first lockdown (9 March 2020–15 June 2020), post-first lockdown (16 June 2020–15 November 2020) and second lockdown (16 November 2020–27 December 2020). An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Compared to the pre-lockdown we observed an abrupt reduction of ADs incidence (Incidence-Ratio: 0.82; 95% Confidence-Intervals: 0.74–0.91) and a slight weekly decrease of prevalence (Prevalence-Ratio: 0.997; 0.996–0.999). During the post-first lockdown AD use increased, with higher incidence- and similar prevalence values compared with those expected in the absence of the outbreak. This pandemic has impacted AD drug use in the general population with potential rebound effects during the period between waves. This calls for future studies aimed at exploring the mid–long term effects of this phenomenon.
Published: 2022

17. Il carico di malattia associato ai virus dell'epatite B e C in Europa. Dati dal Global Burden of Disease Study 2019

Author: Fornari, C, Cortesi, P, Antonazzo, I, Conti, S, Mazzaglia, G, Mantovani, L, Cortesi, PA, Antonazzo, IC, Mantovani, LG, Fornari, C, Cortesi, P, Antonazzo, I, Conti, S, Mazzaglia, G, Mantovani, L, Cortesi, PA, Antonazzo, IC, and Mantovani, LG
Published: 2023

18. Farmacoutilizzazione della terapia per la gestione del paziente con tremore essenziale: uno studio di coorte retrospettivo condotto utilizzando i database dei medici di medicina generale di Regno unito e Francia

Author: Antonazzo, I, Rozza, D, Conti, S, Fornari, C, Eteve-Pitsaer, C, Paris, C, Gantzer, C, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo, IC, Mantovani, LG, Antonazzo, I, Rozza, D, Conti, S, Fornari, C, Eteve-Pitsaer, C, Paris, C, Gantzer, C, Valentine, D, Mantovani, L, Mazzaglia, G, Antonazzo, IC, and Mantovani, LG
Published: 2023

19. COVID-19 e suicidio: uno studio retrospettivo sul territorio di Bergamo e provincia

Author: Crotti, G, Antonazzo, I, Sampietro, G, Fornari, C, Ghisleni, S, Zanchi, A, Tillati, S, Conti, S, Mazzaglia, G, Mantovani, L, Zucchi, A, Antonazzo, IC, Mantovani, LG, Crotti, G, Antonazzo, I, Sampietro, G, Fornari, C, Ghisleni, S, Zanchi, A, Tillati, S, Conti, S, Mazzaglia, G, Mantovani, L, Zucchi, A, Antonazzo, IC, and Mantovani, LG
Published: 2023

20. EE254 A Cost-Utility Analysis of Ferric Derisomaltose Versus Ferric Carboxymaltose in Patients With Inflammatory Bowel Disease in Italy

Author: Cortesi, P, primary, Mazzaglia, G, additional, Rethmeier, L, additional, Nottmeier, M, additional, and Pollock, RF, additional
Published: 2022
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21. I servizi sanitari. Elementi di organizzazione, legislazione sanitaria ed economia sanitaria

Author: Auxilia, F., Castaldi, S., Mantovani, L., Mazzaglia, G., Auxilia, F, Castaldi, S, Mantovani, L, and Mazzaglia, G
Subjects: Settore MED/42 - Igiene Generale e Applicata, Igiene, sanità pubblica, organizzazione e programmazione sanitaria, farmaci
Published: 2022

22. Valutazione dell’impatto della pandemia sugli accessi al sistema sanitario nei territori di Bergamo e Brescia

Author: Conti, S, Fornari, C, Ferrara, P, Madotto, F, Antonazzo, I, Gambioli, A, Zucchi, A, Ciampichini, R, Crotti, G, Maifredi, G, Gasparotti, C, Mazzaglia, G, Mantovani, L, Antonazzo, IC, Mantovani, LG, Conti, S, Fornari, C, Ferrara, P, Madotto, F, Antonazzo, I, Gambioli, A, Zucchi, A, Ciampichini, R, Crotti, G, Maifredi, G, Gasparotti, C, Mazzaglia, G, Mantovani, L, Antonazzo, IC, and Mantovani, LG
Published: 2022

23. Valutazione della prognosi nei soggetti ospedalizzati con COVID-19 in relazione all’utilizzo pregresso di statine: uno studio osservazionale condotto nelle ATS di Bergamo e Brescia

Author: Antonazzo, I, Fornari, C, Conti, S, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Mantovani, L, Mazzaglia, G, Antonazzo, IC, Mantovani, LG, Antonazzo, I, Fornari, C, Conti, S, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Mantovani, L, Mazzaglia, G, Antonazzo, IC, and Mantovani, LG
Published: 2022

24. Association between azithromycin use and clinical outcomes in COVID-19 patients: an Italian observational study

Author: Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Mantovani, L, Mazzaglia, G, Antonazzo, IC, Mantovani, LG, Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Mantovani, L, Mazzaglia, G, Antonazzo, IC, and Mantovani, LG
Published: 2022

25. Timing of hepatitis B and C virus elimination in Europe: a picture from the Global Burden of Disease Study 2019

Author: Cortesi, P, Fornari, C, Antonazzo, I, Conti, S, Mazzaglia, G, Mantovani, L, Cortesi, PA, Antonazzo, IC, Mantovani, LG, Cortesi, P, Fornari, C, Antonazzo, I, Conti, S, Mazzaglia, G, Mantovani, L, Cortesi, PA, Antonazzo, IC, and Mantovani, LG
Published: 2022

26. Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study

Author: Ippazio Cosimo Antonazzo, Carla Fornari, Davide Rozza, Sara Conti, Raffaella Di Pasquale, Paolo Angelo Cortesi, Shaniko Kaleci, Pietro Ferrara, Alberto Zucchi, Giovanni Maifredi, Andrea Silenzi, Giancarlo Cesana, Lorenzo Giovanni Mantovani, Giampiero Mazzaglia, Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Di Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, and Mazzaglia, G
Subjects: pharmacoepidemiology, ICU acce, public health, statin, COVID-19, General Medicine, mechanical ventilation, mortality, statins, ICU access
Abstract: Background: The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis. Methods: Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models. Results: Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38–2.67), ICU access (OR: 0.54; 95% CI: 0.22–1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16–1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18–0.85) was observed in statins-users compared with non-LLT users. Conclusions: These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.
Published: 2022

27. Time trends in the incidence of essential tremor: Evidences from UK and France primary care data

Author: Ippazio Cosimo Antonazzo, Sara Conti, Davide Rozza, Carla Fornari, Caroline Eteve-Pitsaer, Claire Paris, Laurène Gantzer, Dennis Valentine, Lorenzo Giovanni Mantovani, Giampiero Mazzaglia, Antonazzo, I, Conti, S, Rozza, D, Fornari, C, Eteve-Pitsaer, C, Paris, C, Gantzer, L, Valentine, D, Mantovani, L, and Mazzaglia, G
Subjects: Neurology, THIN® database, epidemiology, France, Neurology (clinical), essential tremor, United Kingdom
Abstract: IntroductionAlthough essential tremor (ET) is considered a common adult movement disorder, evidence on its incidence is still scant. This study aims at estimating ET incidence in two European countries, namely, the UK and France.MethodsIncident cases of ET were identified within the Health Improvement Network (THIN®) database between 1st January 2014 and 31 December 2019. Yearly crude and standardized incidence rates (IR) were estimated across the study period for both countries. Poisson regression models were built to assess temporal trends in IRs and differences between sexes and age classes.ResultsIn total, 4,970 and 4,905 incident cases of ET were identified in the UK and France, respectively. The yearly average crude IR (per 100,000 person-years) was 18.20 (95%CI: 15.09–21.32) in UK and 21.42 (17.83–25.00) in France, whereas standardized ones were 19.51 (18.97–20.01) and 19.50 (18.97-20.05). Regression analyses showed slightly increasing trends in both countries, higher incidence among males, and a significant increase with age. Yearly average IR increased from 3.96 (0.95–6.97) and 5.28 (1.12–9.44) in subjects aged 80 year in UK and France.ConclusionsStandardized ET incidence was comparable in the UK and France, showing a slight increase in both countries, reporting a higher value among people aged 60 years and older. This study outlines the need to conduct future studies to estimate the burden of ET in terms of disease control and healthcare resource utilization.
Published: 2022

28. Long COVID Syndrome: Lesson Learned and Future Implications

Author: Giampiero Mazzaglia and Mazzaglia, G
Subjects: symptoms cluster, Long-covid, healthcare professional, SARS-COV-2, General Medicine
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has caused severe illness and mortality on a global scale, with an impact not witnessed since the 1918–19 Spanish influenza pandemic [...]
Published: 2023

29. Increased Risk of Stroke Due to Non-adherence and Non-persistence with Direct Oral Anticoagulants (DOACs): Real-World Analyses Using a Nested Case-Control Study from The Netherlands, Italy and Germany

Author: Emily Holthuis, Elisabeth Smits, George Spentzouris, Dominik Beier, Dirk Enders, Rosa Gini, Claudia Bartolini, Giampiero Mazzaglia, Fernie Penning-van Beest, Ron Herings, Holthuis, E, Smits, E, Spentzouris, G, Beier, D, Enders, D, Gini, R, Bartolini, C, Mazzaglia, G, Penning-van Beest, F, Herings, R, Epidemiology and Data Science, APH - Quality of Care, and APH - Methodology
Subjects: Pharmacology (medical), adherence, DOAC, stroke, electronic healthcare database
Abstract: Background: A high degree of adherence to direct oral anticoagulants is essential for reducing the risk of ischaemic stroke and systemic embolism in patients with atrial fibrillation, owing to the rapid decline in anticoagulation activity when doses are omitted (i.e. rebound effect). Objective: We aimed to assess the relationship between non-adherence and non-persistence with direct oral anticoagulants and the incidence of ischaemic stroke in patients with atrial fibrillation. Methods: A nested case–control study was conducted in the Netherlands, Italy and Germany among patients with atrial fibrillation starting direct oral anticoagulants between the drug approval date and the end of database availability. Patients with an ischaemic stroke during the follow-up were selected as cases and compared with matched controls (matched on age ± 5 years, sex, year of cohort entry date and CHA2DS2-VASc-score at cohort entry date). The cohort entry date was the first dispensing date. Study patients were those aged ≥ 45 years, with ≥ 1 year database history, ≥ 1 year follow-up and at least two direct oral anticoagulant dispensings after the cohort entry date. Adherence and persistence to direct oral anticoagulant treatment were defined as the proportion of days covered ≥ 80% or direct oral anticoagulant continuous use between the cohort entry date and the index date (i.e. date of ischaemic stroke), respectively. Results: In The Netherlands, Italy and Germany, 105 cases and 395 controls, 1580 cases and 6248 controls, and 900 cases and 3570 controls were included, respectively. Odds ratios (ORs) for stroke among current users who were non-adherent compared to adherent users were 0.43 (95% confidence interval [CI] 0.09–1.96) in The Netherlands, 1.11 (95% CI 0.98–1.26) in Italy and 1.21 (95% CI 1.01–1.45) in Germany. The risk of stroke was significantly higher among non-persistent users compared with persistent users in all three databases [OR 1.56 (95% CI 1.00–2.44), OR 1.48 (1.32–1.65) and OR 1.91 (95% CI 1.64–2.22), respectively]. In The Netherlands and Germany, the risk of stroke was higher the longer a patient had stopped using direct oral anticoagulants. Conclusions: Both non-adherence (in Germany) and non-persistence increased the risk of stroke, either using a once-daily or twice-daily regime.
Published: 2022

30. Azithromycin use and outcomes in patients with COVID-19: an observational real-world study

Author: Ippazio Cosimo Antonazzo, Carla Fornari, Davide Rozza, Sara Conti, Raffaella di Pasquale, Paolo Cortesi, Shaniko Kaleci, Pietro Ferrara, Alberto Zucchi, Giovanni Maifredi, Andrea Silenzi, Giancarlo Cesana, Lorenzo Giovanni Mantovani, Giampiero Mazzaglia, Antonazzo, I, Fornari, C, Rozza, D, Conti, S, Pasquale, R, Cortesi, P, Kaleci, S, Ferrara, P, Zucchi, A, Maifredi, G, Silenzi, A, Cesana, G, Mantovani, L, and Mazzaglia, G
Subjects: Microbiology (medical), SARS-CoV-2, MED/42 - IGIENE GENERALE E APPLICATA, COVID-19, General Medicine, Azithromycin, Respiration, Artificial, COVID-19 Drug Treatment, Hospitalization, Infectious Diseases, Mechanical ventilation, Intensive care unit acce, Italy, Humans, Mortality
Abstract: Objectives: Previous studies ruled out the benefits of azithromycin for treatment of patients with COVID-19 who are hospitalized. However, the effects of azithromycin for treatment of patients with positive SARS-CoV-2 test results in the community remains a matter of debate. This study aimed to assess whether azithromycin, when used in subjects with positive test results for SARS-CoV-2, is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death. Methods: Two study cohorts were selected. Cohort A included subjects with positive test results for SARS-CoV-2 between February 20, 2020 and December 10, 2020; cohort B included subjects infected with SARS-CoV-2 and hospitalized between February 20, 2020 and December 31, 2020. We compared the risk of hospitalization, intensive care unit access, need for mechanical ventilation, and death in azithromycin users versus nonusers. A clustered Fine-Gray analysis was employed to assess the risk of hospitalization; logistic and Cox regressions were performed to assess the risk of intensive care unit access, mechanical ventilation, and death. Results: In cohort A, among 4861 azithromycin users and 4861 propensity-matched nonusers, azithromycin use was associated with higher risk of hospitalization (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.45-1.75) compared with nonuse. In cohort B, among 997 subjects selected in both groups, azithromycin use was not significantly associated with intensive care unit access (odds ratio [OR] 1.22, 95% CI 0.93-1.56), mechanical ventilation (OR 1.30, 95% CI 0.99-1.70), 14-day mortality (HR0.88, 95% CI 0.74-1.05), or 30-day mortality (HR 0.89, 95% CI 0.77-1.03). Conclusion: Our findings confirm the lack of benefits of azithromycin treatment among community patients infected with SARS-CoV-2, raising concern on potential risks associated with its inappropriate use.
Published: 2022

31. The Value of Tucatinib in Metastatic HER2-Positive Breast Cancer Patients: An Italian Cost-Effectiveness Analysis

Author: Ippazio Cosimo Antonazzo, Paolo Angelo Cortesi, Gerardo Miceli Sopo, Giampiero Mazzaglia, Pierfranco Conte, Lorenzo Giovanni Mantovani, Antonazzo, I, Cortesi, P, Miceli Sopo, G, Mazzaglia, G, Conte, P, and Mantovani, L
Subjects: Cancer Research, breast cancer, Italy, Oncology, TDM-1, cost-effectiveness analysis, tucatinib, cost-effectiveness analysi
Abstract: Background: This study was aimed at estimating the appropriate price of tucatinib plus trastuzumab and capecitabine (TXC), as third-line treatment, in HER2+ breast cancer (BC) patients from the Italian National Health System (NHS) perspective. Methods: A partitioned survival model with three mutually exclusive health states (i.e., progression-free survival (PFS), progressive disease (PD), and death) was used to estimate the price of tucatinib vs trastuzumab emtansine (TDM-1), considering a willingness to pay (WTP) of 60,000 EUR. Data from the HER2CLIMB trial, the Italian population, and the literature were used as input. The model also estimated the total costs and the life-years (LY) of TXC and TDM1. Deterministic and probabilistic (PSA) sensitivity analyses were conducted to evaluate the robustness of the model. Results: In the base case scenario, the appropriate price of tucatinib was 4828.44 EUR per cycle. The TXC resulted in +0.28 LYs and +16,628 EUR compared with TDM-1. Results were mainly sensitive to therapy intensity variation. In PSA analysis, TXC resulted cost-effective in 53% of the simulations. Assuming a WTP ranging 20,000–80,000 EUR, the tucatinib price ranged from 4090.60 to 5197.41 EUR. Conclusions: This study estimated the appropriate price for tucatinib according to different WTP in order to help healthcare decision makers to better understand the treatment value.
Published: 2023

32. Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis

Author: Ippazio Cosimo Antonazzo, Carla Fornari, Sandy Maumus-Robert, Eleonora Cei, Olga Paoletti, Sara Conti, Paolo Angelo Cortesi, Lorenzo Giovanni Mantovani, Rosa Gini, Giampiero Mazzaglia, Antonazzo, I, Fornari, C, Maumus-Robert, S, Cei, E, Paoletti, O, Conti, S, Cortesi, P, Mantovani, L, Gini, R, and Mazzaglia, G
Subjects: Emergency department acce, Epilepsy, SARS-CoV-2, Health, Toxicology and Mutagenesis, Time-series analysi, COVID-19, Italy, epilepsy, anti-seizure medication, emergency department access, time-series analysis, Public Health, Environmental and Occupational Health, Article, Pharmaceutical Preparations, Communicable Disease Control, Medicine, Humans, Emergency Service, Hospital, Pandemics
Abstract: Background: In 2020, during the COVID-19 pandemic, Italy implemented two national lockdowns aimed at reducing virus transmission. We assessed whether these lockdowns affected anti-seizure medication (ASM) use and epilepsy-related access to emergency departments (ED) in the general population. Methods: We performed a population-based study using the healthcare administrative database of Tuscany. We defined the weekly time series of prevalence and incidence of ASM, along with the incidence of epilepsy-related ED access from 1 January 2018 to 27 December 2020 in the general population. An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Results: Compared to pre-lockdown, we observed a relevant reduction of ASM incidence (0.65; 95% Confidence Intervals: 0.59–0.72) and ED access (0.72; 0.64–0.82), and a slight decrease of ASM prevalence (0.95; 0.94–0.96). During the post-lockdown the ASM incidence reported higher values compared to pre-lockdown, whereas ASM prevalence and ED access remained lower. Results also indicate a lower impact of the second lockdown for both ASM prevalence (0.97; 0.96–0.98) and incidence (0.89; 0.80–0.99). Conclusion: The lockdowns implemented during the COVID-19 outbreaks significantly affected ASM use and epilepsy-related ED access. The potential consequences of these phenomenon are still unknown, although an increased incidence of epilepsy-related symptoms after the first lockdown has been observed. These findings emphasize the need of ensuring continuous care of epileptic patients in stressful conditions such as the COVID-19 pandemic.
Published: 2021

33. Generalizability and treatment with sodium-glucose co-trasporter-2 inhibitors (SGLT2i) among patients with type 2 diabetes: an assessment using an Italian primary care database.

Author: Antonazzo IC, Rozza D, Cortesi PA, Fornari C, Zanzottera Ferrari E, Paris C, Eteve-Pitsaer C, Gnesi M, Mele S, D'Amelio M, Maurizi AR, Palladino P, Mantovani LG, and Mazzaglia G
Abstract: Aims: This study aimed to assess the proportions of type 2 diabetes (T2D) subjects meeting cardiovascular outcome trials (CVOTs) criteria for sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and estimate SGLT2i utilization, along with associated demographic and clinical characteristics, in a primary care setting., Methods: T2D patients in Italy were selected between January 1, 2021, and December 31, 2022, from The Health Improvement Network (THIN ® ) database. Representativeness was determined by dividing patients meeting key inclusion criteria for four CVOTs (CANVAS, DECLARE-TIMI 58, EMPA-REG OUTCOME, VERTIS-CV) to the total T2D population. Demographic and clinical characteristics of eligible T2D subjects and SGLT2i users were compared, and logistic regression models assessed the likelihood of receiving SGLT2i., Results: Out of 17,102 T2D patients, 8,828 met eligibility criteria for at least one CVOT. DECLARE-TIMI 58 exhibited the highest representativeness (51.1%), compared to CANVAS (21.1%), EMPA-REG OUTCOME (5.5%), and VERTIS-CV (4.9%) trials. Eligible CVOTs patients were older (74.6 vs. 68.3 years), with a longer disease duration (10.2 vs. 9.7 years), and higher established cardiovascular disease (CVD) prevalence (36.0 vs. 27.3%) compared to SGLT2i users. Less than 10% of eligible T2D patients received SGLT2i. Males (OR: 1.43; 95%CI: 1.24-1.66) were more likely to be prescribed SGLT2i than other antidiabetic drugs, while the elderly (80 + vs. 40-64 years, OR: 0.17; 95% CI: 0.14-0.22) were less likely. Eligible T2D patients with CVD reported an increased likelihood of receiving SGLT2is compared to other antidiabetics., Conclusion: This study highlights significant variability in the proportion of T2D subjects meeting SGLT2i CVOT inclusion criteria, with DECLARE-TIMI-58 being the most represented. Low SGLT2i prescription rates in the Italian primary care setting, along with substantial demographic and clinical differences between SGLT-2i users and T2D eligible patients, emphasize the need for targeted interventions to optimize the use of these medications in primary care settings., (© 2024. The Author(s).)
Published: 2024
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34. Waxing and waning consciousness in a patient with a midbrain cavernous malformation: illustrative case.

Author: Mazzaglia G, Falco J, Rossi Sebastiano D, Savoldi AP, Magnani FG, Castelli A, Ferroli P, and Gemma M
Abstract: Background: Understanding the intricate relationship between consciousness and the midbrain's structures remains a significant challenge in neuroscience. Transient lesions are perfect examples of the physiological functioning mechanism of these structures., Observations: The authors present the case of a 49-year-old female who experienced a transient disorder of consciousness due to a midbrain hematoma following surgical interventions to remove a cavernous malformation in the midbrain. This case explores the interplay between the ascending reticular activating system (ARAS) and the thalamic centers, highlighting the role of structural disruptions in influencing consciousness levels. Notably, the patient's recovery correlated with the resolution of midbrain edema, reinstating normal ARAS function and consciousness., Lessons: In patients affected by midbrain lesions, edema can lead to a fluctuating neurological status, which can be difficult to diagnose. This case highlights the midbrain's crucial role in the consciousness network and the need to comprehend the intricate connections between subcortical and cortical structures for a comprehensive understanding of human consciousness. https://thejns.org/doi/10.3171/CASE2411.
Published: 2024
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35. Health and economic impact of dapagliflozin for type 2 diabetes patients who had or were at risk for atherosclerotic cardiovascular disease in the Italian general practitioners setting: a budget impact analysis.

Author: Cortesi PA, Antonazzo IC, Palladino P, Gnesi M, Mele S, D'Amelio M, Zanzottera Ferrari E, Mazzaglia G, and Mantovani LG
Subjects: Humans, Italy epidemiology, General Practitioners statistics & numerical data, General Practitioners economics, Budgets statistics & numerical data, Cost-Benefit Analysis, Cardiovascular Diseases economics, Cardiovascular Diseases prevention & control, Cardiovascular Diseases epidemiology, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors economics, Hypoglycemic Agents economics, Hypoglycemic Agents therapeutic use, Male, Female, Middle Aged, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 economics, Diabetes Mellitus, Type 2 complications, Benzhydryl Compounds economics, Benzhydryl Compounds therapeutic use, Glucosides therapeutic use, Glucosides economics, Atherosclerosis economics, Atherosclerosis drug therapy
Abstract: Aim: In 2022, in Italy, general practitioners (GPs) have been allowed to prescribe SGLT2i in Type 2 Diabetes (T2D) under National Health Service (NHS) reimbursement. In the pivotal clinical trial named DECLARE-TIMI 58, dapagliflozin reduced the risk of hospitalization for heart failure, CV death and kidney disease progression compared to placebo in a population of T2D patients. This study evaluated the health and economic impact of dapagliflozin for T2D patients who had or were at risk for atherosclerotic cardiovascular disease in the Italian GPs setting., Methods: A budget impact model was developed to assess the health and economic impact of introducing dapagliflozin in GPs setting. The analysis was conducted by adopting the Italian NHS perspective and a 3-year time horizon. The model estimated and compared the health outcomes and direct medical costs associated with a scenario with dapagliflozin and other antidiabetic therapies available for GPs prescription (scenario B) and a scenario where only other antidiabetic therapies are available (scenario A). Rates of occurrence of cardiovascular and renal complications as well as adverse events were captured from DECLARE-TIMI 58 trial and the literature, while cost data were retrieved from the Italian tariff and the literature. One-way sensitivity analyses were conducted to test the impact of model parameters on the budget impact., Results: The model estimated around 442.000 patients eligible for the treatment with dapagliflozin in the GPs setting for each simulated year. The scenario B compared to scenario A was associated with a reduction in the occurrence of cardiovascular and renal complication (-1.83%) over the 3 years simulated. Furthermore, the scenario A allowed for an overall cost saving of 102,692,305€: 14,521,464€ in the first year, 33,007,064€ in the second and 55,163,777€ in the third. The cost of cost of drug acquisition, the probability of cardiovascular events and the percentage of patients potentially eligible to the treatment were the factor with largest impact on the results., Conclusions: The use of dapagliflozin in GPs setting reduce the number of CVD events, kidney disease progression and healthcare costs in Italy. These data should be considered to optimize the value produced for the T2D patients who had or were at risk for atherosclerotic cardiovascular disease., (© 2024. The Author(s).)
Published: 2024
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36. Epidemiology of SLE in Italy: an observational study using a primary care database.

Author: Ferrara P, Antonazzo IC, Zamparini M, Fornari C, Borrelli C, Boarino S, Bettiol A, Mattioli I, Palladino P, Zanzottera Ferrari E, Emmi G, Mantovani LG, and Mazzaglia G
Subjects: Humans, Italy epidemiology, Male, Female, Retrospective Studies, Adult, Middle Aged, Incidence, Prevalence, Aged, Young Adult, Adolescent, Lupus Erythematosus, Systemic epidemiology, Primary Health Care statistics & numerical data, Databases, Factual
Abstract: Objectives: To estimate the incidence and prevalence of SLE in Italy, and to describe the demographic and clinical characteristics of patients with newly diagnosed SLE., Methods: A retrospective cohort study was conducted using The Health Improvement Network general practice database in Italy, encompassing data from 634 753 people. SLE cases were identified over the period 2017-2022, employing three alternative definitions to provide a more detailed understanding of SLE characteristics. Incidence rates were expressed as cases per 100 000 person-years and prevalence as cases per 100 000 people. Demographic and clinical characteristics of incident SLE cases were also studied., Results: From 2017 to 2022, a total of 191 incident and 1385 prevalent cases were identified under our first definition. In 2022, the incidence rate was 6.51 cases (95% CI 6.29 to 6.74) per 100 000 person-years, and the prevalence 60.57 (95% CI 59.89 to 61.25) per 100 000 people, being the prevalence five times higher in women compared with men. Both estimates have trended upwards since 2017. A geographical variation across the country was also seen. The demographic and clinical characteristics of incident SLE cases were described, while the potential associations of SLE incidence with some pre-existing conditions were observed, such as chronic kidney disease, chronic hepatic disease, rheumatoid arthritis and Sjogren's syndrome., Conclusions: The results of this nationwide study, the first conducted in Italy, showed that the incidence of SLE has increased in Italy in recent years. Age, sex, and area of residence strongly correlate with the epidemiology of this condition., Competing Interests: Competing interests: PF, ICA, MZ, CF, AB, IM and GE declare no conflicts of interest. EZF and PP are employees of Cegedim Srl, which is a private company that performs financially supported studies for several pharmaceutical companies.CB are SB are employees of AstraZeneca Italy. LGM reports receiving grants from Bayer, Daiiki-Sankyo, and Boehringer Ingelheim and speaker fees from Pfizer and Bayer, outside this work. GM reports receiving grants from CSL Behring for consultancy outside this work., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2024
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37. Immunogenicity of Recombinant Zoster Vaccine: A Systematic Review, Meta-Analysis, and Meta-Regression.

Author: Losa L, Antonazzo IC, Di Martino G, Mazzaglia G, Tafuri S, Mantovani LG, and Ferrara P
Abstract: Background: The adjuvanted recombinant zoster vaccine (RZV), consisting of varicella-zoster virus glycoprotein E (gE) and the AS01 B adjuvant system, effectively prevents herpes zoster (HZ). In the absence of a well-defined correlate of protection, it is important to monitor the RZV immune response, as a proxy of clinical effectiveness., Methods: This systematic review examined post-vaccination parameters: humoral and cell-mediated immunity, avidity index, geometric mean concentration of antibody (GMC), and immunity persistence. The meta-analysis used a random-effects model, and subgroup and meta-regression analyses were conducted., Results: Among 37 included articles, after one month from RZV-dose 2, the pooled response rate for anti-gE humoral immunity was 95.2% (95%CI 91.9-97.2), dropping to 77.6% (95%CI 64.7-86.8) during immunosuppression. The anti-gE cell-mediated immunity-specific response reached 84.6% (95%CI 75.2-90.9). Varying factors, such as age, sex, coadministration with other vaccines, prior HZ, or live-attenuated zoster vaccine, did not significantly affect response rates. RZV induced a substantial increase in gE avidity. Immunity persistence was confirmed, with more rapid waning in the very elderly., Conclusions: This systematic review indicates that RZV elicits robust immunogenicity and overcomes immunocompromising conditions. The findings underscore the need for further research, particularly on long-term immunity, and have the potential to support HZ vaccination policies and programs.
Published: 2024
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38. Treatment patterns in essential tremor: Real-world evidence from a United Kingdom and France primary care database.

Author: Antonazzo IC, Rozza D, Conti S, Fornari C, Cortesi PA, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, and Mazzaglia G
Subjects: Humans, Primary Health Care, United Kingdom epidemiology, France epidemiology, Retrospective Studies, Essential Tremor diagnosis, Essential Tremor drug therapy, Essential Tremor epidemiology
Abstract: Background and Purpose: Essential tremor (ET) is one of the most common neurological disorders, but information on treatment pattern is still scant. The aim of this study was to describe the demographic and clinical characteristics, treatment patterns, and determinants of drug use in patients with newly diagnosed ET in France and the United Kingdom., Methods: Incident cases of ET diagnosed between January 1, 2015 and December 31, 2018 with 2 years of follow-up were identified by using The Health Improvement Network (THIN®) general practice database. During the follow-up, we assessed the daily prevalence of use and potential switches from first-line to second-line treatment or other lines of treatment. Logistic regression models were conducted to assess the effect of demographic and clinical characteristics on the likelihood of receiving ET treatment., Results: A total of 2957 and 3249 patients were selected in the United Kingdom and France, respectively. Among ET patients, drug use increased from 12 months to 1 month prior the date of index diagnosis (ID). After ID, nearly 40% of patients received at least one ET treatment, but during follow-up drug use decreased and at the end of the follow-up approximately 20% of patients were still on treatment. Among treated patients, ≤10% maintained the same treatment throughout the entire follow-up, nearly 20% switched, and 40%-75% interrupted any treatment. Results from the multivariate analysis revealed that, both in France and the United Kingdom, patients receiving multiple concomitant therapies and affected by psychiatric conditions were more likely to receive an ET medication., Conclusion: This study shows that ET is an undertreated disease with a lower-than-expected number of patients receiving and maintaining pharmacological treatment. Misclassification of ET diagnosis should be acknowledged; thus, results require cautious interpretation., (© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Published: 2024
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39. Long COVID Syndrome: Lesson Learned and Future Implications.

Author: Mazzaglia G
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has caused severe illness and mortality on a global scale, with an impact not witnessed since the 1918-19 Spanish influenza pandemic [...].
Published: 2023
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40. The Value of Tucatinib in Metastatic HER2-Positive Breast Cancer Patients: An Italian Cost-Effectiveness Analysis.

Author: Antonazzo IC, Cortesi PA, Miceli Sopo G, Mazzaglia G, Conte P, and Mantovani LG
Abstract: Background: This study was aimed at estimating the appropriate price of tucatinib plus trastuzumab and capecitabine (TXC), as third-line treatment, in HER2 + breast cancer (BC) patients from the Italian National Health System (NHS) perspective., Methods: A partitioned survival model with three mutually exclusive health states (i.e., progression-free survival (PFS), progressive disease (PD), and death) was used to estimate the price of tucatinib vs trastuzumab emtansine (TDM-1), considering a willingness to pay (WTP) of 60,000 EUR. Data from the HER2CLIMB trial, the Italian population, and the literature were used as input. The model also estimated the total costs and the life-years (LY) of TXC and TDM1. Deterministic and probabilistic (PSA) sensitivity analyses were conducted to evaluate the robustness of the model., Results: In the base case scenario, the appropriate price of tucatinib was 4828.44 EUR per cycle. The TXC resulted in +0.28 LYs and +16,628 EUR compared with TDM-1. Results were mainly sensitive to therapy intensity variation. In PSA analysis, TXC resulted cost-effective in 53% of the simulations. Assuming a WTP ranging 20,000-80,000 EUR, the tucatinib price ranged from 4090.60 to 5197.41 EUR., Conclusions: This study estimated the appropriate price for tucatinib according to different WTP in order to help healthcare decision makers to better understand the treatment value.
Published: 2023
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41. Anesthesia-induced Takotsubo cardiomyopathy in trigeminal neuralgia: illustrative case.

Author: Mazzaglia G, Bonomo G, Rubiu E, Murabito P, Amato A, Ferroli P, and Gemma M
Abstract: Background: Takotsubo syndrome (TS) represents a form of nonischemic cardiomyopathy characterized by sudden and temporary weakening of the myocardium. Many data suggest a primary role for sympathetic overstimulation in its pathogenesis. Nevertheless, these correlates are less easily identified during anesthesia., Observations: A 50-year-old female patient with a 4-year history of drug-resistant left trigeminal neuralgia. She was scheduled for surgical microvascular decompression. In the operating room, after induction of general anesthesia and oral intubation, the electrocardiogram revealed a significant ST segment elevation along with a sudden decrease in systolic blood pressure and heart rate. Administration of atropine caused a conversion into ventricular tachycardia. The advanced cardiac life support protocols were applied with prompt defibrillation and rapid recovery at sinus rhythm. A transthoracic echocardiogram revealed apical akinesia with ballooning of the left ventricle with a reduction of systolic function. An emergency coronary arteriography was performed, showing normal epicardial coronary vessels. After 4 days, echocardiography revealed normalization of the left ventricular function with improvement of the ejection fraction., Lessons: In patients affected by trigeminal neuralgia, chronic pain can lead to a state of adrenergic hyperactivation, which can promote TS during the induction of general anesthesia, probably through the trigeminocardiac reflex.
Published: 2023
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42. Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study.

Author: Antonazzo IC, Fornari C, Rozza D, Conti S, Di Pasquale R, Cortesi PA, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, and Mazzaglia G
Abstract: Background: The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis., Methods: Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models., Results: Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38-2.67), ICU access (OR: 0.54; 95% CI: 0.22-1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16-1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18-0.85) was observed in statins-users compared with non-LLT users., Conclusions: These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.
Published: 2022
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43. Increased Risk of Stroke Due to Non-adherence and Non-persistence with Direct Oral Anticoagulants (DOACs): Real-World Analyses Using a Nested Case-Control Study from The Netherlands, Italy and Germany.

Author: Holthuis E, Smits E, Spentzouris G, Beier D, Enders D, Gini R, Bartolini C, Mazzaglia G, Penning-van Beest F, and Herings R
Abstract: Background: A high degree of adherence to direct oral anticoagulants is essential for reducing the risk of ischaemic stroke and systemic embolism in patients with atrial fibrillation, owing to the rapid decline in anticoagulation activity when doses are omitted (i.e. rebound effect)., Objective: We aimed to assess the relationship between non-adherence and non-persistence with direct oral anticoagulants and the incidence of ischaemic stroke in patients with atrial fibrillation., Methods: A nested case-control study was conducted in the Netherlands, Italy and Germany among patients with atrial fibrillation starting direct oral anticoagulants between the drug approval date and the end of database availability. Patients with an ischaemic stroke during the follow-up were selected as cases and compared with matched controls (matched on age ± 5 years, sex, year of cohort entry date and CHA 2 DS 2 -VASc-score at cohort entry date). The cohort entry date was the first dispensing date. Study patients were those aged ≥ 45 years, with ≥ 1 year database history, ≥ 1 year follow-up and at least two direct oral anticoagulant dispensings after the cohort entry date. Adherence and persistence to direct oral anticoagulant treatment were defined as the proportion of days covered ≥ 80% or direct oral anticoagulant continuous use between the cohort entry date and the index date (i.e. date of ischaemic stroke), respectively., Results: In The Netherlands, Italy and Germany, 105 cases and 395 controls, 1580 cases and 6248 controls, and 900 cases and 3570 controls were included, respectively. Odds ratios (ORs) for stroke among current users who were non-adherent compared to adherent users were 0.43 (95% confidence interval [CI] 0.09-1.96) in The Netherlands, 1.11 (95% CI 0.98-1.26) in Italy and 1.21 (95% CI 1.01-1.45) in Germany. The risk of stroke was significantly higher among non-persistent users compared with persistent users in all three databases [OR 1.56 (95% CI 1.00-2.44), OR 1.48 (1.32-1.65) and OR 1.91 (95% CI 1.64-2.22), respectively]. In The Netherlands and Germany, the risk of stroke was higher the longer a patient had stopped using direct oral anticoagulants., Conclusions: Both non-adherence (in Germany) and non-persistence increased the risk of stroke, either using a once-daily or twice-daily regime., (© 2022. The Author(s).)
Published: 2022
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44. Azithromycin use and outcomes in patients with COVID-19: an observational real-world study.

Author: Antonazzo IC, Fornari C, Rozza D, Conti S, di Pasquale R, Cortesi P, Kaleci S, Ferrara P, Zucchi A, Maifredi G, Silenzi A, Cesana G, Mantovani LG, and Mazzaglia G
Subjects: Humans, Azithromycin adverse effects, SARS-CoV-2, Hospitalization, Respiration, Artificial, COVID-19 Drug Treatment
Abstract: Objectives: Previous studies ruled out the benefits of azithromycin for treatment of patients with COVID-19 who are hospitalized. However, the effects of azithromycin for treatment of patients with positive SARS-CoV-2 test results in the community remains a matter of debate. This study aimed to assess whether azithromycin, when used in subjects with positive test results for SARS-CoV-2, is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death., Methods: Two study cohorts were selected. Cohort A included subjects with positive test results for SARS-CoV-2 between February 20, 2020 and December 10, 2020; cohort B included subjects infected with SARS-CoV-2 and hospitalized between February 20, 2020 and December 31, 2020. We compared the risk of hospitalization, intensive care unit access, need for mechanical ventilation, and death in azithromycin users versus nonusers. A clustered Fine-Gray analysis was employed to assess the risk of hospitalization; logistic and Cox regressions were performed to assess the risk of intensive care unit access, mechanical ventilation, and death., Results: In cohort A, among 4861 azithromycin users and 4861 propensity-matched nonusers, azithromycin use was associated with higher risk of hospitalization (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.45-1.75) compared with nonuse. In cohort B, among 997 subjects selected in both groups, azithromycin use was not significantly associated with intensive care unit access (odds ratio [OR] 1.22, 95% CI 0.93-1.56), mechanical ventilation (OR 1.30, 95% CI 0.99-1.70), 14-day mortality (HR0.88, 95% CI 0.74-1.05), or 30-day mortality (HR 0.89, 95% CI 0.77-1.03)., Conclusion: Our findings confirm the lack of benefits of azithromycin treatment among community patients infected with SARS-CoV-2, raising concern on potential risks associated with its inappropriate use., Competing Interests: Declarations of competing interest ICA, CF, DR, SC, PF, PC, RDP, SK, AZ, GM, AS, GC and GM have no conflicts of interest to declare. LGM reported receiving grants from Bayer, Daiiki-Sankyo, and Boehringer Ingelheim outside the submitted work and speaker fees from Pfizer and Bayer., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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45. Time trends in the incidence of essential tremor: Evidences from UK and France primary care data.

Author: Antonazzo IC, Conti S, Rozza D, Fornari C, Eteve-Pitsaer C, Paris C, Gantzer L, Valentine D, Mantovani LG, and Mazzaglia G
Abstract: Introduction: Although essential tremor (ET) is considered a common adult movement disorder, evidence on its incidence is still scant. This study aims at estimating ET incidence in two European countries, namely, the UK and France., Methods: Incident cases of ET were identified within the Health Improvement Network (THIN®) database between 1st January 2014 and 31 December 2019. Yearly crude and standardized incidence rates (IR) were estimated across the study period for both countries. Poisson regression models were built to assess temporal trends in IRs and differences between sexes and age classes., Results: In total, 4,970 and 4,905 incident cases of ET were identified in the UK and France, respectively. The yearly average crude IR (per 100,000 person-years) was 18.20 (95%CI: 15.09-21.32) in UK and 21.42 (17.83-25.00) in France, whereas standardized ones were 19.51 (18.97-20.01) and 19.50 (18.97-20.05). Regression analyses showed slightly increasing trends in both countries, higher incidence among males, and a significant increase with age. Yearly average IR increased from 3.96 (0.95-6.97) and 5.28 (1.12-9.44) in subjects aged <20 years to 49.27 (26.29-72.24) and 51.52 (30.19-72.86) in those aged >80 year in UK and France., Conclusions: Standardized ET incidence was comparable in the UK and France, showing a slight increase in both countries, reporting a higher value among people aged 60 years and older. This study outlines the need to conduct future studies to estimate the burden of ET in terms of disease control and healthcare resource utilization., Competing Interests: Author LM has received grants and personal fees from Bayer AG, Boehringer Ingelheim, Pfizer and Daiichi-Sankyo. Authors CE-P, CP, LG, and DV are employed by Cegedim. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Antonazzo, Conti, Rozza, Fornari, Eteve-Pitsaer, Paris, Gantzer, Valentine, Mantovani and Mazzaglia.)
Published: 2022
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46. Antidepressants Drug Use during COVID-19 Waves in the Tuscan General Population: An Interrupted Time-Series Analysis.

Author: Antonazzo IC, Fornari C, Maumus-Robert S, Cei E, Paoletti O, Ferrara P, Conti S, Cortesi PA, Mantovani LG, Gini R, and Mazzaglia G
Abstract: In Italy, during the COVID-19 waves two lockdowns were implemented to prevent virus diffusion in the general population. Data on antidepressant (AD) use in these periods are still scarce. This study aimed at exploring the impact of COVID-19 lockdowns on prevalence and incidence of antidepressant drug use in the general population. A population-based study using the healthcare administrative database of Tuscany was performed. We selected a dynamic cohort of subjects with at least one ADs dispensing from 1 January 2018 to 27 December 2020. The weekly prevalence and incidence of drug use were estimated across different segments: pre-lockdown (1 January 2018-8 March 2020), first lockdown (9 March 2020-15 June 2020), post-first lockdown (16 June 2020-15 November 2020) and second lockdown (16 November 2020-27 December 2020). An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Compared to the pre-lockdown we observed an abrupt reduction of ADs incidence (Incidence-Ratio: 0.82; 95% Confidence-Intervals: 0.74-0.91) and a slight weekly decrease of prevalence (Prevalence-Ratio: 0.997; 0.996-0.999). During the post-first lockdown AD use increased, with higher incidence- and similar prevalence values compared with those expected in the absence of the outbreak. This pandemic has impacted AD drug use in the general population with potential rebound effects during the period between waves. This calls for future studies aimed at exploring the mid-long term effects of this phenomenon.
Published: 2022
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47. Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis.

Author: Antonazzo IC, Fornari C, Maumus-Robert S, Cei E, Paoletti O, Conti S, Cortesi PA, Mantovani LG, Gini R, and Mazzaglia G
Subjects: Communicable Disease Control, Emergency Service, Hospital, Humans, Pandemics, SARS-CoV-2, COVID-19, Epilepsy drug therapy, Epilepsy epidemiology, Pharmaceutical Preparations
Abstract: Background: In 2020, during the COVID-19 pandemic, Italy implemented two national lockdowns aimed at reducing virus transmission. We assessed whether these lockdowns affected anti-seizure medication (ASM) use and epilepsy-related access to emergency departments (ED) in the general population., Methods: We performed a population-based study using the healthcare administrative database of Tuscany. We defined the weekly time series of prevalence and incidence of ASM, along with the incidence of epilepsy-related ED access from 1 January 2018 to 27 December 2020 in the general population. An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes., Results: Compared to pre-lockdown, we observed a relevant reduction of ASM incidence (0.65; 95% Confidence Intervals: 0.59-0.72) and ED access (0.72; 0.64-0.82), and a slight decrease of ASM prevalence (0.95; 0.94-0.96). During the post-lockdown the ASM incidence reported higher values compared to pre-lockdown, whereas ASM prevalence and ED access remained lower. Results also indicate a lower impact of the second lockdown for both ASM prevalence (0.97; 0.96-0.98) and incidence (0.89; 0.80-0.99)., Conclusion: The lockdowns implemented during the COVID-19 outbreaks significantly affected ASM use and epilepsy-related ED access. The potential consequences of these phenomenon are still unknown, although an increased incidence of epilepsy-related symptoms after the first lockdown has been observed. These findings emphasize the need of ensuring continuous care of epileptic patients in stressful conditions such as the COVID-19 pandemic.
Published: 2021
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