Todd Berner MD

Introduction: For patients with chronic kidney disease (CKD), the need for phosphate binder (PB) treatment peaks at onset of dialysis. This real-world study assessed rates of PB utilization and switching in patients with dialysis-dependent CKD (DD-CKD). Methods: We identified patients with PB utilization among those with prevalent DD-CKD using 2...

BACKGROUND AND AIMS End-stage kidney disease (ESKD) is associated with a high clinical and economic burden. Dialysis modalities include in-center hemodialysis (ICHD) and home dialysis [home hemodialysis (HHD) or peritoneal dialysis (PD)]. The prevalence of anemia in ESKD is estimated to be > 50% and is associated with an increased risk of comorbidi...

Aromatic-l-amino acid decarboxylase (AADC) deficiency is an ultra-rare inherited autosomal recessive disorder characterized by sharply reduced synthesis of dopamine as well as other neurotransmitters. Symptoms, including hypotonia and movement disorders (especially oculogyric crisis and dystonia) as well as autonomic dysfunction and behavioral diso...

Abstract Background Often, patients with primary immunodeficiency diseases (PID), which are marked by the absence or loss of functional antibodies, require lifelong treatment with immunoglobulin (IG) replacement therapy administered either intravenously (intravenous immunoglobulin [IVIG]) or subcutaneously (subcutaneous immunoglobulin [SCIG]). In p...

Introduction IgSCf est une Ig à 10 % associée avec la hyaluronidase humaine recombinante (rHuPH20) afin de faciliter la perfusion SC de l’IG, et approuvée dans l’union européenne (UE) comme un traitement de substitution chez les adultes, enfants et adolescents (0–18 ans) atteints de PID, hypogammaglobulinémie secondaire à un myélome ou une leucémie...

**Background:** Overactive bladder (OAB) is a chronic condition which may be associated with a significant negative impact on quality of life. Antimuscarinic drugs are currently the mainstay of medical therapy, but persistence and adherence are generally poor. Treatment switching may be considered in order to maximise benefits from pharmacological...

Background: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially...

The role of payer ACOs in the modern healthcare industry.

Objectives To examine potentially inappropriate medication (PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder (OAB). DesignRetrospective database analysis. SettingMedical and pharmacy claims data. ParticipantsMedicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on...

Objective: Overactive bladder (OAB) is a particular challenge to treat in older adults with co-morbid conditions taking multiple medications. Antimuscarinics (e.g., solifenacin, fesoterodine) and β3-adrenergic receptor agonists (mirabegron) are similarly efficacious; however, antimuscarinics may be associated with side effects that result in poor...

Objectives: To investigate treatment persistence with 2 treatments for overactive bladder (OAB): the β3-adrenoceptor agonist, mirabegron (25 and 50 mg once-daily), and the antimuscarinic, tolterodine extended release (4 mg once-daily). Study Design: Claims records of patients in the Optum database, with a valid prescription of mirabegron or toltero...

Objectives To determine the proportion of nursing home (NH) residents (NHR) with overactive bladder (OAB) or urinary incontinence (UI) with potential pharmacodynamic contraindications to antimuscarinic treatment because of concomitant anticholinergic medications or acetylcholinesterase inhibitors (AChEIs) and nonpharmacological limitations to antim...

Background: Chronic pain is a significant health problem that affects an estimated 100 million American adults (aged ≥ 18 years). Chronic pain affects more individuals than heart disease, stroke, diabetes, and cancer combined. Chronic pain sufferers cost up to $635 billion annually in medical treatment and lost productivity. Opioids are commonly u...

Objective: To identify clinical characteristics of residents with a diagnosis of overactive bladder (OAB) and/or urinary incontinence (UI) to determine the prevalence of comorbidities, severe mobility impairment (SMI), moderate-to-severe cognitive impairment (MSCI), and a toileting program and the response to that program. Design: Cross-sectiona...

Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) often present with voiding and storage symptoms, which may require combination therapy with an alpha blocker and an antimuscarinic (AM). This study compared treatment persistence in LUTS/BPH patients on alpha blocker monotherapy with those using com...

Introduction: Antimuscarinics are the principal pharmacological treatment for overactive bladder (OAB), but frequently give rise to anticholinergic side effects, such as dry mouth, a factor leading to poor persistence. The β3-adrenoceptor agonist mirabegron is devoid of significant anticholinergic activity, while being effective in OAB. We evaluat...

Purpose: Until recently pharmacological overactive bladder (OAB) treatment consisted exclusively of antimuscarinics, a subclass of anticholinergics (AC). Mirabegron, a new β-3 adrenergic agonist, is approved for the treatment of OAB patients, including those ineligible due to anticholinergic burden per the Beers criteria or intolerant of antimuscar...

Objectives: To compare the healthcare costs of patients with overactive bladder (OAB) who switch vs persist on anti-muscarinic agents (AMs), describe resource use and costs among OAB patients who discontinue AMs, and assess factors associated with persisting vs switching or discontinuing. Methods: OAB patients initiating an AM between January 1,...

Compare direct and indirect costs of oxymorphone extended-release ('oxymorphone') and oxycodone controlled-release ('oxycodone') users. Patients, aged 18+, with ≥1 claim for oxymorphone/oxycodone, Q2:2006-Q4:2009, were selected from a de-identified private payer claims database and observed from the first such claim ('index date') until the earlies...

Our goal was to examine the daily average consumption (DACON) of oxycodone controlled-release tablets (OxyContin CR)and oxymorphone extended-release tablets (Opana ER) in patients with low back pain. An observational, retrospective cohort study enrolled patients with multiple prescriptions for oxycodone CR or oxymorphone ER tablets. These patients...

This post hoc subgroup analysis evaluated scheduled short-term preventive frovatriptan therapy for women with migraine occurring exclusively in association with menstruation (occurring day -2 to +3; day 1 = menses start, no migraines outside this window). A previously published randomized, double-blind, placebo-controlled 3-way crossover trial asse...

Hurler's syndrome is usually diagnosed by chemical means; however, characteristic roentgenographic findings of "hook-shaped" vertebral bodies or "oar-shaped" ribs may be helpful in diagnosing the disorder.

Pulmonary contusions following blunt trauma often are visible roentgenographically immediately after injury. The case presented illustrates the need for prompt x-ray studies of the chest following blunt injury.