Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

A Conceptual Model of Expatriate Turnover

Many factors may contribute to the high rate of expatriate turnover experienced by U.S. multinational corporations. The objective of this article is to present a comprehensive model of the expatriate turnover process by identifying the key contributing factors and suggesting intermediate linkages and relationships. The model appears to have both managerial and theoretical implications.© 1992 JIBS. Journal of International Business Studies (1992) 23, 499–531

Organizational Predictors of expatriate Job Satisfaction

The study presented here attempted to identify the factors under the control of the organization that may predict expatriate job satisfaction. The results indicate that both job/task and organization characteristics are significantly related to both intrinsic and extrinsic job satisfaction. The results appear to have both managerial and research implications.© 1993 JIBS. Journal of International Business Studies (1993) 24, 61–80

Customer satisfaction and business performance: a firm‐level analysis

PurposeThis study aims to examine the relationships between customer satisfaction and a variety of company performance metrics at the firm‐level of analysis.Design /methodology/approachThe primary research method used in the study was a longitudinal analysis of series of quarterly surveys of customer attitudes, in relation to various company performance metrics of one large Fortune 100 company. The data were collected over a five‐year period and were analyzed with several statistical tests of association.FindingsIt was found that there are significant, and moderate‐to‐strong associations between satisfaction levels and a firm's financial and market performance. More specifically, there are strong links between customer satisfaction, and retention, revenue, earnings per share, stock price, and Tobin's q.Research implications/limitationsThe main implication of this study is that the longitudinal findings demonstrate a strong consistent link between customer attitudes and financial performance at the firm level. The study is clearly limited to one firm, from one industry sector, but offers future researchers a wealth of replication opportunities.Originality/valueNumerous experts have noted that marketing needs to document the financial impact of marketing activities. Unlike most studies in this area, this study investigated these associations at the firm level, rather than at the aggregate or industry level where some relationships are potentially masked. The study also investigated the links between satisfaction and financial performance in the business‐to‐business services sector, rather than in business‐to‐customer services. Finally, the firm provided access to large samples of real customer attitude data over a five‐year period, rather than from a cross‐sectional study

Toward a contingency theory of CRM adoption

Acknowledging the paucity of research on customers who are the targets of customer relationship management (CRM) efforts, this paper presents a contingency theory framework and set of research propositions suggesting that successful CRM adoption is contingent on a variety of contextual factors that influence value exchange in B2B channel relationships. Grounded in theoretical perspectives on the customer selection process, channel governance, transaction costs, power distribution in marketing channels, and dynamic capabilities, the authors identify five broad categories of variables potentially important in studying CRM adoption and directly affecting CRM success/failur