A Systematic Literature Review on the Cost-Effectiveness of Apixaban for Stroke Prevention in Non-valvular Atrial Fibrillation

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s40119-016-0066-2">https://link.springer.com/article/10.1007/s40119-016-0066-2</a></p><p></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

<div><p>Background</p><p>Human papillomavirus (HPV) infection, particularly with type 16, causes a growing fraction of oropharyngeal cancers, whose incidence is increasing, mainly in developed countries. In a double-blind controlled trial conducted to investigate vaccine efficacy (VE) of the bivalent HPV 16/18 vaccine against cervical infections and lesions, we estimated VE against prevalent oral HPV infections 4 years after vaccination.</p><p>Methods and Findings</p><p>A total of 7,466 women 18–25 years old were randomized (1∶1) to receive the HPV16/18 vaccine or hepatitis A vaccine as control. At the final blinded 4-year study visit, 5,840 participants provided oral specimens (91·9% of eligible women) to evaluate VE against oral infections. Our primary analysis evaluated prevalent oral HPV infection among all vaccinated women with oral and cervical HPV results. Corresponding VE against prevalent cervical HPV16/18 infection was calculated for comparison. Oral prevalence of identifiable mucosal HPV was relatively low (1·7%). Approximately four years after vaccination, there were 15 prevalent HPV16/18 infections in the control group and one in the vaccine group, for an estimated VE of 93·3% (95% CI = 63% to 100%). Corresponding efficacy against prevalent cervical HPV16/18 infection for the same cohort at the same visit was 72·0% (95% CI = 63% to 79%) (p versus oral VE = 0·04). There was no statistically significant protection against other oral HPV infections, though power was limited for these analyses.</p><p>Conclusions</p><p>HPV prevalence four years after vaccination with the ASO4-adjuvanted HPV16/18 vaccine was much lower among women in the vaccine arm compared to the control arm, suggesting that the vaccine affords strong protection against oral HPV16/18 infection, with potentially important implications for prevention of increasingly common HPV-associated oropharyngeal cancer.</p><p></p><p>ClinicalTrials.gov, Registry number <a href="http://clinicaltrials.gov/ct2/show/NCT00128661?term=NCT00128661&rank=1" target="_blank">NCT00128661</a></p></div

Proportion of women who accepted oral specimen collection among all women who attended the 4- year annual visit by selected characteristics.

*<p>Unknown excluded from calculation.</p>∫<p>P value for the comparison of women who did and did not accept oral specimen collections.</p>◊<p>Two 17 yr olds are classified in the ‘18–19’ group and one 27 yr old is classified in the ‘24–25’ group.</p

Estimated vaccine efficacy against oral and cervical HPV16 and 18 infections 4 years after vaccination.

*<p>There was one woman with a mixed infection with HPV 16 and 18.</p>∫<p>P for arm* site interaction for VE against HPV 16/18 = 0.04.</p

General characteristics of the analytic population by vaccination arm (N = 5834).

*<p>Unknown excluded from calculation.</p>∫<p>Two 17 yr olds are classified in the ‘18–19’ group and one 27 yr old is classified in the ‘24–25’ group.</p>◊<p>Chi square p value for difference by arm = 0.02.</p