Introduction: Compliance with antidiabetic therapy has the potential to impact on the risk for complications by an effect on glycemic control. Fixed-dose combinations (FDCs) offer a simplified dosing regimen that may improve patient compliance. We undertook a retrospective database analysis to understand the real-world association between FDCs, treatment practices, glycated hemoglobin (HbA1c) levels, and patient perspectives in type 2 diabetes. Methods: Data were drawn from the Adelphi Diabetes Disease Specific Programme (DSP), a multicenter, patient record-based market research study of primary care physicians and diabetologists/endocrinologists in Europe. The study is based on physician interviews, completion of detailed patient record forms by physicians, and a self-completion questionnaire by patients. Regression analyses were used to identify factors associated with (1) physician-reported dipeptidyl peptidase-4 inhibitor (DPP-4)/metformin FDC prescribing in dual or triple therapy regimens; (2) HbA1c of patients prescribed a DPP-4 FDC alone versus free-form DPP-4 plus metformin dual therapy regimens; and (3) differences between patients prescribed any oral antidiabetic therapy (OAD) FDC therapy (alone or in combination with one other OAD) versus those prescribed dual or triple OAD free‑form combination therapy. Results: Physician-reported data were available for 5891 patients (mean age 61.5 years, 43% female, mean duration since diagnosis 5.7 years). Factors associated with DPP-4 FDC usage included physicians’ reason for choice being “improves patient compliance.” The relative mean % HbA1c level associated with being on a DPP-4 FDC rather than free-form independent of the physician perception of patient compliance was 0.25 lower (CI –0.40 to –0.09). When physician-perceived patient compliance was described as “fairly compliant” rather than “poorly compliant” or “not at all compliant,” the relative mean % HbA1c level was 0.42 lower (CI –0.67 to –0.18). Similarly, being perceived as “fully compliant” rather than “fairly compliant” was associated with a relative mean % HbA1c level that was 0.17 lower (CI –0.31 to –0.02). A significant predictor for the current regimen being any FDC (alone or in combination with one other OAD) regimen was patients’ satisfaction with treatment (odds ratio 1.32; 95% CI 1.10 to 1.58; P=0.003). Conclusions: These results suggest that DPP-4 FDC prescribing is considered to be a positive prescribing choice to improve compliance and that choice is associated with improved glycemic control. From the patient’s perspective, the decision to prescribe an FDC is associated with improved satisfaction with treatment.

Introduction: To examine the comparative short-term effects of brimonidine/timolol and dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with primary open angle glaucoma (OAG). Methods: In a prospective, randomized, doubleblind, crossover study, intraocular pressure (IOP), blood pressure (BP), ocular perfusion pressure (OPP), and retrobulbar hemodynamics were assessed in 15 patients with OAG (mean age 68.1 years, eight women) with well controlled IOP. IOP was measured by Goldman applanation tonometery and color Doppler imaging was utilized to assess the retrobulbar blood vessels before and 1 month after treatment with topical brimonidine/timolol and dorzolamide/timolol. Statistical analysis was performed by Friedman two-way analysis of variance by ranks and post-hoc Wilcoxon signed rank test for multiple comparisons with Holm’s sequential Bonferroni procedure. P values <0.05 were considered statistically significant. Results: The Friedman test and subsequent post-hoc analysis indicated that IOP, BP, OPP, and retrobulbar blood flow velocities did not significantly differ between brimonidine/timolol and dorzolamide/timolol after 1-month treatment administration in patients with OAG and well controlled IOP. Conclusion: In this cohort of patients with OAG, short-term treatment with brimonidine/timolol and dorzolamide/timolol results in similar effects on OPP and retrobulbar blood flow velocities.

Introduction: The aim of this study was to investigate the efficacy and safety of a fludarabine-based individualized regimen in elderly patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
Methods: Sixteen patients were treated with the individual regimen of fludarabine combined with rituximab. Adverse reactions and efficacy of treatment were observed.
Results: Sixteen patients received a total of 69 courses of immunochemotherapy, with an average administration of 275 mg fludarabine per person. The overall response rate was 81.3% (13/16), in which seven cases (43.8%) achieved complete remission, six cases (37.5%) achieved partial remission, two cases (12.5%) had stable disease, and one case (6.3%) developed disease progression. The most frequent side effect was myelosuppression. Two patients experienced grade 3-4 cytopenia, one case developed a grade 3 infection, and no treatment-related death was observed.
Conclusion: The individual regimen of fludarabine combined with rituximab demonstrated marked clinical efficacy and acceptable toxicity in elderly patients with CLL/SLL.