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首页> 外文期刊>Open access Medical Statistics >>Preferred S-adenosylmethionine prescription in routine practice for intrahepatic cholestasis management: results of a multinomial logistic regression grid-optimization approach
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>Preferred S-adenosylmethionine prescription in routine practice for intrahepatic cholestasis management: results of a multinomial logistic regression grid-optimization approach

机译：>肝内胆汁淤积症常规治疗中首选S-腺苷甲硫氨酸处方：多项Logistic回归网格优化方法的结果

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Background: S-adenosylmethionine (AdoMet) is available for the treatment of intrahepatic cholestasis in different doses and in different administration forms. The aim of this study was to develop a categorization model, also called a nomogram, to discern if there was a relationship between prescribers’ treatment preferences and patient baseline characteristics for the treatment options, and to assess whether effectiveness was positively correlated with prescriber preference. Materials and methods: Baseline characteristics of patients in a post-marketing observational study (PMOS) were analyzed by multinomial logistic regression to produce preference probabilities for the prescription of different AdoMet starting regimens: 400 mg injection, 800 mg injection, and 800 mg oral tablets. Grid-optimization based on the preference probabilities was used to subdivide the patients into seven relative treatment preference categories. Subsequently, for each category, the effectiveness of the three treatments was assessed by determining the response rate after 2 weeks of treatment for each treatment group. Results: Elevated total bilirubin values, high Child–Pugh scores, and symptomatic cholestasis were associated with prescriber preference for the 800?mg injection, whereas low total bilirubin and low Child–Pugh scores were related to prescriber preference for the 400?mg injection. In?the absence of cholestatic symptoms, the 800?mg tablet starting regimen was preferred. In the category where the baseline characteristics did not come to a more- or less-preferred treatment, the response rates were highest for the 800 mg tablets group (67%) and lowest in the 400 mg injection group (50%); however, the total sample size in this category was small (N = 22). Conclusion: Categorization of patients into treatment preference groups based on baseline data might be an interesting approach to assess the validity of the treatment preference versus the respective treatment effectiveness as shown in a PMOS with three AdoMet treatment regimens.
机译：背景：S-腺苷甲硫氨酸（AdoMet）可用于治疗肝内胆汁淤积症，其剂量和给药方式不同。这项研究的目的是建立一个分类模型，也称为列线图，以辨别处方者的治疗偏爱与治疗方案的患者基线特征之间是否存在关系，并评估疗效是否与处方者偏爱成正相关。材料和方法：通过多项Logistic回归分析售后观察研究（PMOS）中患者的基线特征，以得出不同AdoMet起始方案处方的优先选择概率：400 mg注射，800 mg注射和800 mg口服片剂。基于偏好概率的网格优化用于将患者细分为七个相对治疗偏好类别。随后，对于每个类别，通过确定每个治疗组治疗2周后的缓解率，评估三种治疗的有效性。结果：总胆红素值升高，Child-Pugh评分高和症状性胆汁淤积与800mg注射者的处方偏爱相关，而总胆红素低和Child-Pugh分数低与400mg者处方偏爱有关。在没有胆汁淤积症状的情况下，首选800mg片剂开始方案。在基线特征未得到或多或少优先治疗的类别中，800 mg片剂组的缓解率最高（67％），而400 mg注射组的缓解率最低（50％）。但是，此类别中的总样本量很小（N = 22）。结论：根据基线数据将患者分类为治疗偏好组可能是一种评估治疗偏好与各自治疗效果的有效性的有趣方法，如采用三种AdoMet治疗方案的PMOS所示。

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