Grant: Fellowship - Priority Announcement: Drug Safety and Effectiveness

Optimal treatment decisions surrounding drug therapies rely on information about the trade-offs among benefits and harms. Moreover, the selection of an appropriate drug therapy is very patient specific and should take into consideration not only the potential benefits and harms, but also patient preferences. There are currently no standardized approaches that take these three factors into consideration to allow for a quick comparison across treatment alternatives. My research will use advanced methods for quantifying the relationship between effectiveness, safety and patient preference. Specifically, I will study the newest medications approved in Canada to treat type 2 diabetes called the sodium-glucose transport protein-2 (SGLT-2) inhibitors. The SGLT-2 inhibitors work by blocking the kidney from reabsorbing sugar back into the bloodstream thereby lowering blood glucose levels. These drugs are effective in managing diabetes and have even been shown to reduce the risk of heart attacks and strokes in high risk patients. There are however several safety concerns including higher rates of infections, kidney disease and bone fractures. The manner in which patients make trade-offs between these benefits and harms are not understood. My doctoral dissertation will consist of four studies: the first will summarize the clinical evidence and rank the safety and effectiveness of the SGLT-2 inhibitors compared to other common diabetes medications; the second will evaluate the reasons why patients prefer certain diabetes medications over others; the third and fourth studies will use findings from the first two studies to calculate a summary measure regarding the overall trade-offs of the potential benefits and harms for the SGLT-2 inhibitors using two different approaches. My research aims to improve patient safety and lead to better health outcomes and lower healthcare costs.