comprised exclusively platinum-pretreated population. Ado-trastuzumab emtansine showed the best numerical results according to ORR (54.5%), but the worst PFS (2.8 months; 95% CI 1.4-4.4) and OS (8.1 months; 95% CI 3.5-13.2) of all therapeutic alternatives. The highest numerical efficacy results were achieved by amivantamab [PFS = 8.3 months (95% CI 6.5-10.9); OS = 22.8 months (95% CI 14.6 to not reached)] and mobocertinib [PFS = 7.3 months (95% CI 5.5-9.2); OS = 24.0 months (95% CI, 14.6-28.8)].
Conclusion and RelevanceResults of amivantamab and mobocertinib suggested a higher numerical efficacy for clinically relevant endpoints in platinum pre-treated NSCLC harbouring EGFR exon 20 insertions. However, comparative RCTs with larger sample sizes are necessary to obtain reliable data.
For those drugs with more than one study, a previous metaanalysis was performed using Joaquin Primo calculator. An adjusted indirect comparison (IC) of the drugs used in AS versus tofacitinib was performed using the Bucher method, using Joaquin Primo calculator. Due to lack of data in the literature and considering that therapy failure can be recovered with second lines, half of the ASAS40 value obtained in meta-analysis was taken as delta value. ATE guide was followed in order to establish a positioning.
ResultsSixteen studies were included 4 adalimumab, 2 golimumab, 1 infliximab, 1 certolizumab, 2 etanercept, 1 upadacitinib, 2 tofacitinib, 1 secukinumab and 2 ixekizumab. The difference in ASAS40 of the drugs before versus tofacitinib expressed as RAR (IC 95%
Background
Simplification of antiretroviral treatment (ART) is a very useful therapeutic tool to facilitate adherence and prevent or reverse some adverse effects.
Purpose
To monitor patients with simplified ART to assess clinical response, adherence and the financial savings of the simplification.
Materials and methods
The authors selected patients who were given simplified ART in 2010 with the combination lopinavir/ritonavir. For each patient the ART before simplification, the CD4 cell count and viral load were analysed. The authors also noted the reason for the initiation of simplified ART and dispensing records from the Pharmacy department were used to calculate the adherence. The cost savings were calculated by comparing the cost of the patient's last ART and the cost of the simplified ART, using the official laboratory price and the number of prescriptions dispensed.
Results
20 patients were included in the study. 90% of them had been taking at least two antiretroviral regimens before starting the simplified treatment. All patients completed at least 6 months with an undetectable viral load (<50 copies/mL) before starting simplified ART. In 100% of the cases, the reason for simplification was greater immunological and virological control of the patient. The viral load at 3 months of treatment remained undetectable in all patients. There were no adverse effects or dropouts, the adherence was above 90% in all cases and all patients had a good immune status. Regarding the financial impact of ART change, the difference between the old ART and the new simplified regimen was found for each patient. The overall cost of the simplified ART was 83,506€. If patients had continued with the previous ART, the cost would have been 159,189€. Therefore, the cost saving resulting was 75,683€.
Conclusions
Simplified ART with lopinavir/ritonavir is a regimen with significant cost savings and no loss of virological efficacy or adverse effects.
limit chemical contamination and thus, to prevent occupational exposure. No conflict of interest. Switch from cErA to EPo ZEtA in PAtiEntS with AnAEmiA And chronic KidnEy diSEASE
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