Conclusion and Relevance A PCP in patients undergoing cardiac surgery was successfully implemented, ensuring a correct preoperative drug management, with 0.8 severe medication errors avoided per patient that was interviewed and potential savings of 992.130C ¼ .
to the product information, an implant releases FAc for a maximum of 36 months, and an additional implant can be placed after 12 months if vision decreases or retinal thickness increases. Pivotal studies and the IRISS observational study concluded in the need to use 1.3 implants/eye and 1.13 implants/eye affected during the first 3 years respectively, this last value being the one considered by the ERG (Evidence Review Group). Taking this last reference, the cost of treatment/affected eye at C ¼ 1558.84/eye/year or C ¼ 4676.53/ eye/3 years.To estimate the target population, we used the criteria of the SMC evaluation report in which they considered a total of 179 patients with pseudophakic chronic DME eligible for treatment in the first year, increasing to 186 in the fifth year. Unlike the SMC, our NHS restricts its funding to third-line, after anti-angiogenic agents and in patients with a suboptimal response to various intravitreal dexamethasone implants or pseudophakic patients.Making a parallelism with the Scottish population, 33.5 patients/1st year-34.8 patients/5th year would be candidates to receive FAc in our region.NICE and the ERG found that in clinical practice 35% of patients would require bilateral treatment. Thus 12 patients/ year would need treatment in both eyes in our population. The economic impact in our region would range between C ¼ 5,3000.56/year if it were inserted in only one eye and C ¼ 71,706.64/year in both eyes.
Conclusion and RelevanceThe financing conditions of our NHS position the drug in the third-line, which in a certain way contains the budget impact.Since SMC restricting the conditions of use more than our NHS, the budget impact could be underestimated.
samples. An important increase in the number of isoforms even with changes in their masses, including the main isoform, was detected. Conclusion and relevance Exposure to light may cause modifications in the nivolumab isoform profile which suggests protein degradation. This work shows the importance of protecting opened vials of the medicine Opdivo from light (and by extension, bags for infusion) when they are at room temperature (up to 25°C).
particularly in treatment modifications of anxiolytics and sedatives.This study suggests that pharmacists may find it difficult to achieve anticholinergic burden reductions by suggesting AD changes to physicians and patients.
not affect the activity of CTX. In the case of Toxoplasma gondii, the folate of choice is folinic acid because the microorganism can intake exogenous folate through the BT1 family transmembrane proteins which also have no affinity for folic acid.
Conclusion and relevanceIn general, theoretically folic acid supplementation can be used to prevent myelotoxicity as it does not interfere with the action of the antibiotic in the case of bacteria. However, in infections caused by more complex eukaryotic organisms such as other fungi or parasites with lipophilic cell walls or specifical transmembrane proteins, each case must be evaluated on its own merits.
and the results are expressed as means± SD for continuous variables and as percentages (%) for categorical variables. Results 71 patients (53.3% women, mean age 82.7±6.7 (58-94) years) were treated with an AChEI. 74.6% (53 patients) were simultaneously treated with a DAP. Mean concomitant prescribed drugs (DAP and non-DAP) was 11.6±4.7 drugs (2-26). Prescribed AChEI were rivastigmine 56.3%, donepezil 38% and galantamine 5.6%. According to the classification of the systematic review of Durán et al, 71 patients were treated with a total of 95 DAP. The seven most frequently prescribed anticholinergic drugs were: quetiapine 39.4%, haloperidol 22.5%, ipratropium 21.1%, trazodone 14.1%, risperidone 12.7%, mirtazapine 7% and tramadol 5.6%. 57.7% of patients had dementia symptoms: confusional syndrome 31%, cognitive impairment 28.2%, mood disturbances 12.9% and somnolence 9.9%. The main destination was hospitalisation 85.9%, followed by hospital discharge 11.3% and death 2.8%. Conclusion and relevance A high percentage of elderly patients with dementia treated with AChEI were taking concomitant DAP, that present accumulated risk. The combined use of these drugs can increase cognitive impairment and also antagonise the effects of AChEI. The results of the study suggest the need for considering other treatment options or a decrease in the prescriptions for DAPs to reduce the pharmacological interactions and the related adverse effects of concomitant use.
Results 13 patients were included, 76.9% men, mean age 60.4 ±8.8 years. Among the four patients with tumour samples that were evaluated for PD-L1 expression, 75% had a score !1. Three patients were treated with at least one previous line. Previous treatments were: sunitinib (n=3) cabozantinib (n=1) or nivolumab (n=1). IMDC risk classification: 7.7% favourable, 53.8% intermediate and 38.5% poor risk. Presence of metastases: lung (7/13), bone (5/13), liver (3/13), ganglionar (2/13), cerebral (1/13) and unknown (2/13). All patients were treated with pembrolizumab 200 mg every 3 weeks and axitinib 5 mg twice daily until progression, unacceptable toxicity or death. Mean duration of treatment was 28.7 weeks. 46% are continuing with active treatment. Discontinuation causes included: death (n=3), adverse effects (n=3) and progression (n=1). Toxicities included: asthenia grade (G)1-3 (n=11), anorexia G1-2 (n=6), diarrhoea G1-4 (n=5), liver profile alterations G1-3 (n=3), hyperthyroidism G1-3 (n=3), abdominal pain G1-2 (n=3), palmar-plantar erythrodysesthesia G2-3 (n=2), pruritus G1 (n=1), dizziness and paraesthesia G1 (n=1), vomiting G1 (n=1), thrombopenia G2 (n=1) and arthralgias G1 (n=1). Best TAC responses obtained were: 50% stable disease, 25% partial response and 12.5% progressive disease. In five patients the response rate was not evaluated. Conclusion and relevance Effectiveness in our patients resulted in a higher objective response rate than that in the KEYNOTE -426 trial. The combination treatment was well tolerated. To rationalise the use of novel medicines and optimise efficiency, measuring health results is crucial.
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