Efficacy and safety of biologics in the treatment of moderate to severe psoriasis: a comprehensive meta-analysis of randomized controlled trials Eficácia e segurança de agentes biológicos no tratamento da psoríase moderada a grave: uma meta-análise de ensaios clínicos randomizados e controlados Eficacia y seguridad de los agentes biológicos en el tratamiento de la psoriasis moderada a severa: un metaanálisis de ensayos aleatorios y controlados

Background Adherence to prescribed drug therapy is associated with lower rates of cardiovascular causes of death. In view of the relevance for public health, it is important to understand the relation between medication adherence tools' scores, especially in low literacy patients discharged from a cardiology ward. Objectives We aimed to assess: (a) the association between number of controlled clinical conditions and adherence tools scores, and (b) the correlation between the scores of three instruments to assess adherence. Methods We conducted a prospective study and included patients discharged from a specialized cardiovascular ward in Brazil. The results of the Beliefs about Medicines questionnaire (BMQ), the Adherence to Refills and Medication Scale (ARMS) and the MedTake test were compared. Results Of 53 included patients, most of them were elderly, and did not complete primary school. On average, there were six health conditions per patient, where two of them were not controlled. ARMS was the only tool that was associated with number of controlled health conditions (r = -0.312, p < 0.05). Moreover, ARMS (average score 15.6 ± 3.4) had significant correlation with MEDTAKE (r = 0.535, p < 0.01) and BMQ (r = 0.38, p < 0.01). BMQ and MEDTAKE were also positively correlated (r = 0.311, p < 0.05). Conclusions Clinically, higher ARMS scores (>12) suggest assumed non-adherence. It is also negatively correlated with the number of controlled clinical conditions in low literacy elderlies with cardiovascular diseases.

hibidores, el costo promedio por paciente/mes en demanda es de $ 26,427,616 y el costo promedio paciente/mes en profilaxis secundaria es de $ 23,032,817 (p= 0,456). Sin contabilizar los medicamentos antinhibidores el costo promedio por paciente/ mes en demanda es de $ 4,143,308 y el costo promedio paciente/mes en profilaxis secundaria es de $ 19,113,948 (p< 0,0001). ConClusiones: No se observa diferencia significativa en la tasa de sangrados en los grupos de profilaxis secundaria y demanda. El grupo de pacientes con inhibidores experimenta el mayor costo dentro de la población observada. Al excluir los inhibidores el costo promedio/paciente/mes en profilaxis secundaria es 4,6 veces mayor que el costo en tratamiento a demanda.

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RESUMO:A psoríase é uma doença crônica que afeta principalmente o órgão cutâneo e que está associada a várias comorbidades. Pacientes com a condição moderada a grave da doença eventualmente são tratados por terapias sistêmicas. Dentre estas, as não biológicas estão associadas a desenvolvimento de eventos adversos em órgãos alvo e intolerância ao tratamento. Os medicamentos biológicos são tecnologias recentes, mais caras e com característica de não afetarem órgãos alvo. Trata-se de medicamentos que modicam sistemicamente a resposta imunológica na psoríase. Como a doença tem origem em processos inamatórios de células T (notadamente células Th1 e Th17) que levam à hiperproliferação celular, os biológicos atuam mediando as interações especícas das células T com o antígeno, no bloqueio das interações intercelulares, ou inibindo diretamente citocinas inamatórias que desencadeiam ou exacerbam a resposta imunológica e proliferativa. Este artigo é uma revisão de literatura sobre ecácia e segurança de medicamentos imunobiológicos utilizados no tratamento da psoríase moderada a grave. Palavras-chave: Medicamentos biologicos, Psoriase, Ecácia, Segurança ABSTRACT:Psoriasis is a chronic disease that affects mainly the skin and it is associated with much co-morbidity. Patients that develop the moderate-to-severe condition eventually need to be treated with systemic therapies. Among those therapies, non biologics medicines are associated with arise of adverse events in target organs and intolerance to treatment. In other hand, biologic medicine is a recent technology, more expensive and with characteristics do not related with toxicity in target organs. They are new medicines that modify the immunologic response in psoriasis. The disease has origin in inammatory process of T cells (specially Th1 and Th17 cells) that leads to a cellular hyper proliferation. The biologics acts as mediator of the specic interactions of T cells with the antigen, blocking the intercellular interactions, or inhibiting directly the inammatory cytokines that initiate or acerbate the proliferative immunologic response. This article is a literature review about the efcacy and safety of biologic medicines used in treatments of moderate to severe psoriasis.

RESUMO:Para um planejamento de farmacovigilância ser bem sucedido, os termos utilizados para segurança no uso dos medicamentos precisam ser cuidadosamente denidos, visto que as classicações adotadas atualmente são bastante confusas e limitadas. Nesse sentido, o presente artigo tem como objetivo descrever as principais denições de eventos adversos a medicamentos e seus componentes, a m de esclarecer pontos importantes sobre a segurança no uso de medicamentos e auxiliar no acompanhamento, prevenção, diagnóstico e resolução de eventos adversos relacionados ao uso de medicamentos. Os resultados demonstram que atualmente existe uma grande diversidade de denições diferentes ligadas à segurança do paciente relacionada com os medicamentos. Torna-se evidente a necessidade de padronização dos termos e denições utilizados no que diz respeito à segurança no uso de medicamentos. Palavras-chave: Eventos adversos a medicamentos; Segurança no uso de medicamentos. ABSTRACT:For a pharmacovigilance plan to be successful, the terms used for the safe use of medications need to be carefully dened, since the classications adopted today are quite confusing and limited. In this sense, the present article aims to describe the main denitions of adverse drug events and their components in order to clarify important points about the safe use of medications and assist in the monitoring, prevention, diagnosis and resolution of adverse events related to use of medications. The results show that there is currently a wide range of different denitions related to patient safety related medications. It becomes clear need for standardization of terms and denitions used in relation to the safe use of medicines.

A727have investigated the utility of pharmacotherapy and epidural steroid injections (ESI) in large practice setting. We sought to gather comprehensive data about the characteristics, efficacy, tolerability and quality of life (QoL) of patients with LBP with these therapies. Methods: Information was collected on a standardized form. Information included patient characteristics, type and duration of therapies, adverse events, pain relief using visual analogue scale (VAS) and QoL by measuring disability using modified ODQ at each month of follow-up. Results: Consecutive 81 patients were recruited and followed for 6 months. Average baseline pain duration was found to be 45.5 months. Combination of drugs and ESI was given in 75 (92%) patients. Anticonvulsants (75%) and Antidepressants (57%) were most commonly prescribed medications. Change in VAS & ODQ score from baseline to each follow-up at 3 months (VAS -15), 6 months (VAS -25) was significantly (P < 0.05) improved. ConClusions: Pregabalin and amitriptyline were most commonly used drugs with maximum pain relief and improved Qol. Desired pain relief fluctuated with time. ESI can be promising choice when desirable pain relief is not achieved with medications.