Objective: Based on the cost-effectiveness analysis (CEA) to determine economic and clinical consequences of using mepolizumab instead of omalizumab in adults with severe eosinophilic asthma, when omalizumab is administered once every 2 weeks or mepolizumab is administered once every 4 weeks. Methods: Effectiveness and safety analysis was conducted based on the published network meta-analysis, because head-to-head clinical trials of omalizumab versus mepolizumab were not identified during targeted scientific literature search. Direct medical costs were calculated using information from the register of manufacturers` maximum selling prices for vital and essential drugs (VED), instructions for medical use, the unit cost of healthcare services. Results: Effectiveness and safety of the compared drugs were determined based on the results of the network meta-analysis. Frequency of clinically significant asthma exacerbations (risk ratio = 0,19; 95% CI: 0,02–2,32) and withdrawals due to adverse events (risk ratio = 0,05; 95% CI: 0,002–0,95). Therefore, despite the tendency to mepolisumab benefits, it was concluded that there are no statistically significant differences in the effectiveness and safety of the compared drugs due to the insufficient statistical power of the result. Direct medical costs were 870130 rubles and 1852063 rubles for mepolizumab and omalizumab respectively. Saving of direct medical costs for mepolizumab treatment was 959170 rubles per patient per year or 52%. Conclusion: treatment with mepolizumab versus omalizumab in patients with severe eosinophilic asthma, when omalizumab is administered once every 2 weeks or mepolizumab is administered once every 4 weeks, leads to saving of direct medical costs for drug treatment.
air pollutants among infants and children in Macao. Methods: ARDL Model was used to evaluate the associations of the respiratory viruses with meteorological factors (weekly average temperature (T), wind speed (WS), dew point (DP)) and air pollutants (PM10, PM2.5, NO 2) among children aged 12 years or younger hospitalized for acute respiratory infections (ARIs) from 2014 to 2017 (208 weeks in total). Eviews was used to establish 3 models which dependent variable were the number of infection with respiratory syncytial virus (RSV), human metapneumovirus virus (hMPV) and influenza virus (INF). Results: Among the 3767 hospitalized children with ARIs infected by viruses included in this study, 756 (20.1%) were infected by RSV, 334 (8.9%) were infected by hMPV and 441 (11.7%) were infected by INF. In Model 1, PM2.5 (b=0.075, P=0.041) was positive associated with RSV. Model 2 showed that T lagged 1 week (b=0.-0.244, P=0.019) and WS lagged 4 weeks (b=-0.113, P=0.042) were negatively associated with hMPV. Model 3 showed that T lagged 1 week (b=-0.256, P=0.017) and NO 2 lagged 3 weeks (b=-0.037, P=0.038) were also negatively associated with INF. All the remaining variables with time lag showed no significant correlation. Conclusions: Meteorological factors and air pollutants influences can be used to investigate the prevalence of respiratory viral infections. ARDL Model is useful to help explain the time lag. However, not all air pollutants appear to be the risk factors for viral infection warranting further research.
Objective: to review the data on the efficacy and consumption of octocog alfa and rurioctoctog alfa pegol in standard prophylaxis and individualized prophylaxis in hemophilia A patients based on published international data. Material and methods: a systematic literature search and review were performed. Among 25 sources identified within the systematic search 7 relevant sources describing the comparison of treatment with octocog alfa and rurioctocog alfa pegol in adult and pediatric patients with severe and moderate hemophilia A based on personalized assessment of the pharmacokinetic curve using the interactive tool myPKFit versus the standard (non-personalized) dosage regimen were selected. Data on individual patients, as well as data from secondary subgroups defined by age, bleeding rate, risk of bleeding associated with the daily physical activity were combined and analyzed. Results. In observational studies, adjustments of the dose and administration of octocog alfa in patients with severe hemophilia based on personalized assessment of the pharmacokinetic curve using myPKFit resulted in the reduced consumption and/or increased efficacy of prophylaxis — a reduced annual bleeding rate. In an extended controlled study of rurioctocog alpha pegol a trend toward reduced bleeding rate and increased mean annual consumption of the drug was reported in patients who received myPKFit guided prophylaxis compared to a non-personalized treatment regimen. In the single-cut studies, myPKFiT use resulted in the regimen revisions in less than a quarter of patients. Summary. Personalized dosing for octocog alpha and rurioctocog alpha pegol based on pharmacokinetic curve built using pharmacokinetic population model enables reasonable dose adjustments and improves outcomes.
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