Evaluation of the pharmacoeconomics of drugs used for the treatment of long-term complications of sulfur mustard

Abstract

Sulfur mustard (SM), a cytotoxic vesicant chemical warfare agent, has powerful irritant and blistering effects on the skin, eyes and respiratory tract. Since during the Iraq-Iran war, many Iranian soldiers and civilians were exposed to SM, there are several victims still suffering from long-term cutaneous, ocular and pulmonary complications. Currently, there is no definite treatment for long-term complications of SM, and only supportive medical care is being taken to minimize the symptoms. In this study, we compared the cost-effectiveness of common drugs that are used against long-term SM-induced complications in Iranian patients. In this review article, electronic databases were checked using the following key words: sulfur mustard, lung, skin, eye, cost-effectiveness, pharmacoeconomics and treatment. Abstracts of non-English papers and proceedings of congresses on SM were also assessed. Among the studied drugs, high-dose oral N-acetyl cysteine and long-acting inhaled corticosteroids against respiratory complications, topical corticosteroids and oral antihistamines against cutaneous complications and NSAIDS and corticosteroids ophthalmic drops against ocular complications were found to be cost-effective. Usage of different drugs in the treatment of SM injuries in Iran, have imposed a significant economic burden to patients and their families because many drugs that are effective against chemical injuries are not covered by insurance. In addition, development of more effective drugs in this field is considered as an urgent demand that should be noticed by the pharmaceutical industry.

Carvacrol ameliorates haematological parameters, oxidant/antioxidant biomarkers and pulmonary function tests in patients with sulphur mustard‐induced lung disorders: A randomized double‐blind clinical trial

“…The uses of different drugs in the treatment of SM injuries in Iran have imposed a significant economic burden to patients and their families. In addition, the development of more effective drugs in this field is considered as an urgent demand that should be noticed by the pharmaceutical industry . Lung injury is an ongoing pathological and active disorder even years after exposure to SM.…”

“…In addition, the development of more effective drugs in this field is considered as an urgent demand that should be noticed by the pharmaceutical industry. 27 Lung injury is an ongoing pathological and active disorder even years after exposure to SM. Different drug classes have been studied; nevertheless, there are no curative modalities for mustard lung.…”

Glutathione conjugates of the mercapturic acid pathway and guanine adduct as biomarkers of exposure to CEES, a sulfur mustard analog

“…The severity of SM-induced complications mainly depends on dose, duration, and body part of the exposure [3,4]. SM contamination may cause adverse health effects in many organs especially the skin, eyes, and respiratory system [3,4].…”

“…The severity of SM-induced complications mainly depends on dose, duration, and body part of the exposure [3,4]. SM contamination may cause adverse health effects in many organs especially the skin, eyes, and respiratory system [3,4]. The first symptoms, including ocular, dermal, and respiratory damage, usually become evident only approximately 12 hours after exposure [5].…”