scholarly journals Parecoxib nel trattamento del dolore postoperatorio: considerazioni farmacoeconomiche

2003 ◽  
Vol 4 (1) ◽  
pp. 39-50
Author(s):  
Lorenzo Pradelli ◽  
Mario Eandi
Keyword(s):  
Patient Monitoring ◽  
Scientific Evidence ◽  
Drug Acquisition ◽  
Effective Management ◽  
Efficacy And Safety ◽  
Analgesic Action ◽  
Surgical Pain ◽  
Minor Surgery ◽  
Safety Studies

Parecoxib sodium is the first selective COX- 2 inhibitor to be available for parenteral administration. This pharmaceutical feature, alongside its favorable efficacy and safety profile, makes the new drug particularly suitable for simple and effective management of post-surgical pain. The first part of the present article describes the most important pharmacological characteristics of parecoxib and reviews the main efficacy and safety studies that were performed on patients presenting with post-surgical pain. Starting from these clinical data, the second part outlines the pharmacoeconomical profile of the drug in the Italian setting, focusing on the comparison with parenteral ketorolac, the most widely prescribed treatment for post-surgical pain in Italy. The available scientific evidence suggests that the introduction of parecoxib in the arsenal of available options for the management of this kind of patients in Italy may have a positive clinical and economical impact, despite of the higher drug acquisition price. In particular, the better tolerability shown by parecoxib in the comparison with non-selective NSAIDs would permit a reduction in the costs for the prevention and the cure of drugrelated adverse events and reduce the need for patient monitoring. Furthermore, the improved safety and the longer duration of the analgesic action could allow the management of more minor surgery patients in daysurgery units, with great economical advantages for the hospital and the health system and improved quality of life for the patients.

scholarly journals Parecoxib nel trattamento del dolore post-operatorio: considerazioni farmacoeconomiche

2004 ◽  
Vol 5 (4) ◽  
pp. 227-242
Author(s):  
Federica Mathis ◽  
Lorenzo Pradelli ◽  
Mario Eandi
Keyword(s):  
Safety Profile ◽  
Parenteral Administration ◽  
Effective Management ◽  
Efficacy And Safety ◽  
The Public ◽  
New Drug ◽  
Surgical Pain ◽  
Safety Studies ◽  
Cox 2

Parecoxib sodium is the first selective COX- 2 inhibitor to be available for parenteral administration. This pharmaceutical feature, alongside its favorable efficacy and safety profile, makes the new drug particularly suitable for simple and effective management of post-surgical pain. Aim of this work is to describe the pharmacoeconomical profile of the drug in the Italian setting, focusing on the comparison with parenteral ketorolac, the most widely prescribed treatment for post-surgical pain in Italy. The first part of the article describes the most important pharmacological characteristics of parecoxib and reviews the main efficacy and safety studies that were performed on patients presenting with post-surgical pain. A similar article about parecoxib was published on “Farmeconomia e percorsi terapeutici” 2003; 4(1): 39-50. At that moment, the price to the public wasn’t yet fixed and therefore the pharmacoeconomical analysis was based on estimated price. Moreover, during this year, extra studies were published on the efficacy of parecoxib on patients with post-surgical pain. For these reasons, we intend to present here an updated version of the profile.

scholarly journals Valutazione farmacoeconomica dell’uso di tramadolo vs ketorolac nella gestione del dolore postoperatorio

2003 ◽  
Vol 4 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Lorenzo G. Mantovani
Keyword(s):  
Economic Evaluation ◽  
Cost Minimization ◽  
Drug Acquisition ◽  
Economic Consequences ◽  
Analgesic Action ◽  
Surgical Pain ◽  
Consumption Data ◽  
Lower Drug ◽  
Acquisition Costs ◽  
The Mean

This article represents the first evaluation that compares the economic consequences of managing postsurgical pain with tramadol or ketorolac in the Italian setting. The economic evaluation was based on 5 clinical trials that directly compared the efficacy and tolerability of tramadol and ketorolac treatments in different settings and that contained drug consumption data. Since the review of these data confirmed that their efficacy is comparable (tramadol showed a quicker onset of the analgesic action, which was not considered for the purposes of the economic evaluation), it was chosen to conduct a cost minimization analysis. The calculations were made considering two different drug acquisition costs: the hypothetical price for the hospital, computed by discounting 50% off the retail price, and the mean price really paid by hospitals according to the IHS. The analyses showed that, when the discounted price is applied, tramadol induces costs that are similar to those induced by ketorolac in 2/3 of the cases and lower in the remaining 1/3. Considering the mean price paid by hospitals, tramadol results economically more advantageous than ketorolac in all considered settings. In conclusion, ketorolac and tramadol are two effective and tolerable drugs in the management of post-surgical pain, although they differ in the adverse event pattern and in the rapidity of their action. In the Italian setting, tramadol appears to be economically more efficient, due to lesser consumption and lower drug acquisition costs.

Understanding the New Clinical Landscape for Psoriasis: A Comparative Review of Biologics

2004 ◽  
Vol 8 (4) ◽  
pp. 205-212 ◽  
Author(s):  
Daniel N. Sauder ◽  
Adam J. Mamelak
Keyword(s):  
Scientific Evidence ◽  
Life Quality ◽  
Severity Index ◽  
Efficacy And Safety ◽  
Biologic Therapies ◽  
Biologic Drugs ◽  
Comparative Review ◽  
Important Addition ◽  
Primary Measure

Background: Encouraging results from clinical trials suggest that biologic therapies are effective treatments for psoriasis. Objective: The aim of our study was to evaluate the scientific evidence for the efficacy and safety of biologic drugs for psoriasis. Methods: The studies reviewed include data on the biologies alefacept, efalizumab, etanercept, and infliximab. This article reviews all data published in the dermatology literature listed in the MEDLINE database, as well as data presented as abstracts and posters at dermatology society meetings, including the annual meetings of the American Academy of Dermatology. Results: The majority of the studies used an improvement from baseline of 75% or more in the psoriasis area and severity index (PASI 75) as the primary measure of efficacy. Conclusions: Overall, biologics represent an important addition to the psoriatic therapies and have a great impact on the disease course and life quality of those afflicted with psoriasis.

scholarly journals Tobramycin inhalation powder for the treatment of pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis: a review based on clinical evidence

2017 ◽  
Vol 11 (5) ◽  
pp. 193-209 ◽  
Author(s):  
Kamal Hamed ◽  
Laurie Debonnett
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Ease Of Use ◽  
Efficacy And Safety ◽  
Safety Studies ◽  
Pseudomonas Aeruginosa Infection ◽  
Cleaning And Disinfection ◽  
Inhalation Powder

Chronic airway infection with Pseudomonas aeruginosa is a major cause of increased morbidity and mortality in patients with cystic fibrosis (CF). The development and widespread use of nebulized antibacterial therapies, including tobramycin inhalation solution (TIS), has led to improvements in lung function and quality of life. However, the use of nebulizers is associated with various challenges, including extended administration times and the need for frequent device cleaning and disinfection. Multiple therapies are required for patients with CF, which poses a considerable burden to patients, and adherence to the recommended treatments remains a challenge. Tobramycin inhalation powder (TIP), delivered via the T-326 Inhaler, has been shown to have similar clinical efficacy and safety as compared to TIS, with improved patient convenience, satisfaction, and treatment adherence. Long-term safety studies have shown that TIP was well tolerated with no unexpected adverse events in patients with CF. This review of the TIP pivotal and postmarketing studies reinforces the well-established efficacy and safety profile of TIP and its ease of use.

scholarly journals Self-administered acupressure for allergic rhinitis: Study protocol for a randomized, single blind, non-specific controlled, parallel trial

2019 ◽  
Author(s):  
Yaqun Liang ◽  
George Binh Lenon ◽  
Angela Wei Hong Yang
Keyword(s):  
Allergic Rhinitis ◽  
Scientific Evidence ◽  
Life Questionnaire ◽  
Efficacy And Safety ◽  
Chi Square ◽  
Non Invasive ◽  
Ige Mediated ◽  
Single Blind

Abstract Background Allergic rhinitis (AR) is an IgE-mediated inflammatory disease. Current conventional therapies for AR are unsatisfactory. Acupuncture has been recommended as an optional treatment for AR patients who are interested in non-pharmacotherapy in the new clinical practice guidelines for AR. Acupressure is a sub-type of acupuncture which is non-invasive with a low risk and can be self-administered. However, the current limited evidence is compromised by the high risk of bias and heterogeneity of methodology. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. This proposed RCT aims to evaluate the efficacy and safety of self-administered acupressure for the management of AR. Methods/design We have designed a randomized, single blind, non-specific controlled, two-arm, parallel clinical trial involving a 2-week run-in period, a 4-week intervention period and an 8-week follow-up period. The eligible participants will be randomized into either specific or non-specific acupressure group. They will be required to perform self-administered acupressure on either 5 specific acupressure points or 5 non-specific acupressure points, one minute for each point, twice a day for 4 weeks. Participants will be asked to complete self-administered questionnaires for outcome measures including 7-point scale of symptom severity, Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQs), relief medication scores, adverse events and participants’ opinion of this study at the different assessment points throughout the trial period. Data will be analyzed by chi-square or t-test using Statistical Package for Social Science (SPSS) software. Discussion The findings from this study will provide scientific evidence for the efficacy and safety of self-administered acupressure for the management of AR. This study may assist to develop a non-cost, non-invasive self-management method for AR sufferers.

scholarly journals Self-administered acupressure for allergic rhinitis: Study protocol for a randomized, single blind, non-specific controlled, parallel trial

2019 ◽  
Author(s):  
Yaqun Liang ◽  
George Binh Lenon ◽  
Angela Wei Hong Yang
Keyword(s):  
Allergic Rhinitis ◽  
Scientific Evidence ◽  
Life Questionnaire ◽  
Efficacy And Safety ◽  
Chi Square ◽  
Non Invasive ◽  
Ige Mediated ◽  
Single Blind

Abstract Background Allergic rhinitis (AR) is an IgE-mediated inflammatory disease. Current conventional therapies for AR are unsatisfactory. Acupuncture has been recommended as an optional treatment for AR patients who are interested in non-pharmacotherapy in the new clinical practice guidelines for AR. Acupressure is a sub-type of acupuncture which is non-invasive with a low risk and can be self-administered. However, the current limited evidence is compromised by the high risk of bias and heterogeneity of methodology. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. This proposed RCT aims to evaluate the efficacy and safety of self-administered acupressure for the management of AR. Methods/design We have designed a randomized, single blind, non-specific controlled, two-arm, parallel clinical trial involving a 2-week run-in period, a 4-week intervention period and an 8-week follow-up period. The eligible participants will be randomized into either specific or non-specific acupressure group. They will be required to perform self-administered acupressure on either 5 specific acupressure points or 5 non-specific acupressure points, one minute for each point, twice a day for 4 weeks. Participants will be asked to complete self-administered questionnaires for outcome measures including 7-point scale of symptom severity, Rhinoconjunctivitis Quality of Life Questionnaire with Standardized Activities (RQLQs), relief medication scores, adverse events and participants’ opinion of this study at the different assessment points throughout the trial period. Data will be analyzed by chi-square or t-test using Statistical Package for Social Science (SPSS) software. Discussion The findings from this study will provide scientific evidence for the efficacy and safety of self-administered acupressure for the management of AR. This study may assist to develop a non-cost, non-invasive self-management method for AR sufferers.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

Public Procurement and Innovative Economy Forming

2010 ◽  
pp. 108-117 ◽  
Author(s):  
I. Smotritskaya ◽  
S. Chernykh
Keyword(s):  
Conceptual Framework ◽  
Public Procurement ◽  
Innovative Activity ◽  
Institutional Framework ◽  
Effective Management ◽  
Russian Economy ◽  
Public Resources ◽  
Innovative Economy ◽  
Procurement System

The article analyzes the conceptual framework of public procurement system as an integral part of public regulation to ensure effective management of public resources. The authors consider the problems of transition to a new "quality" of the procurement system, increasing its innovative activity. They put forward proposals for institutional framework and mechanisms of regulating procurement, meeting the needs in innovative upgrading and modernization of the Russian economy.

scholarly journals Prognostic factors for chronic post-surgical pain after lung or pleural surgery: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051554
Author(s):  
Pascal Richard David Clephas ◽  
Sanne Elisabeth Hoeks ◽  
Marialena Trivella ◽  
Christian S Guay ◽  
Preet Mohinder Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Meta Analysis ◽  
Case Series ◽  
Related Factors ◽  
Surgical Pain ◽  
Literature Reviews ◽  
Chronic Post Surgical Pain

IntroductionChronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods heterogeneous and the methodological quality questionable. Systematic reviews and meta-analyses are therefore needed to summarise the evidence.Methods and analysisThe reporting of this protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We will include retrospective and prospective studies with a follow-up of at least 3 months reporting patient-related factors and surgery-related factors for any adult population. Randomised controlled trials will be included if they report on prognostic factors for CPSP after lung or pleural surgery. We will exclude case series, case reports, literature reviews, studies that do not report results for lung or pleural surgery separately and studies that modified the treatment or prognostic factor based on pain during the observation period. MEDLINE, Scopus, Web of Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature reviews will be searched. Independent pairs of two reviewers will assess studies in two stages based on the PICOTS criteria. We will use the Quality in Prognostic Studies tool for the quality assessment and the CHARMS-PF checklist for the data extraction of the included studies. The analyses will all be conducted separately for each identified prognostic factor. We will analyse adjusted and unadjusted estimated measures separately. When possible, evidence will be summarised with a meta-analysis and otherwise narratively. We will quantify heterogeneity by calculating the Q and I2 statistics. The heterogeneity will be further explored with meta-regression and subgroup analyses based on clinical knowledge. The quality of the evidence obtained will be evaluated according to the Grades of Recommendation Assessment, Development and Evaluation guideline 28.Ethics and disseminationEthical approval will not be necessary, as all data are already in the public domain. Results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42021227888.

scholarly journals Physicochemical Characterization Cascade of Nanoadjuvant–Antigen Systems for Improving Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 544
Author(s):  
Giuditta Guerrini ◽  
Antonio Vivi ◽  
Sabrina Gioria ◽  
Jessica Ponti ◽  
Davide Magrì ◽  
...  
Keyword(s):  
Immune Response ◽  
Protein Structure ◽  
Physicochemical Properties ◽  
Physicochemical Characterization ◽  
Protein Antigen ◽  
Efficacy And Safety

Adjuvants have been used for decades to enhance the immune response to vaccines, in particular for the subunit-based adjuvants. Physicochemical properties of the adjuvant-protein antigen complexes, such as size, morphology, protein structure and binding, influence the overall efficacy and safety of the vaccine. Here we show how to perform an accurate physicochemical characterization of the nanoaluminum–ovalbumin complex. Using a combination of existing techniques, we developed a multi-staged characterization strategy based on measurements of increased complexity. This characterization cascade has the advantage of being very flexible and easily adaptable to any adjuvant-protein antigen combinations. It will contribute to control the quality of antigen–adjuvant complexes and immunological outcomes, ultimately leading to improved vaccines.

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