RESUMEN
Preparation of injectable anticancer drugs is centralized within chemotherapy preparation unit of hospital pharmacies under pharmaceutical responsibility. Improving the chemotherapy preparation unit's efficiency in the face of increasing demand, resource constraints and the need to ensure high quality is a challenge. Hospital pharmacists in search of efficiency in order to combine productivity and quality, have several tools to respond to this problem. These are in particular the quality management, whether they go through certification or not, a source of rationalization of activities and which will strengthen the cohesion of the staff through common objectives. The management of production flows, early preparation or dose-banding will allow a smoothing of activity reducing the risk of medication error and patient waiting times. The continuous training of hospital pharmacy technicians is an important lever so that they acquire and then maintain these specific skills. Finally, the use of the most recent technologies constitutes an important part of the possibilities offered to hospital pharmacists : computerization, automated production and quality controls.
Asunto(s)
Antineoplásicos , Servicio de Farmacia en Hospital , Farmacia , Humanos , Farmacéuticos , Técnicos de Farmacia/educaciónRESUMEN
PURPOSE: Rituximab (R) or obinutuzumab (G) combined with CHOP chemotherapy are used in previously untreated follicular lymphoma (FL). The aim is to compare in real life setting the efficacy and safety of these therapeutic strategies and assess the economic impact of introducing G. METHODS: This retrospective study, performed in 3 centers, included data from all patients who received R-CHOP or G-CHOP for previous untreated FL from June 1st, 2016 to December 31st, 2020. Progression-Free Survival (PFS) were estimated according to the Kaplan-Meier method. A budgetary impact model was performed from the French health care system's perspective. RESULTS: N = 124 patients were included (58 G-CHOP; 66 R-CHOP). Fifty-one and 57 patients achieved a complete response at the end of induction in the G-CHOP and R-CHOP group, respectively. PFS was not significantly longer in the G-CHOP group (HR 0.28; 95% CI 0.08-0.97; p value = 0.14). Hematological toxicity occurred more frequently with G-CHOP than R-CHOP during induction treatment (n = 58; 100% vs. n = 61; 92%), including higher severe neutropenia (grade ≥ 3) (n = 26; 45% vs. n = 23; 35%). Infusion-related reactions during the first infusion occurred more frequently with G-CHOP (n = 19; 33% vs. n = 16; 24%). The introduction of a completed G treatment (induction and maintenance) results in an additional cumulative cost per patient estimated at more than 30,000. CONCLUSION: Similar results were found in the GALLIUM subgroup analysis study, suggesting that at this time there is no absolute benefit to administer G-CHOP instead of R-CHOP in all patients with previously untreated FL and may encourage clinical and economic trials including quality of life data.
Asunto(s)
Linfoma Folicular , Humanos , Rituximab , Linfoma Folicular/tratamiento farmacológico , Linfoma Folicular/patología , Estudios Retrospectivos , Calidad de Vida , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Ciclofosfamida , Vincristina , Doxorrubicina , PrednisonaRESUMEN
Methylphenidate (MPH) is a piperidine similar to amphetamines, and is indicated for attention deficit hyperactivity disorder. Studies concerning stuttering occurring with MPH are contradictory. We investigated the association between MPH and stuttering. We analysed reports in the World Health Organization global individual case safety reports database, Vigibase, up to 31 December 2018, with the MedDRA preferred term "dysphemia" and the lower level terms "stutter" and "stuttering". The association between exposure to MPH and occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (RORs) were calculated with 95% confidence intervals (CIs). In total, 2975 cases of dysphemia were reported, of which 46 reports were associated with MPH. For the Preferred Term "dysphemia", the ROR was 7.3 (95% CI: 5.4-9.8). With the Lower Level Term "stuttering", 584 cases were registered in the database of which 17 involved MPH. The ROR was 13.9 (95% CI: 8.6-22.5). This study found a signal for stuttering with MPH.