RESUMEN
The first global workshop on implementation of the WHO guidelines on procedures and data requirements for changes to approved biotherapeutic products adopted by the WHO Expert Committee in 2018 was held in June 2019. The workshop participants recognized that the principles based on sound science and the potential for risk, as described in the WHO Guidelines on post-approval changes, which constitute the global standard for product life-cycle management are providing clarity and helping national regulatory authorities in establishing guidance while improving time-lines for an efficient regulation of products. Consequently, the regulatory situation for post-approval changes and guideline implementation is changing but there is a disparity between different countries. While the guidelines are gradually being implemented in some countries and also being considered in other countries, the need for regional workshops and further training on post-approval changes was a common theme reiterated by many participants. Given the complexities relating to post-approval changes in different regions/countries, there was a clear understanding among all participants that an efficient approach for product life-cycle management at a national level is needed to ensure faster availability of high standard, safe and efficacious medicines to patients as per the World Health Assembly Resolution 67.21.
Asunto(s)
Productos Biológicos/normas , Evaluación de Medicamentos/normas , Guías como Asunto , Organización Mundial de la Salud , Aprobación de Drogas , Control de Medicamentos y Narcóticos , Humanos , SeúlRESUMEN
A new family of protic NHC Ru complexes ligated with a phosphine-tethered imidazole moiety were prepared, which can act as excellent catalysts for acceptorless dehydrogenation of secondary alcohols and dehydrogenative coupling of primary and secondary alcohols, thus leading to the formation of a variety of carbonyl compounds with release of H2.
RESUMEN
Evidence regarding the association between cancer and heart failure (HF) is scarce. This study is to investigate the association between HF and cancer and explore the prognostic value of NT-proBNP in cancer patients. This cohort study used National Health and Nutrition Examination Survey data from 1999 to 2018 and linked mortality information until 2019. We included all participants with valid answer to questions regarding self-reported cancer and HF. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs. Our study included data from 54,847 adult participants. During a median (IQR) follow-up of 9.6 (4.0-15.1) years, 7674 deaths were recorded. HF was associated with an increased occurrence of cancer after propensity score matching (OR = 1.46, 95% CI: 1.17-1.82, p < 0.001). Cancer was associated with a higher occurrence of HF (OR = 1.33, 95% CI: 1.11-1.59, p = 0.002). Kaplan-Meier survival analysis over 10 years revealed the shortest survival in patients with both HF and cancer (log-rank p < 0.0001). Importantly, NT-proBNP was significantly higher in cancer patients, no matter whether with known HF (p < 0.01). In cancer patients without HF, NT-proBNP higher than 51.51 pg/mL was associated with shorter survival (log-rank p < 0.0001). Findings from this cohort study suggest that HF is significantly associated with cancer. NT-proBNP was higher in cancer patients, with significant prognostic value in cancer patients.