Effect of Rorrico, extracted from group of Chinese medicines, on influenza A and H1N1 infections.

OBJECTIVE: To investigate the therapeutic and preventive effects of Rorrico on influenza, especially influenza A viral infection, including swine flu (H1N1) in humans. METHODS: Eighty-nine subjects were recruited in Hong Kong and Macau, and divided into treatment group (TG) and prevention group (PG) based on their influenza A and swine flu symptoms. All subjects were prescribed Rorrico or placebo, and monitored by a Chinese medicine practitioner. Blood samples were collected before and after 7-day Rorrico or placebo treatment for laboratory investigations. RESULTS: After treatment, there were some full recoveries and obvious relief of onset symptoms in the TG. Blood test results showed that Rorrico produced (a) no adverse effects on subjects' renal and liver functions, muscle enzyme and hematological status, (b) no up-regulation of pro-inflammatory cytokines tumour necrosis factor-a and interleukin-18 in both TG and PG, (c) mild yet statistically significant elevation of plasma mannose-binding lectin (MBL) in PG. CONCLUSION: Rorrico has no up-regulating effect on the participants' immune response, or, equally likely, the immuno-modulatory effects of Rorrico do not non-specifically or unnecessarily promote inflammation when not required. It is possible that oral administration of Rorrico can promote hepatic synthesis of MBL in healthy PG subjects, thereby conferring increased protection against infection.

Access to the next wave of biologic therapies (Abatacept and Tocilizumab) for the treatment of rheumatoid arthritis in England and Wales: addressing treatment outside the current NICE guidance.

Patients in England and Wales with rheumatoid arthritis (RA) receive treatment from the National Health Service (NHS) with therapies approved by the European Medicines Agency (EMA), under guidance from the National Institute for Health and Clinical Excellence (NICE). This document overviews the current NICE guidelines for the treatment of RA and identifies scenarios when such guidance may not represent the optimum management strategy for individual patients. Specifically, we consider the use of tocilizumab or abatacept as the most appropriate treatments for some patients. In such scenarios, it may be possible for the clinician to secure access to the required therapy through an application procedure known as an 'individual funding request', the process of which is described in detail here. At present, it is unclear the extent to which the proposed reform of the NHS will affect the role of NICE in providing guidance and setting standards of care. Until the full impact of the proposed changes are realized, individual funding requests will remain a valuable way of securing the optimal treatment for all patients suffering from RA.