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1.
Front Pharmacol ; 12: 802942, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34970153

RESUMO

Background: Pembrolizumab is a guideline-recommended, both first- and second-line treatment option for microsatellite-instability-high (MSI-H)/mismatch repair-deficient (dMMR)advanced colorectal cancer patients. The aim of the present study is to investigates the health and economic outcomes of three treatment strategies with or without pembrolizumab in MSI-H/dMMR advanced colorectal cancer to define the best treatment strategy from the perspective of the US payer. Methods: A microsimulation model was developed to estimate the cost and effectiveness of three treatment strategies: 1) pembrolizumab used as first-line, 2) pembrolizumab used as second-line and, 3) chemotherapy. Life years (LYs), quality-adjusted LYs (QALYs) and lifetime costs were estimated. Results: The model projected that patients receiving pembrolizumab in the first-line setting gained 5.579 QALYs; this value was 1.501 and 3.941 QALYs more than that for patients receiving pembrolizumab in the second-line setting and chemotherapy, respectively. First-line pembrolizumab strategy dominated second-line pembrolizumab strategy. Compared with chemotherapy, first-line pembrolizumab strategy yielded an incremental cost of $50613.7, which resulted in an ICER of $13441 per QALY. Conclusion: For patients with MSI-H/dMMR advanced colorectal cancer, reserving pembrolizumab for second-line line use is dominated by its first-line use, and first-line use of pembrolizumab is cost-effective compared with chemotherapy.

2.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-852030

RESUMO

Objective To prepare the puerarin-loaded PEGylated mesoporous silica nanoparticles (PUE@PEG-MSNs) and evaluate its protection on the acute myocardial ischemic rats. Methods PEG-MSNs functionalized mesoporous silica nanoparticles were achieved by the condensation method, and then they were loaded by PUE. The morphology of PUE@PEG-MSNs was examined by detection methods of particle diameter, Zeta potential, transmission electron microscope (TEM), and Fourier transform infrared spectra (FTIR). Moreover, the drug loading and encapsulation rate were measured by HPLC. Sixty acute ischemic myocardial model rats were prepared by coronary artery ligation, and then they were randomly divided into six groups: Sham, MIRI model, puerarin injection, low-, mid-, and high-dose PUE@PEG-MSNs groups. Different doses of PUE@PEG-MSNs and puerarin injection were given 5 min after the ligation. Monitoring the changes of ST, the blood was collected at the end of reperfusion for detecting the changes of serum creatine kinase (CK), lactic dehydrogenase (LDH), aspartate aminotransferase (AST), and malondialdehyde (MDA). The myocardial infarct size was also determined. Results PUE@PEG-MSNs presented uniform spherical morphology and particle size distribution. The particle size and Zeta potential was 300 nm and -30 mV respectively. The drug loading and entrapment efficiency was 14.7% and 67.8% respectively. Both puerarin injection and PUE@PEG-MSNs could reduce the ST-elevation of electrocardiogram, decrease the contents of CK, LDH, AST, and MDA, and reduce the myocardial infarct size. The efficacy of mid- and high-dose PUE@PEG- MSNs groups was better than that of puerarin injection group. Conclusion PUE@PEG-MSNs were successfully prepared and exerted the protective effects on the acute myocardial ischemic rats.

3.
Hum Vaccin Immunother ; 11(11): 2740-3, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26158590

RESUMO

Kawasaki disease (KD) after rotavirus and hepatitis A vaccination has not previously been reported in a baby in China. Herein, we describe a 20-month-old child who developed Kawasaki disease after receiving her second dose of Lanzhou lamb rotavirus vaccine (LLR) and her first dose of freeze-dried live attenuated hepatitis A vaccine. The case report was conducted by collecting and analyzing the hospital in-patient medical records and reviewing both the domestic and foreign pertinent literature. These findings will be important to note this possible side effect and to further investigate the association between the above 2 vaccines and Kawasaki disease.


Assuntos
Vacinas contra Hepatite A/efeitos adversos , Síndrome de Linfonodos Mucocutâneos/induzido quimicamente , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Vacinas contra Rotavirus/efeitos adversos , China , Feminino , Vacinas contra Hepatite A/administração & dosagem , Humanos , Lactente , Síndrome de Linfonodos Mucocutâneos/patologia , Vacinas contra Rotavirus/administração & dosagem
4.
Pharmacoeconomics ; 32(3): 235-43, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23709451

RESUMO

BACKGROUND: Postoperative adjuvant chemotherapy with capecitabine and oxaliplatin was first recommended for resectable gastric cancer patients in the 2011 Chinese National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Gastric Cancer, but the economic influence of this therapy in China is unknown. OBJECTIVE: The aim of the present study was to determine the cost-effectiveness of adjuvant chemotherapy with capecitabine and oxaliplatin after a gastrectomy with extended (D2) lymph-node dissection, compared with a D2 gastrectomy alone, for patients with stage II-IIIB gastric cancer. METHODS: On the basis of data from the CLASSIC trial, a Markov model was created to determine economic and clinical data for patients in the chemotherapy and surgery group (CSG) and the surgery-only group (SOG). The costs, presented in 2010 US dollars and estimated from the perspective of the Chinese health-care system, were obtained from the published literature and the local health system. The utilities were based on published literature. Costs, life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were estimated. A lifetime horizon and a 3 % annual discount rate were used. One-way and probabilistic sensitivity analyses were performed. RESULTS: For the base case, the CSG compared with SOG would increase LYs and QALYs in a 3-, 5-, 10- or 30-year time horizon (except the QALYs at 3 or 5 years). In the short run (such as in 3 or 5 years), the medical costs would increase owing to adjuvant chemotherapy of capecitabine plus oxaliplatin after D2 gastrectomy, but in the long run the costs would decline. The ICERs suggested that the SOG was dominant at 3 or 5 years and the CSG was dominant at 10 or 30 years. The one-way sensitivity analysis showed that the utility of disease-free survival for 1-10 years for the SOG and the cost of oxaliplatin were the most influential parameters. The probabilistic sensitivity analysis predicted a 98.6 % likelihood that the ICER for the CSG would be less than US$13,527/QALY (three times the per capita gross domestic product of China). CONCLUSION: For patients in China with resectable disease, our results suggest that adjuvant chemotherapy with capecitabine plus oxaliplatin after a D2 gastrectomy is cost-saving and dominant in the long run on the basis of a current clinical trial, compared with treatment with a D2 gastrectomy alone.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/economia , Desoxicitidina/análogos & derivados , Fluoruracila/análogos & derivados , Gastrectomia/economia , Compostos Organoplatínicos/economia , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Capecitabina , Quimioterapia Adjuvante/economia , Análise Custo-Benefício , Desoxicitidina/administração & dosagem , Desoxicitidina/economia , Desoxicitidina/uso terapêutico , Intervalo Livre de Doença , Fluoruracila/administração & dosagem , Fluoruracila/economia , Fluoruracila/uso terapêutico , Humanos , Cadeias de Markov , Modelos Moleculares , Estudos Multicêntricos como Assunto , Compostos Organoplatínicos/administração & dosagem , Compostos Organoplatínicos/uso terapêutico , Oxaliplatina , Guias de Prática Clínica como Assunto , Anos de Vida Ajustados por Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Pharmacoeconomics ; 27(10): 873-86, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19803541

RESUMO

An oncology trial compared four cycles of doxorubicin/cyclophosphamide (AC) with four cycles of docetaxel/cyclophosphamide (TC) in operable breast cancer patients (71% were diagnosed with hormone receptor positive and 48% with node-negative breast cancer). The objective of this study was to estimate the lifetime cost effectiveness of AC versus TC, from a Chinese healthcare provider perspective, based on a clinical trial. A lifetime cost-effectiveness analysis was performed using a Markov model. Events rates and utilities in the Markov model were derived from published papers. Data on cost of breast cancer care were obtained from the Second Xiangya Hospital of Central South University, Changsha, PR China. One-way sensitivity analysis and probabilistic sensitivity analysis were undertaken. Cost estimates were valued in Chinese yuan (Y), year 2008 values. All costs and outcomes were discounted at 3% per annum. Patients receiving TC gained 14.45 QALYs, 0.41 QALYs more than patients receiving AC. The lifetime costs of patients receiving TC were Y93 511, Y10 116 more than that of AC patients. The incremental cost-effectiveness ratios were Y26 742 per life-year gained ( pound 2719.8 per year) and Y24 305 per QALY gained ( pound2471.9 per QALY). The most sensitive parameter in the model was the cost of primary cancer treatments in the TC arm. At a threshold willingness to pay of Y86 514 per QALY, the probability of TC being cost effective was 90%. Our model suggests that TC may be considered cost effective from a Chinese healthcare provider perspective, according to the threshold defined by the WHO.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/economia , Neoplasias da Mama/economia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/terapia , Quimioterapia Adjuvante/economia , China , Ensaios Clínicos como Assunto , Análise Custo-Benefício , Ciclofosfamida/administração & dosagem , Docetaxel , Doxorrubicina/administração & dosagem , Feminino , Humanos , Cadeias de Markov , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Taxoides/administração & dosagem
6.
China Pharmacy ; (12)2005.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-532278

RESUMO

OBJECTIVE:To fathom the overseas research method for the evaluation of pharmacoeconomics and to improve the development of pharmacoeconomics in China and provide scientific bases for clinical rational use of medicine.METHODS:The research paper abroad introducing the latest therapeutic scheme for breast cancer was taken as an example to expound the method of applying Markov model in the evaluation of pharmacoeconomics.RESULTS & CONCLUSION:Drawing useful experience from abroad about the analytical method and using decision analytic model for the study of pharmacoeconomics are conducive to the development of pharmacoeconomics in China.

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