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1.
J Cardiovasc Pharmacol ; 73(5): 290-300, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31082960

RESUMO

Erythropoietin (EPO) has been linked to cardioprotective effects. However, its effects during the aging process are little known. We investigated the effect of EPO administration on hemodynamic parameters, cardiac function, oxidative damage, and erythropoietin receptor (EPOR) expression pattern in the hypovolemic state. EPO was administered (1000 IU/kg/3 days) and then acute hemorrhage (20% blood loss) was induced in young and adult rats. There was no difference in plasmatic EPO in either age group. The hemodynamic basal condition was similar, without alterations in renal function and hematocrit, in both age groups. After bleeding, both EPO-treated age groups had increased blood pressure at the end of the experimental protocol, being greater in adult animals. EPO attenuated the tachycardic effect. Ejection fraction and fractional shortening were higher in adult EPO-treated rats subjected to hemorrhage. In the left ventricle, young and adult EPO-treated rats subjected to bleeding showed an increased EPOR expression. A different EPOR expression pattern was observed in the adult right atrial tissue, compared with young animals. EPO treatment decreased oxidative damage to lipids in both age groups. EPO treatment before acute hemorrhage improves cardiovascular function during the aging process, which is mediated by different EPOR pattern expression in the heart tissue.


Assuntos
Sistema Cardiovascular/efeitos dos fármacos , Epoetina alfa/administração & dosagem , Hematínicos/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Hemorragia/tratamento farmacológico , Função Ventricular Esquerda/efeitos dos fármacos , Fatores Etários , Animais , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatologia , Modelos Animais de Doenças , Hemorragia/metabolismo , Hemorragia/fisiopatologia , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Miocárdio/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Ratos Sprague-Dawley , Receptores da Eritropoetina/agonistas , Receptores da Eritropoetina/metabolismo
2.
J Med Econ ; 22(8): 736-741, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30915883

RESUMO

Objectives: There is a lack of data in Panama on the potential differences in total healthcare professional (HCP) time between routine administrations of short-acting erythropoietin simulating agents (ESAs) (i.e. epoetin alfa) and continuous erythropoietin receptor activator (CERA) (i.e. methoxy polyethylene glycol-epoetin beta). This study aimed to quantify the HCP time associated with a single administration of epoetin alfa and CERA for the treatment of anemic patients with chronic kidney disease (CKD) on hemodialysis. Methods: This was a multi-center, cross-sectional study, using a time-and-motion methodology. Costs related to HCP time and consumables usage associated with administration of epoetin alfa and CERA were estimated. Results: Based on 60 administrations of either CERA or epoetin alfa, the estimated savings in mean total active HCP time were 2.34 (95% confidence interval = 1.87-2.81) min (-30%) per administration. When extrapolating to a full year's treatment with intravenous ESA, it would require a total of 20.3 (95% CI = 19.90-20.71) h of HCP time for epoetin alfa vs 1.1 (95% CI = 1.01-1.19) h for CERA per patient per year. Estimated savings in active HCP time per patient per year were 19.20 (95% CI = 19.20-19.21) h (-95%). This, in turn, translates into staff cost efficiency that favors Mircera with an estimated annual saving of $78.24 (95% CI = 78.24-78.28) (-95%) per patient. Conclusions: Data from a real-world setting showed that the adoption of CERA could potentially lead to a reduction in active HCP time. Highlights Few comparative data have explored the costs and potential savings of using long-acting erythropoietin-stimulating agents (ESA) instead of short-acting ESAs to treat anemia in CKD patients on hemodialysis. This time-and-motion study shows that use of CERA reduces total healthcare professional time and could represent a save for an institution in a real-world setting in Panama.


Assuntos
Epoetina alfa/economia , Eritropoetina/economia , Pessoal de Saúde/economia , Hematínicos/economia , Polietilenoglicóis/economia , Anemia/tratamento farmacológico , Anemia/etiologia , Estudos Transversais , Custos de Medicamentos , Epoetina alfa/administração & dosagem , Eritropoetina/administração & dosagem , Feminino , Pessoal de Saúde/estatística & dados numéricos , Hematínicos/administração & dosagem , Humanos , Masculino , Panamá , Polietilenoglicóis/administração & dosagem , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/terapia , Fatores de Tempo
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