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1.
Hautarzt ; 71(3): 227-243, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32130433

RESUMO

In Germany, approximately 2% of the population suffers from psoriasis, which is no longer considered only a cutaneous, but rather a systemic disease. Accordingly, common comorbidities and potential joint involvement in psoriasis must be recorded. If necessary, interdisciplinary patient care has to be organized. The use of validated scores is recommended to complete the patient's medical history. The individual treatment should include intensified topical therapies as well as short-term phototherapy in case of an acute phase. In addition to conventional systemic therapies (e.g., fumarates, methotrexate), a number of new therapeutics for psoriasis are in development. Apart from the PDE­4 inhibitor apremilast, targeted therapies are currently available to block TNF-alpha, IL-17A, the IL-17 receptor and IL-23. Decisions on individualized, patient-centered psoriasis management should be based on assessment of disease severity and the existence of comorbidities. Furthermore, economic aspects should be taken into account.


Assuntos
Terapia Biológica/métodos , Terapia de Alvo Molecular , Fototerapia/métodos , Psoríase/diagnóstico , Psoríase/terapia , Administração Oral , Administração Tópica , Adulto , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Fármacos Dermatológicos/uso terapêutico , Alemanha , Humanos , Metotrexato/uso terapêutico , Inibidores da Fosfodiesterase 4/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
2.
Wien Klin Wochenschr ; 132(1-2): 12-18, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915925

RESUMO

BACKGROUND: The rate of restoration of intestinal continuity after colonic resection and stoma creation in patients with Crohn's disease has not been well-documented in the era of biologics. Thus, the incidence of restoration of intestinal continuity since the introduction of biological drugs was assessed. METHODS: Consecutive patients (n = 43) who underwent colonic resection with ileostomy or colostomy formation for Crohn's disease at a single tertiary referral center between 2002 and 2014 were identified. Data from individual chart review were analyzed retrospectively. Patients were personally contacted for follow-up. RESULTS: Of the 43 patients 8 (18.4%) had a proctectomy leaving 35 patients (81.4%) with the rectum preserved. Of the 30 patients qualifying for final analysis restoration of bowel continuity was finally achieved in 10 patients (33.3%). Permanent stoma rates were comparable in the group of patients with and without biological therapy after surgery (64.3% vs. 60%). The median follow-up period was 7 years (range 3-15 years). Of the patients 20 suffered from perianal disease involvement (66.7%), which was associated with a higher rate of permanent stoma (n = 16/20, 80%) in contrast to patients without perianal disease (n = 4/10, 40%, p = 0.045). CONCLUSION: The overall incidence of stoma formation was low for patients with Crohn's disease; however, once a stoma is created the chance of ending up with a permanent stoma is high even in the era of biologics. Despite the use of new therapeutic agents perianal disease increases the risk of a permanent stoma.


Assuntos
Terapia Biológica , Doença de Crohn , Colostomia , Doença de Crohn/tratamento farmacológico , Doença de Crohn/cirurgia , Feminino , Humanos , Ileostomia , Masculino , Estudos Retrospectivos
3.
Expert Opin Drug Saf ; 19(1): 99-106, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31661986

RESUMO

Objectives: Biological drugs have been successfully tested in asthma, especially in the most severe forms of the disease. The goal of this study was to characterize the safety profile of biologicals used in asthma.Methods: Retrospective and descriptive analysis of spontaneous reports (SRs) involving omalizumab and mepolizumab, sent to the Portuguese Pharmacovigilance System, since market launch until October 2018.Results: A total of 127 SRs for omalizumab and 10 SRs mepolizumab were found. Most patients were female (75.6% omalizumab and 90.0% mepolizumab), and aged 18-64 years (61.4% and 50.0%, respectively). 71.7% of the reports for omalizumab were serious, with 2 cases of anaphylaxis, 12 malignant neoplasms and 2 abortions. Only 20.0% of the reports for mepolizumab were considered serious. A total of 391 adverse drug reactions (ADRs) for omalizumab and 20 ADRs for mepolizumab were found. Most reported ADRs belonged to System organ class (SOC) groups: 'respiratory, thoracic and mediastinal disorders' and 'investigations', for omalizumab; 'musculoskeletal and connective tissue disorders' and 'general disorders and administration site conditions' for mepolizumab.Conclusion: Over the years, there was an increasing trend of SRs with these biological drugs. However, it is necessary to continue to develop educational programs in order to get a better reporting system.


Assuntos
Antiasmáticos/efeitos adversos , Anticorpos Monoclonais Humanizados/efeitos adversos , Asma/tratamento farmacológico , Omalizumab/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Idoso , Antiasmáticos/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Terapia Biológica/efeitos adversos , Terapia Biológica/métodos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omalizumab/administração & dosagem , Farmacovigilância , Portugal/epidemiologia , Estudos Retrospectivos , Adulto Jovem
4.
Arch Oral Biol ; 110: 104597, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31739076

RESUMO

OBJECTIVES: To systematically review and evaluate what is known regarding contemporary biological therapy capable of accelerating orthodontic tooth movement (OTM) in animal model. MATERIALS AND METHODS: MedLine, Scopus, Web of Science and OpenGrey were searched without restrictions until June 2019. Following study retrieval and selection, relevant data was extracted using a standardized table. Risk of bias (RoB) assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. RESULTS: Fifty-one animal studies were included. Two biological therapies were identified as capable of accelerating the OTM: chemical methods (49 studies) and gene therapy (2 studies). The main substances that increased the OTM rate were cytokines (13 studies), followed by growth factors (6 studies) and hormones (5 studies). Most studies were assessed to be at unclear or high RoB. The application protocols, measurement and reporting of outcomes varied widely and methodologies were not adequately reported. CONCLUSIONS: Although biological therapies to accelerate OTM have been widely tested and effective in preclinical studies, the validity of the evidence is flawed to support translational of these results. There is a need for well-designed experimental studies to translate these methods for clinical field.


Assuntos
Terapia Biológica , Técnicas de Movimentação Dentária , Animais , Modelos Animais de Doenças , Proteômica
5.
Int J Cancer ; 146(7): 1780-1790, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31291465

RESUMO

The prevalence of colorectal cancer (CRC) has markedly increased worldwide in the last decade. Alterations of bile acid metabolism and gut microbiota have been reported to play vital roles in intestinal carcinogenesis. About trillions of bacteria have inhabited in the human gut and maintained the balance of host metabolism. Bile acids are one of numerous metabolites that are synthesized in the liver and further metabolized by the gut microbiota, and are essential in maintaining the normal gut microbiota and lipid digestion. Multiple receptors such as FXR, GPBAR1, PXR, CAR and VDR act as sensors of bile acids have been reported. In this review, we mainly discussed interplay between bile acid metabolism and gut microbiota in intestinal carcinogenesis. We then summarized the critical role of bile acids receptors involving in CRC, and also addressed the rationale of multiple interventions for CRC management by regulating bile acids-microbiota axis such as probiotics, metformin, ursodeoxycholic acid and fecal microbiota transplantation. Thus, by targeting the bile acids-microbiota axis may provide novel therapeutic modalities in CRC prevention and treatment.


Assuntos
Transformação Celular Neoplásica/metabolismo , Microbioma Gastrointestinal , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Animais , Ácidos e Sais Biliares/metabolismo , Terapia Biológica , Biomarcadores , Neoplasias Colorretais/etiologia , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Disbiose , Microbioma Gastrointestinal/efeitos dos fármacos , Humanos , Mucosa Intestinal/patologia , Redes e Vias Metabólicas/efeitos dos fármacos , Terapia de Alvo Molecular , Ligação Proteica , Receptores Citoplasmáticos e Nucleares/metabolismo
6.
Inflamm Bowel Dis ; 26(1): 147-149, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31300824

RESUMO

Biologic therapy continues to be underutilized despite its efficacy and overall favorable side effect profile when compared with corticosteroids. Siegel et al found in a well-done, cross-sectional study that patients perceived that corticosteroids were more beneficial, more familiar, and less dreadful than biologics despite perceiving that corticosteroids are more risky. They also found that perception of risk may be influenced by a patient's personality trait. Patients who believe that their health is influenced by their own choices or behaviors perceived biologic therapy less scary compared with patients who believed their health is influenced by chance. Physicians and patients disagree about how much medication-related risk is tolerable for improvements on efficacy. However, they are both willing to accept risks for therapies that offer significant therapeutic benefit. Physicians are tasked to translate complex evidenced-based data accurately and should take into account a patient's personality trait in order to provide individualized care and help guide shared decision-making. Future research should assess physician's personality traits, treatment experiences, and perception of risks, benefits, and dread of IBD medications and how it influences shared-decision making.


Assuntos
Produtos Biológicos , Doenças Inflamatórias Intestinais , Terapia Biológica , Estudos Transversais , Humanos , Medição de Risco
8.
Rev Chilena Infectol ; 36(5): 608-615, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859802

RESUMO

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of two manuscripts. This first part details the risks of developing infectious complications depending on the type of biological used for a certain pathology. This evaluation included a broad search in MEDLINE and Epistemonikos of systematic reviews and meta-analyzes of controlled clinical trials and casecontrol examining post-treatment infections with anti-TNF alpha, anti-CD20, anti-CD52, CTLA4-Ig and anti-integrins. The research was complemented by a review of: multicentre cohorts of biological users, the MMWR of the CDC, Atlanta, U.S.A., and national registers and scientific societies in which infectious complications derived from the use of biological therapies were mentioned.


Assuntos
Anticorpos Monoclonais/efeitos adversos , Terapia Biológica/efeitos adversos , Doenças Transmissíveis/induzido quimicamente , Consenso , Terapia Biológica/normas , Chile , Humanos , Infecções Oportunistas/induzido quimicamente , Infecções Oportunistas/prevenção & controle , Medição de Risco , Fatores de Risco
9.
Rev Chilena Infectol ; 36(5): 616-628, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859803

RESUMO

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.


Assuntos
Terapia Biológica/efeitos adversos , Doenças Transmissíveis/induzido quimicamente , Consenso , Emigrantes e Imigrantes , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/induzido quimicamente , Chile , Feminino , Hepatite B/induzido quimicamente , Hepatite B/prevenção & controle , Humanos , Programas de Rastreamento , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Medição de Risco , Fatores de Risco
10.
Intern Med J ; 49(11): 1349-1351, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31713337
11.
Arq Gastroenterol ; 56(3): 318-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31633732

RESUMO

BACKGROUND: The introduction of anti-TNF agents represented a landmark in the management of both Crohn's disease (CD) and ulcerative colitis (UC), with improved efficacy and safety when compared with conventional treatment. However, significant challenges still exist in Latin America to facilitate the access of biological agents for physicians and patients. OBJECTIVE: The aim of this review was to summarize current evidence on penetration of biological agents for CD and UC in Latin America. METHODS: Data are derived from a previous complete systematic review that explored different characteristics of inflammatory bowel diseases (IBD) in Latin America. The studies fully included in this previous systematic review which contained detailed descriptions of the percentage of use of biological agents in different cohorts throughout Latin American and Caribbean countries were included, and descriptive findings were compiled, describing CD and UC penetration of these drugs in different patient cohorts from different countries. RESULTS: From the 61 studies included in the original systematic review, only 19 included data of the percentage of patients treated with biological agents. Anti-TNF use in CD varied from 1.51% in Mexico up to 46.9% in Colombia, with most of the studies describing anti-TNF use in approximately 20%-40% of CD patients. On the other side, the frequency of the use of biologics was clearly lower in UC, varying from 0% in 2009 to up 16.2% in 2018, according to two different Mexican studies. Only two studies described the penetration of anti-TNF agents in IBD overall: 13.4% in a Colombian and 37.93% in a Brazilian study. No studies described percentage of use of new biologic agents (vedolizumab and ustekinumab). CONCLUSION: Penetration of anti-TNF agents in Latin America is comparable to the rest of the world in CD, but lower in UC. With the increase in the incidence and prevalence of IBD, specific strategies to increase access to anti-TNF agents in UC and new biological agents overall are warranted.


Assuntos
Doenças Inflamatórias Intestinais/tratamento farmacológico , Fator de Necrose Tumoral alfa/uso terapêutico , Terapia Biológica , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológico , Humanos , América Latina , Revisão Sistemática como Assunto
12.
S Afr Med J ; 109(10): 745-749, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31635571

RESUMO

The treatment of inflammatory bowel disease (IBD) is often challenging. It has a vexing and waning course with frequent relapses, despite adequate maintenance therapy. Biological  agents have been available for the treatment of IBD for the last two decades, with impressive results. However, these drugs are costly and often have significant side-effects. Therefore, the benefit of aggressive treatment must be carefully balanced against the risk of serious adverse events. Despite good clinical outcomes, patients often request to discontinue the drugs because of cost and detrimental effects, especially the risk of malignancy. This review focuses on the benefits of biological treatment, strategies to de-escalate therapy, risk of relapse when these agents are discontinued and success with retreatment with the same or a similar biological agent.


Assuntos
Fatores Biológicos/administração & dosagem , Terapia Biológica/métodos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Fatores Biológicos/efeitos adversos , Terapia Biológica/efeitos adversos , Humanos , Suspensão de Tratamento
13.
Autoimmun Rev ; 18(12): 102398, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31639514

RESUMO

The five TNF inhibitors currently approved for the treatment of RA are characterised by differences in their molecular structures, half-lives, administration routes, dosing intervals, immunogenicity, and use in women who wish to become pregnant. TNF inhibitors still represent the first biologic after conventional synthetic DMARD (csDMARD) in the majority of patients according to registry data. This was possibly because they were historically the first biological agents available (biological DMARDS with a different mechanism of action or targeted synthetic DMARDs did not become available until 2006s), and so switching from one to another was frequent in the case of an inadequate response and/or side effects. TNF inhibitors are also efficacious for other inflammatory joint and spine diseases, and have been approved for inflammatory bowel disease, uveitis and psoriasis. In addition, national registries have provided long-term safety data and demonstrated their beneficial effect on cardiovascular morbidity and mortality. However, approximately 30-40% of patients discontinue anti-TNF treatment because of primary failure, secondary loss of response, or intolerance. The options for managing anti-TNF treatment failures include switching to an alternative anti-TNF (cycling) or to another class of targeted drug with a different mechanism of action (swapping). The aim of this review is to evaluate the pros and cons of whether it is more appropriate to choose a second anti-TNF biological agents after the failure of the first or swap treatment early.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Fator de Necrose Tumoral alfa/uso terapêutico , Fatores Biológicos/uso terapêutico , Terapia Biológica/métodos , Substituição de Medicamentos , Feminino , Humanos
15.
Immunology ; 158(4): 281-286, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31509236

RESUMO

Despite sharing interleukin-4 receptor α (IL-4Rα) in their signaling cascades, IL-4 and IL-13 have different functions in atopic inflammation. IL-13 preferentially participates in the peripheral tissues because tissue-resident group 2 innate lymphoid cells produce IL-13 but not IL-4. In contrast, lymph node T follicular helper cells express IL-4 but not IL-13 to regulate B-cell immunity. The dominant microenvironment of IL-13 is evident in the lesional skin of atopic dermatitis (AD). The IL-13-rich local milieu causes barrier dysfunction by down-regulating the OVOL1-filaggrin (FLG) axis and up-regulating the periostin-IL-24 axis. Genome-wide association studies also point to the crucial involvement of the IL-13, OVOL1 and FLG genes in the pathogenesis of AD. Biologics targeting IL-13, such as the anti-IL-4Rα antibody dupilumab and the anti-IL-13 antibody tralokinumab, successfully improve AD lesions and further highlight the importance of IL-13 in the pathogenesis of AD.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Dermatite Atópica/imunologia , Interleucina-13/metabolismo , Subunidade alfa de Receptor de Interleucina-4/metabolismo , Proteínas de Filamentos Intermediários/metabolismo , Linfócitos/imunologia , Pele/imunologia , Fatores de Transcrição/metabolismo , Animais , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Terapia Biológica , Dermatite Atópica/terapia , Humanos , Imunidade Inata , Interleucina-13/imunologia , Subunidade alfa de Receptor de Interleucina-4/imunologia , Transdução de Sinais
16.
BMC Complement Altern Med ; 19(1): 248, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488127

RESUMO

BACKGROUND: Autologous whole blood (AWB) is used in complementary medicine for the treatment of infections and skin disorders. So far, the efficacy of AWB is discussed controversially. METHODS: To estimate the efficacy of AWB therapy and to gather evidence in regard to effector mechanisms, we effected a systematic review of articles accessible through Pubmed and Cambase. Further trials were identified through references and by contacting study authors. Prospective controlled trials concerning intramuscular AWB therapy were included with the exception of trials using oxygenated, UV radiated or heated blood. Information was extracted on the indication, design, additions to AWB and outcome. Full texts were screened for information about the effector mechanisms. RESULTS: Eight trials suited our criteria. In three controlled trials about atopic dermatitis and urticaria, AWB therapy showed beneficial effects. In five randomized controlled trials (RCTs), two of which concerned respiratory tract infections, two urticaria and one ankylosing spondylitis, no efficacy could be found. A quantitative assessment was not possible due to the heterogeneity of the included studies. We only found four controlled trials with sample sizes bigger than 37 individuals per group. Only one study investigated the effector mechanisms of AWB. CONCLUSIONS: There is some evidence for efficacy of AWB therapy in urticaria patients and patients with atopic eczema. Firm conclusions can, however, not be drawn. We see a great need for further RCTs with adequate sample sizes and for investigation of the effector mechanisms of AWB therapy.


Assuntos
Terapia Biológica/métodos , Terapias Complementares/métodos , Dermatite Atópica/terapia , Urticária/terapia , Análise Química do Sangue , Ensaios Clínicos como Assunto , Humanos , Injeções Intramusculares , Estudos Prospectivos
17.
Rev Esp Quimioter ; 32 Suppl 2: 63-68, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31475814

RESUMO

The use of biological (or targeted) therapies constitutes a major advance in the management of autoinflammatory and malignant diseases. However, due to the selective effect of these agents on the host's immune response, reactivation of certain pathogens that cause latent infection is to be expected. The most relevant concern is the risk of reactivation of latent tuberculosis infection (LTBI) and progression to active tuberculosis among patients treated with agents targeting tumor necrosis factor (TNF)-α. Systematic screening for LTBI at base-line with appropriate initiation of antituberculous treatment, if needed, is mandatory in this patient population as risk minimization strategy. In addition, reactivation of hepatitis B virus induced by B-cell-depleting (anti-CD20) and anti-TNF-α agents should be also prevented among HBsAg-positive patients and those with isolated anti-HBc IgG positivity (risk of "occult HBV infection"). The present review summarizes available evidence regarding the risk of reactivation of these latent infections induced by newer biological agents, as well as the recommendations included in the most recent guidelines.


Assuntos
Terapia Biológica/métodos , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Animais , Humanos , Hospedeiro Imunocomprometido
18.
Biomed Res Int ; 2019: 8142368, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31396534

RESUMO

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting multiple organ systems that runs an unpredictable course and may present with a wide variety of clinical manifestations. Advances in treatment over the last decades, such as use of corticosteroids and conventional immunosuppressive drugs, have improved life expectancy of SLE sufferers. Unfortunately, in many cases effective management of SLE is still related to severe drug-induced toxicity and contributes to organ function deterioration and infective complications, particularly among patients with refractory disease and/or lupus nephritis. Consequently, there is an unmet need for drugs with a better efficacy and safety profile. A range of different biologic agents have been proposed and subjected to clinical trials, particularly dedicated to this subset of patients whose disease is inadequately controlled by conventional treatment regimes. Unfortunately, most of these trials have given unsatisfactory results, with belimumab being the only targeted therapy approved for the treatment of SLE so far. Despite these pitfalls, several novel biologic agents targeting B cells, T cells, or cytokines are constantly being evaluated in clinical trials. It seems that they may enhance the therapeutic efficacy when combined with standard therapies. These efforts raise the hope that novel drugs for patients with refractory SLE may be available in the near future. This article reviews the current biological therapies being tested in the treatment of SLE.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Produtos Biológicos/uso terapêutico , Terapia Biológica , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia
19.
Am J Health Syst Pharm ; 76(17): 1296-1304, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418790

RESUMO

PURPOSE: The development of a tool to measure medication safety, therapeutic efficacy, and other quality outcomes in patients receiving self-injectable biologic therapy for the management of inflammatory bowel disease (IBD) at a health-system specialty pharmacy is described. SUMMARY: Through a collaborative initiative by pharmacists, gastro-enterologists, and representatives of a pharmacy benefit manager and a pharmaceutical company, a set of clinical and specialty pharmacy quality measures was developed. The clinical measures are intended for use in assessing patient safety, disease status, treatment efficacy, and healthcare resource utilization during 3 assessments (pre-treatment, on-treatment, and longitudinal). The specialty pharmacy measures can be used to assess medication adherence, medication persistence, specialty pharmacy accreditation, and patient satisfaction. The proposed quality measures provide a foundation for evaluating the quality of IBD care and improving patient outcomes within a health-system specialty pharmacy. Future efforts to validate and implement the tool in clinical practice are planned. CONCLUSION: The proposed quality measures provide a foundation for future inquiry regarding the appropriateness and feasibility of integrating the measures into clinical care. Further work is needed to implement and validate these quality measures and determine their impact in optimizing health outcomes.


Assuntos
Produtos Biológicos/administração & dosagem , Doenças Inflamatórias Intestinais/tratamento farmacológico , Serviço de Farmácia Hospitalar/organização & administração , Autoadministração/normas , Terapia Biológica/métodos , Terapia Biológica/normas , Comportamento Cooperativo , Indústria Farmacêutica/organização & administração , Gastroenterologistas/organização & administração , Humanos , Farmacêuticos/organização & administração
20.
Appl Microbiol Biotechnol ; 103(20): 8301-8314, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31414162

RESUMO

Escalating antibiotic resistance is now a serious menace to global public health. It may be led to the emergence of "postantibiotic age" in which most of infections are untreatable. At present, there is an essential need to explore novel therapeutic strategies as a strong and sustainable pipeline to combat antibiotic-resistant infections. This review focuses on recent advances in this area including therapeutic antibodies, antimicrobial peptides, vaccines, gene therapy, genome editing, and phage therapy for tackling drug-resistant infections.


Assuntos
Bactérias/efeitos dos fármacos , Infecções Bacterianas/terapia , Terapia Biológica/métodos , Farmacorresistência Bacteriana Múltipla , Terapia de Alvo Molecular/métodos , Humanos
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