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Related Concept Videos

Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

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Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Drug Dosage Regimen: Overview01:15

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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
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Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
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Fixed or weight-adjusted dose in immunotherapy?

Marca Diaz-Rangel1, Francisca Sanchez-Rubio2, Andrea Drozdz-Vergara3

  • 1Pharmacy, Hospital General de Albacete, Albacete, Spain marcad@sescam.jccm.es.

European Journal of Hospital Pharmacy : Science and Practice
|December 18, 2024
PubMed
Summary
This summary is machine-generated.

Fixed-dose immune checkpoint inhibitors lead to significant drug overdose and increased costs. Weight-adjusted dosing offers substantial economic savings and is increasingly adopted in Spanish hospitals, improving therapeutic optimization.

Keywords:
Antineoplastic AgentsCLINICAL MEDICINECost-Benefit AnalysisECONOMICS, PHARMACEUTICALPHARMACY SERVICE, HOSPITAL

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Area of Science:

  • Oncology
  • Pharmacoeconomics
  • Hospital Pharmacy

Background:

  • Immune checkpoint inhibitors (ICIs) are crucial in cancer therapy.
  • Current fixed-dose regimens may lead to suboptimal dosing and increased healthcare expenditure.
  • Variability in ICI dosing practices exists across healthcare settings.

Purpose of the Study:

  • To analyze the economic impact of fixed-dose ICIs.
  • To determine potential cost savings with weight-adjusted dosing.
  • To describe current ICI dosing practices in Spanish hospitals.

Main Methods:

  • Retrospective, multicenter observational study of 297 patients receiving ICIs (pembrolizumab, nivolumab, avelumab, durvalumab, cemiplimab).
  • Analysis of clinical and economic variables, including drug cost, overdose percentage, and opportunity cost.
  • Anonymous survey of Spanish hospitals regarding ICI dosage regimen selection.

Main Results:

  • Significant opportunity costs identified for fixed-dose ICIs: pembrolizumab (€615,316), nivolumab (€486,327).
  • Weight-adjusted dosing partially implemented in 54.7% of cases, often decided by Pharmacy and Oncology services.
  • Survey revealed variability in ICI dosage regimens across Spanish hospitals.

Conclusions:

  • Fixed-dose ICIs result in drug overdose and considerable budget impact compared to weight-adjusted dosing.
  • Therapeutic optimization through weight-adjusted dosing presents potential budgetary savings.
  • Healthcare practices in Spain show variability in ICI dosing, highlighting the need for optimization.