在巨细胞动脉炎中使用托西利祖马布:比较南澳大利亚的制药福利计划的合格和不合格病例
Lucinda Robinson1, Maddison Hamden2, Kim Griggs1,3
1Rheumatology Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Internal medicine journal
|July 2, 2024
概括
托西利祖马布 (TCZ) 越来越多地用于巨细胞动脉炎 (GCA),但面临着澳大利亚严格的资金限制. 个体患者使用批准主要用于标准资金不符合条件的患者的视力损失.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 药物经济学 药物经济学
背景情况:
- 巨细胞动脉炎 (GCA) 是一种严重的血管炎,其中托西利祖马布 (TCZ) 作为一种类固醇节约剂显示出希望.
- 在澳大利亚,对TCZ的访问受到严格的制药福利计划 (PBS) 标准的限制.
- 个人患者使用 (IPU) 方案提供了一个替代方案,但可能不是普遍可用的.
研究的目的:
- 通过IPU计划接受TCZ的患者与PBS补贴TCZ进行比较.
- 确定GCA患者IPU批准不符合PBS资助的原因.
主要方法:
- 通过IPU与PBS接受TCZ的GCA患者的回顾性比较.
- 对IPU批准的临床特征和理由的分析.
主要成果:
- 在GCA中对TCZ的IPU批准主要授予视力损失的患者.
- 这些患者通常不符合TCZ现有的PBS标准.
- 视力损失是一种严重的并发症,是授予IPU访问的关键因素.
结论:
- IPU计划为患有严重并发症的GCA患者提供TCZ访问,例如视力损失,但不符合PBS标准.
- 需要进行进一步的研究,以确定TCZ的比较有效性和成本效益与普雷迪尼索隆单一治疗相比.
- 需要证据来支持在GCA管理中扩大TCZ的PBS标准.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
130
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
130
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
156
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
156
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
115
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
115
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
166
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
166
Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
270
Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
270
Inflammatory Bowel Disease IV: Pharmacological Management
125
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
125


