Anti-interleukin-5 in the Management of Eosinophilic Asthma: A Review of Effectiveness, Safety, and Budgetary Impact From the Perspective of the Brazilian Health System

2021 ◽  
Vol 26 ◽  
pp. 169-181
Author(s):  
Kelli Carneiro de Freitas Nakata ◽  
Luisa Daige Marques ◽  
Helder Cássio de Oliveira ◽  
Graciane Catarina Batista Magalhães ◽  
Ruberlei Godinho de Oliveira ◽  
...  
2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Winckler ◽  
F Zioni ◽  
G Johson

Abstract Background This study aims to analyse the social representations of health needs in a Brazilian municipality, questioning the capacity that public policies developed and implemented by the Brazilian Health System (SUS) had to meet these needs. Methods Qualitative case study in which the data were analysed by: 1) the Health Needs Taxonomy (Matsumoto, 1999), as an instrument for assessing health needs, formatting the interview guide and organizing the empirical data; 2) the Theory of Social Representations (Jovchelovitch, 2000), to capture health needs; 3) Content Analysis (Bardin, 2004), as an instrument of analysis and comparison of perceived needs. The methodological path used was the same in the two moments in which this research is based (2009 and 2016). The entire municipal territory was analyzed and 26 representatives of civil society organizations were interviewed. Results Based on the results given, we state that health is a permanent and timeless need, but the mediations for its satisfaction have changed historically. The interface between quantitative indicators and subjectivity in assessing needs reveals the authoritarian architecture of its decision-making process, which has ruined the necessary democracy for prioritising and meeting those needs. The asymmetrical relationships present in the Brazilian society have both undermined the collective character of health needs and promoted the distance between who care and who are cared for. Most of the priorities listed by the interviewees in 2009 remain composing the social context of the municipality in 2016. Conclusions The challenges for comprehensive health care remain critical given both the decrease in popular political participation and in institutional spaces, which leads to the annulment of the right to a universal health. Interdisciplinary and participatory diagnostics remain essential to understand the complexity of social changes and the challenges for the consolidation of meeting health needs. Key messages The capacity that public policies developed and implemented by the Brazilian Health System (SUS) had to meet these needs. The challenges for meeting health needs remain critical given both the decrease in political participation and in institutional spaces, which leads to the annulment of the right to a universal health.


2014 ◽  
Vol 17 (3) ◽  
pp. A243
Author(s):  
C.N. Ferreira ◽  
C.S. Rufino ◽  
D.F. Manfrin

2015 ◽  
Vol 29 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Grazielle Christine Maciel MATTOS ◽  
Jennifer Elizabeth GALLAGHER ◽  
Saul Martins PAIVA ◽  
Mauro Henrique Nogueira Guimarães ABREU

2018 ◽  
pp. 44-52 ◽  
Author(s):  
N. M. Nenasheva

Eosinophilic asthma is a common phenotype of severe asthma, occurring in at least half of patients. In recent years, there have been significant changes in the approaches to the treatment of severe bronchial asthma and, above all, eosinophilic asthma. The article discusses the role of eosinophils in the pathogenesis of severe asthma, the detection of the phenotype of severe eosinophilic asthma, and modern approaches to targeting severe asthma with an eosinophilic phenotype using biological agents. A special emphasis is placed on preparations of monoclonal antibodies to interleukin-5, in particular, mepolizumab, recently approved for clinical use in our country.


2016 ◽  
Vol 2 ◽  
pp. 51-52
Author(s):  
Michela Prestes Gomes ◽  
Nathalia Halax Orfão ◽  
Aline Ale Beraldo ◽  
Aldaísa Cassanho Forster ◽  
Claudia Souza Passador ◽  
...  

2019 ◽  
Vol 5 (3) ◽  
pp. 00009-2019 ◽  
Author(s):  
Andrew Menzies-Gow ◽  
Jonathan Corren ◽  
Elisabeth H. Bel ◽  
Jorge Maspero ◽  
Liam G. Heaney ◽  
...  

Benralizumab is an interleukin-5 receptor α-directed cytolytic monoclonal antibody approved in several countries for the add-on maintenance treatment of patients with severe eosinophilic asthma aged 12 years and older. In the 28-week Phase III ZONDA trial (ClinicalTrials.gov identifier: NCT02075255), benralizumab produced a median 75% reduction from baseline in oral corticosteroid (OCS) dosage (versus 25% for placebo) while maintaining asthma control for patients with OCS-dependent severe asthma. This manuscript presents the detailed protocol for the Phase IIIb PONENTE (ClinicalTrials.gov identifier: NCT03557307), a study that will build on the findings from ZONDA.As the largest steroid-sparing study undertaken in severe asthma, PONENTE has a faster steroid tapering schedule for prednisone dosages ≥7.5 mg·day−1 than previous studies, and it includes an evaluation of adrenal insufficiency and an algorithm to taper OCS dosage when prednisone dosage is ≤5 mg·day−1. It also has a longer maintenance phase to assess asthma control for up to 6 months after completion of OCS tapering.The two primary endpoints are whether patients achieve 100% reduction in daily OCS use and whether patients achieve 100% reduction in daily OCS or achieve OCS dosage ≤5 mg·day−1, if adrenal insufficiency prevented further reduction, both sustained over ≥4 weeks without worsening of asthma. Safety and change from baseline in health-related quality of life will also be assessed.PONENTE should provide valuable guidance for clinicians on tapering OCS dosage, including the management of adrenal insufficiency, following benralizumab initiation for the treatment of patients who are OCS-dependent with severe, uncontrolled eosinophilic asthma.


2015 ◽  
Vol 18 (7) ◽  
pp. A847-A848
Author(s):  
AQ Soares ◽  
PI Silva ◽  
MA Melo ◽  
MP Provin ◽  
RG Amaral

2017 ◽  
Vol 27 (4) ◽  
pp. 1039-1064
Author(s):  
Juliana Pires de Arruda Leite ◽  
Ana Carolina Spatti ◽  
Matheus Leite de Campos

Abstract Most policies, explicitly or implicitly, involve sharing responsibilities between different organizations, such as departments, government spheres, ministries, or private organizations. Thus, in recent decades, networks have become increasingly common in public policies. The Brazilian health system - given its size and geographic scope - is an example of complexity and sometimes fragmentation in policy implementation. In this context, the government adopts the concept of Healthcare Networks (RASs) in the operation of its health system. A characteristic that defines RASs is their regional character, since it is necessary to go beyond the municipal borders for the optimization of resources. This scenario of interregional relations becomes denser when the territory in question is configured in an urban superstructure, as is the case in metropolitan regions. Thus, this paper proposes the discussion of the case of Healthcare Networks in the Brazilian metropolitan regions and describes, in greater detail, the case of Campinas Metropolitan Region.


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