Home Self-Administration of Biologics – A German Survey among Omalizumab-Treated Patients with Severe Asthma and their Treating Physicians

Pneumologie ◽  
2020 ◽  
Vol 74 (02) ◽  
pp. 103-111
Author(s):  
H. Timmermann ◽  
C. Mailänder

AbstractIn the EU, five biologics have been approved as add-on therapy for patients with severe asthma. Until recently, none of the biologics was approved for home use and had to be administered under medical supervision, a time-consuming schedule for both patients and physicians, accompanied by greater expenditure. However, over the last year, four out of the five biologics have been granted approval for patient self-administration at home. The objective of this multiple-choice survey was to understand how patients with severe asthma treated with omalizumab and their treating physicians view the potential home use of biologics exemplified by omalizumab. The questionnaires were answered by 120 physicians and 432 patients (response rate: 51.7 % and 20.6 %, respectively). Overall, 44.7 % of patients were in favour of self-administration at home while 30.6 % opposed this method of administration and 23.8 % of patients were neutral. Especially teenagers and young adults had a positive attitude towards self-administration. 76.7 % of the questioned physicians were in favour of home use for certain patients. Time saving was the main advantage for self-administration mentioned by patients (53.2 %) as well as by physicians (72.5 %). The main concern for patients was ‘making a mistake while injecting’ (43.8 %) while ‘forgetting to inject omalizumab’ (73.3 %) was the main concern for physicians. 44.4 % of patients expressed a wish for individual training and 70.8 % of physicians agreed with this statement. The latter group also considered a starter kit including several information materials (54.2 %) as well as an electronic reminder system (50.8 %) as useful. In conclusion, self-administration of biologics has the potential to be timesaving for both patients and physicians.

2021 ◽  
Vol 9 ◽  
Author(s):  
Erika Paladini ◽  
Mattia Giovannini ◽  
Simona Barni ◽  
Giulia Liccioli ◽  
Lucrezia Sarti ◽  
...  

Acute asthma remains one of the most frequent causes of children's access to healthcare. Asthma exacerbation is an essential defining characteristic of its severity, and respiratory infections entail increased risks of exacerbations with potential hospitalization. In the literature, contradictory findings have been reported about the risk and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients affected by asthma, with several implications for its management. Anti-IgE monoclonal antibody therapy is meant for patients affected by severe persistent allergic asthma without adequate control with other treatments. Indeed, biological therapies, such as omalizumab, are used as add-on treatments (step 5 in the Global Initiative for Asthma report) for severe asthma with several benefits, including a reduction in the frequency of exacerbations. To the best of our knowledge, we hereby report the first case in which an adolescent with severe allergic asthma treated with omalizumab has switched to self-administration at home during SARS-CoV-2 infection. Based on our peculiar experience, physicians may consider switching to self-administration of omalizumab at home, even during the coronavirus disease 2019 pandemic. However, more extensive research data from future studies are needed to confirm these first findings.


2020 ◽  
Vol 1 (2) ◽  
pp. 169-173
Author(s):  
Andrzej Lorkowski ◽  
Robert Jeszke

The whole world is currently struggling with one of the most disastrous pandemics to hit in modern times – Covid-19. Individual national governments, the WHO and worldwide media organisations are appealing for humanity to universally stay at home, to limit contact and to stay safe in the ongoing fight against this unseen threat. Economists are concerned about the devastating effect this will have on the markets and possible outcomes. One of the countries suffering from potential destruction of this situation is Poland. In this article we will explain how difficult internal energy transformation is, considering the long-term crisis associated with the extraction and usage of coal, the European Green Deal and current discussion on increasing the EU 2030 climate ambitions. In the face of an ongoing pandemic, the situation becomes even more challenging with each passing day.


2021 ◽  
Vol 10 (11) ◽  
pp. 2509
Author(s):  
Pei-Yuan Su ◽  
Yang-Yuan Chen ◽  
Hsu-Heng Yen ◽  
Siou-Ping Huang ◽  
I-Ling Liu ◽  
...  

Hepatitis C virus (HCV) infection can induce insulin resistance, and patients with diabetes mellitus (DM) have a higher prevalence of HCV infection. Patient outcomes improve after HCV eradication in DM patients. However, HCV micro-elimination targeting this population has not been approached. Little is known about using electronic alert systems for HCV screening among patients with DM in a hospital-based setting. We implemented an electronic reminder system for HCV antibody screening and RNA testing in outpatient departments among patients with DM. The screening rates and treatment rates at different departments before and after system implementation were compared. The results indicated that the total HCV screening rate increased from 49.3% (9505/19,272) to 78.2% (15,073/19,272), and the HCV-RNA testing rate increased from 73.4% to 94.2%. The anti-HCV antibody seropositive rate was 5.7%, and the HCV viremia rate was 62.7% in our patient population. The rate of positive anti-HCV antibodies and HCV viremia increased with patient age. This study demonstrates the feasibility and usefulness of an electronic alert system for HCV screening and treatment among DM patients in a hospital-based setting.


2015 ◽  
Vol 59 (12) ◽  
pp. 30-40
Author(s):  
V. Vasil'ev

The article investigates approaches taken by major political parties and civil society in the FRG toward the Transatlantic partnership. It reveals the tendencies of the prospective promotion of Berlin’s cooperation with Washington; the article also gives a forecast of further interaction between the EU and the USA, indicates the direction of discourse regarding the future Russia–Germany relations model in the context of the Ukrainian crisis and in reference to the increased transatlantic solidarity. Disputes in German socio-political circles on the issue of the FRG’s policy toward the U.S. are emerging all the time, but they have to be considered within a concrete historical and political context. Being of primary significance for all German chancellors, the Trans-Atlantic factor has been shaping itself in a controversial way as to the nation’s public opinion. This has been confirmed by many opinion polls, including the survey on the signing of the EU–U.S. Agreement on the Trans-Atlantic Trade and Investment Partnership. Chancellor A. Merkel is playing an important role: she is either ascribed full compliancy with Washington, or is being tentatively shown as a consistent government figure in advancing and upholding of Germany's and the EU's interests. A. Merkel has implemented her peace-seeking drive in undoing the Ukrainian tangle by setting up the “Normandy format” involving the leaders of Germany, France, Russia and Ukraine while having cleared it through with the U.S. President B. Obama well in advance. Despite the increasing criticism of Washington’s policy among some part of Germans, for the majority of German voters, the USA remains a country of implementable hopes, the only power in the world possessing a high education level and the most advanced technologies. Americans, for their part, are confident of the important role that Berlin plays in world politics, particularly in what concerns the maintenance of unity within the EU. Berlin aims at further constructive interaction with the USA in the frame of NATO as well as within other Trans-Atlantic formats. Notwithstanding the steady tendency toward increasing of the Washington policy’s critical perception degree in German society, officially Berlin continues as Washington’s true ally, partner and friend. There is every reason to believe that after the 2017 Bundestag elections, the new (the former) Chancellor will have to face a modernized Trans-Atlantic partnership philosophy, with a paradigm also devised in the spirit of the bloc discipline and commitments to allies. The main concern for Berlin is not to lose its sovereign right of decision-making, including the one that deals with problems of European security and relations with Moscow. Regrettably, Germany is not putting forward any innovative ideas on aligning a new architecture of European security with Russia’s participation. Meanwhile, German scholars and experts are trying to work out a tentative algorithm of a gradual return to the West’s full-fledged dialogue with Russia, which, unfortunately, is qualified as an opponent by many politicians. Predictably, the Crimea issue will remain a long-lasting political irritant in relations between Russia and Germany. Although not every aspect of Berlin’s activation in its foreign policy finds support of the German public, and the outburst of anti-American feeling is obvious, experts believe that the government of the FRG is “merely taking stock of these phenomena and ignores them”. Evident is the gap between the government's line and the feeling of the German parties’ basis – the public. It is noteworthy that the FRG has not yet adopted the Law on Holding General Federal Referendums on key issues of the domestic and foreign policy. There is every indication to assume that the real causes of abandoning the nationwide referendums are the reluctance of the German ruling bureaucracy and even its apprehensions of the negative voting returns on sensitive problems, – such as basic documents and decisions of the EU, the export of German arms, relations with the U.S., etc. The harmony between Berlin’s "Realpolitik" and German public opinion is not yet discernible within the system of Trans-Atlantic axes.


PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1023-1028
Author(s):  
Renato Stein ◽  
Gerard J. Canny ◽  
Desmond J. Bohn ◽  
Joseph J. Reisman ◽  
Henry Levison

The management of children with severe acute asthma who required admission to the intensive care (ICU) of this hospital during 1982 to 1988 was reviewed retrospectively. A total of 89 children were admitted to the ICU on 125 occasions. During the study period, 24% of the patients were admitted to the ICU on more than one occasion. Prior to admission to this hospital, patients had been symptomatic for a mean of 48 hours. Although all patients had received bronchodilators before admission to hospital, only 23% of patients had received oral corticosteroids. According to initial arterial blood gas values determined in the ICU, 77% of the patients had hypercapnia (PaCO2 >45 mm Hg). The pharmacologic agents used in the ICU included nebulized β2agonists (100% of admissions), theophylline (99%), steroids (94%), nebulized ipratropium bromide (10%), IV albuterol (38%), and IV isoproterenol (10%). Mechanical ventilation was necessary in 33% of admissions; the mean duration of ventilation was 32 hours. Ten patients had pneumothorax; in six cases, these were related to mechanical ventilation. Three of the patients who received mechanical ventilation died, representing a mortality of 7.5%. In each of these patients, sudden, severe asthma episodes had developed at home, resulting in respiratory arrest. They had evidence of hypoxic encephalopathy at the time of admission to the ICU and eventually were declared brain dead. It was concluded that delay in seeking medical care and underuse of oral corticosteroids at home may have contributed to the need for ICU admission. The mortality and morbidity for children with severe asthma who require ICU admissions are small, provided that bronchodilators and IV steroids are used optimally and that patients who require mechanical ventilation are carefully selected.


Significance The presidency will put Romania's isolation in the spotlight. It has no backers in the EU prepared to overlook its escalating retreat from democratic and reform commitments, and there is no sign that the United States is prepared to act as a counterweight. Impacts Romania is ill-prepared for the presidency while political warfare at home will absorb government energies. It is likely that real decision-making will reside in Brussels with Romania having no more than a ceremonial role. Dragnea’s hostility to Brussels makes a tough EU response likely in response to more creeping authoritarianism.


Significance The government has capitulated to demands by trade unions to lower the retirement age despite a growing demographic imbalance and public finances under strain. In the process, the government has demonstrated its weakness and unpopularity. Impacts Surrender to the unions will encourage discontented public sector workers to seek pay rises, with teachers threatening strike action. Popular discontent with fiscal cutbacks will pose a risk to plans for Croatia to adopt the euro early next decade. Divisions at home will limit Croatia’s ability to push its political priorities when it assumes the EU Council presidency in January 2020.


2011 ◽  
Vol 60 (2) ◽  
pp. 521-533 ◽  
Author(s):  
Niamh Moloney

Since the outset of the financial crisis, the EU financial markets regime1 has been undergoing a period of turbulence which contrasts sharply with the period of relative stability which it briefly enjoyed over 2005–2007 and post-FSAP (Financial Services Action Plan2). The FSAP reforms had been adopted. The Committee of European Securities Regulators (CESR) had emerged as an influential actor, driving some degree of supervisory coordination and co-operation and constructing a significant soft law ‘rule-book.’ And the 2007 Lamfalussy Review suggested broad political, institutional and stakeholder satisfaction with the Lamfalussy process. There was little enthusiasm for grand adventures in institutional design, albeit that supervision, an institutionally-driven concern, was presciently if belatedly emerging as a concern of the EU institutions. The Review's main concern, however, was with strengthening the pragmatic, if somewhat haphazard, network-based, ‘supervisory convergence’ model as the means for supervising the integrating EU financial market. With respect to regulation, reflecting the wider international zeitgeist pre-crisis,3 ‘Better Regulation’ and the need for a ‘regulatory pause’ were the watchwords of a Commission which, once the massive FSAP regime was safely in place, espoused the benefits of self-regulation and highlighted the risks of intervention without impact assessment, extensive consultation and evidence of market failure.4 This was most apparent with respect to credit rating agencies,5 debt market transparency,6 hedge funds,7 and clearing and settlement.8 Institutionally, a relatively sophisticated law-making apparatus, in the form of the Lamfalussy structures, a plethora of advisory bodies and stakeholder bodies (notably FIN-NET which represents the consumer and SME interest), had been established.


2016 ◽  
Vol 2 (1) ◽  
pp. 80-99
Author(s):  
Davidson Lütkenhaus ◽  
Marcella Nunes De Freitas

This research assesses the suitability of the Six-sigma program for R&D in FMCG companies. The study also includes an analysis of its potential advantages and challenges for this business area. This was performed through data acquisition using a web-based survey targeting large scale multinational companies. Results showed that most R&D personnel within FMCG companies see Six-sigma as a positive methodology for their sector. Roughly 80% of the participants selected time saving and better knowledge allocation as the main advantages of the Six-sigma system. Almost 90% of the survey contributors believe that the series of potential benefits could lead to important scientific breakthroughs. A financial challenge is expected with the implementation and it was said to be the main concern of R&D personnel, especially from those with managerial backgrounds. Cultural changes and scientific obstacles were not reported as imminent threats to the new system. In light of the above, Six-sigma was found to be suitable for R&D in FMCG companies requiring only a few modifications in its standards and a well-defined strategic implementation plan.


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