scholarly journals Comparative analysis of the cost of pharmacotherapy schemes for patients with rheumatoid arthritis

2020 ◽  
pp. 37-45
Author(s):  
N. L. Khanyk ◽  
O. R. Levytska ◽  
G. I. Bilushchak ◽  
T. Ya. Khanyk
Keyword(s):  
Rheumatoid Arthritis ◽  
Analysis Data ◽  
Two Component ◽  
Retail Prices ◽  
Inflammatory Drugs ◽  
The Cost ◽  
Comparative Content ◽  
Data Generalization ◽  
Very High

Rheumatoid arthritis (RA) is an unpredictable and progressive inflammatory disease of the joints of an immune nature, which in general for various reasons reduces the life expectancy of patients by 5 to 10 years. Pharmacotherapy of RA is based on long-term use of a large number of drugs of different pharmacotherapeutic groups, the cost of which varies significantly. The above makes the study of economic parameters of RA treatment an urgent problem. The aim of the study was to analyse the cost characteristics of pharmacotherapy of inpatients with RA in a hospital in order to optimize the cost of medication for these patients. The data of medical cards and medical records of 89 and 108 inpatients with RA, which were treated in the rheumatology department of the 4th Lviv City Clinical Hospital in 2009 and 2019, respectively, were selected as objects of the study. The methods of information retrieval, mathematical statistics, frequency, comparative, content analysis, data generalization, cost analysis were used. Disease-modifying antirheumatic drugs (DMARDs), glucocorticosteroids (GCs), and nonsteroidal anti-inflammatory drugs (NSAIDs) were grouped into six schemes for the RA pharmacotherapy in 2009 and 2019. An increase in the number of appointments of those schemes in which DMARDs were used has been established. The maximum share in both analysed periods was occupied by the triple pharmacotherapy scheme, which included all the above-mentioned drugs. This scheme was also the most expensive and its value at average retail prices (ARP) increased the most (9.4 times) from 2009 till 2019. During the analysed period, the average salary in Lviv region increased in 5.4 times, while the cost change indices (Ic) of different pharmacotherapy schemes, calculated on the basis of ARP, ranged from 6.9 for the two-component scheme with DMARDs and NSAIDs to 9.4 for the three-component scheme with DMARDs, GCs and NSAIDs. The analysis of affordability indices (Ia) showed that the most accessible was a two-component scheme, which included DMARDs and NSAIDs (Ia = 0.78). The study of the influence of the cost of the treatment schemes on the frequency of their prescribing using correlation analysis showed a very high dependence of these indices (R = 0.97). Pairwise correlations of pharmacotherapy appointment change indices (Iap) from Ic based on minimum (RPmin), maximum (RPmax) or average retail prices in Lviv pharmacies made it possible to establish a very high pair dependence of Iap from Ic calculated only on the basis of RPmax or ARP (R = 0.90). Thus, the analysis of patients' consumption of drugs for pharmacotherapy RA in the hospital allowed us to establish that in 2019 the treatment of RA became less available in comparison to 2009.

Natural inhibitors against potential targets of cyclooxygenase, lipoxygenase and leukotrienes

2021 ◽  
Vol 25 ◽  
Author(s):  
Rishita Dey ◽  
Sudatta Dey ◽  
Asmita Samadder ◽  
Anil Saxena ◽  
Sisir Nandi
Keyword(s):  
Rheumatoid Arthritis ◽  
Arachidonic Acid ◽  
Side Effects ◽  
Extensive Study ◽  
Alternative Medicines ◽  
Great Acceptance ◽  
Inflammatory Drugs ◽  
Lox Inhibitors ◽  
Natural Inhibitors

Background: The cyclooxygenase (COX) and lipoxygenase (LOX) enzymes catalyze the production of pain mediators like prostaglandins (PGs) and leukotrienes (LTs) respectively from arachidonic acid. Introduction: The COX and LOX enzyme modulators are responsible for the major PGs and LTs mediated complications like asthma, osteoarthritis, rheumatoid arthritis, cancer, Alzheimer’s disease, neuropathy and cardiovascular syndromes (CVS). Many synthetic nonsteroidal anti-inflammatory drugs (NSAIDs) used in the treatment have serious side effects like nausea, vomiting, hyperacidity, gastrointestinal ulcers, CVS, etc. Methods: The natural inhibitors of pain mediators have great acceptance worldwide due to fewer side effects on long-term uses. The present review is an extensive study of the advantages of plant-based vs synthetic inhibitors. Results: These natural COX and LOX inhibitors control inflammatory response without causing side-effect-related complicacy. Conclusion: Therefore, the natural COX and LOX inhibitors may be used as alternative medicines for the management of pain and inflammation due to their less toxicity and resistivity.

scholarly journals Can very high-dose anti-tumor necrosis factor blockade at onset of rheumatoid arthritis produce long-term remission?

2002 ◽  
Vol 46 (7) ◽  
pp. 1971-1972 ◽  
Author(s):  
Philip G. Conaghan ◽  
Mark A. Quinn ◽  
Philip O'Connor ◽  
Richard J. Wakefield ◽  
Zunaid Karim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
High Dose ◽  
Very High ◽  
Necrosis Factor

scholarly journals NSAID enteropathy

2020 ◽  
Vol 92 (2) ◽  
pp. 85-92
Author(s):  
E. N. Kareva
Keyword(s):  
Small Intestine ◽  
Therapeutic Strategy ◽  
Intestinal Flora ◽  
Nsaid Enteropathy ◽  
The World ◽  
Prevention And Treatment ◽  
Nsaid Gastropathy ◽  
Inflammatory Drugs ◽  
Very High

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used drugs in the world, and their side effects are very high. First of all, these are NSAID gastropathy, but in the long term, 5070% of NSAIDs cause damage to the small intestine (NSAID enteropathy), sometimes with serious consequences. To date, no drugs have been proposed with proven effectiveness to prevent this side effect. Apparently, this is not due to the fully clarified mechanism of pathogenesis. The most promising is the hypothesis of the participation of individual representatives of microflora in the development of enteropathy. Therefore, modulating the intestinal flora with the help of probiotics can be the basic therapeutic strategy for the prevention and treatment of such damage.

scholarly journals Testing two-component models on very high-energy gamma-ray-emitting BL Lac objects

2020 ◽  
Vol 640 ◽  
pp. A132
Author(s):  
◽  
V. A. Acciari ◽  
S. Ansoldi ◽  
L. A. Antonelli ◽  
A. Arbet Engels ◽  
...  
Keyword(s):  
Gamma Ray ◽  
High Energy ◽  
Component Model ◽  
Bl Lac Objects ◽  
Two Component ◽  
Very High Energy ◽  
Component Models ◽  
Very High ◽  
Optical Polarisation

Context. It has become evident that one-zone synchrotron self-Compton models are not always adequate for very high-energy (VHE) gamma-ray-emitting blazars. While two-component models perform better, they are difficult to constrain due to the large number of free parameters. Aims. In this work, we make a first attempt at taking into account the observational constraints from very long baseline interferometry (VLBI) data, long-term light curves (radio, optical, and X-rays), and optical polarisation to limit the parameter space for a two-component model and test whether or not it can still reproduce the observed spectral energy distribution (SED) of the blazars. Methods. We selected five TeV BL Lac objects based on the availability of VHE gamma-ray and optical polarisation data. We collected constraints for the jet parameters from VLBI observations. We evaluated the contributions of the two components to the optical flux by means of decomposition of long-term radio and optical light curves as well as modelling of the optical polarisation variability of the objects. We selected eight epochs for these five objects based on the variability observed at VHE gamma rays, for which we constructed the SEDs that we then modelled with a two-component model. Results. We found parameter sets which can reproduce the broadband SED of the sources in the framework of two-component models considering all available observational constraints from VLBI observations. Moreover, the constraints obtained from the long-term behaviour of the sources in the lower energy bands could be used to determine the region where the emission in each band originates. Finally, we attempt to use optical polarisation data to shed new light on the behaviour of the two components in the optical band. Our observationally constrained two-component model allows explanation of the entire SED from radio to VHE with two co-located emission regions.

Selected problems in the use of genetic engineering biological therapy in patients with rheumatoid arthritis

2021 ◽  
Vol 6 (4) ◽  
pp. 36-39
Author(s):  
K. Leonova
Keyword(s):  
Rheumatoid Arthritis ◽  
Biological Therapy ◽  
Pharmacological Therapy ◽  
Genetically Engineered ◽  
Biological Drugs ◽  
Inflammatory Drugs ◽  
The Moment ◽  
Attending Physician

Rheumatoid arthritis, like any chronic non-infectious disease, requires constant pharmacological therapy and monitoring of treatment. To relieve exacerbation, maintain long-term remission and improve the quality of life of patients, basic anti-inflammatory drugs are used, which have passed many years of testing for efficacy and safety and are available for patients. But there is a group of drugs that have appeared relatively recently - genetically engineered biological drugs. At the moment, their use is somewhat limited due to the presence of a number of problems. With the accumulation of data on the study of the safety of genetically engineered drugs in the treatment of rheumatoid arthritis, it will be possible to solve many practical issues that arise in the attending physician during the supervision of patients.

scholarly journals On the Thermal and Thermodynamic (In)Stability of Methylammonium Lead Halide Perovskites

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Bruno Brunetti ◽  
Carmen Cavallo ◽  
Andrea Ciccioli ◽  
Guido Gigli ◽  
Alessandro Latini
Keyword(s):  
X Ray Diffraction ◽  
Knudsen Effusion ◽  
Term Operation ◽  
Lack Of Information ◽  
Knudsen Effusion Mass Spectrometry ◽  
Halide Perovskites ◽  
The Cost ◽  
Lead Halide ◽  
Very High

Abstract The interest of the scientific community on methylammonium lead halide perovskites (MAPbX3, X = Cl, Br, I) for hybrid organic-inorganic solar cells has grown exponentially since the first report in 2009. This fact is clearly justified by the very high efficiencies attainable (reaching 20% in lab scale devices) at a fraction of the cost of conventional photovoltaics. However, many problems must be solved before a market introduction of these devices can be envisaged. Perhaps the most important to be addressed is the lack of information regarding the thermal and thermodynamic stability of the materials towards decomposition, which are intrinsic properties of them and which can seriously limit or even exclude their use in real devices. In this work we present and discuss the results we obtained using non-ambient X-ray diffraction, Knudsen effusion-mass spectrometry (KEMS) and Knudsen effusion mass loss (KEML) techniques on MAPbCl3, MAPbBr3 and MAPbI3. The measurements demonstrate that all the materials decompose to the corresponding solid lead (II) halide and gaseous methylamine and hydrogen halide and the decomposition is well detectable even at moderate temperatures (~60 °C). Our results suggest that these materials may be problematic for long term operation of solar devices.

scholarly journals AB0272 CAN NONSTEROIDAL ANTI-INFLAMMATORY DRUGS CONTROL THE SYMPTOMS OF MODERATE RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1162.2-1162
Author(s):  
E. Pogozheva ◽  
A. Karateev ◽  
V. Amirdzhanova ◽  
E. Filatova
Keyword(s):  
Rheumatoid Arthritis ◽  
Global Health ◽  
Disease Activity ◽  
Biological Agents ◽  
Das 28 ◽  
Moderate Disease ◽  
Inflammatory Drugs ◽  
Moderate Disease Activity

Objectives:to evaluate the efficacy of long-term pain therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA) with an initially moderate disease activity (DAS 28 <5,1).Methods:the study included 404 RA patients, disease duration was more than 1 year, mean DAS 28 3.7±1.6, mean age 58.6±10.0 years, 69% women, 76,7% RF “+”, 81,5% ACPA “+”. 91,2% of the patients received conventional DMARDs (methotrexate), 8,8% - biological agents. All patients received NSAIDs (aceclofenac) to control their symptoms. Тhe follow-up period was 6 months. We evaluated the dynamics of the DAS 28 index, the level of pain and patient global health on a 100- mm visual analog scale (VAS).Results:the level of pain (VAS) decreased from 63,1 ± 15,4 to 46,3± 8,3 (p=0,001) by 3 months of follow-up and up to 39,5± 11,2 (p= 0,001) by 6 months of follow-up. The patient global health (VAS) also improved from 58,2 ± 13,4 at baseline to 40,3 ± 11,2 (p=0,001) at 3 months and to 35,5 ± 9,7 (p=0,001) at 6 months of follow up. The mean DAS 28 remained within the moderate disease activity and decreased from 3,7±1,5 to 3,4 ±1,1 (p=0,01) after 3 months, and to 3,1± 0,9 (p=0,01) after 6 months.Conclusion:long-term NSAID therapy allows to control the disease activity in patients with moderate RA. This should be taken into account when planning therapy, including deciding whether to “switch” DMARDs and prescribing biological agents.Disclosure of Interests:None declared

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