Perceptions About Biosimilar Medicines Among Belgian Patients in the Ambulatory Care

Background and objectives: Biosimilar medicines have been on the European market for 15 years. Despite the extensive and positive experience with biosimilars across Europe, their uptake remains limited in Belgium. One of the possible factors limiting uptake in clinical practice is the inadequate understanding and lack of trust in biosimilars among patients. This study aimed to assess the level of knowledge and perceptions about biosimilar medicines among Belgian patients in the ambulatory care.Methods: This study consisted of online questionnaires among Belgian patients in the ambulatory care (i.e., rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, Crohn’s disease, ulcerative colitis, diabetes mellitus type I and II). The results were collected between December 2020 and February 2021. The data were analyzed with descriptive and inferential statistics.Results: In total, 657 patients across all disease areas of interest participated in this study. Only 38% of patients had heard of biosimilars before. Of those patients, most (58%) were aware that biosimilars are as safe and effective as their reference product. The vast majority of respondents (68%) would agree with transitioning to a biosimilar if their physician prescribed it, only 3% would never agree with a transition to a biosimilar. If a physician would propose to change their current originator biological therapy with its biosimilar, nearly all patients (95%) want their physician to explain the decision and inform them. For additional information about biosimilars, Belgian patients prefer brochures or folders (41%), or available resources on the internet (35%). Physicians were indicated as the preferred source of information (95%), followed by pharmacists (51%), academia (39%), and patient associations (35%). Most patients require information regarding the safety and efficacy (78%), price and reimbursement (64%), and the clinical development process (56%) of the biosimilar.Conclusion: Belgian patients require information about biosimilar medicines. However, most patients are open and positive towards transitioning their current biological therapy with its biosimilar if sufficiently supported by their healthcare providers.

Six Autoimmune Disorders Are Associated With Increased Incidence of Gastric Cancer: A Systematic Review and Meta-Analysis of Half a Million Patients

BackgroundGastric cancer is one of the most common cancers worldwide, with a high mortality rate. The potential etiological role of autoimmune (AI) disorders has been described in gastric cancer; however, the literature is controversial. This study aims to provide a comprehensive summary of the association between autoimmune disorders and the incidence of gastric cancer.MethodsThis study was registered on PROSPERO under registration number CRD42021262875. The systematic literature search was conducted in four scientific databases up to May 17, 2021. Studies that reported standardized incidence rate (SIR) of gastric cancer in autoimmune disorders were eligible. We calculated pooled SIRs with 95% confidence intervals (CIs) in this meta-analysis.ResultsWe included 43 articles describing 36 AI disorders with data of 499,427 patients from four continents in our systematic review and meta-analysis. Significantly increased incidence of gastric cancer was observed in dermatomyositis (SIR = 3.71; CI: 2.04, 6.75), pernicious anemia (SIR = 3.28; CI: 2.71, 3.96), inflammatory myopathies (SIR = 2.68; CI:1.40; 5.12), systemic lupus erythematosus (SIR = 1.48; CI: 1.09, 2.01), diabetes mellitus type I (SIR = 1.29; CI:1.14, 1,47), and Graves’ disease (SIR = 1.28; CI: 1.16, 1.41). No significant associations could be found regarding other AI disorders.ConclusionsPernicious anemia, Graves’ disease, dermatomyositis, diabetes mellitus type I, inflammatory myopathies, and systemic lupus erythematosus are associated with higher incidence rates of gastric cancer. Therefore, close gastroenterological follow-up or routinely performed gastroscopy and application of other diagnostic measures may be cost-effective and clinically helpful for patients diagnosed with these autoimmune diseases.

The Link between Cancer, Autoimmunity and Diabetes

In cancer, corrupted neoplastic cell successfully evades the immune attack using two main strategies: avoiding the immune recognition and instigating an immunosuppressive tumor microenvironment. Cancer is able to induce immune tolerance and present itself to immune system as normal tissue. There is a defect in immune tolerance: the tolerance is wrongly induced toward cancer. In autoimmune diseases, immune system attacks normal tissue because it fails to recognize its own constituent parts as self. There is a defect in immune tolerance: the tolerance is lost toward normal tissues. In both diseases wrong information in the communication between tissue (neoplastic) cells and immune system is crucial: in cancer, neoplastic cells avoid immune attack, whilst in autoimmune diseases, immune system attacks normal cells. Diabetes mellitus type I and II are associated with an increased risk of developing different types of cancer. Pathogenesis of diabetes mellitus type I and pathogenesis of cancer overlap in genetic, environmental and immunologic factors. Diabetes mellitus type II and obesity can both induce oncogenesis.

COGNITIVE DISORDERS ANALYSIS IN CHILDREN WITH DIABETES MELLITUS TYPE I DEPENDING ON THE STAGE OF THE DISEASE

The aim of the study was to estimation of possible cognitive deficits in adolescents with type I diabetes mellitus at different stages of the disease

Evaluation of the effectiveness of professional hygiene results in patients with diabetes mellitus type I and overweight

Relevance. At present, the problem of the prevalence of overweight is becoming increasingly important in countries with a high standard of living, especially among the urban population. The social significance of this problem is determined by the threat of the development of diseases of the cardiovascular system, gastrointestinal tract, musculoskeletal system, as well as diabetes mellitus, which in turn are serious risk factors for the development and progression of periodontal pathology. One of the stages in the treatment of periodontal diseases is professional oral hygiene, the tactics of which, the effectiveness and stability of the results obtained also depend on taking into account the individual characteristics of the organism. Objective – to assess the effect of overweight (ICD 10 - K63.5) on the manifestation of periodontal disease and the clinical effectiveness of professional oral hygiene as a stage of initial periodontal therapy in the presence of diabetes mellitus. Materials and methods. The study involved 83 patients with diabetes mellitus type I aged 25 to 45 years with overweight and normal constitution, with chronic generalized periodontitis of mild and moderate severity. All patients underwent a standard complex of professional oral hygiene. Re-examination was carried out after 1 month. Results. The severity of clinical manifestations of periodontitis in patients with diabetes mellitus and overweight was higher than in the group of patients with normal constitution. The analysis of the effectiveness of professional oral hygiene as one of the stages of conservative periodontal therapy revealed differences in the response from the organism as a whole, and periodontal tissues in particular in the examined groups, demonstrating the pathological effect of excess body weight on the decrease in the effectiveness of hygiene measures. Conclusion. The identification of differences in the examined groups confirms the importance of overweight as an aggravating component in patients with periodontal disease and diabetes mellitus type I and dictates the need for a more detailed study of this parameter in the management of patients in this group and predicting treatment results, as well as creates the need for development and implementation of a comprehensive treatment and prevention strategy, including the assessment and monitoring of body mass index, promotion of a healthy lifestyle, elimination of modifiable risk factors.

Short Literature Review on Diagnosis of CKD using Gas Sensors

According to the recent survey, Chronic Kidney Disease (CKD), Hypertension, Diabetes Mellitus type I & II are very common among the people now a days. The portable and user friendly devices like sphygmomanometer, Glucometer are developed for the diagnosis of Blood pressure (BP) and blood glucose respectively, which are available commercially. This literature review focuses on the development of portable CKD diagnosis system using different types of gas sensors. The Ammonia is marked as the major biomarker in the diagnosis of any kidney disease, the presence of elevated concentration of ammonia in the breath of a person reflects any kidney problem in the body. This Ammonia and other gases which constitute the kidney problem like Nitrogen oxide which acts as the biomarker for end stage acute kidney disorder are diagnosed with the help of several gas sensors like Ammonia gas sensor, Gold Nano particles sensors, Nano composites sensors etc., It is possible to develop a system for the diagnosis of CKD using the gas sensors which could reduce the time consuming regular clinical diagnosis of the same.