Inflammation associated with chronic obstructive pulmonary disease (COPD) causes narrowing of the airways and destruction of the lung parenchyma. The triple therapy (ICS+LABA+LAMA) may improve lung ...function, patient‑reported outcomes, and exacerbation risk in a specified subset of GOLD group D patients. A better understanding of the factors leading to the single‑inhaler triple therapy (SITT) prescription in real-life scenario is still an unmet need.
We assessed the characteristics of 838 GOLD group D patients treated with SITT and way of how those patients had been routinely managed before in their outpatient settings. The cross-sectional observational survey was based on an assessment of routine practice patterns and retrospective collection of anonymous medical data.
Severe and very severe forms of airflow obstruction were experienced by 52 % and 34 % of patients, respectively. The mean number of exacerbations during the 12‑month period antecedent to SITT prescription was 2.01. Before starting SITT, various combinations of COPD medications were prescribed: LABA (95 %), followed by ICS and LAMA. Compared to patients with 0-1 exacerbation, the patients with ≥2 exacerbations had higher levels of mMRC and CAT scores (2.47 vs 2.69 and 16.02 vs 19.31, respectively, both p <0.001), worse treatment adherence and higher need for rescue medication (4.7 vs 3.9 units, p=0.0011). The driver for switching the treatment to SITT was an expected improvement in lung function followed by reduction in dyspnoea and number of exacerbations.
Despite current treatment, the burden of COPD remains significant in GOLD group D patients. The lung function, symptoms burden and exacerbation history are among the most important factors involved in the decision for stepping up to SITT with potential roles of both bronchodilator and anti-inflammatory components (Tab. 2, Fig. 9, Ref. 66).
OBJECTIVESBiopharmaceuticals improved the prognosis and quality of life of patients with chronic diseases. The aim of our study was to analyse the total reported suspected adverse drug reactions ...(ADR) and ADRs of reference biologicals and their biosimilars in Slovakia. METHODSUsing data from the State Institute for Drug Control database, we analysed the trends of suspected ADR submitted between 2001-2017 including the registered biosimilars and their reference biologicals: erythropoietin, filgrastim and infliximab. RESULTSSevere suspected ADR represented 42.95 % from all the reported cases (n=13,462) over the time period 2006-2017 and 54.98 % over 2015-2017 respectively. Reports from 2015-2017 were further analysed. From 4,364 cases, 27 were associated with infliximab and one with erythropoietin. 75 % of these ADR were severe including one death. The difference between the suspected ADR for infliximab reference biological compared to the biosimilar was not statistically significant (p=0.171) after adjustment to the number of prescribed drug units. CONCLUSIONWe did not find any evidence of increased risks associated with biosimilars compared to reference biologics. The spontaneous reporting system represents an inexpensive tool of reporting ADRs and should be utilized more frequently by health professionals, but even more importantly, by patients (Tab. 3, Fig. 2, Ref. 30). Text in PDF www.elis.sk Keywords: adverse drug reaction, spontaneous reporting, biopharmaceuticals, biosimilars, infliximab.
Generic substitution of branded pharmaceuticals is a widely adopted tool among payers to achieve cost savings. The adoption and safe use of generics among consumers is predicated upon their knowledge ...of and attitudes toward these products.
The aims of this study were to assess patients' attitudes towards generic drugs and their experience with using generics, identify factors associated with differences in attitudes and/or experience, and discern the rate of generic substitution in Slovakia.
Two thousand questionnaires were distributed to patients via pharmacies throughout Slovakia by eleven pharmaceutical companies representing GENAS (the Slovak Generic Association). Responses were received from 1,777 persons (88.85% response rate). Demographic information of respondents was also acquired.
Only 33.8% (600/1773) of respondents care to know about the product which they are using. Over one half (61.1%, 1084/1774) of respondents indicated no distrust in using generics, with many of them indicating a preference for a product with a lower co-payment.
About 1/3 of patients care to know whether they are using generic or branded pharmaceuticals. If there is a lack of information about generics, this could inhibit the use of generics by patients and discern a rate of generic substitution (Tab. 3, Fig. 1, Ref. 18).
The standardized extract of Ginkgo biloba (EGb 761) was found not only to improve memory and aging associated cognitive deficits but also to exert beneficial effects on mood. An antistress action of ...the extract has been suggested but not directly proven. The present study was aimed to evaluate the effects of EGb 761 on salivary cortisol and blood pressure responses during stress in healthy young volunteers (n = 70) in a double blind placebo controlled design. A stress model involving a combination of static exercise (handgrip) and mental stimuli was used. Single treatment with EGb 761 (120 mg) reduced stress-induced rise in blood pressure without affecting the heart rate. Salivary cortisol responses showed differences with respect to the gender and the time of day of the stress exposure, with the activation only in male subjects in the afternoon. This activation was absent if they were treated with EGb 761. The performance in a short memory test with higher scores achieved by women remained unaffected by EGb 761 treatment. Thus, this study provides evidence that EGb 761 has an inhibitory action on blood pressure and it may influence cortisol release in response to some stress stimuli.
Chronic obstructive pulmonary disease (COPD) is one of the main cases of mortality and morbidity of population worlwide. In spite of enormous efforts there are not pharmacological agents evidently ...influencing natural course of disease available. Besides looking for new drugs influencing the long term outcome of patients with COPD, there is also running the process of reevaluation of the role of several already established drug groups.
Through the use of recent knowledge and results from large-scale clinical studies as well as metaanalyses we give a view on action of inhaled corticosteroids in the pathophysiological mechanisms of COPD and complex summary of their role in the therapeutic management of the disease.
Contrary to systemic corticosteroids, agreement regarding usage of inhaled corticosteroids necessary by acute exacerbations of disease has not been reached yet. Recent meta-analyses of the long-term clinical studies have clearly demonstrated that inhaled corticosteroids could pose with ability of slowing down the progressive deterioration of lung functions and lead to the prolongation of life in broad population of patients with COPD. Benefit of treatment insists in decrease of frequency and severity of exacerbations, mildering symptoms, improving overall health state as well as exercise tolerance in patients with COPD. Clinical relevant is also reduction of the number of hospitalizations and mortality related to progression of COPD (Tab. 2, Ref 45) Full Text (Free, PDF) www.bmj.sk.
Pharmacology is one of the core subjects for further graduation in both preclinical and clinical area. Medical education is being performed either in the "classical" way (lecture based learning--LBL) ...or in a more advanced form, such as problem based learning (PBL). According to the Medline database, the interest in PBL is still increasing. At our department, the PBL has been introduced using the knowledge obtained at the the Mac Master University and University of Groningen. PBL in pharmacology requires well-qualified staff with clinical experience. A common character of PBL is the use of selected clinical cases as models and starting points to study certain topics with a student centred approach. In an interview we made on a sample of 88 students of our medical faculty in the last study year, 65.5% of them found the amount of information concerning pharmacotherapy not sufficient for their future clinical practice and 83.3% did not feel able to use the knowledge obtained. More than 90% of students did not see enough opportunities for pharmacotherapy training during clinical subject courses. These results are in support of our orientation of teaching towards the PBL. This type of teaching forces students to be active, trains their skills in communication and selection of knowledge, which is believed to enhance the long-term knowledge retention. By using the hybrid PBL-LBL model at our department we respect the principal proposal of medical education and attempt to improve skills in decision making in training of future medical doctors. (Tab. 3, Fig. 2, Ref. 13.)
The aim of the presented study was to analyse the types and quantity of inquiries received at Drug Information Centre in Bratislava during the period from May 1997 to May 2006. The study analyses ...also the profile of the users of the latter centre with focus on the perception of drug risk, adverse drug reactions, and drug interactions.
The Drug Information Centre (Druginfo) was established in Slovak Republic as part of the Department of Pharmacology in May 1997. In 2002 Druginfo became a member of International Register of Drug Information Services of the Society of Hospital Pharmacists of Australia. Druginfo provides voluntary free of charge drug information for healthcare professionals.
Statistical processing of all inquiries received at Druginfo during a 10-year period focused on the aspect of drug risk perception.
867 inquiries were received in total. The most frequent inquiries came from hospital teaching clinics in Bratislava. Questions concerning pregnancy/lactation (25 %), adverse drug reactions (16 %), basic information about drugs (14 %) and interactions (13 %) were asked most frequently.
The types of inquiries and inquirers using the service are generally similar to those recorded at many others Druginfos within Europe and USA. The number of questions is lower than in other centres. Druginfo in Bratislava has a very important role in providing independent drug information (Tab. 1, Fig. 8, Ref. 9). Full Text (Free, PDF) www.bmj.sk.
The aim of the presented study was to evaluate the profile of users, the number and character of questions which were received during the period May 1997-December 2004.
The drug information centre ...(Druginfo) has been established in Slovak Republic at the Department of Pharmacology in May 1997. Since 2002 Druginfo is a member of International Register of Drug Information Services of the Society of Hospital Pharmacists of Australia. Druginfo provides voluntarily free of charge drug information for healthcare professionals.
Druginfo receives questions addressed via phone, fax and e-mail. The questions were replied by consulting pharmacologists on duty. The data for this study were obtained from records which include list the received questions and the basic information about the questioners.
The Druginfo received 495 questions during the period May 1997-December 2004. Questions were mostly from hospital physicians, followed by outpatient physicians and employees of the Faculty of Medicine. The most frequent specializations of the asking physicians were internal medicine, gynaecology-obstetrics, clinical pharmacology and general medicine. The most common topic was basic information about drugs, followed by questions concerning the use of drugs in pregnancy and lactation. According to the ATC classification the questions were most often related to antiinfective drugs, cardiovascular drugs and psychiatric drugs.
The existence of Druginfo in Slovak Republic represents a possibility of an open access to independent drug information. (Fig. 3, Ref. 11.)
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