Activités pharmaceutiques relatives aux essais cliniques de médicaments et dispositifs médicaux réalisées au sein des établissements de santé – guide professionnel

Background and objectivesThe hospital pharmacist, in charge of the pharmaceutical aspects of clinical trials plays a central role in the management and the proper use of investigational health products (IHP), in accordance with the Good Clinical Practices and Public Health Code. The working group “Clinical trials” of the CPCHU (French University Hospitals Pharmacists’ Commission) aimed to prepare national guidelines to describe the activities and involvement of the pharmacists, whatever the type of health care institution.MethodologyAfter an analysis of the existing literature, form and content requirements were set and the structure was established. The chapters were written in subgroups, with systematic revision and validation in plenary.ResultsThe professional guidelines are composed of 109 pages and are available as an interactive pdf file on the SFPC and CNCR websites. Topics covered in the guidelines are divided into 4 chapters, and include inserts of specific recommendations and/or some illustrations. There are 374 references, including 329 regulatory texts, and 5 appendices.Discussion–conclusionThese guidelines are a part of process of dissemination, standardization and securing practices, in order to help hospital pharmacists in the management of IHP and in the development or improvement of their own performance systems in terms of quality. Its pedagogical format also makes it a training tool for students, compounders and senior pharmacists. Its regular updating is necessary

Hydroxychloroquine in Coronavirus Disease 2019 Patients: What Still Needs to Be Known About the Kinetics

International audienceDifferent dosage regimens of hydroxychloroquine are used to manage coronavirus disease 2019 (COVID-19) patients, without information on the pharmacokinetics in this population. Blood samples (n = 101) were collected from 57 COVID-19 patients for 7 days, and concentrations were compared with simulated kinetic profiles. Hydroxychloroquine exposure is low and cannot be predicted by other populations

Remdesivir for Patients Hospitalized with COVID-19 Severe Pneumonia: A National Cohort Study (Remdeco-19)

International audienceBackground. Given the rapidly evolving pandemic of COVID-19 in 2020, authorities focused on the repurposing of available drugs to develop timely and cost-effective therapeutic strategies. Evidence suggested the potential utility of remdesivir in the framework of an early access program. REMDECO-19 is a multicenter national cohort study assessing the ability of remdesivir to improve the outcome of patients hospitalized with COVID-19. Methods. We conducted a retrospective real-life study that included all patients from the early access program of remdesivir in France. The primary endpoint was the clinical course evolution of critically ill and hospitalized COVID-19 patients treated with remdesivir. Secondary endpoints were the SOFA score evolution within 29 days following the admission and mortality at 29 and 90 days. Results. Eighty-five patients were enrolled in 22 sites from January to April 2020. The median WHO and SOFA scores were respectively reduced by two and six points between days 1 and 29. Improvement in the WHO-CPS and the SOFA score were observed in 83.5% and 79.3% of patients, respectively, from day 10. However, there was no effect of remdesivir on the 90-day survival based on the control cohort for hospitalized COVID-19 patients with invasive ventilation. Conclusions. SOFA score appeared to be an attractive approach to assess remdesivir efficacy and stratify its utilization or not in critically ill patients with COVID-19. This study brings a new clinical benchmark for therapeutic decision making and supports the use of remdesivir for some hospitalized COVID-19 patients