Evaluation of drug use health related quality of life and pharmacoeconomics in autoimmune skin disorders: focus on blistering skin disorders-a prospective observational study

Background: Autoimmune skin disorders (ASDs) are complex diseases triggered by autoantibodies action against epidermal antigens or the dermo epidermal junction. Although rare, they present high morbidity, affecting the quality of life (QoL) of patients and financial status of patient.Methods: This prospective, observational study was carried out in department of dermatology for 2-3 months after ethical approval. Drug usage pattern, heath related QoL (HRQOL) by using DLQI (Dermatology life quality index) and cost were evaluated in patients with ASDs. Statistical analysis was done using Microsoft excel office 2019 and rechecked with SPSS (version 23.0). P<0.001 was considered as statistically significant.Results: Out of 73 patients enrolled, 32 were male and 41 were female with the mean age was 48.27±14.93 years; 55% patients had autoimmune blistering skin disorders (AIBDs) and 45% having other ASDs (OADs). Pemphigus vulgaris (PV) (35%) being the most common among all ASDs. Systemic steroid (60.27%), topical steroid (79.45%), levocetirizine (63%) were most commonly prescribed drugs. Mean DLQI score at baseline and after treatment was 11.64±2.49 and 6.8±2.75 respectively. It was highly significant statistically (p<0.0001). Total cost of illness per month was 813.64±481.21 INR. Maximum percentage variation in cost was seen with prednisolone (1706.28%).Conclusions: ASDs have a female bias and inflict severe impairment to the QoL of patients. Appropriate drug therapy with corticosteroids and other adjuvant drug lead to positive impact on QoL. There was very wide price variation of different brands of the same generic most commonly prednisolone and levocetirizine

Comparative evaluation of efficacy and safety of methyldopa and labetalol in pregnancy‑induced hypertension: A meta‑analysis

Introduction: Methyldopa and labetalol are the drugs that frequently used for the management of pregnancy‑induced hypertension. But fewer data available for the efficacy and safety of their use. So, here we are doing a systemic review for the safety and efficacy of methyldopa in comparison to labetalol.Objectives: Assessment of efficacy and safety of methyldopa versus labetalol in pregnancy‑induced hypertension.Method: A total of 10 randomized controlled trials (RCTs) following PRISMA guidelines (2015) and have included pregnant women who developed hypertension after the 20th week of gestation and receiving methyldopa (100–400 mg/day) or labetalol (250–1000 mg/day). All RCTs with changes in mean arterial pressure (MAP) before and after drug administration was collected. The adverse effects of the respective drugs were also noted. RevMan 5.3 software was used for the calculation of standardized mean difference (SMD). P value less than 0.05 will be considered significant.Result: Data of 1,200 patients were included in our study. Both the drug decreases MAP statistically significantly. In the labetalol group, P value was statistically significant (random effect model P &lt; 0.005 and in the fixed‑effect model &lt;0.001). In methyldopa group, P &lt; 0.001, significant in fixed effect. In the majority of the studies, the difference in the reduction of MAP was higher in labetalol than methyldopa. In labetalol vs methyldopa study using random‑effect model SMD was 1.568 (95% CI, 0.735 to 2.401, P &lt; 0.001). Drowsiness, headache, nausea, vomiting, weakness, and myalgia were associated with drugs. Out of the six adverse effects, there was a significant difference found in drowsiness (P = 0.023) which was seenmore in patients receiving methyldopa. There was no significant difference in the prevalence of the other maternal side effects.Conclusions: Labetalol is more efficacious and safer as compared to methyldopa. Key words: Efficacy; labetalol; methyldopa; pregnancy‑induced hypertension; safety