A multicriteria decision analysis (MCDA) applied to three long-term prophylactic treatments for hereditary angioedema in Spain

Introduction: Hereditary angioedema (HAE) is a rare genetic disease that impairs quality of life and could be life-threatening. The aim of this study was to apply a multicriteria decision analysis to assess the value of three long-term prophylactic (LIP) therapies for HAE in Spain. Methods: A multidisciplinary committee of 10 experts assessed the value of lanadelumab (subcutaneous use), C1-inhibitor (C1-INH; intravenous), and danazol (orally), using placebo as comparator. We followed the EVIDEM methodology that considers a set of 13 quantitative criteria. The overall estimated value of each intervention was obtained combining the weighting of each criterion with the scoring of each intervention in each criterion. We used two alternative weighting methods: hierarchical point allocation (HPA) and direct rating scale (DRS). A reevaluation of weightings and scores was performed. Results: Lanadelumab obtained higher mean scores than C1-INH and danazol in all criteria, except for the cost of the intervention and clinical practice guidelines. Under the HPA method, the estimated values were 0.51 (95% confidence interval [CI]: 0.44-0.58) for lanadelumab, 0.47 (95%CI: 0.41-0.53) for C1-INH, and 0.31 (95%CI: 0.240.39) for danazol. Similar results were obtained with the DRS method: 0.51 (95%CI: 0.42-0.60), 0.47 (95%CI: 0.40-0.54), and 0.27 (95%CI: 0.18-0.37), respectively. The comparative cost of the intervention was the only criterion that contributed negatively to the values of lanadelumab and C1-INH. For danazol, four criteria contributed negatively, mainly comparative safety. Conclusion: Lanadelumab was assessed as a high-value intervention, better than C1-INH and substantially better than danazol for LTP treatment of HAE

Level of knowledge about oral health of pregnant patients: Descriptive study

Introduction: During pregnancy, the woman may be exposed to infectious processes, lesions in the oral cavity or painful symptoms, which is sometimes difficult to manage, given the precautions that the pregnancy condition demand. The aim is to understand that the state of maternal oral health determines to a large extent the state of health of the future baby, as well as adequate oral health conditions for pregnant women. The information that the mother acquires during this period will allow her to evaluate her oral and child health. Aim: To describe the level of knowledge of the oral health of pregnant women. Method: Descriptive, cross-sectional investigation. The sample was non-probabilistic and for convenience; was composed of 50 pregnant women. The variables studied were age, pregnancy trimester, level of education and level of knowledge. Results: Secondary studies predominated in the sample. The level of regular knowledge prevailed (64%) in the 3 trimesters. According to the perceived needs of oral health status, 66% said it was good. All the pregnant women, between 41 and 45 years old, showed regular knowledge. Conclusions: In the younger women, a deficient level of knowledge predominates. There are also differences for the weeks of gestation, because women with more weeks of gestation have more knowledge. 64% of the sample presented a regular level. Only 10%, got a correct assessment