Elaboração de Informes Técnicos sobre o uso de medicamentos na COVID-19: um trabalho colaborativo de Centros de Informações sobre Medicamentos do Brasil

Introduction: There is an urgency to have drugs capable of treating COVID-19. However, there are still shortages of studies and difficulties in accessing secure information. Drug Information Centers (DIC) operate in the production and dissemination of quality, objective, and timely information, based on the best scientific evidence. Objective: To describe the collaborative experience of preparing Technical Notes (TN) and Drugs Alerts (DA) on the use of medicines at COVID-19, carried out by members of DICs in Brazil. Method: This is an experience report of a descriptive and analytical type, with a qualitative approach. The profile of the participating DICs and their professionals were initially analyzed, and then the method adopted for conducting the work from March to June 2020 was presented. Results: Four DICs from the Northeast of Brazil participated in this experience, that of the Federal University of Vale São Francisco, the Federal University of Sergipe Lagarto campus, the Federal University of Ceará and the DIC of the Regional Pharmacy Council of Bahia. The stages of the TN development process were: 1) Definition of the TN objectives; 2) Selection of themes; 3) Search for information; 4) Construction process and description of the TNs; 5) Review and 6) Publication of TNs. Four TNs were produced, on antihypertensive and non-steroidal anti-inflammatory drugs; hydroxychloroquine or chloroquine; ivermectin and, vitamin D, in addition, a DA about ivermectin and your potential to cause neurotoxicity. Conclusions: The experience of this collaborative work demonstrates that DICs are playing an important role in combating the pandemic by the new coronavirus and infodemic, promoting quality information, based on the best evidence.Introdução: Há uma urgência em se ter medicamentos capazes de tratar a COVID-19, mas existe ainda carência de estudos e dificuldades no acesso a informações seguras. Os Centros de Informações sobre Medicamentos (CIM) atuam na produção e difusão de informações de qualidade, baseadas nas melhores evidências científicas. Objetivo: Descrever a experiência colaborativa da elaboração de notas técnicas (NT) e de alerta de medicamento (AM) sobre a utilização de medicamentos na COVID-19, realizada por membros de CIM do Brasil. Método: Trata-se de um relato de experiência do tipo descritivo e analítico, com abordagem qualitativa. Foi analisado inicialmente o perfil dos CIM participantes e de seus profissionais envolvidos, e então apresentado o método adotado para a condução do trabalho, que foi realizado entre março a junho de 2020. Resultados: Participaram quatro CIM do Nordeste brasileiro: o da Universidade Federal do Vale do São Francisco, o da Universidade Federal de Sergipe, campus Lagarto, o da Universidade Federal do Ceará e o CIM do Conselho Regional de Farmácia da Bahia. As etapas do processo de desenvolvimento dos documentos técnicos foram: 1) Definição dos objetivos; 2) Seleção dos temas; 3) Busca de informação; 4) Processo de construção e descrição; 5) Revisão e 6) Publicização. Foram produzidas quatro NT e um AM. Conclusões: A experiência deste trabalho colaborativo demonstra que os CIM estão exercendo relevante papel no combate a pandemia pelo novo coronavírus e a infodemia, promovendo informação de qualidade, baseada nas melhores evidências

Evidence on the effect and safety of the use of ivermectin in human coronavirus infection: an integrative review

A integrative review about the effects and safety of using ivermectin in patients with coronavirus infection. This research will be carried out by a group of researchers from three centers of drug information in the northeast of Brazil: CIM / UNIVASF, CIM / UFS-LAGARTO and CIM / CRF-BA

Methotrexate-related response on human peripheral blood mononuclear cells may be modulated by the Ala16Val-SOD2 gene polymorphism.

Methotrexate (MTX) is a folic acid antagonist used in high doses as an anti-cancer treatment and in low doses for the treatment of some autoimmune diseases. MTX use has been linked to oxidative imbalance, which may cause multi-organ toxicities that can be attenuated by antioxidant supplementation. Despite the oxidative effect of MTX, the influence of antioxidant gene polymorphisms on MTX toxicity is not well studied. Therefore, we analyzed here whether a genetic imbalance of the manganese-dependent superoxide dismutase (SOD2) gene could have some impact on the MTX cytotoxic response. An in vitro study using human peripheral blood mononuclear cells (PBMCs) obtained from carriers with different Ala16Val-SOD2 genotypes (AA, VV and AV) was carried out, and the effect on cell viability and proliferation was analyzed, as well as the effect on oxidative, inflammatory and apoptotic markers. AA-PBMCs that present higher SOD2 efficiencies were more resistance to high MTX doses (10 and 100 µM) than were the VV and AV genotypes. Both lipoperoxidation and ROS levels increased significantly in PBMCs exposed to MTX independent of Ala16Val-SOD2 genotypes, whereas increased protein carbonylation was observed only in PBMCs from V allele carriers. The AA-PBMCs exposed to MTX showed decreasing SOD2 activity, but a concomitant up regulation of the SOD2 gene was observed. A significant increase in glutathione peroxidase (GPX) levels was observed in all PBMCs exposed to MTX. However, this effect was more intense in AA-PBMCs. Caspase-8 and -3 levels were increased in cells exposed to MTX, but the modulation of these genes, as well as that of the Bax and Bcl-2 genes involved in the apoptosis pathway, presented a modulation that was dependent on the SOD2 genotype. MTX at a concentration of 10 µM also increased inflammatory cytokines (IL-1β, IL-6, TNFα and Igγ) and decreased the level of IL-10 anti-inflammatory cytokine, independent of SOD2 genetic background. The results suggest that potential pharmacogenetic effect on the cytotoxic response to MTX due differential redox status of cells carriers different SOD2 genotypes

Comparison of oxidative metabolism variables of peripheral blood mononuclear cells (PBMCs) carrier’s different Ala16Val-SOD2 genotypes exposed to Methotrexate.

<p>MTX = methotrexate; sd = standard deviation; Different letters (a, b, c) indicate significant differences among each MTX treatment determined by analysis of variance followed by Tukey's post hoc test at p<0.05.</p><p>Comparison of oxidative metabolism variables of peripheral blood mononuclear cells (PBMCs) carrier’s different Ala16Val-SOD2 genotypes exposed to Methotrexate.</p