Multicentre, non-interventional study to assess the profile of patients with uncontrolled rhinitis prescribed a novel formulation of azelastine hydrochloride and fluticasone propionate in a single spray in routine clinical practice in the UK

OBJECTIVE: The aims of this study were (1) to characterise the type of patient prescribed MP-AzeFlu (Dymista, a novel formulation of azelastine hydrochloride, fluticasone propionate and excipients in a single spray) in real life in the UK and physicians' reasons for prescribing it and (2) to quantify the personal and societal burden of allergic rhinitis (AR) in the UK prior to MP-AzeFlu prescription. DESIGN, SETTING AND PARTICIPANTS: This multicentre, non-interventional study enrolled patients (n=193) with moderate-to-severe AR and acute symptoms who were eligible to receive treatment with MP-AzeFlu according to its licensed indications. Information was gathered on patient demographics, AR history and symptom severity, symptomatology and AR treatments in the previous calendar year (prior to MP-AzeFlu prescription). Physicians also recorded the number of previous AR visits, specific reasons for these visits and their reason for prescribing MP-AzeFlu. RESULTS: Most patients had seasonal AR either alone (10.4%) or in combination with perennial AR (35.2%), but many had AR of unknown origin (35.8%). Prior to MP-AzeFlu prescription, patients reported troublesome symptoms (78.2%) and sleep disturbance (64.8%), with congestion considered the most bothersome (54.4%) and ocular symptoms reported by 68.4% of patients. The most frequent reason for MP-AzeFlu prescription was that other therapies were not sufficient in the past (78.8%) or not sufficient to treat acute symptoms (16.1%). 79.3% of patients reported using ≥2 AR therapies in the past year. An average of 1.6 (SD 1.9) doctor visits due to AR were reported prior to MP-AzeFlu prescription. CONCLUSIONS: In the UK, MP-AzeFlu was prescribed for individuals (≥12 years) with moderate/severe AR irrespective of (1) previous AR treatment (mono or multiple), (2) previous or likely treatment failure, (3) phenotype, (4) number of previous physician visits for AR and (5) for the relief of both acute symptoms and in anticipation of allergen exposure

Avances en el diagnóstico y tratamiento de las enfermedades alérgicas

199 páginas.Entre el 20% y el 25% de la población mundial sufre alguna enfermedad alérgica. Los nuevos avances en el campo de la alergología han permitido que se clasifiquen, diagnostiquen y traten mejor estas enfermedades, mejorando claramente la calidad de vida de todas aquellas personas que las padecen. Los médicos de atención primaria (médicos de familia y pediatras) suelen ser los encargados de atender en primera instancia al paciente alérgico, intentando instaurar un tratamiento que ayude a controlar su enfermedad, siendo necesaria la derivación al alergólogo cuando esto no es posible. Por ello es de vital importancia que el médico de atención primaria conozca todas las novedades diagnósticas y de tratamiento de las enfermedades alérgicas, para poder identificar cuáles son los pacientes que más se beneficiarían de un diagnóstico y tratamiento más preciso por parte del alergólogo. De igual modo, no hay que olvidar la importancia de establecer una estrategia integral, basada en la colaboración directa entre todos los profesionales sanitarios pueden estar implicados de una forma u otra en el manejo del paciente alérgico (médicos de familia, médicos de urgencias, dermatólogos, pediatras, neumólogos, etc.), lo que claramente redundará en una mejora sustancial de su salud

UK prescribing practices as proxy markers of unmet need in allergic rhinitis:A retrospective observational study

Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for 420% of SAR and 437% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and 450% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies

Rinoconjuntivitis y asma por hipersensibilidad al polen de salsola kali (chenopodiaceae): aspectos clínico-inmunológicos y valoración de la inmunoterapia

Tesis doctoral inédita. Universidad Autónoma de Madrid, Facultad de Medicina. Departamento de Medicina. Fecha de lectura: 27 de Marzo de 199

¿Cómo debemos actuar ante un caso de anafilaxia?

págs. 128-145Capítulo incluido en el libro: Avances en el diagnóstico y tratamiento de las enfermedades alérgicas. Manuel Alcántara Villar (coordinador). Sevilla: Universidad Internacional de Andalucía, 2022. ISBN 978-84-7993-376-0. Enlace: http://hdl.handle.net/10334/615

Ambulatory and hospital pharmacy expenditure in patients with breast cancer in the community of valencia. Analysis of the clinical risk groups 2014-2015

Objectives Analizar el gasto farmacéutico ambulatorio y los gastos hospitalarios de las pacientes con cancer de mama (CDM) de una comunidad autónoma española a través de los CRG en los años 2014 y 2015. Methods De la poblacion total dada de alta en el sistema de informacion de farmacia ambulatoria de la comunidad valenciana (N= 4.714.844) se identificaron 31.685 (año 2014) y 33.683 (año 2015) mujeres con CDM utilizando la clasificación CIE-9 y el sistema de clasificación a través del software 3M Clinical Risk Groups (CRG). Se obtuvieron el importe farmacéutico ambulatorio y los ingresos hospitalarios relacionados con la patología y sus comorbilidades, a través de los códigos CIE-9 y GRD, así como los costos promedios aplicados a cada código GRD. Results La prevalencia de la enfermedad estimada a través de los CRG fue de 1,32% (IC 95% 1,33 - 1,30) para el 2014 y de 1,39% (IC95% 1,40 - 1,37) (1 de cada 76 mujeres recibe atención por CDM). El promedio del gasto farmacéutico ambulatorio por paciente en los años 2014 y 2015 fue de €991,4 y €1.018,9, respectivamente siendo el gasto total de €31,4 millones en el 2014 y €34 millones en el 2015. El 97% de este valor se concentra en los grupos CRG 5 a 8. Durante los años 2014 y 2015 en pacientes con CDM se presentaron 11.390 y 11.959 ingresos hospitalarios, respectivamente. Los costos en hospitalizaciones por la patología de base y sus comorbilidades ascendieron a 46,9 millones en el 2014 y €49,3 millones en el 2015. Conclusions El costo farmacéutico ambulatorio de los pacientes con CDM en 2014-2015 fue de €65,4 Millones, los ingresos hospitalarios representaron €96,2 millones. Los CRG en CDM son una opción alternativa de evaluación del gasto sanitario que permite monitorear los recursos.Objectives To analyze outpatient pharmaceutical expenditure and hospital expenses of breast cancer patients (CDM) of a Spanish autonomous community through CRGs in 2014 and 2015. Methods Of the total population registered in the ambulatory pharmacy information system of the Valencian community (N = 4,714,844), 31,685 (2014) and 33,683 (2015) women with CDM were identified using the ICD-9 classification and the classification system through the 3M Clinical Risk Groups (CRG) software. The ambulatory pharmaceutical amount and the hospital admissions related to the pathology and its comorbidities were obtained through the ICD-9 and GRD codes, as well as the average costs applied to each GRD code. Results The prevalence of the disease estimated through the CRG was 1.32% (95% CI 1.33-1.30) for 2014 and 1.39% (95% CI 1.40 - 1.37) ( 1 out of every 76 women receives care through CDM). The average outpatient pharmaceutical expenditure per patient in 2014 and 2015 was € 991.4 and € 1,018.9, respectively, with the total cost of € 31.4 million in 2014 and € 34 million in 2015. The 97 % of this value is concentrated in groups CRG 5 to 8. During the years 2014 and 2015 in patients with CDM there were 11,390 and 11,959 hospital admissions, respectively. The costs in hospitalizations for the basic pathology and its comorbidities amounted to 46.9 million in 2014 and € 49.3 million in 2015. Conclusions The outpatient pharmaceutical cost of patients with CDM in 2014-2015 was € 65.4 Million, hospital admissions represented € 96.2 million. The CRGs in CDM are an alternative option for evaluating health expenditure that allows monitoring resources