ABSTRACT
Background: The current flows of the SSN represent the set of interest whose interconnection alone justifies the current study. These flows can be interconnected with other sources, institutional or otherwise, in order to answer well-defined questions. Objective: The objective of the study is to verify, through the analysis of administrative databases, any differences in the consumption of health resources between biological off-patent originator drugs and biosimilars in real clinical practice, with particular reference to the rheumatology area. Methods: Through the use of assisted databases (BDA) of ATS Pavia we evaluated the differences in terms of consumption of health resources related to the different drugs under analysis. Annual and daily costs were calculated by total patient cost, stratified for different treatments, considering the sum of total costs for the prescriptions of drugs subject to the analysis. Another objective was to evaluate the adherence of the drugs of interest, by utilizing specific indicators (MPR). Results: A total of 145 patients were analyzed. Among enrolled patients, 26.9% of users were treated with a biosimilar drug, while 73.1% with a biologic originator. Adherence is higher if it is considered the population treated with biosimilar drugs (82.1%). Total cost (including drug prescriptions, hospitalizations, outpatient services, tests for any cause) during the observation period of 1 year is 14,274.08. 87.7% of the total is attributable to drugs. Non-hospitalized patients are the least expensive, whether they were treated with biologics or biosimilars. Conclusion: In our sample, biosimilar drugs tend to be underused: the treatment of a patient with a chronic autoimmune disease is a clinical process that involves many health professionals, and a criticality could also derive from the difficult communication between the various professional figures who get involved with the whole patient treatment.
ABSTRACT
BACKGROUND: Glioblastoma multiforme (GBM) is the most common and deadly brain form of tumor. GBM exhibits high resistance to the standard treatment consisting of temozolomide (TMZ) combined with radiotherapy. Isofuranodiene (IFD) is a bioactive sesquiterpene occurring in the essential oils obtained from Alexanders (Smyrnium olusatrum L., Apiaceae). This compound has shown a broad spectrum of antitumoral activities in different human cancer cell lines both in vitro and in vivo. However, the mechanism of action of IFD on GBM and its potential effects in combination with chemotherapeutic drugs, have not been fully elucidated. PURPOSE: The aim of the present study was to evaluate the anticancer effects of IFD itself and in combination with TMZ in GBM. METHODS: Sulforhodamine B-based proliferation assay, cell cycle analysis and Annexin V/PI staining were carried out to determine the IFD effects on three human GBM cell lines, U87, T98, U251 and in normal human astrocyte. Modulation of protein expression levels was determined by western blot analysis. Reactive oxygen species (ROS) production was evaluated by cytofluorimetry. Moreover, the effects on cell viability of the IFD and TMZ co-administration was evaluated through the calculation of combination index (CI). RESULTS: IFD exerted cytotoxic effects against the GBM cell lines, but not in normal cells (normal human astrocytes). This compound induced a cell cycle blockage and a necrotic cell death depending on the increase of intracellular ROS levels. Furthermore, the synergism between IFD and TMZ was demonstrated in GBM cell lines. CONCLUSION: This study demonstrated the glioma selectivity of IFD and its cytotoxic properties suggesting a new strategy for the treatment of GBM in order to overcome the TMZ resistance and to reduce its side effects.
