Comparison of Branded and Generic Imatinib Plasma Concentrations in Patients With Chronic Myelogenous Leukemia: Unicentric Study.

INTRODUCTION: For over a decade, imatinib has been the first-line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML). Doubts on the bioequivalence and bioavailability of emerging generic compounds have been expressed. Adequate imatinib plasma concentration ([IPC] ≥1000 µmol/L) is associated with a better chance of optimal treatment response in patients with CML. In this study, we compared the achieved IPCs between the branded compound and its 2 generic forms. PATIENTS AND METHODS: IPCs were compared in 24 consecutive patients with CML in the first chronic phase who changed from branded to generic imatinib. The median age was 49 years (range, 22-76 years). Fifteen of them were male. Six patients were switched to Neopax, 13 to Imakrebin, and 5 patients received both generics consecutively. All compounds were used in an equivalent dose of 400 mg orally once daily for at least 1 month before plasma concentrations were measured. High-performance liquid chromatography was used to determine imatinib plasma concentration from a specimen collected 21 to 24 hours after the last dose. RESULTS: The median IPC achieved with branded imatinib was 1454 µmol/L (range, 485-2707 µmol/L) with 18 patients (75%) having IPC ≥ 1000 µmol/L. For Neopax and Imakrebin, median IPCs were 1717 µmol/L (range, 1249-3630 µmol/L) and 1458 µmol/L (range, 707-880 µmol/L), respectively, with 11 of 11 (100%) and 16 of 18 (89%) patients having IPC ≥ 1000 µmol/L. No significant difference in measured IPCs between all 3 compounds was found (P > .257). CONCLUSION: When taken at equivalent doses, imatinib generics are bioequivalent and comparable in clinical efficacy and have the potential for substantial savings in the treatment cost for CML.

[Virtual communication in nursing--are we ready?]. / Virtualna komunikacija u sestrinstvu--jesmo li spremni?

Electronic correspondence is undeniably important in professional communication, education, research and development of a profession. As for others, it is also crucial for development of the nursing profession. Even though e-mail today is a very important tool in the healthcare system, it has not been given sufficient attention yet. There are numerous examples of poor communication, and the answers are often hidden behind attitudes and knowledge of communicators. Therefore, the aim of this study was to examine the level of knowledge and attitudes of nurses about electronic communication. The research has shown that even though the nurses have positive attitudes about electronic communication and a desire to acquire new knowledge, they do not attend computer science courses nor did they have proper IT training while at school. Only 17% of the interviewees gave satisfactory answers to the survey about the knowledge of e-mail. This result can be indicative of the total knowledge of information and communication technology, signaling the need to implement an organized IT education of nurses, which is a necessary requirement for professional development and better functioning of the healthcare system.