[Experience with nebulised colistin in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa]. / Experiencia con colistina nebulizada en pacientes con bronquiectasias no fibrosis quística colonizadas por Pseudomonas aeruginosa.

OBJECTIVE: Chronic colonisation/infection by Pseudomonas aeruginosa of the bronchiectasis is related to a faster deterioration of lung function, an increase in the number of exacerbations and a higher morbidity and mortality. Nebulised colistin decreases bacteria load. Therefore, a reduction in the number and in the severity of exacerbations and a delay of pulmonary decline is expected. The main objective is to evaluate if the treatment with nebulised colistin, for at least 6 months reduces the number of admissions and visits to the emergency department. METHODS: Observational, retrospective and non-interventionist study carried out in an organizational structure with an integrated management. Patients with non-cystic fibrosis bronchiectasis colonised / infected by P. aeruginosa, older than 18 years, were selected. Patients must have received nebulized colistin during at least 6 months. Clinical, microbiological and therapeutic data from the patients were collected from the SERGAS computerized clinical history (IANUS® v.4.20.0503) and the electronic prescription, which were divided into two time periods: 1) 6 months pre-treatment and during the treatment and 2) 12 months pre-treatment and during the treatment, in those who completed 1 year of treatment. RESULTS: Forty-four patients were included and of these, 29 (65.9%) had a follow-up of 12 months. The use of nebulized colistin decreased significantly the number of visits to the emergency (at 6 months), the frequency and duration of hospitalizations admissions (at 6 and 12 months), the antibiotic consumption (at 6 and 12 months) and the positive cultures. The treatment was well tolerated in almost all patients. CONCLUSIONS: The treatment with nebulised colistin during 6 and 12 months of non-cystic fibrosis bronchiectasis, colonised/infected by P. aeruginosa, seems beneficial for the patient, from the clinical and quality of life point of view, and could reduce the economic cost of the process.

Effect of tyrosine kinase inhibitors on the glucose levels in diabetic and nondiabetic patients.

CONTEXT: Tyrosine kinase inhibitors (TKIs) are used in different types of cancers due to their good profile of adverse reactions and their convenience in the oral administration. Some studies describe that certain TKIs are associated with changes in the glycemic profile of the patients. AIMS: This study aims to determine if treatment with ITK affects to serum glucose levels in clinical practice. SETTINGS AND DESIGN: A retrospective study was carried out in 136 episodes (112 patients treated with sorafenib, sunitinib, imatinib, dasatinib, or nilotinib). SUBJECTS AND METHODS: The serum glucose levels were analyzed before treatment and after months 1, 2, 3, 6, 9, and 12 of treatment. STATISTICAL ANALYSIS USED: Statistical analysis was completed with SPSS version 20 for Windows. RESULTS: There were significant differences in the serum glucose levels before treatment between diabetic and nondiabetic patients, but not between the average blood glucose readings before treatment and the average of the subsequent readings, once their treatment had begun. CONCLUSIONS: The results of this study do not reproduce the results of the literature since changes in the serum glucose levels have not been found in this sample of patients.

Efectividad y toxicidad de erlotinib en la farmacoterapia del cáncer de pulmón no microcítico / Efficacy and toxicity of erlotinib in non-small cell lung cancer treatment

Objetivo Evaluar la efectividad y toxicidad del erlotinib en pacientes con cáncer de pulmón no microcítico. Métodos Los pacientes se han seleccionado de una base de datos de dispensación a pacientes ambulatorios. El periodo de tiempo seleccionado fue de enero 2008 a enero 2010 y para la recolección de datos se empleó la historia clínica del paciente en formato electrónico y en papel. Como medida de respuesta hemos usado los criterios RECIST (Response Evaluation Criteria in Solid Tumors), también hemos medido el tiempo hasta la progresión y la supervivencia global. La toxicidad se evaluó según la Common Terminology Criteria for Adverse Events (CTCAE).Resultados Se encontraron respuestas parciales en 5/46 pacientes y criterios de enfermedad estable en 14/46 pacientes. El tiempo hasta progresión de la enfermedad fue 4,01 meses (mediana 2,33 meses) y la supervivencia global 5,63 meses (mediana 4,67). Las toxicidades más frecuentes fueron exantema, anorexia, astenia, infecciones y efectos adversos gastrointestinales. Los pacientes que desarrollaron toxicidad cutánea tuvieron un tiempo hasta la progresión y una supervivencia global mayor (estadísticamente significativo) que el grupo que no la desarrolló (media de tiempo hasta la progresión: 7,87 meses versus 2,76; media supervivencia global: 10,74 meses versus 3,98).Conclusiones Los hallazgos del análisis de supervivencia indican una efectividad menor en nuestra población de pacientes en relación con otras publicaciones y las reacciones adversas describen el patrón esperado. A pesar de tener en cuenta nuestra principal limitación, el tamaño de la muestra, podría tratarse de una alternativa para los pacientes con cáncer de pulmón no microcítico (AU)

Objective To evaluate the efficacy and toxicity of erlotinib in patients with non-small cell lung cancer. Method Patients were selected from an outpatients’ dispensing database. The time period selected was from January 2008 to January 2010. Data was collected from patient's medical history - electronic and paper based. We used Response Evaluation Criteria in Solid Tumours (RECIST) to measure response and measured time to progression and overall survival. Toxicity was evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE).Results We found partial response in 5/46 patients and stable disease in 14/46 patients. Time to disease progression was 4.01 months (median 2.33 months) and overall survival was 5.63 months (median 4.67). The most common toxicities were rash, anorexia, asthenia, infection and gastrointestinal side effects. Patients who developed skin toxicity had a (statistically significant) greater time to progression and overall survival rate than the group that did not develop this toxicity (mean time to progression: 2.76 vs. 7.87 months; mean overall survival: 10.74 months vs. 3.98).Conclusions Survival analysis findings suggest lower efficacy in our patient population in comparison with data seen in other publications, and adverse events followed the expected pattern. Although our greatest limitation was sample size, which must be kept in mind, this therapy could be an alternative for patients with non-small cell lung cancer (AU)

[Efficacy and toxicity of erlotinib in non-small cell lung cancer treatment]. / Efectividad y toxicidad de erlotinib en la farmacoterapia del cáncer de pulmón no microcítico.

OBJECTIVE: To evaluate the efficacy and toxicity of erlotinib in patients with non-small cell lung cancer. METHOD: Patients were selected from an outpatients' dispensing database. The time period selected was from January 2008 to January 2010. Data was collected from patient's medical history - electronic and paper based. We used Response Evaluation Criteria in Solid Tumours (RECIST) to measure response and measured time to progression and overall survival. Toxicity was evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE). RESULTS: We found partial response in 5/46 patients and stable disease in 14/46 patients. Time to disease progression was 4.01 months (median 2.33 months) and overall survival was 5.63 months (median 4.67). The most common toxicities were rash, anorexia, asthenia, infection and gastrointestinal side effects. Patients who developed skin toxicity had a (statistically significant) greater time to progression and overall survival rate than the group that did not develop this toxicity (mean time to progression: 2.76 vs. 7.87 months; mean overall survival: 10.74 months vs. 3.98). CONCLUSIONS: Survival analysis findings suggest lower efficacy in our patient population in comparison with data seen in other publications, and adverse events followed the expected pattern. Although our greatest limitation was sample size, which must be kept in mind, this therapy could be an alternative for patients with non-small cell lung cancer.