تالیفات

 

Cost-EffectivenessAnalysisofTocilizumabinComparisonwith Infliximab inIranianRheumatoidArthritisPatientswith Inadequate ResponsetotDMARDs:AMultistageMarkovModel

Authers: Amir Hashemi-Meshkini, PharmD1, ShekoufehNikfar, PharmD, PhD1, ElizabethGlaser, MS, MA2, Ahmadreza Jamshidi, MD3, SeyedAlirezaHosseini, PharmD, PhD1, 4, *

Abstract: To analyzethecost-effectivenessoftwocommontreat- ment strategiesinIran,comparinginfliximab plusmethotrexatewith tocilizumab plusmethotrexateinpatientswithrheumatoidarthritis with inadequateresponsetotraditionaldisease-modifyinganti- rheumatic drugs. Methods: A multistageMarkovdecisionmodel was appliedtoassesstheincrementalcost-effectivenessratio(ICER) of atocilizumab-containingregimenversusaninfliximab-containing regimen overa5-yeartimeperiod.Inthecaseofnoresponse,we assumed thatpatientsswitchedtothenexttreatment(adalimumab, rituximab, orsupportivecare)insequenceforeachstrategy.We consideredmajorcostitems,suchasdirectmedicalcostsanddirect nonmedical costs,fromapayer(patientsandthird-partypayers) perspective.Adeterministicsensitivityanalysiswasconductedto assess therobustnessofthemodelresultsovertheuncertaintyofkey parameters. Results: In thebase-caseanalysis,theICERofthe tocilizumab-containingregimenwasUS$60,800perquality-adjusted life-year ascomparedtotheinfliximab-containingregimen.In the sensitivityanalysis,changesinthepriceofthedrugsby generic substitution,inutilityscores,andindiscountratedidnot change ouroverallconclusions.Amongallinputstotheprimary study andthesensitivityanalyses,however,thepriceoftocili- zumab hadthemostimpactontheICER. Conclusions: Although tocilizumab andmethotrexateprovidealargergaininquality- adjusted life-years,theircurrentpriceisquitehighascomparedwith those ofourotherinterventions.Therefore,aregimencontaining tocilizumab isnotcost-effectiveascomparedwithaninfliximab- containingregimenforpatientswithrheumatoidarthritisinIran. Keywords: cost-effectiveness,infliximab, Iran,rheumatoidarthritis, tocilizumab. سال انتشار: 2015
 

Photoclinic Figure 1. Abdominal CT scan showing ascites (asterisk) and target sign (arrow) Figure 2. Abdominal CT scan showing comb sign (arrow)

Authers: Sara Sagharnia MD1, Farideh Darabi MD1, Ahmadreza Jamshidi MD•

Abstract: A 17-year-old woman with 2 weeks history of generalized crampy abdominal pain, progressive nausea/vomiting, and loose stools was admitted to the emergency department. She was a known case of systemic lupus erythematosus (SLE) with a history of associated mucocutaneous symptoms (Malar rash), nephritis (proteinuria 600 mg/24 h which wasn’t biopsied), arthritis and positive serology (positive ANA and Anti ds –DNA, with titer 2 سال انتشار: 2016
 

Cost-EffectivenessAnalysisofTocilizumabinComparisonwith Infliximab inIranianRheumatoidArthritisPatientswith Inadequate ResponsetotDMARDs:AMultistageMarkovModel

Authers: Amir Hashemi-Meshkini, PharmD1, ShekoufehNikfar, PharmD, PhD1, ElizabethGlaser, MS, MA2, Ahmadreza Jamshidi, MD3, SeyedAlirezaHosseini, PharmD, PhD1, 4, *

Abstract: To analyzethecost-effectivenessoftwocommontreat- ment strategiesinIran,comparinginfliximab plusmethotrexatewith tocilizumab plusmethotrexateinpatientswithrheumatoidarthritis with inadequateresponsetotraditionaldisease-modifyinganti- rheumatic drugs. Methods: A multistageMarkovdecisionmodel was appliedtoassesstheincrementalcost-effectivenessratio(ICER) of atocilizumab-containingregimenversusaninfliximab-containing regimen overa5-yeartimeperiod.Inthecaseofnoresponse,we assumed thatpatientsswitchedtothenexttreatment(adalimumab, rituximab, orsupportivecare)insequenceforeachstrategy.We consideredmajorcostitems,suchasdirectmedicalcostsanddirect nonmedical costs,fromapayer(patientsandthird-partypayers) perspective.Adeterministicsensitivityanalysiswasconductedto assess therobustnessofthemodelresultsovertheuncertaintyofkey parameters. Results: In thebase-caseanalysis,theICERofthe tocilizumab-containingregimenwasUS$60,800perquality-adjusted life-year ascomparedtotheinfliximab-containingregimen.In the sensitivityanalysis,changesinthepriceofthedrugsby generic substitution,inutilityscores,andindiscountratedidnot change ouroverallconclusions.Amongallinputstotheprimary study andthesensitivityanalyses,however,thepriceoftocili- zumab hadthemostimpactontheICER. Conclusions: Although tocilizumab andmethotrexateprovidealargergaininquality- adjusted life-years,theircurrentpriceisquitehighascomparedwith those ofourotherinterventions.Therefore,aregimencontaining tocilizumab isnotcost-effectiveascomparedwithaninfliximab- containingregimenforpatientswithrheumatoidarthritisinIran. Keywords: cost-effectiveness,infliximab, Iran,rheumatoidarthritis, tocilizumab. Copyright & 2015, سال انتشار: 2016
 

Causes of Blindness in Ocular Behçet’s Disease Comparing the End-Blinding Results in Two Genders

Authers: Hormoz Chams, MD1 • Hassan Behboudi, MD2 • Fariba Ghassemi, MD3 Fereydoun Davatchi, MD4 • Farhad Shahram, MD4 • Sheyda Chams-Davatchi, MD5

Abstract: To investigate and compare the causes of blindness in ocular Behçet’s disease (BD) in men and women Methods: In a retrospective, descriptive investigation from 1976 to 2008, 6,021 BD cases were registered in our BD Unit of Shariati Hospital of Tehran University of Medical Sciences (TUMS). At the last visit, 187 patients (124 men and 63 women) were blind (vision=1/10 or less) at least in one eye and with at least ... سال انتشار: 2012
 

Plasma Homocysteine Level in Patients with Behcet’s Disease with or without Thrombosis

Authers: Farhad Shahram MD, Alireza Faridar MD1, Mohammad Ghaffari Hamedani MD, Abdolhadi Nadji MD1, Nassim Naderi MD, Niloofar Mojarad Shaee BS, Johannes J. Rasker MD, Fereydoun Davatchi MD

Abstract: Aim: To nd the possible role of plasma homocysteine level as a contributing factor in venous and arterial thrombosis in patients with Behcet’s disease (BD). Methods: In a case control study, two groups of BD patients were included: 47 with thrombosis and 49 without thrombosis. All patients fullled the International Study Group Criteria for BD and the conrming diagnostic procedures for vascular thrombosis were either Doppler sonography or angiography. Forty-nine controls were selected by ... سال انتشار: 2010
 

Risk Factors of Blindness in Behcet’s Disease

Authers: Hormoz Chams, MD1, Fereydoun Davatchi, Amir Hossein Mahmoudi, Farhad Shahram, Cheyda Chams, Saeideh Dahaghein

Abstract: Purpose: To investigate long-term ocular manifestations of ocular Behcet’s disease (BD), and the causes for blindness Methods: In August 2008, at Shariati hospital of Tehran (Behcet unit) all files of the ocular BD patients from 1976 to 2008 who were legally blind (Visual acuity=20/200 or less) at least in one eye at the last visit and had at least three years of follow-up were reviewed and the desired informations were extracted. ... سال انتشار: 2010