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
 

The Comparison of Serum Zinc Level in Behcet Patients and Healthy Controls

Authers: Kamal Esalatmanesh MD, Ahmadreza Jamshidi MD, Farhad Shahram MD, Fereydoun Davatchi MD, Zahra Soleimani MD, Shohreh Movahedi MD*****, , Mansour Salesi MD, Mansoor Karimifar MD

Abstract: Zinc was suggested as an antioxidant and immunomodulator trace element in parallel with other trace elements and antioxidant enzymes. Recently selenium deficiency was indicated in Behcet disease. In this study, we evaluated the correlation of serum zinc level and Behcet disease. Background: In a cross-sectional, descriptive study serum level of zinc was measured in 49 cases satisfying International Study Group criteria and 51 controls. Serum zinc level was measured by atomic absorption spectrometry and compared the mean of serum ... سال انتشار: 2009