1.A Program for Optimizing Product Combination of Injectable Drugs
Yasuyuki TAKASHIMA ; Yasuyuki BABA ; Masato HOMMA ; Kunihiro OHNO ; Isao NAGASAWA ; Yukinao KOHDA
Japanese Journal of Pharmacoepidemiology 2003;8(2):61-66
Objective : Injectable drugs usually include several products of different dosage and price. It is, therefore, difficult for pharmacists and medical staff to select the optimal combination of the products, which provides product selection and sufficient drug amounts prescribed while minimizing the price. We developed a support program for optimizing by using a processing software, NaU DSP®.
Methods : Our program has a simple function to calculate and find the optimal combinations among the potential alternatives. We applied this program to analyze RANDA®, a cisplatin preparation, which has three products containing 10mg, 25mg and 50mg at a price of ¥4, 555, ¥11, 000 and ¥19, 860, respectively. Seven hundred forty-two prescriptions including RANDA® were investigated.
Results : In seventy-eight prescriptions (11%), there was a reduction in the total price of the product combinations between the selection aided with and without the program.
Conclusion : By using the optimization program, pharmaceutical costs can be curtailed more effectively than by arbitrary selection by medical staff.
2.Effects of a fertility-sparing re-treatment for recurrent atypical endometrial hyperplasia and endometrial cancer: a systematic literature review
Isao MURAKAMI ; Hiroko MACHIDA ; Tohru MORISADA ; Yasuhisa TERAO ; Tsutomu TABATA ; Mikio MIKAMI ; Yasuyuki HIRASHIMA ; Yoichi KOBAYASHI ; Tsukasa BABA ; Satoru NAGASE
Journal of Gynecologic Oncology 2023;34(4):e49-
Objective:
To examine the effectiveness of progestin re-treatment for recurrent endometrial intraepithelial neoplasia (EIN), atypical endometrial hyperplasia (AH) and endometrial cancer (EC) following initial fertility-sparing treatment.
Methods:
A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Endometrial Cancer Committee. Multiple search engines, including PubMed/MEDLINE and the Cochrane Database, were searched in December 2021 using the keywords “Endometrial neoplasms,” “Endometrial hyperplasia,” “Endometrial intraepithelial neoplasia,” “Fertility preservation,” “Progestins,” AND “Recurrence.” Cases describing progestin re-treatment for recurrent EIN, AH and EC were compared with cases that underwent conventional hysterectomy. The primary outcomes were survival and disease recurrence, and the secondary outcome was pregnancy.
Results:
After screening 238 studies, 32 with results for recurrent treatment were identified. These studies included 365 patients (270 received progestin re-treatment and 95 underwent hysterectomy). Most progestin re-treatment involved medroxyprogesterone acetate or megestrol acetate (94.5%). Complete remission (CR) following progestin re-treatment was achieved in 219 (81.1%) cases, with 3-, 6- and 9-month cumulative CR rates of 22.8%, 51.7% and 82.6%, respectively. Progestin re-treatment was associated with higher risk of disease recurrence than conventional hysterectomy was (odds ratio [OR]=6.78; 95% confidence interval [CI]=1.99–23.10), and one patient (0.4%) died of disease. Fifty-one (14.0%) women became pregnant after recurrence, and progestin re-treatment demonstrated a possibility of pregnancy (OR=2.48; 95% CI=0.94–6.58).
Conclusion
This meta-analysis suggests that repeat progestin therapy is an effective option for women with recurrent EIN, AH and EC, who wish to retain their fertility.
3.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
4.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
5.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.