1.Application of immunotherapy in relapsed/refractory B-cell acute lymphoblastic leukemia
Qihui CHU ; Tong GAO ; Suxin QU ; Meixing YAN
China Pharmacy 2024;35(7):886-889
Immunotherapy, as an emerging treatment method, has been proven to improve the prognosis of patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) and has good application prospects. Immunotherapy, including chimeric antigen receptor T cell immunotherapy (CAR-T) and monoclonal antibodies, has shown great potential for application, and has been approved for marketing. This article summarizes the application of the above two therapies in the treatment of relapsed/ refractory B-ALL, and concludes that CAR-T is a kind of personalized immunotherapy, and the selection of ideal targets is an important part of its action. Currently, the ideal targets in clinical studies include CD19, CD22 and CD19/CD22. Monoclonal antibodies, including blinatumomab and inotuzumab ozogamicin, have shown superior therapeutic efficacy for relapsed/refractory B- ALL. Immunotherapy has shown superior therapeutic effects compared to conventional chemotherapy, expanding the selection of treatment options for relapsed/refractory B-ALL.
2.Construction of standardized training system for medication direction provided by pediatric pharmacists
Canhui CHEN ; Meixing YAN ; Shujuan SUN ; Xiaoling WANG ; Suxin QU
China Pharmacy 2022;33(24):3053-3058
OBJECTIVE To explore the establishment of standardized training system for medication direction provided by pediatric pharmacists. METHODS Based on the questionnaire, the current needs of pediatric pharmacists and parents of children for medication direction were investigated, and the standardized training content of pediatric medication direction was constructed as a whole with reference to the survey results, instructions, databases and other literature. The basic knowledge of medication direction was integrated and summarized from the basic information of drugs such as drug name, usage and dosage, as well as the course of treatment, order of medication and special precautions, so as to form the general introduction of training content. In accordance with the principle of “integrated drug classification based on diseases”, a standardized framework of medication direction for various common diseases in children was constructed to form various theories of training content. Concomitantly, the pilot training of pharmacists in Qingdao Women and Children’s Hospital of Qingdao University was carried out, and the training effect was preliminarily evaluated. RESULTS After standardized training, the daily examination scores of pharmacists in this hospital were significantly higher than those before training, and the situation of ‘0’ times of receiving patients’ thank-you letters in the window service was broken through; the effective satisfaction rate of window service showed an increasing trend; after the pharmacist explained the medication to the patient, the times of patient returning to consult the doctor on how to use the medicine showed downward trend. CONCLUSIONS The establishment and implementation of a systematic standardized training system for pediatric-specialist pharmacists can help to further improve the professional skills and professionalism of pharmacists, strengthen the standardization of window medication direction and enhance patients’ sense of gain.
3.Indirect meta-analysis of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis
Jia WANG ; Shuyue LI ; Suxin QU ; Hao WANG ; Weihong GE
China Pharmacy 2022;33(23):2901-2907
OBJECTIVE To systematically evaluate the clinical efficacy and safety of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. METHODS Randomised controlled trials on pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis which were publicly published in Chinese and English were searched from CNKI, Wanfang, VIP, PubMed, Cochrane library and other databases. The search time was set from January 2000 to December 2021. The existing studies were combined with indirect meta-analysis to systematically evaluate the efficacy and safety of the two drugs in the treatment of idiopathic pulmonary fibrosis. RESULTS A total of 15 randomized controlled trials were included, involving 1 026 cases in trial group of pirfenidone and 845 cases in control group of pirfenidone, 1 846 cases in trial group of nintedanib and 1 848 cases in control group of nintedanib. Both control groups were placebo. The results of indirect meta-analysis showed that the two drugs were similar in the evaluation indicators of therapeutic efficacy as acute exacerbation rate, the incidence of forced vital capacity (FVC)% decrease ≥10% from baseline or the incidence of absolute value decrease ≥0.2 L (P values of indirect analysis results were all > 0.01, and the difference was not statistically significant); but in terms of disease progression rate, nintedanib 150 mg (bid) was superior to pirfenidone 800 mg (tid) (RR=1.66, 95%CI=1.06-2.63); in terms of safety, the incidence of diarrhea induced by nintedanib 150 mg (bid) was higher than pirfenidone 800 mg (tid) (RR=0.42, 95%CI=0.33-0.53). CONCLUSIONS Compared with pirfenidone, nintedanib has slightly superior efficacy in terms of disease progression control, but the incidence of adverse reactions is also increased.
4.Research about clinical comprehensive evaluation methods of pediatric drugs :taking pediatric anti-allergic drugs as an example
Lu LIU ; Yue XIAO ; Chang LIU ; Suxin QU ; Rong LI ; Baodong YU ; Xiaomei MO ; Kejun LIU ; Meixing YAN
China Pharmacy 2022;33(2):142-145
OBJEC TIVE To provide reference for clinical comprehensive evaluation of pediatric drugs in China. METHODS Taking pediatric anti-allergic drugs as an example ,the clinical comprehensive evaluation methods of pediatric drugs in medical institutions were explored from the aspects of theme selection ,evaluation content and dimension ,evaluation index ,evaluation method and evaluation result report. RESULTS & CONCLUSIONS During the clinical comprehensive evaluation of pediatric drugs,under the guidance of relevant national guidelines for clinical comprehensive evaluation ,the evaluation topics could be selected according to the three principles of importance ,relevance and evaluability ,and then an appropriate evaluation index system could be developed around the six dimensions of safety , effectiveness, economy, suitability,accessibility and innovativeness;qualitative and quantitative data integration analysis of the drugs to be evaluated were performed. In the evaluation , it is necessary to focus on children ’s clinical basic drug use practice and decision-making needs ,normatively,scientifically and reasonably define the core index set and standard data set required by different dimensions of evidence ,standardize the collection and use of real-world data ,and effectively combine other types of evidence to truly play its advantageous role in the clinical comprehensive evaluation of pediatric drugs in China.