Inappropriate polypharmacy is common in older patients with co-morbidities, and prescription streamlining can help to ensure the safety of medications for older patients with co-morbidities.In 2023, The Alliance of European Geriatrics Societies(AEGS)summarized the literature on medication review and prescription streamlining to propose 33 recommendations for optimizing polypharmacy and prescription streamlining in older patients with co-morbidities.The strategy suggests incorporating prescription streamlining into the daily practice of geriatricians and clinical pharmacists, and provides recommendations about education and training of clinical staff, development of disease guidelines, policy support, and clinical trial research in older adults aiming to improve the management of polypharmacy.This article explains the key elements of this strategy to provide reference for high-quality healthcare for elderly patients with co-morbid in China.

Inappropriate polypharmacy is common in older patients with co-morbidities, and prescription streamlining can help to ensure the safety of medications for older patients with co-morbidities.In 2023, The Alliance of European Geriatrics Societies(AEGS)summarized the literature on medication review and prescription streamlining to propose 33 recommendations for optimizing polypharmacy and prescription streamlining in older patients with co-morbidities.The strategy suggests incorporating prescription streamlining into the daily practice of geriatricians and clinical pharmacists, and provides recommendations about education and training of clinical staff, development of disease guidelines, policy support, and clinical trial research in older adults aiming to improve the management of polypharmacy.This article explains the key elements of this strategy to provide reference for high-quality healthcare for elderly patients with co-morbid in China.

Objective To evaluate the efficacy,safety and economy of efgartigimod alfa in the treatment of generalized myasthenia gravis by rapid health technology assessment,and to provide evidence-based evidence for clinical rational drug use.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,VIP,WanFang Data,SinoMed database and relevant databases of health technology assessment institutions were electronically searched to collect health technology assessment reports,systematic reviews/Meta-analysis and pharmacoeconomic literatures of efgartigimod alfa for the treatment of generalized myasthenia gravis from the inception to June 21,2024.Two researchers screened the literature,extracted data,and evaluated the quality of the literature,summarised the finding and performed qualitative descriptive analysis.Results A total of 6 literature were included,involving 5 systematic reviews/Meta-analysis and one pharmacoeconomic study.In terms of efficacy,efgartigimod alfa demonstrated a significant reduction in MG-ADL,QMGs,and MG-QOLs 15R compared to placebo among generalized myasthenia gravis patients,these differences were statistically significant(P＜0.05).However,findings from different studies regarding comparisons with other biologics like batoclimab,ronzanolixizumab,and eculizumab yielded inconsistent conclusions.In terms of safety,the incidence of adverse events in adults generalized myasthenia gravis patients treated with efgartigimod alfa compared with that of the placebo was not statistically significant(P＞0.05).However,compared with other biological agents,the conclusions drawn from each study were inconsistent.In terms of economics,efgartigimod alfa did not exhibit cost-effectiveness advantages over traditional therapies.Conclusion Efgartigimod alpha showed better efficacy than placebo in the treatment of generalized myasthenia gravis,but there was no definitive conclusion compared with other biological agents.In terms of safety,the incidence of ADE in adult generalized myasthenia gravis patients treated with efgartigimod alpha was not statistically different from that of the placebo group,and no definite conclusion could be drawn when compared with other biological agents.According to U.S.drug economic data,efgartigimod alpha does not have economic advantages over traditional therapies.