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Recommendations for the effective use of T-cell-redirecting therapies: a Canadian consensus statement.

BackgroundT-cell-redirecting therapies, such as bispecific antibodies and chimeric antigen receptor T-cells, exploit the cytotoxic capabilities of the immune system to destroy cells expressing specific surface antigens, including malignant cells. These therapies have demonstrated unprecedented rates, depth, and duration of responses in relapsed and refractory multiple myeloma. However, there are significant challenges in implementing these therapies into practice, which require multidisciplinary and multicenter coordination and significant healthcare resources to effectively manage these patie

Disparities in care of older adults of color with cancer: A narrative review.

This review describes the barriers and challenges faced by older adults of color with cancer and highlights methods to improve their overall care. In the next decade, cancer incidence rates are expected to increase in the United States for people aged ≥65 years. A large proportion will be older adults of color who often have worse outcomes than older White patients. Many issues contribute to racial disparities in older adults, including biological factors and social determinants of health (SDOH) related to healthcare access, socioeconomic concerns, systemic racism, mistrust, and the neighborho

The PRO-CAR-T™ study: achieving excellence in patient and public involvement and engagement.

BackgroundPatient and Public Involvement and Engagement (PPIE) is advocated in Patient Reported Outcome (PRO) research, but implementation remains inconsistent and often suboptimal. Many barriers exist, including a lack of understanding about how to apply the principles of PPIE in practice. This paper offers an example of how PPIE can be meaningfully integrated into the development of a digital PRO system within the complex and rapidly evolving field of advanced therapies. The aims are to offer practical insights about how PPIE was conceptualised and operationalised in the context of this stud

Opportunities for Savings in Risk Arrangements for Oncologic Care.

ImportanceAs the US accelerates adoption of alternative payment through global payment models such as Accountable Care Organizations (ACOs) or Medicare Advantage (MA), high spending for cancer care is a potential target for savings.ObjectiveTo quantify the extent to which ACOs and other risk-bearing organizations operating in a specific geographic area (hospital referral region [HRR]) could achieve savings by steering patients to efficient medical oncology practices.Design, setting, and participantsThis observational study included serial cross-sections of Medicare beneficiaries with cancer fr

Light Chain Amyloidosis: Patient Experience Survey from the Amyloidosis Research Consortium.

IntroductionInformation detailing the experience of patients with light chain (AL) amyloidosis is lacking. The primary aim of this study was to gather data on the patient experience to understand the challenges in diagnosis and to gain insight into barriers to accessing appropriate care.MethodsPatients with amyloidosis, family members, and caregivers were invited to participate in an online 16-question survey (available from January 29 to February 5, 2015). Participants with AL amyloidosis were sent an eight-question follow-up survey.ResultsThe initial survey was completed by 533 participants

Financial challenges of being on long-term, high-cost medications.

The isocitrate dehydrogenase (IDH) inhibitor, vorasidenib, may offer a promising new treatment option for patients with IDH-mutant gliomas. However, the indefinite nature of this targeted therapy raises significant financial concerns. High costs of targeted cancer therapies, often exceeding $150 000 annually, contribute to financial toxicity, characterized by medical debt, income loss, and psychological stress, and place stress on health systems. This review analyzes the drug approval and pricing mechanisms in various countries and their impact on healthcare costs and patient access, focusing

Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update.

BACKGROUND: In Canada, more than 2 million people live with osteoporosis, a disease that increases the risk for fractures, which result in excess mortality and morbidity, decreased quality of life and loss of autonomy. This guideline update is intended to assist Canadian health care professionals in the delivery of care to optimize skeletal health and prevent fractures in postmenopausal females and in males aged 50 years and older. METHODS: This guideline is an update of the 2010 Osteoporosis Canada clinical practice guideline on the diagnosis and management of osteoporosis in Canada. We foll

Seamless Navigation of Bispecific Therapies: Optimizing Management and Outpatient Access With a Focus on Coordination.

Bispecific antibodies (BsAbs) have emerged as crucial therapeutic agents for patients with relapsed/refractory diffuse large B-cell lymphoma, multiple myeloma, and most recently, lung cancer. These therapies have demonstrated remarkable efficacy in clinical trials; however, multidisciplinary collaboration is essential to ensure optimal patient outcomes amid the operational complexities associated with BsAb therapy. As BsAbs are being prepared for broader adoption, clinicians and treatment centers must navigate operational challenges, including financial considerations, patient selection, careg

Updated analysis of CALGB (Alliance) 100104 assessing lenalidomide versus placebo maintenance after single autologous stem-cell transplantation for multiple myeloma: a randomised, double-blind, phase 3 trial.

BackgroundIn the CALGB (Alliance) 100104 study, lenalidomide versus placebo after autologous stem-cell transplantation (ASCT) was investigated for patients with newly diagnosed myeloma. That study showed improved time to progression and overall survival and an increase in second primary malignancies for lenalidomide at a median follow-up of 34 months. Here we report an updated intention-to-treat analysis of CALGB (Alliance) 100104 at a median follow-up of 91 months.MethodsPatients were eligible for this randomised, double-blind, placebo-controlled, phase 3 trial if they had symptomatic disease

Программа оказания помощи пациентам, страдающим множественным склерозом, позволяет повысить уровень знаний и расширить права и возможности людей: предварительное, послеиспытательное многоцентральное исследование.

ЦЕЛЬ: Множественный склероз (МС) связан со сложными потребностями и потребностями, которые требуют ухода с учетом интересов пациентов. Программы для пациентов-экспертов (ЭО) способствуют передаче знаний посредством взаимного обучения, способствуя расширению возможностей пациентов в плане самостоятельного лечения своих заболеваний. На основе предыдущего исследования целевой группы мы разработали программу ЕР для НР, координируемую профессионалами-медиками, для осуществления в различных справочных единицах НР Каталонии (Южная Западная Европа). Цель этого исследования состояла в том, чтобы органи

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. METHODS: We estimated incid

Shortage of plasma-derived medicinal products: what is next? narrative literature review on its causes and counteracting policies in Italy.

Introduction: This paper describes the peculiarities of the plasma-derived medicinal product (PDMP) market and illustrates the results of a review of the literature on policies aimed at counteracting the shortage of PDMPs. Characteristics of PDMPs: Plasma is primarily used for the industrial production of blood products (80%). The demand for PDMPs, particularly immunoglobulins (IGs), is increasing. However, the production of PDMPs is complex, long (7-12 months), and expensive, accounting, according to US estimates, for 57% of the total costs of PDMPs compared to 14% for small molecules. PDMP m

APPLY: A prospective observational study of clinical practice patterns of darbepoetin alfa use in patients with chemotherapy-induced anemia in Romania.

PurposeThe primary objective of this study was to evaluate the compliance of Romanian physicians with the national therapeutic protocol and international guidelines on treatment with erythropoiesis-stimulating agents in anemic cancer patients receiving chemotherapy. The secondary objective was to assess the hemoglobin (Hb) level change due to anemia treatment and safety of darbepoetin alfa.MethodsThis was a single-arm, prospective, longitudinal, multicenter, observational study in patients with nonmyeloid malignancies and symptomatic chemotherapy-induced anemia treated concomitantly with darbe

Patient Perceptions of CAR-T Therapy in the USA: Findings from In-Depth Interviews.

INTRODUCTION: Chimeric antigen receptor-T cell (CAR-T) therapy has revolutionized advanced blood cancer treatment. However, preparation, administration, and recovery from these therapies can be complex and burdensome to patients and their care partners. Utilization of an outpatient setting for CAR-T therapy administration could help improve convenience and quality of life. METHODS: In-depth qualitative interviews were conducted with 18 patients in the USA with relapsed/refractory multiple myeloma or relapsed/refractory diffuse large B-cell lymphoma, 10 of whom had completed investigational or

Prevalence and incidence of multiple sclerosis in healthcare district IV of Asturias, Spain.

BACKGROUND: Multiple sclerosis is an inflammatory demyelinating autoimmune disease of the central nervous system. Studies conducted in recent years point to an increase in its prevalence and a change in the age profile of patients. This study aims to analyse the prevalence and incidence of multiple sclerosis in healthcare district IV of the region of Asturias, in north-western Spain. METHODS: We conducted a retrospective epidemiological study of the population of said healthcare district with a diagnosis of multiple sclerosis according to the 2017 McDonald criteria. The prevalence of the dise

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Показатели качества консенсуса для мониторинга множественного склероза.

Множественный склероз (МС) как хроническое, дегенеративное аутоиммунное заболевание центральной нервной системы имеет продольный и разнородный курс с увеличением вариантов лечения и профилей рисков, требующих постоянного мониторинга растущего числа параметров. Несмотря на руководящие принципы лечения, отсутствуют стратегические и индивидуализированные пути мониторинга, включая соответствующие показатели качества (КИ). Для решения этой проблемы мы систематически разрабатывали транспарентные, отслеживаемые и измеримые КИ для мониторинга НР. С помощью обзора литературы, дискуссий экспертов и форм

A prospective, multicenter, observational study of ixazomib plus lenalidomide-dexamethasone in patients with relapsed/refractory multiple myeloma in Japan.

Real-world studies permit inclusion of a more diverse patient population and provide more information on the effectiveness of treatments used in routine clinical practice. This prospective, multicenter, observational study investigated the effectiveness and safety of ixazomib plus lenalidomide and dexamethasone (IRd) in 295 patients with relapsed/refractory multiple myeloma (RRMM) in routine clinical practice in Japan. Patients had a median age of 74 years, 80.0% were aged ≥ 65 years, 42.0% had received ≥ 3 lines of prior treatment, and 28.5% were "frail" according to the International Myeloma

Эффективность когнитивной реабилитации в когнитивных и мозговых сетях: случайные клинические испытания у пациентов с множественным склерозом.

В этом исследовании была дана оценка эффективности компьютеризованной гуттманнской, нейроперсональной (GNPT) когнитивной реабилитации (CR) и были отмечены изменения, вызванные церебральными сетями у пациентов с множественным склерозом (MS). Это многоцентральное, двойное слепление, случайные клинические испытания по сравнению с повышением интенсивности (активное лечение) и низкой интенсивностью статического обучения (статическое лечение). Когниция оценивалась с использованием краткой повторяемой аккумуляторной батареи до и после 12 недель тренировки и через 10 месяцев, и пациенты были классифиц

Resource Use and Care Quality Differences Among Medicare Beneficiaries Undergoing Chemotherapy.

ImportanceMedicare Advantage (MA) has grown significantly over the last decade; however, MA's performance for patients with serious conditions, such as cancer, remains unclear.ObjectiveTo compare resource use and care quality between MA and traditional Medicare (TM) beneficiaries undergoing cancer chemotherapy.Design, setting, and participantsThis cohort study used TM claims and MA encounter records from January 2015 to December 2019. Participants were MA and TM beneficiaries who initiated cancer chemotherapy between January 2016 and December 2019. Inverse probability of treatment weighting ba

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… Diabetes care among older adults enrolled in Medicare Advantage versus traditional Medicare fee-for-service plans: the Diabetes Collaborative Registry . …