For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
1
views
27
references
 Top references
cited by
2
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      298
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Utilization of Mycophenolic Acid, Azathioprine, Tacrolimus, Cyclosporin, Sirolimus, and Everolimus: Multinational Study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Organ transplantations are difficult, complicated and very expensive interventions. In order to preserve the transplanted organs, it is necessary to provide medical care to the patients in terms of immunosuppression. According to the guidelines, the first-line therapy choices for achieving immunosuppression after transplantation are tacrolimus, cyclosporine, mycophenolic acid, azathioprine, sirolimus, everolimus„ and corticosteroids. The aim of our study was to examine the utilization of this drugs in Montenegro and to compare the results with the ones from Finland, Croatia, and Serbia.

          Methods: In our investigation we used Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Prices per DDD of drugs are presented in euros (€).

          Results: In all observed countries, there is a positive trend in the consumption of all 6 drugs during the analyzed period. The prices per DDD of these drugs generally show a negative trend. Tacrolimus and mycophenolic acid in Montenegro recorded the largest reduction in the price per DDD. Price per one DDD of tacrolimus decreased from €13.28 in 2009 to €5.11 in 2019, thus by about 260%, and as regards mycophenolic acid, the price per one DDD decreased from €9.59 in 2009 to € 3.36 in 2019, thus by almost 300%.

          Conclusion: Despite the reduction in the price per DDD, drugs that are used as immunosuppressants are showing increasing costs from year to year. Since these drugs are expensive, they participate in a significant percentage in the budget for medicines in each country.

          Related collections

          Most cited references27

          • Record: found
          • Abstract: found
          • Article: not found

          KDIGO clinical practice guideline for the care of kidney transplant recipients.

          (2009)
          The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the monitoring, management, and treatment of kidney transplant recipients is intended to assist the practitioner caring for adults and children after kidney transplantation. The guideline development process followed an evidence-based approach, and management recommendations are based on systematic reviews of relevant treatment trials. Critical appraisal of the quality of the evidence and the strength of recommendations followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach. The guideline makes recommendations for immunosuppression, graft monitoring, as well as prevention and treatment of infection, cardiovascular disease, malignancy, and other complications that are common in kidney transplant recipients, including hematological and bone disorders. Limitations of the evidence, especially on the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.
          Article 0 comments Cited 456 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Improved graft survival after renal transplantation in the United States, 1988 to 1996.

            Kevin C. Johnson, B Bresnahan, D Stablein … (2000)
            The introduction of cyclosporine has resulted in improvement in the short-term outcome of renal transplantation, but its effect on the long-term survival of kidney transplants is not known. We analyzed the influence of demographic characteristics (age, sex, and race), transplant-related variables (living or cadaveric donor, panel-reactive antibody titer, extent of HLA matching, and cold-ischemia time), and post-transplantation variables (presence or absence of acute rejection, delayed graft function, and therapy with mycophenolate mofetil and tacrolimus) on graft survival for all 93,934 renal transplantations performed in the United States between 1988 and 1996. A regression analysis adjusted for these variables was used to estimate the risk of graft failure within the first year and more than one year after transplantation. From 1988 to 1996, the one-year survival rate for grafts from living donors increased from 88.8 to 93.9 percent, and the rate for cadaveric grafts increased from 75.7 to 87.7 percent. The half-life for grafts from living donors increased steadily from 12.7 to 21.6 years, and that for cadaveric grafts increased from 7.9 to 13.8 years. After censoring of data for patients who died with functioning grafts, the half-life for grafts from living donors increased from 16.9 years to 35.9 years, and that for cadaveric grafts increased from 11.0 years to 19.5 years. The average yearly reduction in the relative hazard of graft failure after one year was 4.2 percent for all recipients (P<0.001), 0.4 percent for those who had acute rejection (P=0.57), and 6.3 percent for those who did not have acute rejection (P<0.001). Since 1988, there has been a substantial increase in short-term and long-term survival of kidney grafts from both living and cadaveric donors.
            Article 0 comments Cited 65 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Everolimus and sirolimus in transplantation-related but different.

              Jost Klawitter, Björn Nashan, Uwe Christians (2015)
              The inhibitors of the mammalian target of rapamycin (mTOR) sirolimus and everolimus are used not only as immunosuppressants after organ transplantation in combination with calcineurin inhibitors (CNIs) but also as proliferation signal inhibitors coated on drug-eluting stents and in cancer therapy. Notwithstanding their related chemical structures, both have distinct pharmacokinetic, pharmacodynamic and toxicodynamic properties.
              Article 0 comments Cited 44 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 31 March 2021
                Publication date Collection: 2021
                Volume: 9
                Electronic Location Identifier: 671316
                Affiliations
                [1] 1Department for Pharmacology, Faculty of Medicine, University of Montenegro , Podgorica, Montenegro
                [2] 2Institute for Medicines and Medical Devices of Montenegro , Podgorica, Montenegro
                [3] 3Center for Clinical Pharmacology, Military Medical Academy , Belgrade, Serbia
                [4] 4Faculty of Medicine of the Military Medical Academy, University of Defence , Belgrade, Serbia
                Author notes

                Edited by: Mirjana Ratko Jovanovic, University of Kragujevac, Serbia

                Reviewed by: Lana Nezic, University of Banja Luka, Bosnia and Herzegovina; Boris Milijašević, University of Novi Sad, Serbia

                *Correspondence: Snezana Mugosa snezana.mugosa@ 123456calims.me

                This article was submitted to Health Economics, a section of the journal Frontiers in Public Health

                Article
                DOI: 10.3389/fpubh.2021.671316
                PMC ID: 8044364
                SO-VID: 2876ac53-6c03-4239-945b-58ca52e7fb62
                Copyright © Copyright © 2021 Sahman, Mugosa and Rancic.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 23 February 2021
                Date accepted : 08 March 2021
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 38, Pages: 7, Words: 5205
                Categories
                Subject: Public Health
                Subject: Original Research

                Keywords: immunosuppressive agents,organ transplantation,pharmacoepidemiology,pharmacoeconomics,tacrolimus
                Data availability:
                Keywords: immunosuppressive agents, organ transplantation, pharmacoepidemiology, pharmacoeconomics, tacrolimus

                Comments

                Comment on this article

                scite_

                Similar content298

                See all similar

                Cited by2

                See all cited by

                Most referenced authors271

                See all reference authors