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      El farmacéutico en el contexto de las enfermedades raras y los medicamentos huérfanos Translated title: The pharmacist, rare diseases and orphan medicines

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          Abstract

          El tratamiento de las enfermedades raras muchas veces resulta complicado debido a las dificultades que plantean la investigación y desarrollo de medicamentos huérfanos por parte de la industria farmacéutica. Una de las mayores preocupaciones de este grupo de pacientes tan escaso y diverso al mismo tiempo, es el acceso a los fármacos disponibles. La Agencia Europea del Medicamento establece la denominación de medicamentos huérfanos y los incentivos y bases necesarias para su comercialización. La mayoría de los medicamentos huérfanos por sus especiales características, exigen una adecuada vigilancia y control. Los servicios de farmacia hospitalarios están activamente implicados en su gestión y dispensación, así como en un correcto seguimiento farmacoterapéutico de los pacientes.

          Translated abstract

          Treatment of rare diseases is often complicated due to the difficulties posed by the research and development of medicines by the pharmacological industry. One of the greatest concerns of this group of patients, which is both scarce and diverse, is access to available medicines. The European Medicine Agency establishes the term orphan medicines and the incentives and bases for their commercialisation. Due to their special characteristics, the majority of orphan medicines require suitable vigilance and control. The hospital pharmacy services are actively involved in their management and supply, as well as in a correct pharmacotherapeutic monitoring of the patients.

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          Most cited references21

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          Neurological effects of high-dose idebenone in patients with Friedreich's ataxia: a randomised, placebo-controlled trial.

          Friedreich's ataxia (FA) is a progressive, multisystem, degenerative disorder caused by a reduction in frataxin. Loss of frataxin results in mitochondrial dysfunction and oxidative damage in patients and model systems. Previous studies have indicated that the antioxidant idebenone (5 mg/kg daily) reduces cardiac hypertrophy, but definite improvement in neurological function has not been shown. 48 genetically confirmed FA patients, aged 9-17 years, were enrolled in a 6-month, randomised, double-blind, placebo-controlled study. The patients received placebo or one of three doses of idebenone (approximately 5 mg/kg, 15 mg/kg, and 45 mg/kg), stratified by body weight. The primary endpoint was change from baseline in urinary 8-hydroxy-2'-deoxyguanosine (8OH2'dG), a marker of oxidative DNA damage. Secondary endpoints included changes in the international cooperative ataxia rating scale (ICARS), the FA rating scale (FARS), and a survey of activities of daily living (ADL). This study is registered with ClinicalTrials.gov, number NCT00229632. Idebenone was generally well tolerated with similar numbers of adverse events in each group. One child receiving high-dose idebenone developed neutropenia after 6 months, which resolved after discontinuation of treatment. 8OH2'dG concentrations were not increased, and did not significantly change with idebenone treatment. Whereas an overall analysis did not show a significant difference in ICARS, FARS, or ADL total scores, there were indications of a dose-dependent response in the ICARS score. A second, pre-specified analysis, excluding patients who required wheelchair assistance, showed a significant improvement in ICARS (Bonferroni p=0.03) and suggested a dose-related response in ICARS, FARS, and ADL scores. Treatment with higher doses of idebenone was generally well tolerated and associated with improvement in neurological function and ADL in patients with FA. The degree of improvement correlated with the dose of idebenone, suggesting that higher doses may be necessary to have a beneficial effect on neurological function.
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            Ley 29/2006, de 26 de julio, de garantías y uso racional de los medicamentos y productos sanitarios

            (2006)
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              Real Decreto 1345/2007, de 11 de octubre de 2007, por el que se regula el procedimiento de autorización, registro y condiciones de dispensación de los medicamentos de uso humano fabricados industrialmente

              (2007)

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                2008
                : 31
                : suppl 2
                : 127-143
                Affiliations
                [01] Pamplona orgnameHospital Virgen del Camino de Pamplona orgdiv1Servicio de Farmacia
                Article
                S1137-66272008000400009
                10.4321/s1137-66272008000400009
                5322fde2-7980-469c-8e59-09687eab7312

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 17
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                SciELO Spain


                Medicamentos huérfanos,Enfermedades raras,Gestión,Atención farmacéutica,Orphan medicines,Rare diseases,Management,Pharmaceutical care

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