BackgroundCanakinumab is a IgG1 anti-interleukin-1β monoclonal antibody indicated in the treatment of Muckle–Wells syndrome (MWS). It is an autosomal dominant congenital disease that is considered a rare disease. Hives, joint pains, conjunctivitis, deafness, amyloidosis and fever are its symptoms. For years, the only available treatments were non-steroidal anti-inflammatory drugs (NSAIDs) and systemic corticoids.PurposeThe objective of this study was to determine the effectiveness of canakinumab in the treatment of MWS in patients who have failed treatment with NSAIDs and systemic corticoids.Material and methodsAn observational retrospective study was carried out in a tertiary care hospital from February 2011 to October 2016. Patients who were treated with canakinumab during this period were selected. The data was obtained from the electronic software used in the hospital (Landtools). Indication, posology, duration of treatment, previous therapy, adverse effects and C reactive protein (CRP) levels were collected from patients’ digital history. Suspension of treatment with canakinumab was also registered. Remission was defined as clinical improvement plus normal CRP (<6 mg/L). Available treatments were NSAIDs and systemic corticoids.Results6 patients were selected; median age 52 years (36–66 years). The indication for treatment with canakinumab was MWS. Patients received canakinumab 150 mg subcutaneously every 8 weeks (n=5) or 12 weeks (n=1) for a median of 47 months (range 24–70). All patients had received corticoids and NSAIDs with no suitable response. Other previous therapies were antihistamines, methotrexate, colchicine, infliximab, etanercept and hydroxychloroquine. Canakinumab was well tolerated; 1 patient experienced an injection site reaction.Treatment with canakinumab caused a significant reduction in clinical disease activity and CRP levels (average before treatment of 40.7 mg/L (3.7–81.2 mg/L) versus average after treatment of 19.27 mg/L (0.45–86.03 mg/L)). 50% (n=3) of canakinumab treated patients achieved remission. All patients are currently receiving treatment.ConclusionCanakinumab is an effective therapeutic alternative for the treatment of MKS if poor effects have been achieved on other therapies. The observed evolution was favourable, being safe and well tolerated.References and/or acknowledgementsOrphanet guide.No conflict of interest

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BackgroundChemotherapy prescriptions validation by the oncology pharmacist often require interventions to optimise some aspects of the treatment, usually related to the safety and effectiveness of antineoplastic agents.PurposeOur pharmacy department has developed an initiative to register these interventions, in order to characterise possible areas of improvement in the prescription validation process.Material and methodsDuring a period of 2 months, we created a database collecting data from the interventions made, which included the following information: date of intervention, medical record number, drug involved, reason/type of intervention and result of the intervention (accepted/not accepted). Sociodemographic, clinical and laboratory data were obtained from medical records. Statistical analysis of the results was performed using Microsoft Excel.Results44 interventions (43 accepted) were recorded. The department in which more interventions were recorded was medical oncology (64%), followed by haematology (29%), paediatrics (4.8%) and radiotherapy oncology (2.4%). Median age of the patients included in the database was 58.5 years (2–87), and 72% of patients were women. The most common reasons for intervention were due to ‘prescribing errors’ (47.7%), ‘pharmacotherapeutic recommendations’ (22.7%), ‘consultations/requests for information’ (15.9%), ‘adverse events’ (6.8%) and some minor reasons grouped into the category ‘others’ (6.8%). The most common types of intervention were ‘dose modification due to an adverse event (AE)’ (34%) and ‘resolution of consultations regarding prescription/medication administration’ (18%). The next types of interventions by frequency were ‘treatment recommendations’ (9.1%) and dose adjustments based on renal function’ (6.81%). Less common intervention types (4.5%) were: ‘changes in prescription’, ‘dose adjustments based on an AE’, ‘dose adjustments based on pharmacotherapeutic recommendations’, ‘changes in route of administration’ and ‘changes in dosing schedule’. Finally, type of interventions such as ‘changes in the regimen of administration’, ‘treatment interruption’ or ‘pharmaceutical compounding’ were reported in 2.3% of cases.ConclusionOncology pharmacist participation in the patient care multidisciplinary team is essential, as is clear from the high rate of acceptance of our interventions. One of the most important aspects of pharmaceutical validation is to identify errors in the prescription and medication administration process, as well as participation in the individualisation of patient therapy through pharmacotherapeutic recommendations, ensuring the effectiveness and safety of the treatment.No conflict of interest.

BackgroundBenzodiazepines (BZD) have to be reconciled within 24 h of admission to avoid withdrawal symptoms. On the other hand, it’s important to check the discharge report to avoid treatment discrepancies.PurposeTo find out the accuracy of BZD reconciliation at admission and discharge in our hospital.Material and methodsObservational prospective study carried out in a tertiary care hospital over two months. Patients over 65 years and without a relevant psychiatric condition were selected. The BZD prescribed at admission was compared with patient’s home treatment. Clinical data was obtained from the electronic clinical history and electronic prescription. The discharge report was also checked for BZD indications. Reconciliation was classified as “reconciled” (same BZD and same half-life), “partially reconciled” (change to another BZD with different half-life) or “not reconciled”. At discharge, physicians’ indications were revised.Results110 patients were included. The median age was 81 (65–95). They were 71 women (64%) and 39 men (36%). At admission the results were: 1) “Reconciled”: 63 patients (57.3%); 2) “Partially reconciled”: 9 patients (8.2%) and 3) “Not reconciled”: 38 patients (34.5%). At discharge, physicians indicated the following: 1) “Same treatment”: 69 patients (62.7%); 2) “No mention of BZD”: 25 patients (22.7%); 3) “BZD combination”: 5 patients (4.5%); 4) “Changed to other BZD”: 5 patients (4.5%) and 5) “Withdrawal”: 2 patients (1.8%). 4 patients (3.6%) died during the hospitalisation.ConclusionAlmost a third part of patients don’t have their treatment suitably reconciled. It might occur that treatment was changed because it was not warranted, regardless of reconciliation. At discharge, physicians use phrases like “same treatment” or don’t mention anything about BZD. This can lead to treatment discrepancies with Primary Care.References and/or acknowledgementsNo conflict of interest.

samples. An important increase in the number of isoforms even with changes in their masses, including the main isoform, was detected. Conclusion and relevance Exposure to light may cause modifications in the nivolumab isoform profile which suggests protein degradation. This work shows the importance of protecting opened vials of the medicine Opdivo from light (and by extension, bags for infusion) when they are at room temperature (up to 25°C).