No abstract

To detect, report, assess and document the ADRs associated with chemotherapy in geriatric patients. METHODS: A hospital based prospective observational study was carried out among 153 inpatients in the department of medical oncology for a period of 6 months. Patients above 60 years of age with confirmed history of malignancy were included in the study. The potential risk factors for ADR were defined in relation to patient and chemotherapeutic regimen. The relationship between those risk factors and ADRs was assessed by univariate and multi variate logistic-regression analysis. RESULTS: A total of 136 ADRs were observed in 94 patients, the mean age of the study population was 64.75±4.97 years among which females accounted for majority of the ADRs (60.64%). The organ systems mostly affected were found to be Gastrointestinal system (44.85%) (OR= 1.358; 95% CI 0.69-2.64 p< 0.001) followed by dermatologicals (30.15%) (OR= 1.50; 95% CI 0.63-3.56 p< 0.001) and immune system (17.65%) (OR= 2.27; 95% CI 0.9-5.7 p< 0.001). The most commonly reported ADR was found to be alopecia (30.15%) followed by diarrhoea (28.68%), vomiting (14.8%), neutropenia (7.35%), myelosupression (3.68%) and nephrotoxicity (2.94%). Cyclophosphamide (OR= 2.98 95%CI 1.26-7.07 p< 0.001), Carboplatin (OR= 13.359; 95%CI 3.056-58.406 p< 0.001) 5 Fluoro Uracil (OR= 1.938 95%CI 1.266-2.935 p< 0.001) and Adriamycin (OR= 16.45; 95% CI 2.41-112.22 p< 0.001) were found to be the most significant drugs causing ADRs. Assessment of causality by WHO causality assessment scale indicated that 97% of the reactions were 'probable' and 1% was 'possible'. In one patient with cisplatin induced hypersensitivity reaction, rechallenge was attempted and the causality was made as 'certain'. CONCLUSIONS: Individualizing drug therapy, implementation of preventive measures will lead to reduction in the severity of ADRs and thereby reduce the economic burden to the patient and helps to improve the treatment outcome. Knowing the commonly occurring ADRs will aid the practitioner in early detection of ADRs.

polynomial (FP) models using survivalNMA package in R (v3.6.2) and parameters were estimated accordingly. A deviance information criterion (DIC) was used to compare the goodness-of-fit. Results: Among the parametric and FP models, loglogistic showed the best fit (DIC=431.65; 248.18), followed by FP1 and Weibull for both PFS and OS outcomes. The predicted survival of lanreotide LAR, octreotide LAR, and placebo was 44%, 40% and 6% in terms of PFS at 5 years, and 54%, 57% and 54% in terms of OS at 10 years. Lanreotide LAR showed highest PFS, followed by octreotide LAR and Placebo. Regarding OS, octreotide LAR showed the highest survival, while lanreotide LAR and placebo showed near-identical survival prospects. The findings were not sensitive to different distributions, although the survival probabilities varied substantially. The ordering of treatments was also consistent across distributions. Conclusions: Octreotide LAR and lanreotide LAR significantly delayed the time to progression compared to placebo. The results of our multi-dimensional evidence synthesis approach are consistent with previously published HR based metaanalyses. The use of this approach may be more informative for any subsequent costeffectiveness modelling over constant HRs.

The number of PsO patients treated with biologics has steadily increased from 2014 (N=1,133) to 2018 (N=3,167). The increasing trend in biologics users was apparent in 2016 and 2018, which sparked an annual increase of 65% and 83% in total medical costs for biologics users respectively. The 5-year average of PsO medication costs per biologics users amounted to 8,237,266 KRW as opposed to non-biologics users' 225,607 KRW. Total medical costs for treating PsO for biologics users and nonbiologics users on average were 8,372,181 KRW and 377,396 KRW. The gap peaked in 2018 with biologics users' 9,218,123 KRW and non-biologics users' 300,931 KRW. In the next stage of our analysis, the costs per co-morbidities will be stratified. Conclusions: The results demonstrated that high health care costs were associated with PsO patients treated with biologics. Furthermore, among biologics users, the average total medical costs are higher among patients with specified comorbidities indicating additional incremental burden of healthcare spending in management of PsO with associated co-morbid conditions.

A 3 4 7 -A 7 6 6 combinations compared to other endocrine therapies. We compared progressionfree survival (PFS) hazard ratio (HR) of palbociclib combinations against first-and second-line endocrine therapies using a mixed-treatment comparison (MTC) metaanalysis of randomized, controlled trials (RCTs). Methods: A systematic literature review conducted by two independent reviewers identified relevant RCTs in ABC/ MBC. Separate networks were developed for palbociclib plus letrozole and palbociclib plus fulvestrant. MTC analyses were conducted using a Bayesian approach. Based on output from MTC, treatment rankings were established using the surface under the cumulative ranking curve (SUCRA). Results: Sixty-four unique studies met inclusion criteria. Because of sparse networks, fixed-effects model results are reported. Palbociclib plus letrozole had the highest SUCRA value (99.9%) and was associated with significantly longer PFS than all first-line comparators, with the following posterior median PFS HRs and 95% credible intervals (CrI): anastrozole 1 mg, 0.58 (0.42-0.83); and tamoxifen 20 or 40 mg, 0.41 (0.31-0.53). Palbociclib plus fulvestrant had the second highest SUCRA value (93.9%) and was associated with significantly longer PFS than the second-line comparators: anastrozole 1 mg, 0.37 (0.27-0.50); letrozole 2.5 mg, 0.36 (0.22-0.60); fulvestrant 250 mg, 0.36 (0.27-0.48); fulvestrant 500/250 mg, 0.41 (0.23-0.68); and exemestane 25 mg, 0.39 (0.23-0.64). There was no significant difference in the PFS HR for palbociclib plus fulvestrant compared to everolimus plus exemestane (1.03; 95%, 0.58-1.76). ConClusions: The MTC results suggest that palbociclib plus letrozole and palbociclib plus fulvestrant are associated with significantly improved PFS compared with all first-line and most second-line endocrine treatments for ABC/MBC. PCN14