and previous biological treatments. The effectiveness variables are affected body surface area (BSA) and psoriasis area severity index (PASI) AND 90% PASI clearance (PASI90) collected at baseline, and next visits with dermatologist. The main tools used: Diraya© for the clinical history, Modulab© for laboratory values and Excel© for anonymised data recording. The information was collected according to data minimisation policy, article 5.1 of data protection. Results 49 patients (29 men) included with a mean age of 50.9 years. The main biologic pre-treatments were etanercept (31), adalimumab (11), secukinumab (9) and ustekinumab (9). Averaged pre-treatment BSA (13,6 ± 10.27 SD) and PASI (9.7 ± 6.68 SD). Next dermatologist's control at 5 months 43 patients averaged BSA (3.9 ± 9.27 SD) and PASI (2.9 ± 4.17 SD). PASI90 was reached by 48.8% of patients. There were four treatment discontinuities during this period (1 due to lack of adherence, 1 due to primary failure, 1 due to secondary failure and 1 due to toxicity). At 10 months 25 patients averaged BSA (1.8 ± 3.28 SD), PASI (1.8 ± 3.30 SD), and PASI90 was reached by 72%. 3 treatment discontinuities in this period (1 due to gestational desire and 2 due to secondary failure). At 18 months 15 patients averaged BSA (0.9 ± 1.55 SD) and PASI (0.5 ± 0.91 SD). PASI 90 was reached by 73%. Patients not counted had not gone to dermatology control yet when our analysis were made. Safety: One patient had to stop treatment due to strong diarrhoeas after each dose. Conclusion and RelevanceAccording to the results obtained, it is possible to evaluate guselkumab as an effective and safe alternative in the treatment of moderate to severe psoriasis resistant to conventional treatments.

BackgroundMedication systems related to clinical decision support, when implemented in an electronic prescribing program, have the potential to reduce adverse drug reactions.PurposeTo increase safety in the prescription and administration of drugs through the introduction of new warning systems, such as of interactions, maximum doses and a guide to the parenteral administration of drugs, in an electronic prescribing programme (SILICON).Material and methods1. The most relevant interactions between the active pharmaceutical ingredients included in the pharmacotherapy guidelines (TFG) were chosen. 2. A search for the maximum dose of the active ingredients present in the parenteral administration TFG was performed. 3. The necessary information was collected in order to create a link between the proper administration and maintenance of the active pharmaceutical ingredients administered parenterally.ResultsA total of 70 interaction pairs, corresponding to 16 different active pharmaceutical ingredients, were selected and introduced in SILICON. 100% of the selected interactions were accompanied by a pharmacotherapeutic recommendation.From a total of 295 active ingredients, 140 maximum doses were considered useful for prescription and validation, and were included in SILICON. In order not to create confusion when prescribing, 28 (9%) files of active ingredients were duplicated in the program to differentiate oral and parenteral maximum doses.Finally, for the parenteral administration guide, 224 (76%) of active ingredients were selected. Moreover a direct link from the prescription screen to the administration guide was created. All active substances excluded from the guide, have an administration protocol to follow.All information entered in the prescription program was included on the pharmacy service website.ConclusionThe insertion of maximum dose alerts and interactions, and a link to the updated parenteral drugs administration guide, into an electronic administration program, provides a safety tool. In this way, we contribute towards reducing medication errors.ReferenceRivkin A, Yin H. Evaluation of the role of the critical care pharmacist in identifying and avoiding or minimizing significant drug-drug interactions in medical intensive care patients. J Crit Care 2011;26:104.e1–6No conflict of interest.

BackgroundSome patients do not achieve successful results after treatment with older hepatitis C virus (HCV) antiviral drugs. We made a bibliographic research in PubMed and did not find any similar study in this area.PurposeTo assess the effectiveness of new direct acting antivirals (DAA) in previously treated HCV patients, and its relation to the type of previous treatment received.Material and methodsAn observational, descriptive, retrospective study of previously treated patients with HCV that ended their treatment with DAA before February 2016 was conducted. Patients were selected after online clinical history and from a pharmacy service database, analysing the following variables: genotype, degree of fibrosis, HIV coinfection, previous treatment, treatment using DAA, viral load at the end of treatment (VLET) and after 12 weeks (VR12).ResultsOf 250 patients that finished treatment, 160 (64%) had received previous treatment, 146 with pegylated interferon–ribavirin (INF-RBV) and 14 with first generation protease inhibitors (boceprevir/telaprevir). 16 patients had HIV coinfection. The distribution of patients according to genotype (G) was: 15 (9.37%) G4, 14 (8.7%) G3, 4 (2.5%) G1 untyped, 39 (24.37%) G1a and 88 (55%) G1b. According to the degree of fibrosis (F): 1 (0.62%) had F0, 8 (5%) F1, 34 (21.25%) F2, 35 (21.87%) F3 and 82 (51.25%) F4. Following the recommendations of the Clinical Practice Guidelines and the Strategic Plan of the Spanish NHS, 11 combinations of DAA were used (daclatasvir, ledipasvir, sofosbuvir, dasabuvir, ombitasvir, paritaprevir/r, simeprevir), ribavirin and pegylated interferon. VLET was undetectable in 100% of patients. Data were available concerning 121 patients after 12 weeks, 117 of whom (96.7%) maintained a sustained VR12 (SVR12). 4 patients (3.3%) who failed had been treated previously with INF-RBV; 2 had G1b F4, 1 had G1a F4 and 1 had G3 F2.ConclusionThe effectiveness of DAA in patients who had received previous treatment in clinical practice was within the percentages presented in clinical trials. Although there were too few failures in the treatment to conclude significant associations, there may be some relation between failures with DAA and pretreatment with INF-RBV. All patients who had not achieved SVR12 relapsed after an undetectable VLET.References and/or acknowledgementsAcknowledgements to Mireya Amat for the help offered.No conflict of interest