Low-molecular-weight heparins: Pharmacoeconomic decision modeling based on meta-analysis data

Kaduševičius, Edmundas; Kildonaviciute, Gabriele; Varanavičienė, Birutė; Jankauskienė, Danguolė

doi:10.1017/s0266462310000310

Cited by 4 publications

(7 citation statements)

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“…For example, in Lithuania, the utilization of heparins increased from 322,000 defined daily doses (DDDs) in 2003 to 2,074,000 DDDs in 2010-greater than a 6-fold increasewhile total heparin expenditures increased almost 9-fold during this period, from 1,088,000 Lithuanian litas (LTLs) in 2003 up to 9,395,000 LTLs in 2010. 10 Expenditures demonstrated a tendency to increase markedly faster than could be explained by the increased utilization rate of heparin in the country. Therefore, it was important to identify reasons behind that disproportional growth and to anticipate relevant actions that could be taken to manage costs.…”

Section: Safety Assessmentsmentioning

confidence: 98%

Influence of Coadministration of Antithrombotic Medicines, Warfarin, and NSAIDs on Heparin Safety: Data from a Prospective Observational Study

Pranckeviciene¹,

Kaduševičius²,

Putniene³

2013

JMCP

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Section: Safety Assessmentsmentioning

confidence: 98%

Influence of Coadministration of Antithrombotic Medicines, Warfarin, and NSAIDs on Heparin Safety: Data from a Prospective Observational Study

Pranckeviciene¹,

Kaduševičius²,

Putniene³

2013

JMCP

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“…Both heparin and LMW heparins have been widely used as anticoagulant and antithrombotic drugs [25], [26]. LMW heparins are now generally regarded as safer and more effective for the treatment of cardiovascular problems than unfractionated heparin [27].…”

Section: Introductionmentioning

confidence: 99%

Effects of Heparin and Enoxaparin on APP Processing and Aβ Production in Primary Cortical Neurons from Tg2576 Mice

et al. 2011

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BackgroundAlzheimer's disease (AD) is caused by accumulation of Aβ, which is produced through sequential cleavage of β-amyloid precursor protein (APP) by the β-site APP cleaving enzyme (BACE1) and γ-secretase. Enoxaparin, a low molecular weight form of the glycosaminoglycan (GAG) heparin, has been reported to lower Aβ plaque deposition and improve cognitive function in AD transgenic mice.Methodology/Principal FindingsWe examined whether heparin and enoxaparin influence APP processing and inhibit Aβ production in primary cortical cell cultures. Heparin and enoxaparin were incubated with primary cortical cells derived from Tg2576 mice, and the level of APP and proteolytic products of APP (sAPPα, C99, C83 and Aβ) was measured by western blotting. Treatment of the cells with heparin or enoxaparin had no significant effect on the level of total APP. However, both GAGs decreased the level of C99 and C83, and inhibited sAPPα and Aβ secretion. Heparin also decreased the level of β-secretase (BACE1) and α-secretase (ADAM10). In contrast, heparin had no effect on the level of ADAM17.Conclusions/SignificanceThe data indicate that heparin and enoxaparin decrease APP processing via both α- and β-secretase pathways. The possibility that GAGs may be beneficial for the treatment of AD needs further study.

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“…Por ejemplo, si el país produce la molécula, el estudio tendrá favorabilidad hacia ella. En España, la heparina de bajo peso molecular menos costosa es la enoxaparina y, en Colombia, esta es la más costosa [17,26,30]. Este aspecto es muy relevante, ya que implicaría un ahorro significativo para el sistema de salud colombiano.…”

Section: Farmacoeconomíaunclassified

Nadroparina cálcica: una revisión de su farmacología básica y clínica

2011

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Objetivo. Evaluar críticamente la información sobre la farmacología básica y clínica de la nadroparina cálcica. Fuente de datos. Se hizo una búsqueda en la literatura científica de octubre de 1985 a septiembre de 2010, en las bases de datos electrónicas: Pubmed, Cochrane, MDConsult, Scielo y Medscape, y en el Instituto Nacional de Vigilancia de Medicamentos y Alimentos (INVIMA).Selección de estudios. Se incluyeron los estudios publicados en inglés, español o francés, realizados en humanos y animales de experimentación, en los que se revisara la farmacología básica y clínica de la nadroparina cálcica. Extracción y síntesis de datos. Se revisaron 792 resúmenes y se seleccionaron 60 artículos que cumplieron los criterios de inclusión, de acuerdo con un método se resolvieron todas las discrepancias por discusión y consenso.Conclusión. En algunos estudios la nadroparina cálcica ha mostrado una eficacia igual o superior a la de la heparina no fraccionada y la de un placebo. Sin embargo, la información evaluada no es lo suficientemente sólida para considerar superior la nadroparina frente a las otras heparinas de bajo peso molecular. La literatura científica muestra que, en general, el tratamiento con estas últimas es más seguro y costo-efectivo que con heparina no fraccionada. No existen pruebas suficientes, fuertes y concluyentes para calificar la nadroparina cálcica como superior a otras heparinas de bajo peso molecular en el tratamiento antitrombótico. Las de bajo peso molecular han demostrado una reducción significativa en la angiogénesis tumoral y un aumento en la supervivencia de pacientes con enfermedades oncológicas. Sin embargo, se requieren más investigaciones para caracterizar y comprender mejor este nuevo hallazgo.

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Low-molecular-weight heparins: Pharmacoeconomic decision modeling based on meta-analysis data

Abstract: The meta-analysis results of LMWHs could be used to support a policy on reference-based pricing and pharmacoeconomic decision modeling in healthcare institutions, which would allow a decrease in healthcare expenditures.

Cited by 4 publications

References 48 publications

Influence of Coadministration of Antithrombotic Medicines, Warfarin, and NSAIDs on Heparin Safety: Data from a Prospective Observational Study

Influence of Coadministration of Antithrombotic Medicines, Warfarin, and NSAIDs on Heparin Safety: Data from a Prospective Observational Study

Effects of Heparin and Enoxaparin on APP Processing and Aβ Production in Primary Cortical Neurons from Tg2576 Mice

Nadroparina cálcica: una revisión de su farmacología básica y clínica

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