Efficacy and safety of biological treatments of multiple sclerosis

Detalhes bibliográficos
Autor(a) principal: Alves, Andreia Lopes
Data de Publicação: 2013
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.6/1640
Resumo: This report consists of two parts: one related to the Research Project and the second related to the Internship in Community Pharmacy. In the first chapter it is discussed the research work entitled “Efficacy and Safety of Biological Treatments of Multiple Sclerosis”. Multiple Sclerosis (MS) is a chronic, inflammatory, demyelinating disease associated with progressive neurodegeneration which can be seen as a two phase disease: one early acute inflammatory phase and a delayed neurodegenerative phase. However, over time, MS doesn’t follow a fixed pattern and may differ from person to person or even individually which makes it impossible to find an ideal option to treat it. However, advances in the understanding of MS pathogenesis yielded a multistep approach, comprising management of neurological symptoms, treatment of acute relapses, as they occur, and preventing their occurrence and gradual disability accumulation. Disease Modifying Therapy changed the paradigm of MS treatment, allowing the prevention of new disease activity and the modification of disease course. However, these first entities used in MS treatment are poorly effective, but made way to the investigation of new molecules. Concerning these recent and emerging therapies there is no long-term experience and the adverse events are not already well known. The aim of this study was to review the effectiveness and safety of the new and emerging biological treatments used in Multiple Sclerosis. The new molecules which are currently in development in clinical trials at different phases were also reviewed. We conducted a literature search in the Pubmed database database for articles published in English between 2009 and June 2013. The search terms were “Multiple Sclerosis, Relapsing – Remitting/drug therapy” limited to “Journal Article”, “Randomized Controlled Trial”, “Case Reports” or “Clinical Trial” and to studies in Humans, and 64 where included in the present review. The databases the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA) were also consulted. The second Chapter is related to my internship in Community Pharmacy, performed in Farmácia Pereira Martins, in Torres Novas, between February 4 and July 2, 2013. This internship allowed me to understand the important role of the Pharmacist has in society.
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spelling Efficacy and safety of biological treatments of multiple sclerosisExperiência Profissionalizante na vertente de Farmácia Comunitária e InvestigaçãoFarmácia comunitária - Estágio pedagógicoEsclerose Múltipla - Terapia modificadora da doençaNeurodegeneração progressiva - Esclerose múltiplaEsclerose múltipla - Terapias emergentesEsclerose múltipla - Tratamentos biológicos emergentesEsclerose múltipla - Terapias neuroprotectorasTerapias emergentes - EficáciaTerapias emergentes - SegurançaThis report consists of two parts: one related to the Research Project and the second related to the Internship in Community Pharmacy. In the first chapter it is discussed the research work entitled “Efficacy and Safety of Biological Treatments of Multiple Sclerosis”. Multiple Sclerosis (MS) is a chronic, inflammatory, demyelinating disease associated with progressive neurodegeneration which can be seen as a two phase disease: one early acute inflammatory phase and a delayed neurodegenerative phase. However, over time, MS doesn’t follow a fixed pattern and may differ from person to person or even individually which makes it impossible to find an ideal option to treat it. However, advances in the understanding of MS pathogenesis yielded a multistep approach, comprising management of neurological symptoms, treatment of acute relapses, as they occur, and preventing their occurrence and gradual disability accumulation. Disease Modifying Therapy changed the paradigm of MS treatment, allowing the prevention of new disease activity and the modification of disease course. However, these first entities used in MS treatment are poorly effective, but made way to the investigation of new molecules. Concerning these recent and emerging therapies there is no long-term experience and the adverse events are not already well known. The aim of this study was to review the effectiveness and safety of the new and emerging biological treatments used in Multiple Sclerosis. The new molecules which are currently in development in clinical trials at different phases were also reviewed. We conducted a literature search in the Pubmed database database for articles published in English between 2009 and June 2013. The search terms were “Multiple Sclerosis, Relapsing – Remitting/drug therapy” limited to “Journal Article”, “Randomized Controlled Trial”, “Case Reports” or “Clinical Trial” and to studies in Humans, and 64 where included in the present review. The databases the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA) were also consulted. The second Chapter is related to my internship in Community Pharmacy, performed in Farmácia Pereira Martins, in Torres Novas, between February 4 and July 2, 2013. This internship allowed me to understand the important role of the Pharmacist has in society.O presente relatório consiste em duas partes: a primeira parte diz respeito ao trabalho de Investigação, enquanto a segunda parte se refere ao Estágio Curricular em Farmácia Comunitária. No primeiro capítulo é discutido o trabalho de investigação, intitulado de “Efficacy and Safety of Biological Treatments in Multiple Sclerosis”. A Esclerose Múltipla (EM) é uma doença crónica, inflamatória e desmielinizante caracterizada pela formação da chamada “placa de desmielinização” na matéria branca no Sistema Nervoso Central. A placa desmielinizante tem origem na rutura da Barreira Hematoencefálica, seguida de edema tecidular, como consequência da libertação de mediadores de inflamação e proteases pelas células. Esta doença está também associada a neurodegeneração progressiva o que leva a que possa ser vista como uma doença constituída por duas fases: uma primeira fase precoce e inflamatória e uma fase neurodegenerativa tardia. No entanto, apesar de esta visão ser tradicionalmente aceite, a Esclerose Múltipla não segue um padrão fixo de evolução e difere de pessoa para pessoa e no mesmo indivíduo, o que tem tornado a procura de uma única solução terapêutica ideal para tratar a EM impossível. Apesar disto, os frequentes avanços na compreensão da patofisiologia da EM resultaram no desenvolvimento de uma abordagem em várias fases, abrangendo a gestão dos sintomas neurológicos, o tratamento dos surtos quando estes ocorrem, a prevenção da sua ocorrência e da acumulação gradual de incapacidade. As Terapêuticas Modificadoras da Doença vieram mudar o paradigma do tratamento da Esclerose Múltipla, através da sua capacidade para prevenir a ocorrência de novos surtos e para modificar o padrão evolutivo da doença. Apesar de tudo, estas moléculas são pouco efetivas, mas abriram caminho para a investigação de novas moléculas mais efetivas ou com um melhor perfil de administração, de entre as quais se encontram autorizadas apenas algumas delas, como o Natalizumab ou o Fingolimod. Relativamente a estas terapêuticas recentes e emergentes, não existe experiência a longo prazo e os efeitos adversos não estão, ainda, bem identificados. No futuro, para prevenir os efeitos da incapacidade resultante da progressão da doença o desenvolvimento de terapêuticas neuroprotetoras será imperativo. O objetivo deste estudo foi rever a segurança e efetividade dos novos tratamentos biológicos e emergentes utilizados na Esclerose Múltipla. As novas moléculas que estão atualmente em desenvolvimento nas diferentes fases de ensaios clínicos foram, também, revistas. Foi efetuada uma pesquisa bibliográfica na base de dados Pubmed para artigos publicados em Inglês entre 2009 e Junho de 2013. Os termos utilizados na pesquisa foram “Multiple Sclerosis, Relapsing–Remitting/drug therapy” e limitou-se a “Journal Article”, “Randomized Controlled Trial”, “Case Reports” ou “Clinical Trial” e estudos conduzidos em Humanos, e 64 foram incluídos na presente revisão. As bases de dados da European Medicines Agency (EMA) e da United States Food and Drug Administration (FDA) também foram consultadas. O segundo capítulo diz respeito à minha experiência no estágio curricular em Farmácia Comunitária, realizado na Farmácia Pereira Martins, localizada em Torres Novas, entre 4 de fevereiro e 2 de julho de 2013. Este estágio permitiu-me compreender o papel importante que farmacêutico tem na sociedade.Universidade da Beira InteriorLourenço, Olga Maria MarquesuBibliorumAlves, Andreia Lopes2014-03-19T15:01:15Z2013-102013-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10400.6/1640TID:201281279enginfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-12-15T09:37:17Zoai:ubibliorum.ubi.pt:10400.6/1640Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:43:25.772815Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Efficacy and safety of biological treatments of multiple sclerosis
Experiência Profissionalizante na vertente de Farmácia Comunitária e Investigação
title Efficacy and safety of biological treatments of multiple sclerosis
spellingShingle Efficacy and safety of biological treatments of multiple sclerosis
Alves, Andreia Lopes
Farmácia comunitária - Estágio pedagógico
Esclerose Múltipla - Terapia modificadora da doença
Neurodegeneração progressiva - Esclerose múltipla
Esclerose múltipla - Terapias emergentes
Esclerose múltipla - Tratamentos biológicos emergentes
Esclerose múltipla - Terapias neuroprotectoras
Terapias emergentes - Eficácia
Terapias emergentes - Segurança
title_short Efficacy and safety of biological treatments of multiple sclerosis
title_full Efficacy and safety of biological treatments of multiple sclerosis
title_fullStr Efficacy and safety of biological treatments of multiple sclerosis
title_full_unstemmed Efficacy and safety of biological treatments of multiple sclerosis
title_sort Efficacy and safety of biological treatments of multiple sclerosis
author Alves, Andreia Lopes
author_facet Alves, Andreia Lopes
author_role author
dc.contributor.none.fl_str_mv Lourenço, Olga Maria Marques
uBibliorum
dc.contributor.author.fl_str_mv Alves, Andreia Lopes
dc.subject.por.fl_str_mv Farmácia comunitária - Estágio pedagógico
Esclerose Múltipla - Terapia modificadora da doença
Neurodegeneração progressiva - Esclerose múltipla
Esclerose múltipla - Terapias emergentes
Esclerose múltipla - Tratamentos biológicos emergentes
Esclerose múltipla - Terapias neuroprotectoras
Terapias emergentes - Eficácia
Terapias emergentes - Segurança
topic Farmácia comunitária - Estágio pedagógico
Esclerose Múltipla - Terapia modificadora da doença
Neurodegeneração progressiva - Esclerose múltipla
Esclerose múltipla - Terapias emergentes
Esclerose múltipla - Tratamentos biológicos emergentes
Esclerose múltipla - Terapias neuroprotectoras
Terapias emergentes - Eficácia
Terapias emergentes - Segurança
description This report consists of two parts: one related to the Research Project and the second related to the Internship in Community Pharmacy. In the first chapter it is discussed the research work entitled “Efficacy and Safety of Biological Treatments of Multiple Sclerosis”. Multiple Sclerosis (MS) is a chronic, inflammatory, demyelinating disease associated with progressive neurodegeneration which can be seen as a two phase disease: one early acute inflammatory phase and a delayed neurodegenerative phase. However, over time, MS doesn’t follow a fixed pattern and may differ from person to person or even individually which makes it impossible to find an ideal option to treat it. However, advances in the understanding of MS pathogenesis yielded a multistep approach, comprising management of neurological symptoms, treatment of acute relapses, as they occur, and preventing their occurrence and gradual disability accumulation. Disease Modifying Therapy changed the paradigm of MS treatment, allowing the prevention of new disease activity and the modification of disease course. However, these first entities used in MS treatment are poorly effective, but made way to the investigation of new molecules. Concerning these recent and emerging therapies there is no long-term experience and the adverse events are not already well known. The aim of this study was to review the effectiveness and safety of the new and emerging biological treatments used in Multiple Sclerosis. The new molecules which are currently in development in clinical trials at different phases were also reviewed. We conducted a literature search in the Pubmed database database for articles published in English between 2009 and June 2013. The search terms were “Multiple Sclerosis, Relapsing – Remitting/drug therapy” limited to “Journal Article”, “Randomized Controlled Trial”, “Case Reports” or “Clinical Trial” and to studies in Humans, and 64 where included in the present review. The databases the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA) were also consulted. The second Chapter is related to my internship in Community Pharmacy, performed in Farmácia Pereira Martins, in Torres Novas, between February 4 and July 2, 2013. This internship allowed me to understand the important role of the Pharmacist has in society.
publishDate 2013
dc.date.none.fl_str_mv 2013-10
2013-10-01T00:00:00Z
2014-03-19T15:01:15Z
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publisher.none.fl_str_mv Universidade da Beira Interior
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