1
|
González-Navarro M, Gómez-Valent M, Sarlé-Rubí J, Pérez-Comtel A. Optimising electronic health records for highly specialised hospital areas: a call for collaborative hospital pharmacist involvement. Eur J Hosp Pharm 2024:ejhpharm-2024-004148. [PMID: 38458751 DOI: 10.1136/ejhpharm-2024-004148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Affiliation(s)
| | - Mònica Gómez-Valent
- Hospital Pharmacy Department, Corporate Healthcare Consortium Parc Taulí, Sabadell, Spain
| | - Jordi Sarlé-Rubí
- IT Department, Chief Technology Officer, Pere Virgili Health Park, Barcelona, Catalunya, Spain
| | - Alba Pérez-Comtel
- Hospital Pharmacy Department, Corporate Healthcare Consortium Parc Taulí, Sabadell, Spain
| |
Collapse
|
2
|
Redondo Capafons S, Soriano Gutierrez L, Dalmau Portulas E, Barragán Muñoz À, Martínez Robles S, Gómez-Valent M. Antiemetic guidelines: Have we incorporated the changes concerning carboplatin and anthracyclines? Farm Hosp 2023; 47:183-189. [PMID: 37268481 DOI: 10.1016/j.farma.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2023] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE Latest MASCC/ESMO guidelines of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy was published in 2016 incorporating anthracycline schemes as highly emetogenic chemotherapy (HEC), proposing triple antiemetic therapy to control nausea and vomiting. Likewise, they recommend triple therapy for carboplatin. The objectives of this study were to analyze the degree of concordance between guidelines and antiemetic prophylaxis used in the Chemotherapy Outpatient Unit in patients undergoing treatment with HEC and carboplatin, to evaluate its effectiveness and to determine the savings due to the use of netupitant/palonosetron (NEPA) oral (or) with intravenous (iv) dexamethasone (NEPAd) compared to iv Fosaprepitant with ondansetron and dexamethasone (FOD iv). METHODS Prospective observational study recording demographic variables, chemotherapy protocol, tumor location, patient emetogenic risk, antiemetic regimen prescribed, concordance with the MASCC/ESMO guideline, and effectiveness, evaluated by MASCC survey, use of rescue medication and visits to the Emergency Department or hospitalization due to emesis. A cost minimization pharmacoeconomic study was carried out. RESULTS 61 patients were included; 70% women; median age 60.5. Platinum schemes were more frequent in period 1, being 87.5% compared to 67.6% in period 2. Anthracycline schemes were 21.6% and 10% respectively in each period. A 21.1% of the antiemetic regimens did not coincide with the MASCC/ESMO recommendations, being entirely in period 1. The score of the effectiveness questionnaires was total protection in 90.9% in acute nausea, from 100% in acute vomiting and delayed nausea, and 72.7% in delayed vomiting. The frequency of use of rescue medication was 18.7% in period 1 and was not necessary in period 2. No visits to the emergency room or admissions were detected in any of the periods. CONCLUSIONS Use of NEPAd led to a 28% reduction in costs with respect to the use of FOD. A high level of concordance was obtained in both periods between the latest published guideline and healthcare practice in our field. Surveys carried out on patients seem to suggest that both antiemetic therapies have similar effectiveness in clinical practice. The inclusion of NEPAd has led to a reduction in costs, positioning itself as an efficient option.
Collapse
Affiliation(s)
| | | | | | - Àlex Barragán Muñoz
- Servicio de Farmacia Hospitalaria, Corporació Sanitària Parc Taulí, Sabadell, España
| | | | - Mònica Gómez-Valent
- Servicio de Farmacia Hospitalaria, Corporació Sanitària Parc Taulí, Sabadell, España
| |
Collapse
|
3
|
Capafons SR, Gutierrez LS, Portulas ED, Muñoz ÀB, Robles SM, Gómez-Valent M. [Translated article] Have changes concerning carboplatin and anthracyclines been incorporated? Farm Hosp 2023; 47:T183-T189. [PMID: 37500396 DOI: 10.1016/j.farma.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Latest MASCC/ESMO guidelines of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy was published in 2016 incorporating anthracycline schemes as highly emetogenic chemotherapy (HEC), proposing triple antiemetic therapy to control nausea and vomiting. Likewise, they recommend triple therapy for carboplatin. The objectives of this study were to analyze the degree of concordance between guidelines and antiemetic prophylaxis used in the Chemotherapy Outpatient Unit in patients undergoing treatment with HEC and carboplatin, to evaluate its effectiveness and to determine the savings due to the use of netupitant/palonosetron (NEPA) oral (or) with intravenous (iv) dexamethasone (NEPAd) compared to iv Fosaprepitant with ondansetron and dexamethasone (FOD iv). METHODS Prospective observational study recording demographic variables, chemotherapy protocol, tumor location, patient emetogenic risk, antiemetic regimen prescribed, concordance with the MASCC/ESMO guideline, and effectiveness, evaluated by MASCC survey, use of rescue medication and visits to the Emergency Department or hospitalization due to emesis. A cost minimization pharmacoeconomic study was carried out. RESULTS 61 patients were included; 70% women; median age 60.5. Platinum schemes were more frequent in period 1, being 87.5% compared to 67.6% in period 2. Anthracycline schemes were 21.6% and 10% respectively in each period. A 21.1% of the antiemetic regimens did not coincide with the MASCC/ESMO recommendations, being entirely in period 1. The score of the effectiveness questionnaires was total protection in 90.9% in acute nausea, from 100% in acute vomiting and delayed nausea, and 72.7% in delayed vomiting. The frequency of use of rescue medication was 18.7% in period 1 and was not necessary in period 2. No visits to the emergency room or admissions were detected in any of the periods. CONCLUSIONS Use of NEPAd led to a 28% reduction in costs with respect to the use of FOD. A high level of concordance was obtained in both periods between the latest published guideline and healthcare practice in our field. Surveys carried out on patients seem to suggest that both antiemetic therapies have similar effectiveness in clinical practice. The inclusion of NEPAd has led to a reduction in costs, positioning itself as an efficient option.
Collapse
Affiliation(s)
| | | | | | - Àlex Barragán Muñoz
- Servicio de Farmacia Hospitalaria, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | | | - Mònica Gómez-Valent
- Servicio de Farmacia Hospitalaria, Corporació Sanitària Parc Taulí, Sabadell, Spain
| |
Collapse
|
4
|
Lopez-Rico I, Vives R, Cruel M, Cerdan C, Moron-Besolí A, Ruiz MA, de Pedro VJ, Gómez-Valent M. Financial impact of the hospital pharmacy's participation in clinical trials. Eur J Hosp Pharm 2021; 28:e185-e190. [PMID: 34103396 DOI: 10.1136/ejhpharm-2020-002601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/25/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To estimate the cost of the hospital pharmacy's participation in clinical trials (CTs) and to compare it to the amount received in compensation from sponsors.To analyse the financial impact of CTs that end without recruiting any patients and without any financial compensation from promoters. METHODS This retrospective observational study analysed data from 5 years (2014-2018) at a tertiary university hospital.We established an allocation formula taking into account direct costs related to the pharmacy department's CT area's activity (reception, safekeeping, preparation, devolution, and destruction of medication, as well as patient monitoring) and indirect costs (facilities, resources, support staff). We calculated the costs to the department and the compensation received both overall and based on the type of promoter, clinical department involved in the trial, and the number of patients included. RESULTS We included 134 trials. Costs added up to €207 372.95 and the compensation to €149 128.93 (€58 244.02 loss for the department). Trials ending without recruiting patients (33.6%) and without compensation accounted for 57.45% of the deficit. The mean cost of trials ending without recruiting patients was €875. We plan to charge a reimbursable setup fee for opening CTs to safeguard against these losses (€875 for trials in all departments except oncology; €1100 for oncology because 38% of their trials end without recruiting patients) and to compensate for the costs incurred in participating in trials for cooperative groups without financial compensation (20%). CONCLUSIONS Billing sponsors based on costs incurred for each trial would be a fairer system than the current approach based on the number of patients included. Establishing an initial fee would make up for losses from trials that fail to recruit any patients.
Collapse
Affiliation(s)
- Irene Lopez-Rico
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Roser Vives
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Miquel Cruel
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Carla Cerdan
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Anisi Moron-Besolí
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Miguel Angel Ruiz
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Victor José de Pedro
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Mònica Gómez-Valent
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| |
Collapse
|
5
|
Ortonobes Roig S, Soler-Blanco N, Torrente Jiménez I, Van den Eynde Otero E, Moreno-Ariño M, Gómez-Valent M. [Clinical and pharmacological data in COVID-19 hospitalized nonagenarian patients]. Rev Esp Quimioter 2021; 34:145-150. [PMID: 33522213 PMCID: PMC8019469 DOI: 10.37201/req/130.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introducción A pesar del impacto del SARS-CoV-2 en geriatría, disponemos de escasa información en pacientes nonagenarios. Nuestro objetivo es describir características clínicas, respuesta al tratamiento y factores de riesgo de mortalidad en nonagenarios con COVID-19. Material y métodos Estudio retrospectivo observacional de pacientes nonagenarios hospitalizados por COVID-19. Se registraron variables sociodemográficas, clínicas y polifarmacia previa, parámetros analíticos y tratamiento específico. Resultados Se incluyeron 79 pacientes. No se relacionó con mortalidad ninguna de las comorbilidades. La mortalidad fue del 50,6%, siendo mayor en pacientes con dependencia funcional moderada/grave respecto aquéllos independientes/ dependientes leves (59,5% vs 40,5%; p=0,015). Los fármacos específicos más prescritos fueron hidroxicloroquina/cloroquina y azitromicina. Los pacientes fallecidos presentaron más leucocitos y neutrófilos, y mayor linfopenia. Conclusión En nuestra cohorte, el estado funcional es el principal factor de riesgo de mortalidad, independientemente de las comorbilidades y el tratamiento recibido. Implementar la valoración geriátrica integral permitiría individualizar las estrategias terapéuticas en nonagenarios.
Collapse
Affiliation(s)
- S Ortonobes Roig
- Sara Ortonobes Roig, Servicio de Farmacia Hospitalaria. Corporació Sanitària Parc Taulí. Parc del Taulí, 1. 08028 Sabadell (Barcelona), Spain.
| | | | | | | | | | | |
Collapse
|
6
|
de Castro Julve M, Miralles Albors P, Ortonobes Roig S, Vives R, Falgueras L, Gómez-Valent M. Hypertensive crisis following the administration of tedizolid: possible serotonin syndrome. Eur J Hosp Pharm 2018; 27:52-54. [PMID: 32064090 DOI: 10.1136/ejhpharm-2018-001752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/07/2018] [Indexed: 11/04/2022] Open
Abstract
Thiscase report concerns a 34-year-old male with a hip prosthesis infection, under treatment with antidepressant and antihypertensive drugs, who presented with an increase in blood pressure after four days of treatment with oral tedizolid. Tedizolid was discontinued, and the dose of antihypertensive was increased. The patient progressively achieved the normalisation of blood pressure values, which allowed a reduction in the antihypertensive agent dose to its usual regimen. No cases of hypertension or serotonin toxicity are described in the initial tedizolid studies, where patients treated with other serotonergic drugs were excluded. However, this does not mean that these effects may not occur in clinical practice, especially in patients under concomitant treatment with this type of medication, because of the greater risk of drug interactions. The causality of this suspected drug reaction was analysed and it was considered as possible. The case has been reported to the pharmacovigilance system.
Collapse
Affiliation(s)
- Maria de Castro Julve
- Department of Pharmacy, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Paula Miralles Albors
- Department of Pharmacy, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Sara Ortonobes Roig
- Department of Pharmacy, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Roser Vives
- Department of Pharmacology, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Luis Falgueras
- Department of Infectious Diseases, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Mònica Gómez-Valent
- Department of Pharmacy, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| |
Collapse
|
7
|
Pontes C, Fontanet JM, Vives R, Sancho A, Gómez-Valent M, Ríos J, Morros R, Martinalbo J, Posch M, Koch A, Roes K, Rengerink KO, Torrent-Farnell J, Torres F. Evidence supporting regulatory-decision making on orphan medicinal products authorisation in Europe: methodological uncertainties. Orphanet J Rare Dis 2018; 13:206. [PMID: 30442155 PMCID: PMC6238348 DOI: 10.1186/s13023-018-0926-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To assess uncertainty in regulatory decision-making for orphan medicinal products (OMP), a summary of the current basis for approval is required; a systematic grouping of medical conditions may be useful in summarizing information and issuing recommendations for practice. METHODS A grouping of medical conditions with similar characteristics regarding the potential applicability of methods and designs was created using a consensus approach. The 125 dossiers for authorised OMP published between 1999 and 2014 on the EMA webpage were grouped accordingly and data was extracted from European Public Assessment Reports (EPARs) to assess the extent and robustness of the pivotal evidence supporting regulatory decisions. RESULTS 88% (110/125) of OMP authorizations were based on clinical trials, with 35% (38/110) including replicated pivotal trials. The mean (SD) number of pivotal trials per indication was 1.4 (0.7), and the EPARs included a median of three additional non-pivotal supportive studies. 10% of OMPs (13/125) were authorised despite only negative pivotal trials. One-third of trials (53/159) did not include a control arm, one-third (50/159) did not use randomisation, half the trials (75/159) were open-label and 75% (119/159) used intermediate or surrogate variables as the main outcome. Chronic progressive conditions led by multiple system/organs, conditions with single acute episodes and progressive conditions led by one organ/system were the groups where the evidence deviated most from conventional standards. Conditions with recurrent acute episodes had the most robust datasets. The overall size of the exposed population at the time of authorisation of OMP - mean(SD) 190.5 (202.5) - was lower than that required for the qualification of clinically-relevant adverse reactions. CONCLUSIONS The regulatory evidence supporting OMP authorization showed substantial uncertainties, including weak protection against errors, substantial use of designs unsuited for conclusions on causality, use of intermediate variables, lack of a priorism and insufficient safety data to quantify risks of relevant magnitude. Grouping medical conditions based on clinical features and their methodological requirements may facilitate specific methodological and regulatory recommendations for the study of OMP to strengthen the evidence base.
Collapse
Affiliation(s)
- Caridad Pontes
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Unitat Docent Parc Taulí, Universitat Autònoma de Barcelona, C/Parc Taulí, 1, 08208 Sabadell, Spain
- Unitat de Farmacologia Clínica, Institut d’Investigació i Innovació Parc Taulí I3PT, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Parc Taulí 1, 08028 Sabadell, Barcelona Spain
| | - Juan Manuel Fontanet
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Unitat Docent de Sant Pau, C/St Antoni Maria Claret 167, 08025 Barcelona, Spain
| | - Roser Vives
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Unitat Docent Parc Taulí, Universitat Autònoma de Barcelona, C/Parc Taulí, 1, 08208 Sabadell, Spain
- Unitat de Farmacologia Clínica, Institut d’Investigació i Innovació Parc Taulí I3PT, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Parc Taulí 1, 08028 Sabadell, Barcelona Spain
| | - Aranzazu Sancho
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Unitat Docent Parc Taulí, Universitat Autònoma de Barcelona, C/Parc Taulí, 1, 08208 Sabadell, Spain
- Clinical Pharmacology Department, Research Institute Puerta de Hierro, C/Manuel de Falla, 1, 28222 Majadahonda, Madrid Spain
| | - Mònica Gómez-Valent
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Unitat Docent Parc Taulí, Universitat Autònoma de Barcelona, C/Parc Taulí, 1, 08208 Sabadell, Spain
- Servei de Farmàcia, Institut d’Investigació i Innovació Parc Taulí I3PT, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Parc Taulí 1, 08028 Sabadell, Barcelona Spain
| | - José Ríos
- Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona Spain
- Medical Statistics Core Facility, IDIBAPS - Hospital Clinic Barcelona, C/Mallorca 183, Floor -1, 08036 Barcelona, Spain
| | - Rosa Morros
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Unitat Docent de Sant Pau, C/St Antoni Maria Claret 167, 08025 Barcelona, Spain
- Unitat d’Estudis del Medicament, Institut D’Investigació en Atenció Primària IDIAP- Jordi Gol, C/Gran Via Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Jorge Martinalbo
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona Spain
| | - Martin Posch
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Armin Koch
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Kit Roes
- Clinical Trial Methodology, Julius Center for Health Sciences and Primary Care, Biostatistics and Research Support, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Katrien Oude Rengerink
- Clinical Trial Methodology, Julius Center for Health Sciences and Primary Care, Biostatistics and Research Support, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Josep Torrent-Farnell
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Unitat Docent de Sant Pau, C/St Antoni Maria Claret 167, 08025 Barcelona, Spain
| | - Ferran Torres
- Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona Spain
- Medical Statistics Core Facility, IDIBAPS - Hospital Clinic Barcelona, C/Mallorca 183, Floor -1, 08036 Barcelona, Spain
| |
Collapse
|
8
|
Cabré Serres M, García-Peláez M, Payés Peich M, Iglesias Lepine ML, Gómez-Valent M, Raich Montiu L, De Castro Julve M, Borràs Trias L, Gorgas Torner MQ. PS-005 Pharmaceutical interventions in an emergency department under a pharmaceutical care system. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Gómez-Valent M, López MF, García CP, Leno AM, Serres MC, Montiu LR, Torner MG. A fatal event in a patient receiving Ipilimumab for metastasic melanoma: causality analyses. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|