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Pesiou S, Barcelo R, Fradera M, Torres F, Pontes C. Utilisation of drugs for the treatment of psychiatric diseases in the pediatric population: focus on off-label use. Front Pharmacol 2023; 14:1157135. [PMID: 37397481 PMCID: PMC10312111 DOI: 10.3389/fphar.2023.1157135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Psychotropics are increasingly used in pediatrics, often as off-label medicines. The guarantees of safety and efficacy are not always granted in clinical practice compared to adult authorised indications. A retrospective observational study was done to estimate the prevalence of psychotropic use in pediatric subjects of Catalonia (Spain). Anonymised data on dispensation of psychotropics to pediatric patients, demography and other related data were obtained by the local healthcare management for the period 2008-2017. Estimation of off-label use was done through description of drug dispensations with no authorised use related to age range. The prevalence of psychotropics was 40.8-64.2 per 1,000 pediatric inhabitants. Hydroxyzine-only represented two-thirds of dispensations, and when removed, the prevalence dropped to 26.4-32.2 per 1,000 pediatric inhabitants. Adolescents and boys were more likely to receive a psychotropic. Psychostimulants had the highest exposure rate, mainly due to methylphenidate. Off-label use was observed in 12% of subjects, corresponding to 4.6% of all dispensed psychotropics with boys being more exposed. The proportion of off-label use vs. labelled use was higher in younger populations. Aripiprazole had the highest off-label frequency. Our data support the frequent reality of off-label use in pediatrics, despite the potential underestimation related to the selected off-label definition. There is an urgent need to systematically ascertain effectiveness and any potential adverse events in the off-label pediatric setting, and to generate valuable information for risk-benefit assessment in these populations where extrapolation from adults is not reliable.
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Affiliation(s)
- Stella Pesiou
- European Medicines Agency, Amsterdam, Netherlands
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Edifici M Campus de la UAB, Bellaterra, Spain
| | - Rafel Barcelo
- Departament of Pediatrics, Gynecology and Obstetrics, and Preventive Medicine, Universitat Autònoma de Barcelona, Edifici M Campus de la UAB, Bellaterra, Spain
| | - Marc Fradera
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Edifici M Campus de la UAB, Bellaterra, Spain
- Unitat Mixta de Neurociència Traslacional I3PT-INc-UAB, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sabadell, Spain
| | - Ferran Torres
- Departament of Pediatrics, Gynecology and Obstetrics, and Preventive Medicine, Universitat Autònoma de Barcelona, Edifici M Campus de la UAB, Bellaterra, Spain
| | - Caridad Pontes
- European Medicines Agency, Amsterdam, Netherlands
- Department of Medicines, Area of Healthcare Services, Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), Institut d’Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain
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Fuente N, Mañe JM, Barcelo R, Muñoz A, Perez-Hoyos T, Lopez-Vivanco G. Tumor lysis syndrome in a multiple myeloma treated with thalidomide. Ann Oncol 2004; 15:537. [PMID: 14998862 DOI: 10.1093/annonc/mdh116] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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3
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Nasi A, Altman Canestri E, Sanchez C, Barcelo R, Ullia J. [Variceal thromboses, their ambulatory treatment]. Phlebologie 1993; 46:711-7. [PMID: 8115490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A Nasi
- l'Université Argentine John Kennedy, Buenos Aires
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Perreault C, Giasson M, Gyger M, Belanger R, David M, Bonny Y, Boileau J, Barcelo R, Moquin JP. Serum immunoglobulin levels following allogeneic bone marrow transplantation. Blut 1985; 51:137-42. [PMID: 3896351 DOI: 10.1007/bf00320027] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In order to study the posttransplant evolution of serum immunoglobulin levels, we measured serum IgG, IgA and IgM levels in 50 recipients of allogeneic bone marrow before transplantation and at different intervals thereafter (days 39, 120, 365 and 730). IgG and IgM levels were depressed for 1 year and IgA levels for 2 years posttransplant. Immunoglobulin deficiency was more severe and prolonged in patients with graft versus-host-disease. Hypogammaglobulinemia may contribute to the frequent infections observed in these patients, especially those with chronic graft-versus-host disease.
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Dandavino R, Barcelo R, Beaudry C, Cardinal J, Carriere S, Friborg J, Houde M, Ouimet D, Bastien E, Girard R, Laplante L. Cadaver kidney transplantation: a retrospective comparison of two immunosuppressive regimens. Transplant Proc 1982; 14:635-9. [PMID: 6762720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Laplante L, Legresley LP, Dandavino R, Houde M, Friborg J, Barcelo R, Beaudry C. Malignancies associated with renal transplant: first case report of a nephroblastoma occurring in an adult host kidney. J Urol 1981; 126:251-2. [PMID: 6267326 DOI: 10.1016/s0022-5347(17)54464-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The increased incidence of malignancies after renal transplantation has been well documented. We describe the first reported case of a nephroblastoma (Wilms tumor) occurring in the host kidney of an adult after renal transplantation.
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Houde M, Dandavino R, Laplante L, Beaudry C, Cardinal J, Barcelo R. [Recurrence of Goodpasture's syndrome after kidney transplantation]. Union Med Can 1981; 110:236-9. [PMID: 7018045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Laplante L, Barcelo R, Beaudry C, Carrière S, Cardinal J, Friborg J, Houde M, Bastien E, Girard R, Dandavino R. [Renal transplant and rehabilitation]. Union Med Can 1981; 110:88-90. [PMID: 7010743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Dandavino R, Barcelo R, Beaudry C, Cardinal J, Carrière S, Friborg J, Houde M, Girard R, Bastien E, Laplante L. [Renal transplantation at the Maisonneuve-Rosemont Hospital: 10-year experience]. Union Med Can 1981; 110:104-8. [PMID: 7010741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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10
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Laplante L, Carrière S, Barcelo R, Beaudry C. [Major surgery in the patient with hemodialysis-treated chronic renal insuffiency]. Union Med Can 1972; 101:888-92. [PMID: 4666893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Laplante L, Barcelo R, Carrière S, Legresley LP, Beaudry C. [Bullous lesions and necrosis of the sudoriparous glands in acute drug poisoning]. Union Med Can 1971; 100:1755-61. [PMID: 4255803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Beaudry C, Carrière S, Barcelo R. [Chronic hemodialysis: results observed during 6 years' experience (more than 8,000 treatments by Kolff's artificial kidney)]. Union Med Can 1971; 100:100-12. [PMID: 5546535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Carrière S, Beaudry C, Barcelo R. [Effects of parglyine as a long-term antihypertensive agent]. Union Med Can 1968; 97:1623-8. [PMID: 5746561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Barcelo R, Beaudry C, Carrière S. [Effectiveness of 5 types of dialysers used with Kolff's artificial kidney]. Union Med Can 1968; 97:1613-22. [PMID: 5746560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Lévy R, Barcelo R, Carrière S, Beaudry C. [Arteriovenous fistula and external shunt: results observed during 4 years of chronic hemodialysis]. Union Med Can 1968; 97:1586-93. [PMID: 5746557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Beaudry C, Carrière S, Barcelo R. [Diagnostic value of the angiotensin test]. Union Med Can 1968; 97:1548-54. [PMID: 4317813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Barcelo R, Pollak VE. A preliminary immunologic study of urinary proteins: the questionable value of protein clearances in kidney disease. Can Med Assoc J 1966; 94:269-275. [PMID: 20328484 PMCID: PMC1935277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The clearances of seven different proteins were measured by a quantitative immunodiffusion technique in 15 patients with proteinuria. All urines were also studied by immunoelectrophoresis.The renal histology was evaluated in each case, and no correlation was found between histologic changes and the urinary protein excretion. This observation was confirmed by both immunodiffusion and immunoelectrophoretic techniques. No specific urinary protein excretion pattern was found in six patients with systemic lupus erythematosus.High-molecular-weight proteins were rarely found in urine, even when the glomerular basement membrane was definitely thickened. Low-molecular-weight proteins were often observed, but their clearances were variable. The results do not support the suggestion that protein clearances are valuable diagnostic and prognostic tools in renal diseases. They also do not support the view that glomerular filtration is the sole factor responsible for the final patterns of urinary proteins; tubular reabsorption is probably another important factor.
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Barcelo R, Pollak VE. [Protein clearance in renal diseases. Preliminary report]. Union Med Can 1966; 95:138-46. [PMID: 5905186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Barcelo R, Beaudry C. [Treatment of patients with chronic renal insufficiency by repeated hemodialysis]. Union Med Can 1965; 94:617-9. [PMID: 5832980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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