Available evidence and outcome of off-label use of rituximab in clinical practice

Purpose: To analyze the therapeutic indications for off-label use of rituximab, the available evidence for its use, the outcomes, and the cost. Methods: This was a retrospective analysis of patients treated with rituximab for off-label indications from January 2007 to December 2009 in two tertiary hospitals. Information on patient characteristics, medical conditions, and therapeutic responses was collected from medical records. Available evidence for the efficacy of rituximab in each condition was reviewed, and the cost of treatment was calculated. Results: A total of 101 cases of off-label rituximab use were analyzed. The median age of the patients involved was 53 [interquartile range (IQR) 37.568.0] years; 55.4 % were women. The indications for prescribing rituximab were primarily hematological diseases (46 %), systemic connective tissue disorders (27 %), and kidney diseases (20 %). Available evidence supporting rituximab treatment for these indications mainly came from individual cohort studies (53.5 % of cases) and case series (25.7 %). The short-term outcome (median 3 months, IQR 24 months) was a complete response in 38 % of cases and partial response in 32.6 %. The highest short-term responses were observed for systemic lupus erythematosus and membranous glomerulonephritis, and the lowest was for neuromyelitis optica, idiopathic thrombocytopenic purpura, and miscellaneous indications. Some response was maintained in long-term follow-up (median 23 months IQR 1230months) in 69.2%of patients showing a short-term response. Median cost per patient was 5,187.5 (IQR 5,187.57,781.3). Conclusions: In our study, off-label rituximab was mainly used for the treatment of hematological, kidney, and systemic connective tissue disorders, and the response among our patient cohort was variable depending on the specific disease. The level of evidence supporting the use of rituximab for these indications was low and the cost was very high. We conclude that more clinical trials on the off-label use of rituximab are needed, although these may be difficult to conduct in some rare diseases. Data from observational studies may provide useful information to assist prescribing in clinical practice.

Available evidence and outcome of off-label use of rituximab in clinical practice

Purpose: To analyze the therapeutic indications for off-label use of rituximab, the available evidence for its use, the outcomes, and the cost. Methods: This was a retrospective analysis of patients treated with rituximab for off-label indications from January 2007 to December 2009 in two tertiary hospitals. Information on patient characteristics, medical conditions, and therapeutic responses was collected from medical records. Available evidence for the efficacy of rituximab in each condition was reviewed, and the cost of treatment was calculated. Results: A total of 101 cases of off-label rituximab use were analyzed. The median age of the patients involved was 53 [interquartile range (IQR) 37.5-68.0] years; 55.4 % were women. The indications for prescribing rituximab were primarily hematological diseases (46 %), systemic connective tissue disorders (27 %), and kidney diseases (20 %). Available evidence supporting rituximab treatment for these indications mainly came from individual cohort studies (53.5 % of cases) and case series (25.7 %). The short-term outcome (median 3 months, IQR 2-4 months) was a complete response in 38 % of cases and partial response in 32.6 %. The highest short-term responses were observed for systemic lupus erythematosus and membranous glomerulonephritis, and the lowest was for neuromyelitis optica, idiopathic thrombocytopenic purpura, and miscellaneous indications. Some response was maintained in long-term follow-up (median 23 months IQR 12-30months) in 69.2%of patients showing a short-term response. Median cost per patient was 5,187.5 (IQR 5,187.5-7,781.3). Conclusions: In our study, off-label rituximab was mainly used for the treatment of hematological, kidney, and systemic connective tissue disorders, and the response among our patient cohort was variable depending on the specific disease. The level of evidence supporting the use of rituximab for these indications was low and the cost was very high. We conclude that more clinical trials on the off-label use of rituximab are needed, although these may be difficult to conduct in some rare diseases. Data from observational studies may provide useful information to assist prescribing in clinical practice.

Producció de material docent per a ciència de materials mitjançant microscòpia electrònica de rastreig i làser confocal

Aquest projecte s'ha realitzat al Servei de Microscòpia de la Universitat Autònoma de Barcelona, i ha tingut una durada de dos anys (2006-2008). La finalitat d’aquest projecte ha estat l’elaboració de material didàctic basat en la captació d’imatges i l’edició de recursos pedagògics de suport digital aplicats a la ciència de materials. Es pretén millorar així la qualitat docent de les pràctiques de diverses assignatures dels ensenyaments de Física i d’Enginyeria de Materials utilitzant tècniques d’anàlisi actuals com són la Microscòpia Electrònica de Rastreig (MER) i la Microscòpia Optica (MO). Amb aquest projecte es vol fomentar també el treball interdisciplinari en equip entre professionals (docents i tècnics superiors de recerca) i acostar la teoria de les assignatures a la realització pràctica, facilitant el suport digital necessari per aconseguir un màxim aprofitament a les aules. Les imatges de MER i MO ajudaran als alumnes a familiaritzar-se amb el món de la recerca i la indústria.

Les pintures murals de la basílica de "Es Cap des Port" (Fornells, Menorca): materials i tècniques

El present treball ofereix una revisió de les pintures murals de la basílica de «Es Cap des Port» (Fornells, Menorca), així com un estudi de caracterització arqueometrica deIs materials i tecniques per microscopia optica, tant amb lupa binocular com amb micro scopi petrografic mitjanliant ¡¡lmina prima, difracció de raigs X i microscopia electronica de rastreig. Els resultats han permes identificar els pigments emprats, així com la seva tecnica d'aplicació. Igua!ment, han permes caracteritzar els morters i han desvelat l' existencia de dos tipus diferents de suporto Malgrat aquestes diferencies en els morters, els pigments són sempre els mateixos per a tots els conjunts pictorics caracteritzats.