Comparison of Weight Based Parenteral Calcitonin Dosing Strategies: Total Versus Ideal Body Weight.

IF 0.7 Q4 PHARMACOLOGY & PHARMACY
Vivek Kataria, Sammy Daas, Kelsey Kohman
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引用次数: 0

Abstract

Background: Current guidelines and the package insert do not define the appropriate body weight to dose calcitonin and there is a lack of literature evaluating dosing via ideal body weight (IBW). Objective: The objective of this study is to compare calcium reduction among patients with severe hypercalcemia treated with calcitonin via total body weight (TBW) versus IBW. Methods: This was a single-center retrospective analysis of data gathered within a quality improvement project to standardize parenteral calcitonin utilization. The primary outcome was to compare calcium reduction within 24 hours of treatment initiation. Secondary outcomes included calcium reduction within 48, 72, and 96 hours, the incidence of hypocalcemia, the incidence of rebound hypercalcemia, and the average wholesale price (AWP) expenditure. Results: A total of 48 patients met inclusion criteria, with 25 patients in the TBW group and 23 patients in the IBW group. The primary outcome of change in corrected calcium within 24 hours was not statistically significant between groups (1.1 mg/dL vs 1.7 mg/dL, P = .12). Serum calcium levels and change from baseline were followed up to 96 hours, and no difference was noted between groups. Additional secondary outcomes were not significant, with the exception of AWP expenditure, which was statistically lower in the IBW group ($11 274.0 vs $7516.0, P = .02). While no difference was found in the total number of doses administered or total units consumed (600.0 units vs 400.0 units, P = .06), a significant difference was found in the average dose (364.0 units vs 239.0 units, P < .00001). Conclusion: This study suggests that dosing parenteral calcitonin via IBW achieved a similar reduction in calcium compared to TBW. Moreover, dosing via IBW resulted in a significant reduction in average dose and in AWP expenditure when compared to TBW. This approach offers an alternative dosing strategy that uses less medication, without compromising efficacy.

基于体重的肠外降钙素给药策略的比较:总体重与理想体重。
背景:目前的指南和说明书没有定义适当的体重来给药降钙素,并且缺乏通过理想体重(IBW)评估给药的文献。目的:本研究的目的是通过体重(TBW)与体重(IBW)比较降钙素治疗的严重高钙血症患者的钙减少情况。方法:这是一项单中心回顾性分析,收集了一项质量改进项目中收集的数据,以规范肠外降钙素的使用。主要结局是比较治疗开始24小时内钙的减少。次要结局包括48小时、72小时和96小时内的钙减少、低钙血症发生率、反弹高钙血症发生率和平均批发价格(AWP)支出。结果:48例患者符合纳入标准,其中TBW组25例,IBW组23例。24小时内校正钙变化的主要终点在两组间无统计学意义(1.1 mg/dL vs 1.7 mg/dL, P = 0.12)。随访96小时后血清钙水平和基线变化,各组间无差异。除AWP支出外,其他次要结局无显著性差异,IBW组AWP支出在统计学上较低(11274.0美元vs 7516.0美元,P = 0.02)。虽然在总剂量或总消耗单位上没有发现差异(600.0单位vs 400.0单位,P = 0.06),但在平均剂量上发现了显著差异(364.0单位vs 239.0单位,P)。结论:本研究表明,通过IBW给药的肠外降钙素与TBW相比取得了相似的钙减少。此外,与TBW相比,通过IBW给药可显著降低平均剂量和AWP支出。这种方法提供了一种替代剂量策略,使用较少的药物,而不影响疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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