Iranian Journal of Pharmaceutical Research最新文献

{"title":"5-Alpha Reductase Inhibitors on Hypersexuality During the Manic Phase of Bipolar and Psychotic Patients; New Insight to a Well-Known Medicines.","authors":"Mitra Mahmoudi Meymand, Saeed Mohammad Soleymani, Hadi Esmaily","doi":"10.5812/ijpr-156707","DOIUrl":"10.5812/ijpr-156707","url":null,"abstract":"","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"24 1","pages":"e156707"},"PeriodicalIF":1.8,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Mechanisms of Phenothiazine Drugs: A Mini-Review of Advances in Cancer Treatment and Antibiotic Resistance.","authors":"Xuewei Zou, Bai Xie","doi":"10.5812/ijpr-157923","DOIUrl":"10.5812/ijpr-157923","url":null,"abstract":"<p><strong>Context: </strong>Cancer and antibiotic resistance are critical global health challenges. Phenothiazines, initially developed as antipsychotics, have demonstrated diverse biological activities, including antitumor, antibacterial, and antioxidant effects. Advances in phenothiazine synthesis have produced derivatives with broader therapeutic potential by modulating receptors, ion channels, and inducing lysosomal cell death. This review explores the therapeutic potential of phenothiazines in oncology and infectious disease management, focusing on their mechanisms of action and future clinical applications.</p><p><strong>Evidence acquisition: </strong>This narrative review synthesizes insights from relevant preclinical studies on phenothiazines' applications in oncology and infectious diseases. Mechanistic pathways and experimental outcomes were analyzed to highlight therapeutic potentials and limitations.</p><p><strong>Results: </strong>Phenothiazines demonstrate significant potential in oncology by inhibiting tumor growth via apoptosis induction, pathway modulation (e.g., PDK1/Akt, MAPK/ERK1/2, and Akt/mTOR), angiogenesis suppression through vascular endothelial growth factor (VEGF) production inhibition, and enhancing the effectiveness of monoclonal antibody therapies. They disrupt key cancer-promoting pathways and induce lysosomal cell death. Beyond oncology, phenothiazines exhibit antibacterial activity, targeting efflux pumps (Eps) and restoring antibiotic susceptibility in multidrug-resistant (MDR) pathogens. These multifaceted actions position phenothiazines as promising agents for combination therapies in cancer treatment and antibiotic-resistant infections.</p><p><strong>Conclusions: </strong>Phenothiazines hold promise as adjuvants in cancer and antibiotic resistance management. Further research should focus on optimizing their pharmacological profiles, elucidating molecular mechanisms, and validating their efficacy through clinical trials.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"24 1","pages":"e157923"},"PeriodicalIF":1.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curcumin as a Natural Therapeutic Agent: A Rapid Review of Potential Clinical Uses and Mechanisms of Action.","authors":"Mohammad Mohajeri, Reza Momenai, Somayyeh Karami-Mohajeri, Mandana Ohadi, Mohammad Amin Raeisi Estabragh","doi":"10.5812/ijpr-156983","DOIUrl":"10.5812/ijpr-156983","url":null,"abstract":"<p><strong>Context: </strong>Curcumin, a natural compound derived from the rhizome of the turmeric plant, exhibits various pharmacological and therapeutic effects through distinct cellular and molecular mechanisms.</p><p><strong>Evidence acquisition: </strong>Given the therapeutic applications and pharmacological properties of curcumin, it is essential to explore its pharmacological effects for potential use in clinical research. Notably, curcumin demonstrates significant antioxidant, anti-inflammatory, and anti-cancer properties. Importantly, no side effects or specific toxicity have been reported for curcumin.</p><p><strong>Results: </strong>Curcumin, as a natural compound, can be utilized as a drug supplement in treatment regimens for various diseases. Numerous clinical studies have indicated that curcumin enhances the efficacy of chemotherapy drugs or mitigates their side effects when used concurrently.</p><p><strong>Conclusions: </strong>This review presents an overview of studies conducted on the pharmacological effects and therapeutic properties of curcumin.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"24 1","pages":"e156983"},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin Aids in Treating Mood and Sleep Problems Resulting from Hormonal Therapy in Breast Cancer Patients: A Randomized, Double-Blinded, Placebo-Controlled Trial.","authors":"Nima Vaziri, Melika Shakourifar, Parinaz Sattari, Aliereza Sadeghi, Mehran Sharifi, Ayda Moghadas, Azadeh Moghaddas","doi":"10.5812/ijpr-156581","DOIUrl":"10.5812/ijpr-156581","url":null,"abstract":"<p><strong>Background: </strong>Hormone therapy is commonly used to treat breast cancer but can cause mood disorders and sleep disturbances, negatively impacting patients' well-being.</p><p><strong>Objectives: </strong>This trial aimed to evaluate the effects of melatonin on sleep problems and mood changes in breast cancer patients undergoing hormone therapy.</p><p><strong>Methods: </strong>The study was conducted at Omid Hospital in Isfahan, Iran, using a randomized, double-blinded, placebo-controlled design. Participants were assessed using the Hospital Anxiety and Depression Scale (HADS) and were randomly assigned to receive either 6 mg of melatonin or a placebo daily for 4 weeks. Sleep quality, depression levels, and mood states were measured using the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiological Studies-Depression Scale (CES-D), and the Profile of Mood States (POMS) Questionnaires at the beginning and end of the 4-week follow-ups.</p><p><strong>Results: </strong>Sixty participants (34 in the melatonin group and 26 in the placebo group) completed the study. Melatonin administration significantly improved sleep quality, latency, duration, and reduced the use of sleep-promoting medication, according to the PSQI scores. However, there were no significant improvements in depression severity or mood disorders, as assessed by the CES-D and POMS questionnaires, in either group following the 4-week melatonin supplementation period.</p><p><strong>Conclusions: </strong>Melatonin supplementation effectively alleviated sleep disturbances caused by hormone therapy in breast cancer patients. However, the study did not find substantial evidence supporting the use of melatonin for improving mood disorders or depression in this specific context.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e156581"},"PeriodicalIF":1.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Coenzyme Q10 on Cognitive Dysfunction, Antioxidant Defense, Cholinergic Activity, and Hippocampal Neuronal Damage in Monosodium Glutamate-Induced Obesity.","authors":"Zahra Erfanmanesh, Mohammad Amin Edalatmanesh, Mokhtar Mokhtari","doi":"10.5812/ijpr-157068","DOIUrl":"10.5812/ijpr-157068","url":null,"abstract":"<p><strong>Background: </strong>Obesity, a rising global health issue, is linked to numerous disorders, including cognitive impairment.</p><p><strong>Objectives: </strong>This study investigates the effects of coenzyme Q10 (Co-Q10) on cognitive performance, antioxidant defense, cholinergic activity, and hippocampal neuron damage in rats rendered obese by monosodium glutamate (MSG) exposure.</p><p><strong>Methods: </strong>Forty-eight neonatal male Wistar rats were randomly assigned to one of four groups: Control, MSG, MSG + Q10-10, and MSG + Q10-20. Monosodium glutamate (4 g/kg BW) was administered subcutaneously into the cervical region from postnatal day (PND) 2 to PND 10. Coenzyme Q10 (10 mg/kg BW and 20 mg/kg BW) was administered intraperitoneally from PND 30 to PND 42. At the end of the treatment period, working memory and avoidance learning tests were conducted. Anthropometric data were collected, followed by evaluations of hippocampal catalase (CAT), superoxide dismutase (SOD), acetylcholinesterase (AChE), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels. The density of apoptotic/dark neurons (DN) in the CA₁ and CA₃ regions of the hippocampus was also assessed.</p><p><strong>Results: </strong>Monosodium glutamate treatment increased Body Mass Index (BMI) and Lee Index, impaired working memory and avoidance learning, and reduced CAT, SOD, and GPx activities. Additionally, MSG exposure led to elevated MDA levels, increased AChE activity, and higher DN density in the CA₁ and CA₃ hippocampal regions. Treatment with Co-Q10 resulted in a decrease in BMI, enhanced memory and learning, noteworthy increases in CAT, SOD, and GPx activities in the hippocampus, and reductions in MDA levels, AChE activity, and DN density in the CA₁ and CA₃ regions.</p><p><strong>Conclusions: </strong>Coenzyme Q10 mitigates hippocampal neuronal damage and improves cognitive function in MSG-induced obesity, primarily through its antioxidant and AChE inhibitory properties.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e157068"},"PeriodicalIF":1.8,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bupropion Showed Neuroprotective Impacts Against Cerebral Ischemia/Reperfusion Injury by Reducing Oxidative Stress and Inflammation.","authors":"Saeid Baba Ahmadi, Zeinab Afrand Khalilabad, Seyedeh Sepideh Alemohammad, Hasan Yousefi Manesh, Alireza Abdollahi, Farahnaz Jazayeri, Seyyedeh Elaheh Mousavi","doi":"10.5812/ijpr-156838","DOIUrl":"10.5812/ijpr-156838","url":null,"abstract":"<p><strong>Background: </strong>Cerebral ischemia/reperfusion (I/R) injury is the most prevalent form of brain stroke, affecting many patients worldwide. It is believed that oxidative stress and inflammation play major roles in the damage that occurs after the initiation of the disease.</p><p><strong>Objectives: </strong>Therefore, for the first time, the current study aimed to investigate the neuroprotective effects of bupropion against cerebral I/R damage in a rat model.</p><p><strong>Methods: </strong>Forty male rats were divided into four groups: Control, cerebral I/R, and two diseased groups that received 60 and 100 mg/kg of bupropion. One day after induction of the disease, behavioral tests, including grid walking, novel object recognition, and modified neurological severity score (mNSS), were performed on the rats. The levels of inflammatory cytokines, including IL-1β, TNF-α, IL-6, and IL-10, were measured in the rats' brain homogenates. Additionally, the levels of MDA, catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), and NO₂ ^- were measured.</p><p><strong>Results: </strong>Bupropion administration was associated with improved performance in the novel object recognition and grid walking behavioral tests, as well as in the neurological disorder scores, in cerebral I/R rats. Moreover, BCAAO-induced inflammation was reduced by the administration of this drug, evidenced by reduced levels of cytokines IL-1β, TNF-α, and IL-6 and upregulation of IL-10. Additionally, membrane lipid peroxidation was reduced in the cerebral I/R rats receiving 100 mg/kg bupropion, and the level of SOD activity was improved in these animals. Finally, the administration of bupropion prevented the increase in NO₂ ^- levels induced by BCAAO.</p><p><strong>Conclusions: </strong>In conclusion, bupropion has neuroprotective effects against cerebral I/R damage by reducing inflammation and oxidative stress in the brain.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e156838"},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Herbal Compounds as Targeted Therapies for Breast Cancer: Insights from Network Pharmacology, Molecular Docking, MD Simulation, ADME-Toxicity and DFT Profiles.","authors":"Haixia Zhang","doi":"10.5812/ijpr-153579","DOIUrl":"10.5812/ijpr-153579","url":null,"abstract":"<p><strong>Background: </strong>Herbal compounds sourced from various plants are becoming targeted therapies for breast cancer.</p><p><strong>Objectives: </strong>This study aims to explore the potential of focusing on herbal compounds as targeted therapies for breast cancer using computational techniques.</p><p><strong>Methods: </strong>A total of 129 herbal compounds linked with breast cancer were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database. Molecular docking and MD simulation were carried out against three protein targets linked with breast cancer. Network pharmacology was used to identify the common plant sources for the bioactive compounds, and interaction networks were constructed. The ADME-toxicity profiles and density functional theory (DFT) analysis were calculated for the top docking hits.</p><p><strong>Results: </strong>Dipiperitylmagnolol and sophoranone were identified as the top docking hits and lead compounds. Network pharmacology analysis revealed <i>Magnolia species</i> as the common plant sources having multiple bioactive compounds. MD simulation analysis revealed conformational stability of the top docking hits. The analyses underscore the robust binding potential of dipiperitylmagnolol and its possible therapeutic relevance in targeting breast cancer pathways. ADME-toxicity and DFT analysis provided insights into the pharmacokinetic and electronic behavior of the top docking hit. Combinatorial study of herbal therapies with conventional treatments will increase the therapeutic efficacy for breast cancer treatment.</p><p><strong>Conclusions: </strong>The study provides insights into the implications of herbal compounds as targeted therapy for breast cancer. Therefore, the study recommends further experimental validation and development of herbal-based compounds for the treatment of breast cancer.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e153579"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Inhibitory Effects of Probiotic Bacteria and Propolis Extracts on the Growth and Histopathological Changes in Gastric Tissues of <i>Helicobacter pylori</i> Challenged Wistar Rats.","authors":"Roghayeh Kiani, Naheed Mojgani, Farzad Kobarfard, Parvaneh Saffarian, Seyed Abdulmajid Ayatollahi, Mona Khoramjouy","doi":"10.5812/ijpr-148158","DOIUrl":"10.5812/ijpr-148158","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> is a significant contributor to a range of gastrointestinal conditions, with conventional treatment methods primarily relying on antibiotics. However, the rise of antibiotic-resistant strains has necessitated the exploration of alternative therapeutic approaches.</p><p><strong>Objectives: </strong>To determine the <i>in vitro</i> antibacterial potential of probiotic bacteria (<i>Lacticaseibacillus rhamnosus</i> BLRH 260 and <i>Limosilactobacillus reuteri</i>) and four propolis extracts against <i>H. pylori</i> and to analyze their impacts on body weight index and histopathological changes in <i>H. pylori</i>-challenged Wistar rats.</p><p><strong>Methods: </strong>The inhibitory effects of probiotic bacteria (<i>L. rhamnosus</i> BLRH 260 and <i>L. reuteri</i>) and propolis extracts on the growth of <i>H. pylori</i> were evaluated using an agar well diffusion assay. In vivo analysis involved fifty-four male Wistar rats (200 - 250 g) infected with an <i>H. pylori</i> suspension (10⁸ CFU/mL) and orally administered propolis or probiotics (10⁸ CFU/mL) via gavage for 21 days. The effects of different treatments on body weight and histopathological changes in gastric tissue samples were assessed, and the results were statistically analyzed.</p><p><strong>Results: </strong>The tested propolis extracts and the supernatant fluids from the mentioned probiotic strains showed significant antibacterial activity against <i>H. pylori</i> in the agar well diffusion assay, with notable variations. In vivo, the findings demonstrated that oral administrations of propolis and probiotics, either separately or in combination, led to significant increases in body weight and amelioration of histopathological changes in gastric tissue samples, particularly in terms of erosion depth, hemorrhagic inflammation, and apoptosis in the infected animals. Histopathological differences between antibiotic-treated animals and those receiving other treatments were observed, with significant differences.</p><p><strong>Conclusions: </strong>The results of this study underscore the potential therapeutic benefits of propolis and probiotics in addressing <i>H. pylori</i>-induced gastropathy. Additional research is necessary to clarify the mechanisms involved and to refine dosage and treatment protocols for optimal effectiveness.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e148158"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Toxicity Mechanisms of Carbon Nanotubes and Near-Infrared Light Wave on the Colon and Hepatoma Cancer Cells.","authors":"Farshad Lotfollahzadeh, Nasim Nobari, Fatemeh Ghanbary, Hossein Hooshyar","doi":"10.5812/ijpr-157296","DOIUrl":"10.5812/ijpr-157296","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a devastating disease with varying mortality rates and severe treatment side effects. Researchers are exploring alternative treatments that target cancer cells with high selectivity and minimal side effects. Photothermal therapy has shown promise as one such treatment option.</p><p><strong>Objectives: </strong>Single-walled carbon nanotubes (SWCNTs) and multi-walled carbon nanotubes (MWCNTs) can penetrate cellular membranes and convert near-infrared light into heat for photothermal therapy (PTT).</p><p><strong>Methods: </strong>In a recent study, carbon nanotubes (CNTs) were used in combination with PTT to treat HT29 and PCL/PRF/5 cancerous cells for different durations (6, 12, 24, 48, and 72 hours). The cytotoxicity of each treatment was evaluated through MTT assay, reactive oxygen species (ROS) analysis, lipid peroxidation, lysosomal membrane integrity, and protein carbonyl analysis.</p><p><strong>Results: </strong>The study found that SWCNTs, MWCNTs, and PTT each individually had a significant cytotoxic effect on cancer cells. However, when used together, they were even more effective in destroying cancer cells. Combining SWCNTs with PTT resulted in the highest level of cytotoxicity.</p><p><strong>Conclusions: </strong>These findings suggest that using CNTs, especially SWCNTs, in combination with PTT shows promise for treating cancer.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e157296"},"PeriodicalIF":1.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Trastuzumab-Emtansine Versus Trastuzumab for the Treatment of Residual Invasive HER-2-Positive Breast Cancer in Iran.","authors":"Homa Hemati, Marzieh Nosrati, Meysam Seyedifar","doi":"10.5812/ijpr-153452","DOIUrl":"10.5812/ijpr-153452","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is one of the most common types of cancer in women, and its incidence is increasing in Iran. HER-2-positive breast cancer is invasive and often associated with poorer outcomes. Patients with this type of breast cancer can develop resistance to medications like trastuzumab. Trastuzumab-emtansine (TDM1) is a medication developed to reduce cancer cell resistance to trastuzumab. The TDM1 has been shown to decrease the incidence of death and recurrence in breast cancer.</p><p><strong>Objectives: </strong>This study aimed to evaluate the cost-utility and calculate the budget impact of TDM1 versus trastuzumab for the treatment of residual invasive HER-2-positive breast cancer.</p><p><strong>Methods: </strong>A Markov model with a lifetime horizon was developed, incorporating four health states. Women aged 45 with residual invasive HER-2-positive breast cancer entered the model. The study adopted a healthcare system perspective, with costs reported in 2021 US dollars. Discount rates of 7% for costs and 3% for utility values were applied. Utility values and transition probabilities were derived from published literature. Costs were estimated based on guidelines, expert opinions, and Iranian tariffs. Iran's pharmacoeconomic threshold of 1085$ was used for comparison. The incremental cost-effectiveness ratio (ICER) and budget impact of TDM1 were calculated, and sensitivity analyses were conducted to assess the robustness of the model.</p><p><strong>Results: </strong>The model indicated that treatment with TDM1 resulted in a 1.59 quality-adjusted life year (QALY) increase, with an additional cost of 1408$. This was deemed cost-effective, considering Iran's pharmacoeconomic threshold of 1085$ (calculated ICER: 886$ per QALY gained). One-way sensitivity analysis revealed that the model was sensitive to the costs of TDM1 and trastuzumab, the discount rates for utility values and costs, and the probability of achieving invasive disease-free survival (IDFS). Probabilistic sensitivity analysis showed that 59.61% of simulations fell below Iran's pharmacoeconomic threshold, supporting the model's robustness. The budget impact analysis revealed that the additional budget required for TDM1 treatment over a three-year period was 1,120,546$ compared to trastuzumab.</p><p><strong>Conclusions: </strong>Although TDM1 imposes higher costs, it is more cost-effective than trastuzumab for the treatment of residual invasive HER-2-positive breast cancer in Iran.</p>","PeriodicalId":14595,"journal":{"name":"Iranian Journal of Pharmaceutical Research","volume":"23 1","pages":"e153452"},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}