FARMACIA HOSPITALARIA最新文献

{"title":"[Translated article] Multicenter retrospective analysis of sodium thiosulfate as treatment for non-uremic calciphylaxis","authors":"Laura Cardona-Roca ,&nbsp;Laura Borràs Trias ,&nbsp;Rosario Bueno Uceda ,&nbsp;Adrià Siles ,&nbsp;Adrián Vilariño Seijas ,&nbsp;Nuria Rudi Sola ,&nbsp;Carlos Seguí-Solanes","doi":"10.1016/j.farma.2025.05.015","DOIUrl":"10.1016/j.farma.2025.05.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the results obtained in terms of effectiveness and safety of intravenous sodium thiosulfate in patients diagnosed with non-uremic calciphylaxis, to identify and analyse possible etiological factors of the disease, and to determine the associated morbidity and mortality.</div></div><div><h3>Method</h3><div>A multicenter and retrospective study was conducted with patients diagnosed with non-uremic calciphylaxis who received intravenous sodium thiosulfate between 2013 and 2023. Effectiveness was evaluated based on the status of the ulcers at the end of treatment, and safety was assessed according to the main reported adverse effects and the need for dosage adjustment.</div></div><div><h3>Results</h3><div>A total of 33 patients from three university hospitals were evaluated (93.9% Caucasian, 78.8% women, mean age 80 [SD 8.1] years) with non-uremic calciphylaxis confirmed by skin biopsy. The localization pattern was 90.9% distal. The following complementary therapeutic measures were undertaken: topical wound care, removal of precipitating factors (mainly vitamin D supplements and vitamin K antagonists), medications to reduce calcification (bisphosphonates, cinacalcet), and techniques to promote ulcer healing. The main associated factors for developing calciphylaxis were: non-uremic chronic kidney disease (81.8%), vitamin D supplementation (72.7%), and hypoalbuminemia (66.7%). The most commonly used sodium thiosulfate dosage was 25 g (<em>n</em> = 26) three times per week (<em>n</em> = 28) intravenously, with a median treatment duration of 11.4 (IQR 5.7-18) weeks. A complete resolution or improvement of the ulcers was achieved in 78.8% of the cases. Adverse effects were observed in 96.7% of patients, with the most common being metabolic acidosis (<em>n</em> = 19) and nausea and/or vomiting (<em>n</em> = 18). Dosage adjustments due to toxicity were necessary in 9% of cases. The significant morbidity rate was 69.7% (<em>n</em> = 23). The main complications were: 57.6% ulcer superinfection and 24.3% poor pain control. The overall mortality rate was 66.7%; 42.4% within the first 6 months after diagnosis and 39.4% secondary to non-uremic calciphylaxis.</div></div><div><h3>Conclusions</h3><div>Sodium thiosulfate shows a potential benefit in the treatment of ulcers due to non-uremic calciphylaxis, with a similar safety profile to that reported for uremic calciphylaxis, considering the high morbidity and mortality associated with the condition. Further studies are needed to determine its efficacy and assess the specific contribution of the different treatments used.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 5","pages":"Pages T299-T303"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National assessment of the feasibility and satisfaction of e-prescribing programmes in critical care units.","authors":"Eduardo Tejedor-Tejada, Esther Domingo Chiva, Miguel Ángel Amor García, Maria Jesús Jimenez Cerezo, María Martín-Cerezuela","doi":"10.1016/j.farma.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.009","url":null,"abstract":"<p><strong>Introduction: </strong>Intensive Care Units (ICU) are recognized as high-risk settings for medication errors, primarily due to the complex pharmacological regimens and the critical condition of patients. It is estimated that the probability of errors occurring in these units is two to three times higher than in general hospital patients, with prescribing and administration being the stages most frequently associated with such incidents.</p><p><strong>Objective: </strong>To evaluate the applicability and satisfaction with electronic prescribing systems in Intensive Care Units of hospitals in Spain.</p><p><strong>Methods: </strong>A nationwide survey was conducted targeting pharmacists to assess the functionalities of the electronic prescribing systems used in these units. The evaluation covered hospital characteristics, features of the prescribing software, and healthcare professionals' satisfaction, with the aim of understanding the current situation and proposing improvement strategies to enhance medication safety through prescribing systems in the context of critically ill patients.</p><p><strong>Results: </strong>A total of 64 surveys were completed across 55 different hospitals. In 50.8% of cases, a prescribing system different from that used in general hospital wards was employed. In 84.4% of cases, the system had been developed by a commercial vendor. In 65.1% of hospitals, the system enabled communication with the pharmacy, and in 57.7% it allowed for pharmaceutical validation. However, 50.8% of the systems were not capable of interfacing with automated dispensing or administration systems. In 71.9% of cases, the system allowed for direct data extraction. Pharmacists reported satisfactory overall perceptions in only 43.8% of cases, while 42.9% identified unmet needs requiring improvement.</p><p><strong>Conclusions: </strong>Despite significant heterogeneity in the functionalities of electronic prescribing systems across Spanish ICUs, such systems are widely implemented nationwide and are regarded as a key element in ensuring medication safety within these units. Clinical pharmacists reported a generally acceptable level of satisfaction; however, there remains considerable scope for improvement.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification tool for pharmaceutical care in patients with cardiovascular disease.","authors":"Anna de Dios Lopez, Esther Vicente Escrig, Paloma Sempere Serrano, Ramón Morillo-Verdugo","doi":"10.1016/j.farma.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.001","url":null,"abstract":"<p><strong>Objective: </strong>To develop a risk stratification tool for pharmaceutical care in patients with cardiovascular disease who require a comprehensive and personalized pharmaceutical approach.</p><p><strong>Method: </strong>The risk stratification model was collaboratively developed by hospital pharmacists specialized in managing cardiovascular risk patients, all members of the Spanish Society of Hospital Pharmacy. Through three workshops and a pilot study, relevant variables were identified, grouped into four dimensions, and assigned relative weights. In the pilot study, data from patients in the participating centers were collected and analyzed to determine priority levels and assess the contribution of each variable. The Kaiser Permanente pyramidal model was adopted, classifying patients into three priority levels: priority 1 (intensive pharmaceutical care, 90th percentile), priority 2 (60-90th percentiles), and priority 3 (below the 60th percentile). Cut-off points were established based on this stratification, and each center recorded variables in an Excel sheet to calculate mean weighted scores per priority level and total risk scores.</p><p><strong>Results: </strong>Participants completed a questionnaire consisting of 20 variables grouped into four dimensions: demographic, socio-health and functional status, clinical and healthcare utilization, and treatment-related factors. Based on the tool application in a pretest study, the following cut-off points were established: 23 or more points for priority 1, 17-22 points for priority 2, and fewer than 16 points for priority 3. Over 80% of the total score was attributed to the dimensions of \"clinical and healthcare utilization\" and \"treatment-related factors\". Consequently, interventions based on the pharmaceutical care model were recommended for cardiovascular risk patients, tailored to their prioritization level.</p><p><strong>Conclusion: </strong>This stratification tool enables the identification of cardiovascular patients who require a higher level of pharmaceutical care, facilitating the adjustment of healthcare capacity. Validation of the model in a representative population is necessary to establish its broader applicability.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical approach to pain management in pediatric patients in a terminal situation: A systematic review.","authors":"Cristina Casanova-Martínez, Mónica Gayoso-Rey","doi":"10.1016/j.farma.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.001","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric palliative care aims to provide a professional, scientific, and compassionate response to the needs of terminally ill pediatric patients, with pain management being one of its fundamental pillars. This systematic review analyzes the ethical aspects involved in the management of pain in pediatric patients at the end of life, using the core principles of clinical bioethics: autonomy, beneficence, non-maleficence, and justice as a framework.</p><p><strong>Materials and methods: </strong>A systematic review was conducted following the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Original qualitative or quantitative studies published between 2010 and 2024 in English or Spanish were included, provided they addressed pain management in pediatric palliative care from an ethical perspective. The databases consulted were PubMed, Scopus, and Web of Science. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>A total of 18 studies met the inclusion criteria. Autonomy was addressed in a limited manner, often through indirect participation of the child via their caregivers. The principles of beneficence and non-maleficence were compromised by the underuse of analgesics due to fear of adverse effects, delays in referral to palliative care, and the continuation of futile treatments. The principle of justice was reflected in structural barriers, unequal access to opioids, and limited availability of specialized care, particularly in resource-limited settings.</p><p><strong>Conclusions: </strong>Bioethical principles are present in the management of terminal pediatric pain, but their application remains inconsistent. There is a clear need to enhance professional training, implement standardized clinical protocols, and promote effective communication with families.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and pharmacodynamics studies of phage therapy.","authors":"Lucía Blasco, Inés Bleriot, Patricia Fernández-Grela, José Ramón Paño-Pardo, Jesús Oteo-Iglesias, María Tomás","doi":"10.1016/j.farma.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.007","url":null,"abstract":"<p><p>The need for new antimicrobial treatments that work alternatively or synergistically with antibiotics to address the problem of the emergence and transmission of antimicrobial resistance has increased interest in the use of minority therapies such as phage therapy. For safe and widespread application of this therapy, it is necessary to establish the pharmacokinetic and pharmacodynamic parameters for its use in humans. This systematic review analyzes the criteria necessary to establish the PK/PD of this therapy, as well as its current application, based on a review of 66 clinical cases that catch diverse infections and phage administration routes.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Cost-utility of sacubitril/valsartan in heart failure with reduced ejection fraction in Spain.","authors":"Antonio García-Quintana, Héctor Alonso Ramos, Javier Parrondo","doi":"10.1016/j.farma.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hospital discharges in Spain.</p><p><strong>Objective: </strong>To analyze the economic impact of new treatments for heart failure with reduced ejection fraction such as sacubitril/valsartan in out-patient and in-patient setting.</p><p><strong>Material and methods: </strong>The present economic evaluation study was carried out by developing a Markov model. Treatment with sacubitril/valsartan from admission or after hospital discharge was compared, with enalapril being the comparator. Total costs, years of life gained, quality-adjusted life years, and incremental cost-effectiveness ratio and incremental cost-utility ratio were analyzed. Data were obtained from the PARADIGM-HF and PIONEER-HF studies.</p><p><strong>Results: </strong>The results of the base cases of the three comparisons made showed that sacubitril/valsartan produced benefits in years of life gained and quality-adjusted life years compared to enalapril showing incremental cost-utility ratio below €20,000/QALY and that this ratio was better in scenarios starting sacubitril/valsartan in the hospital setting once decompensation was resolved.</p><p><strong>Conclusion: </strong>This study shows that starting sacubitril/valsartan from hospital admission for heart failure is cost-effective from the perspective of the National Health Service in Spain.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on the perioperative management of chronic medication in surgical patients.","authors":"Laura Victoria Valdeolmillos Carbó, Maria Jesus Esteban Gómez, Irene Ruiz-Jarabo Gómez, Almudena Ribed Sánchez, Noelia Vicente Oliveros, Ana Belén Guisado Gil, Ainara Campino Villegas, Pilar Campillos, Pilar Olier Martínez, Jan Thomas de Pourcq","doi":"10.1016/j.farma.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.002","url":null,"abstract":"<p><strong>Introduction: </strong>In the perioperative setting, appropriate management of chronic medications is of great importance in determining which medications to discontinue and when to reintroduce them. Although individual decisions based on patient and surgical risk are required, the need for national consensus has been identified.</p><p><strong>Objective: </strong>To provide a set of specific recommendations for the perioperative management of chronic medication, based on recent scientific evidence and expert consensus, with the aim of improving the safety of surgical patient care.</p><p><strong>Method: </strong>A review of the available literature was conducted on perioperative recommendations for the drugs most commonly included in the chronic medication regimens of patients undergoing surgery. The review encompassed drug datasheets, literature from Medline and the Cochrane Library, as well as information from other databases such as UpToDate® and Micromedex®.</p><p><strong>Results: </strong>Recommendations are summarized for various medications grouped by pharmacotherapeutic group, specific medications for the treatment of immune-mediated diseases, and finally natural supplements and herbal therapy.</p><p><strong>Conclusions: </strong>The information collected in this article can help the healthcare team to determine the approach to the patient's chronic medication.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-acetylcysteine: 50 years since the discovery of an antidote that has changed the prognosis of acetaminophen poisoning.","authors":"Santiago Nogué-Xarau, Lidia Martínez-Sánchez, Milagros García-Peláez, Edurne Fernández de Gamarra-Martínez, Núria Pi-Sala, Àngels Gispert-Ametller, Emilio Salgado-García, Raquel Aguilar-Salmerón","doi":"10.1016/j.farma.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.005","url":null,"abstract":"<p><p>Acetaminophen is one of the most widely used drugs in clinical practice due to its analgesic and antipyretic properties. However, overdose is one of the leading causes of severe acute liver failure. N-acetylcysteine, introduced as an antidote in 1974, has revolutionized the management of this intoxication by reducing hepatotoxicity and mortality associated with acetaminophen toxicity. At the end of the 19th century, acetaminophen was identified as the main active metabolite of phenacetin and acetanilide. Its therapeutic use began to gain popularity in the 1950s and later became one of the main drugs involved in suicide attempts, particularly among adolescents and young adults. Acetaminophen-induced hepatotoxicity was first described in 1966, establishing that an overdose could lead to fulminant hepatic necrosis. In 1975, Rumack and Matthew published a nomogram that allowed stratification of hepatic toxicity risk based on plasma drug levels. The mechanism of hepatotoxicity was elucidated in the early 1970s when it was discovered that acetaminophen is metabolized by cytochrome P450 into a highly reactive intermediate, N-acetyl-p-benzoquinoneimine, which is normally neutralized by hepatic glutathione. In overdose situations, glutathione depletion leads to hepatic necrosis. Based on these findings, sulfhydryl-containing agents such as cysteamine and methionine were introduced as antidotes, but N-acetylcysteine ultimately proved to be the most effective treatment. Since its introduction, N-acetylcysteine administration protocols have evolved to optimize efficacy and minimize adverse effects. Protocols such as the Scottish and Newcastle Acetylcysteine Protocol and the Two Bags regimen have simplified dosing and reduced the incidence of anaphylactoid reactions. Over the past 50 years, N-acetylcysteine has saved thousands of lives and remains the gold-standard antidotal treatment for acetaminophen poisoning.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of age on the efficacy of immunochemotherapy in non-small cell lung cancer.","authors":"Alicia Aguado-Paredes, Laura Moñino-Dominguez, Jaime Cordero-Ramos, Emilio Alegre-Del-Rey","doi":"10.1016/j.farma.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.farma.2025.06.001","url":null,"abstract":"<p><strong>Objective: </strong>There is uncertainty about how age affects the efficacy of immunotherapy due to the natural process of immunosenescence. The aim of this systematic review and meta-analysis is to assess whether age over 65 years affects the efficacy, in terms of overall survival, of immunotherapy treatments in combination with chemotherapy or double immunotherapy, used in first-line metastatic non-small cell lung cancer without molecular alterations.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed. A systematic search of PubMed and Cochrane Library until April 30, 2024 was conducted to identify randomized clinical trials comparing an experimental treatment with immune checkpoint inhibitors plus chemotherapy versus a platinum-based chemotherapy doublet in patients with locally advanced or metastatic non-small cell lung cancer, without molecular mutations and with any level of programmed death ligand 1 expression. The primary endpoint was the difference in efficacy between those older and younger than 65 years, measured in terms of difference in overall survival hazard ratio. We calculated the hazard ratio for overall survival with its 95% confidence interval in both age groups and assessed heterogeneity using an interaction test.</p><p><strong>Results: </strong>A total of 1,505 publications were identified, of which 7 clinical trials were included. In addition, the European public report evaluating pembrolizumab in combination with platinum and nab-paclitaxel was incorporated. In total, the analysis included 5,572 patients: 2,893 under 65 years of age and 2,679 aged 65 years or older. The pooled Hazard Ratio for overall survival for patients in the first group was 0.68 (95% CI: 0.62-0.74), and for the second 0.77 (95% CI: 0.70-0.84). The p-interaction between the pooled Hazard Ratio of both groups was 0.0551.</p><p><strong>Conclusions: </strong>Both those younger and older than 65 years benefit from immunotherapy combined with chemotherapy in the treatment of non-small cell lung cancer. Although there appears to be greater efficacy in those younger than 65 years, the influence of age is not entirely clear.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose abiraterone acetate for the treatment of prostate cancer: An observational cohort study.","authors":"Luis Angel Di-Giuseppe, Rodney Alexander Ramirez-Murillo, Mariano Daniel Aymar, Luis Roberto Basbus, Milagros Cornec, Sergio Adrián Terrasa, Maria Lourdes Posadas-Martínez, Mariana Andrea Burgos, Gabriela Buela, Federico Cayol","doi":"10.1016/j.farma.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.farma.2025.06.012","url":null,"abstract":"<p><strong>Objective: </strong>To compare radiographic progression-free survival in metastatic prostate cancer patients treated with low-dose abiraterone versus standard-dose abiraterone acetate (Abi-SD), and to evaluate prostate-specific antigen progression-free survival.</p><p><strong>Methods: </strong>Retrospective cohort study of patients with metastatic prostate cancer, castration-sensitive or castration-resistant, treated with low or standard-dose abiraterone. All patients were followed until radiographic or prostate-specific antigen progression. Cox proportional hazards regression was used to assess radiographic progression-free survival and prostate-specific antigen progression-free survival according to abiraterone dose (low vs. standard-dose). The model was adjusted for Charlson Comorbidity Index, castration resistance status, disease volume based on CHAARTED criteria, and presence of de novo metastases.</p><p><strong>Results: </strong>A total of 144 patients with metastatic prostate cancer were included in the study, with 28.4% (n = 41) receiving low-dose abiraterone. The median age was 79 years (IQR: 75-85) in the low-dose group and 75 years (IQR: 70-81) in the standard-dose group. For radiographic progression-free survival, the crude hazard ratio for the low-dose group compared with the standard-dose group was 0.49 (95% CI: 0.23-1.07). After adjusting for clinical variables, the adjusted hazard ratio was 0.65 (95% CI: 0.29-1.45). For prostate-specific antigen progression-free survival, the crude hazard ratio was 0.48 (95% CI: 0.24-0.90), and the adjusted hazard ratio was 0.58 (95% CI: 0.29-1.14).</p><p><strong>Conclusion: </strong>This study provides evidence supporting the use of low-dose abiraterone in patients with metastatic prostate cancer, showing survival and progression outcomes comparable to those of the standard-dose. This approach may improve access to treatment; however, larger studies are needed to validate these findings.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}