Canadian Journal of Health Technologies最新文献

{"title":"Maralixibat (Livmarli)","authors":"Cadth","doi":"10.51731/cjht.2024.889","DOIUrl":"https://doi.org/10.51731/cjht.2024.889","url":null,"abstract":"\u0000CADTH recommends that Livmarli should be reimbursed by public drug plans for the treatment of cholestatic pruritus in patients with Alagille syndrome (ALGS) if certain conditions are met. \u0000Livmarli should only be covered to treat patients aged 12 months and older with a diagnosis of ALGS and who have impaired bile flow demonstrated by at least 1 of the following: elevated serum bile acids (sBAs), conjugated bilirubin, or gamma-glutamyl transferase; fat-soluble vitamin deficiency; and/or intractable itch. Patients must experience moderate to severe itch symptoms and must be currently or have been previously treated with systemic medication for itch. \u0000Livmarli should only be reimbursed if it is prescribed under the care of a specialist with experience in managing ALGS, if patients experience an improvement in their itching after using Livmarli for 6 months, and if the cost of Livmarli is reduced. Livmarli should be stopped if the patient receives a liver transplant or biliary diversion surgery. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997040","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":"Infliximab (Remsima SC)","authors":"Cadth","doi":"10.51731/cjht.2024.891","DOIUrl":"https://doi.org/10.51731/cjht.2024.891","url":null,"abstract":"\u0000We recommend that Remsima SC be reimbursed by public drug plans as maintenance treatment for adults with moderately to severely active Crohn disease (CD) whose disease has had an inadequate response, or who were intolerant to, conventional therapy if certain conditions are met. \u0000Remsima SC maintenance treatment should only be covered to treat adults with moderately to severely active CD whose disease had an inadequate response, or who are intolerant, to conventional therapy. Patients are required to achieve a clinical response to induction therapy with infliximab IV at week 10 of treatment to continue with Remsima SC as maintenance therapy. \u0000Remsima SC should only be reimbursed if prescribed by a physician experienced in diagnosing and managing CD and should not be combined with a biologic or Janus kinase (JAK inhibitor) treatment for CD. The cost of Remsima SC should not exceed the drug program cost of treatment with the least costly biologic therapy reimbursed for the treatment of CD. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995191","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":"Inclisiran (Leqvio)","authors":"Cadth","doi":"10.51731/cjht.2024.890","DOIUrl":"https://doi.org/10.51731/cjht.2024.890","url":null,"abstract":"\u0000CADTH recommends that Leqvio not be reimbursed by public drug plans as an adjunct to lifestyle changes, including diet, to further reduce low-density lipoprotein cholesterol (LDL-C) levels in adults who are on a maximally tolerated dose (MTD) of a statin, with or without other LDL-C–lowering therapies, and who have nonfamilial hypercholesterolemia (nFH) with atherosclerotic cardiovascular disease (ASCVD). \u0000Evidence from 2 clinical trials showed that treatment with Leqvio lowered bad cholesterol (LDL-C) in adults with nFH with ASCVD who were already being treated with the highest possible dose of statins and in those who cannot tolerate treatment with statins. \u0000A post hoc pooled analysis of major adverse cardiovascular events (MACEs) from the ORION-10 and ORION-11 trials precluded the Canadian Drug Expert Committee (CDEC) from determining whether inclisiran reduces the risk of cardiovascular morbidity and death in adults with nFH with ASCVD. \u0000Patients identified a need for treatments that are less burdensome, can reduce bad cholesterol (LDL-C) and cardiovascular morbidity and death, and improve health-related quality of life (HRQoL); however, there was not enough evidence to show that Leqvio would reduce cardiovascular morbidity and death or improve HRQoL. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997480","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":"Etranacogene Dezaparvovec (Hemgenix)","authors":"Cadth","doi":"10.51731/cjht.2024.888","DOIUrl":"https://doi.org/10.51731/cjht.2024.888","url":null,"abstract":"\u0000CADTH recommends that public drug plans reimburse Hemgenix for the treatment of hemophilia B if certain conditions are met. \u0000Hemgenix should only be covered to treat patients (≥ 18 years of age) with moderately severe to severe hemophilia B (circulating coagulation factor IX [FIX] ≤ 2%) if their bleeding requires ongoing prophylactic treatment, their titre of the neutralizing antibody to variant adeno-associated virus 5 (AAV5) is below 1:900, they do not have FIX inhibitors, and if they have not previously received gene therapy to treat hemophilia B. \u0000Hemgenix should only be reimbursed if it is prescribed by specialists who are experts in treating hemophilia B and the cost of Hemgenix is reduced. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000960","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":"Cannabidiol (Epidiolex)","authors":"Cadth","doi":"10.51731/cjht.2024.887","DOIUrl":"https://doi.org/10.51731/cjht.2024.887","url":null,"abstract":"\u0000CADTH recommends that Epidiolex be reimbursed by public drug plans as adjunctive therapy for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients aged 2 years and older, if certain conditions are met. \u0000Epidiolex should only be covered to treat patients aged 2 years or older who have a clinical diagnosis of seizures associated with LGS and experience at least 2 drop seizures per week over the course of 28 days, and whose seizures are not adequately controlled with 2 or more other antiseizure medications. \u0000Epidiolex should be reimbursed if prescribed by a physician with expertise in the diagnosis and management of patients with LGS and if the price of Epidiolex is reduced. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"27 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004752","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":"Anticytokine Therapy and Corticosteroids for Cytokine Release Syndrome and for Neurotoxicity Following T-Cell Engager or CAR T-Cell Therapy","authors":"Cadth","doi":"10.51731/cjht.2024.884","DOIUrl":"https://doi.org/10.51731/cjht.2024.884","url":null,"abstract":"What Is the Issue? \u0000 \u0000Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are the most common toxicities secondary to T-cell engager or chimeric antigen receptor (CAR) T-cell therapy. \u0000The US FDA and Health Canada approved tocilizumab, an anti-interleukin-6 receptor antagonist, for the management of severe or life-threatening cases of CRS. \u0000Corticosteroids also play an important role in CRS management and are the mainstay of ICANS management. \u0000Decision-makers are interested in understanding the use of anticytokine drugs (i.e., tocilizumab, anakinra, siltuximab) and/or corticosteroids in the management of CRS and ICANS following T-cell engager or CAR T-cell therapy. \u0000 \u0000What Did We Do? \u0000 \u0000We identified and summarized the literature comparing the clinical effectiveness and safety of anticytokine therapy and/or corticosteroids with alternative care or treatment as usual for treating and preventing of CRS and ICANS. We also searched for evidence-based recommendations for the use of anticytokine therapy and/or corticosteroids to treat and prevent CRS and ICANS. \u0000A research information specialist conducted a literature search of peer-reviewed and grey literature sources published between January 1, 2019 and February 26, 2024 for CRS; and between January 1, 2019 and March 4, 2024 for ICANS. One reviewer screened citations for inclusion based on predefined criteria, critically appraised the included studies, and narratively summarized the findings. \u0000 \u0000What Did We Find? \u0000 \u0000This report presents evidence-based findings on 3 retrospective chart review studies, 2 prospective cohort studies, and 4 consensus guidelines. \u0000Limited and low-quality clinical evidence from studies with a high risk of bias suggested that early use of tocilizumab or corticosteroids, or prophylactic use of tocilizumab or anakinra may reduce the risk of a high-grade CRS without a negative impact on neurotoxicity or immunotherapy treatment outcomes. \u0000The included guidelines recommend the use of tocilizumab for treatment of higher-grade CRS, or for treatment of grade 1 CRS if symptoms persist for 3 days or more. Corticosteroids could be added in conjunction if there is no improvement or persistent symptoms after tocilizumab therapy. \u0000For the management of ICANS in the absence of concurrent CRS, supportive care is the preferred treatment option for grade 1 ICANS, while corticosteroids are recommended for the management of grade 2 to 4 ICANS. In the presence of concurrent CRS, guidelines recommend tocilizumab therapy as per management of CRS, and corticosteroids should be continued until improvement to grade 1. \u0000We did not identify any clinical evidence regarding the clinical efficacy and safety of anticytokine therapy and/or corticosteroids for treatment of CRS and ICANS compared with alternative treatment or treatment as usual. \u0000We also did not identify any guidelines for the use of prophylactic anticytokine therapy, corticosteroids, or both fo","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018522","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":"Biologic Drugs for Severe Asthma","authors":"Jason R. Randall, Richard Leigh, Ellen T. Crumley, Sylvia Aponte-Hao, Ngoc Khanh Vu, Karen Martins, Scott Klarenbach","doi":"10.51731/cjht.2024.883","DOIUrl":"https://doi.org/10.51731/cjht.2024.883","url":null,"abstract":"\u0000Several biologic drugs are available to treat severe asthma. These biologics are designed to target specific inflammatory subtypes of asthma (eosinophilic or allergic). \u0000A Rapid Review was conducted to describe the evidence on the comparative efficacy and safety of biologics, and to characterize the patient populations studied. The Rapid Review was done to determine if a subsequent health technology assessment (HTA) was feasible which would be used to provide guidance on the alignment of the drug funding criteria by the public drug plans. \u0000The evidence included in the Rapid Review mainly focused on specific severe asthma subtypes. Comparing the efficacy of biologics for asthma was challenging because of differing definitions of asthma severity and inconsistent application of severity criteria in the included studies. Recruitment and outcome reporting among different asthma subgroups was limited and varied. An HTA of the existing data is unlikely to provide new insights to further inform the reimbursement of biologics in severe asthma. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"6 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055007","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":"Artificial Intelligence for Patient Flow","authors":"Cadth Horizon, Scan","doi":"10.51731/cjht.2024.877","DOIUrl":"https://doi.org/10.51731/cjht.2024.877","url":null,"abstract":"Why Is This an issue? \u0000 \u0000Inefficient patient flow contributes to the overcrowding of health care settings and negative clinical outcomes and patient experiences downstream. \u0000Patient flow management aims to achieve seamless patient movement through the health care system and between acute and long-term settings, ensuring timely access to quality care. \u0000 \u0000What Is the Technology? \u0000 \u0000Artificial intelligence (AI)-based patient flow management tools are interventions designed to forecast and monitor patient movement from admission to discharge as they progress through different care settings. AI-driven tools can leverage big data and digital information systems (e.g., electronic health records) to facilitate effective patient flow. \u0000AI-based patient appointment scheduling tools, which can help improve patient flow, are created to automate appointment scheduling and optimize it by minimizing wait times and matching the demand for health services and hospital capacity. \u0000 \u0000What Is the Potential Impact? \u0000 \u0000AI tools for patient flow management can support volume forecasting of patients with various conditions, especially those experiencing chronic conditions that require different types of treatment or care in different settings over a long period of time. \u0000These AI tools can predict admissions, patient movement from the emergency department to inpatient beds, discharge, and transfers to different health care settings. Evidence for their effectiveness in patients with emergency admissions and those transferred to tertiary and quaternary care, as well as inpatients from the general, cardiology, and mental health departments, was reported. In addition, evidence suggested that AI tools can optimize appointment scheduling in general outpatient settings and operating rooms. \u0000In health care systems in Canada, AI tools are being used or investigated to enhance patient flow by predicting emergency admissions, transfers to alternate levels of care, and general inpatient discharges, as well as optimizing capacity planning for patients receiving oncology care. AI appointment scheduling tools are currently being used in some oncology care settings and operating rooms across Canada. \u0000The implementation of AI systems generally requires an upfront investment of time and other resources in addition to the financial cost of the system itself for set-up, integration, and staff training. The goal of these systems is to improve efficiency and save money, time, and human resources in the long run. \u0000 \u0000What Else Do We Need to Know? \u0000 \u0000Patient privacy and data security issues are concerns regarding widespread implementation of AI tools trained on electronic health records systems and patient datasets. \u0000AI algorithms trained on datasets lacking adequate representation of all relevant patients may not predict their flow accurately. Training datasets with sufficient data from all relevant patient groups can ensure the inputs and outputs of the algorithms accurately reflect patient ca","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033119","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":"Teclistamab (Tecvayli)","authors":"Cadth","doi":"10.51731/cjht.2024.874","DOIUrl":"https://doi.org/10.51731/cjht.2024.874","url":null,"abstract":"\u0000CADTH recommends that Tecvayli (teclistamab) be reimbursed by public drug plans for the treatment of adults with relapsed or refractory (r/r) multiple myeloma (MM) who have received at least 3 prior lines of therapy, including a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 monoclonal antibody (mAb), and who have demonstrated disease progression on the last therapy if certain conditions are met. \u0000Tecvayli should only be covered to treat adults with MM who have received at least 3 prior treatments, have disease that has not responded to their last treatment, and are in relatively good health. Tecvayli should not be reimbursed to treat those whose MM is affecting their brain or spinal cord or those showing signs that the tissue layers protecting the brain and spinal cord are affected by MM. It also should not be reimbursed in those with amyloidosis (a buildup of a protein, amyloid, in organs) that is not secondary to MM, and those with plasma cell leukemia. \u0000Tecvayli should only be reimbursed if it is prescribed and administered by health professionals at treatment centres with adequate medical resources and personnel. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"42 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140662916","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":"Drospirenone (Slynd)","authors":"Cadth","doi":"10.51731/cjht.2024.867","DOIUrl":"https://doi.org/10.51731/cjht.2024.867","url":null,"abstract":"\u0000CADTH recommends that Slynd should be reimbursed by public drug plans for conception control in adolescent and adult women if certain conditions are met. \u0000Slynd should be covered for conception control in adolescent and adult women provided that Slynd is listed in a similar way to other oral contraceptive pills currently reimbursed by public drug plans for the prevention of pregnancy. \u0000Slynd should only be reimbursed if the cost does not exceed that of other progestin-only pills (POPs) for contraception. \u0000","PeriodicalId":505661,"journal":{"name":"Canadian Journal of Health Technologies","volume":"6 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140745926","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}