Uso e Abuso dei Farmaci

P Pronzato

Padova, 23.03.2016

PERIPLO

Choosing Wisely®: ASCO Identifies Five Key Opportunities

in Oncology to Improve Value of Patient Care

5. Don’t use white cell stimulating

factors for primary prevention

of febrile neutropenia for

patients with less than 20% risk

for this complication (with few

exceptions).

2

2

LE Schnipper, JCO 2012

• Use: (proper) utilization/application

• Abuse: misuse, excessive use, over-use

• Under-use: under-utilization

THM

• Clinical Condition of High Risk for FN

– Not for any CT

• Reduction (not removal) of FN

– Relevant for Perception

• Results achieved with «long-term»

administration

– No evidence for «short-term»

PPP versus CP

G von Minckwitz, EJC 2008

JD Wright, JAMA 2013

S Barni, Med Oncol 2013

S Barni, Med Oncol 2013

Results Interpretation

• Unappropriate undertreatment for FN Risk

>20%

• Empirycal treatment with low dosages for FN

risk low

• «Cosmetic» use

• Application to weekly CT

• Use: (proper) utilization/application– According EORTC Guidelines

• Abuse: misuse, excessive use, over-use– FN risk <20% (incl weekly schedules), late or short

administration

• Under-use: under-utilization– Late or short administration for FN risk >20%