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Comparison between Reference Infliximab (Remicade) and its Biosimilar (Remsima) in Patients with Ankylosing Spondylitis: A Field-based Pharmacoeconomic Study
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Background: Ankylosing spondylitis is a chronic inflammatory disease that mostly involves the spine and sacroiliac joints. It is associated with a decreased quality of life. Biological medicines such as infliximab and its biosimilar are the mainstay treatments for active ankylosing spondylitis.

Objective: The study objective was to conduct a pharmacoeconomic study comparing the cost-effectiveness of the reference infliximab with its biosimilar in ankylosing spondylitis patients visiting public hospitals.

Subjects and Method: This is a two-center pharmacoeconomic study performed at two large teaching governmental hospitals in Baghdad, Iraq, which supplied infliximab to outpatients with ankylosing spondylitis. The outcome data were obtained from patient’s medical records and face-to-face interviews with the patients from December 2021 through April 2022. The Independent T-Test was used to measure the differences in areas of utility, and quality of life, between the two infliximab groups.

Results: The study recruited 62 patients with ankylosing spondylitis who received infliximab (31 received Remicade, and 31 received Remsima) for at least 12 weeks at two public teaching hospitals. The mean age of the patients was 37.85 years and 83.9% were men. In general, both reference infliximab and its biosimilar were successful in increasing the quality of life. Their importation costs were different from 2019 to 2021. The incremental cost-effectiveness ratio of reference infliximab versus biosimilar was $ 40,909/quality-adjusted life year (QALY) according to 2019 pricing. In contrast, in 2021 reference infliximab (Remicade) was less expensive and yielded slightly better quality of life improvement than biosimilar (Remsima) making Remicade more cost-effective (dominant).

Conclusion: Remicade was slightly superior to Remsima in quality of life improvement. However, it was difficult to determine whether the reference or its biosimilar was more cost-effective in 2019 because the health officials did not specify a willingness to pay per quality-adjusted life year. Compared to Remsima, Remicade was more cost-effective in 2021 because it was less expensive and more effective in terms of quality of life improvement.

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Publication Date
Tue May 11 2021
Journal Name
Research J. Pharm. And Tech
Association of Serum Renal Function Levels with Heart Failure Disease in Iraqi Patients
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Renal function tests are commonly used in clinical practice to look for renal disease, the most common includes the serum urea, uric acid and creatinine. Heart failure patients have a higher incidence of renal function test abnormalities than individuals who do not have heart failure disease. Fifty subjects of adults (male) were divided in to two groups, 25 subjects (healthy) as control (group1) and 25 subjects with heart failure (group 2). Our results indicate that serum uric acid, urea, and creatinine values were significantly elevated (P≤0.05) in patients group (2) compared with healthy group (1). The results also showed, the effect of age categories on uric acid blood urea nitrogen and creatinine values (P≤0.05) and there were no si

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Publication Date
Wed Oct 24 2018
Journal Name
Al-kindy College Medical Journal
Echocardiographic assessment of Left Ventricular Dyssynchrony in Hypertensive Patients with Normal Systolic Function
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Background: Normal Left Ventricular systolic function is present in nearly 50% of patients with congestive heart failure, the majority of such patients have systemic hypertension. Recent studies have demonstrated Left Ventricular dyssynchrony among patients with heart failure and normal systolic function. The co-existence between Left Ventricular dyssynchrony and hypertension with normal systolic function (with no clinical evidence of heart failure) is less well understood.

Objective:

To assess the Left Ventricular dyssynchrony among hypertensive patients with normal systolic function by using Tissue doppler imaging.To find out the associations between the LV dyssynchrony and other global

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Publication Date
Tue Jun 11 2019
Journal Name
Al-kindy College Medical Journal
Conservative Treatment of Tuberculosis of the Spine in Patients with no Neurological Deficits
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Background: Patients who have both neurological impairment and kyphotic deformity can be treated medically, and this treatment can be achieved with anti-tuberculous drugs alone.

Objective: To evaluate conservative medical management of patients with tuberculosis of the spine (Pott disease). The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated.

Methods: Between January 2009 and January 2018 data were collected prospectively at The Neurosciences Hospital/ Baghdad/ Iraq in 44 patients with Pott disease in the thoracic and lumbar spine. These patients had no major neurological deficits or

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Publication Date
Mon Jan 01 2018
Journal Name
Iosr Journal Of Pharmacy And Biological Sciences
Seroprevalence of Hepatitis B markers in Iraqi patients with chronic Hepatitis B virus
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To determine the seroprevalence of hepatitis B markers in chronic hepatitis B patients, 75 patients with chronic hepatitis B virus of ages (8-70) years have been investigated and compared with 50 apparently healthy individuals. All the studied groups were carried out to measure (HBsAg), (HBsAb), (HBeAg), (HBeAb), and (Total HBcAb) by Enzyme linked immunosorbent assay (ELISA) technique. The percentage distribution of HBsAg was (86.67%) and HBsAb was (1.33%) in sera of CHB patients and there were a highly significant differences (P<0.01) when compared between studied groups, while, the percentage distribution of HBeAg was (22.67%) in sera of CHB patients and the significant represent the difference in distribution of HBeAg as infection but no

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Psychiatric Squele of Sodium Valproate Versus Carbamazipine In Patients with Primary Generalized Epilepsy
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Background: psychiatric and behavioral side effects
are common in patients with epilepsy and it may
represent an intrinsic feature of the disease itself or a
side effect of the antiepileptic use. Our aim in the
present study is to assess the psychiatric side effects of
Sodium Valproate and Carbamazipine .as these drugs
are the most commonly used antiepileptic drugs in Iraq.
Methods: 80 patients with primary generalized
epilepsy on Carbamazipine and 50 patients on Sodium
Valproate were enrolled in the present study; all the
patients were assessed for any psychological
disturbances using semi-structural interview based on
the tenth edition of the international classification of
the diseases(ICD 10) ad

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Neutrophil / Lymphocyte Ratio is not Correlated with Disease Activity in Rheumatoid Arthritis Patients
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Rheumatoid arthritis is a chronic systemic inflammatory disease. Inflammation leads to joint damage and increases the risk of cardiovascular diseases. Neutrophil lymphocyte ratio (NLR) is a measure of inflammation in many diseases. Therefore, we aimed to evaluate the usefulness of NLR to detect inflammation in RA, and its correlation to RA disease activity indices and some hematological parameters. A cross-sectional study involving 24 patients with active rheumatoid arthritis (RA) who are using MTX participated in this study. All patients were clinically evaluated using disease activity score of 28 joints (DAS28) and simplified disease activity index (SDAI), whereas functional disability was assessed by health assessment questionnaire di

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Publication Date
Thu Jan 07 2016
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci.
Determination of Some Trace Element Levels in Iraqi Male patients with Colorectal Cancer
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Alterations of trace element concentrations adversely affect biological processes and could promote carcinogenesis. Trace element deficiency or excess is implicated in the development or progression of some cancers like colorectal cancer. The aim of the present study was to compare the serum copper (Cu) and zinc (Zn) concentrations in patients with colorectal cancer from Iraqi male patient with those of healthy subjects. During the period of March 2015 until august 2015, a total of 25 patients with metastatic colon cancer and 20 healthy volunteers were enrolled from the Al-Kadhimia Teaching Hospital after the diagnosis using a histopathological examination for the malignant tumor; their age was between (38-60) years. Higher levels o

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Publication Date
Tue Jan 01 2019
Journal Name
Annals Of Tropical Medicine And Public Health
Arlyesterase activity of Paraoxonase-1 enzyme in Iraqi patients with β-thalassemia minor
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Background: Arylesterase activity of Paraoxonase-1 (ARE-PON-1) exhibits an antioxidant role which protects lipoprotein from oxidation. It is known that ARE-PON-1 antioxidant activity associated with high density lipoprotein cholesterol (HDL-C) reduces the oxidative damage mediated by low density lipoprotein cholesterol (LDL-C). The present study was aimed to examine the level of serum ARE-PON1 in Iraqi patients with β-thalassemia minor and its relationship with lipid profile (total cholesterol (TC), HDL-C, very low density lipoprotein (VLDL-C), and LDL-C) and hematologic changes as a part of antioxidant system action. Methods: In the present study, the ARE-PON-1 activity was investigated in serum of patients with β-thalassemia minor. Resu

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Publication Date
Sun Sep 20 2020
Journal Name
Biochemical And Cellular Archives
MOLECULAR INVESTIGATION OF EPSTEIN-BARR VIRUS IN IRAQI PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA
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Chronic lymphocytic leukemia (CLL) is one type of leukemia that arises from lymphocytes' progenitor cell in the Bone marrow, it affects individuals over the age of 50 years in both genders. In Iraq, leukemia affected 1532 (847 males and 683 females) according to the latest announced statistics of the Iraqi Cancer Registry Center in 2012. Chronic lymphocytic leukemia may occur due to several genetic causes, such as chromosomal aberrations and gene mutations, or exposure to carcinogens and mutagens (radiation, chemicals, and oncogenic viruses). The most famous virus is the Epstein-Barr virus (EBV), which is a gamma herpesvirus that infects more than 90% of individuals. Its infection is mostly a latent infection, and EBV remains latent in memo

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Pharmacist Intervention to Address Drug Related Problems in Patients with Decompensated Liver Cirrhosis
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Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.

Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommend

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