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SCOTTISH HOSPITAL NEWS TRIAL FINDS HUGE SUCCESS IN HIV


TREATMENT RESEARCHERS HAVE BEEN SUCCESSFUL IN INCREASING HIV TREATMENT SUCCESS RATES BY


ALMOST 18 PER CENT. Teams from the Universities of Aberdeen, Maastricht and the University and Academic Medical Centre in Amsterdam have developed a new programme designed to better assist patients treated for HIV in taking their medication prescribed to control the virus.


The study, published recently in The Lancet Infectious Diseases, reports that whilst HIV medication does not


deliver a cure, it works so well that the life-expectancy of people living with HIV is quite similar to that of healthy people. Patients successfully treated for HIV are also extremely unlikely to transmit the virus to others. However, a significant proportion of people with HIV take their medication too irregularly for it to work well, or discontinue their medication entirely.


Irregular use of the medication – or


UWS PLAYING KEY ROLE IN LUNG DISEASE PROJECT


University of the West of Scotland (UWS) is a key academic partner in a €7.7 million EU INTERREG V supported cross-border research project, designed to better understand and alleviate the impact of lung disease.


The ‘BREATH’ (Border and Regions Airways Training Hub) project, will involve a strong cross-border partnership including the Dundalk Institute of Technology in the Republic of Ireland, Queen’s University Belfast and UWS.


This EU funded project will establish a world-class cluster of researchers who will help address the causes, treatment and potential prevention of chronic obstructive


pulmonary disease (COPD).


COPD-related hospital admission is particularly prevalent across Scotland and Ireland. In Ayrshire and Dumfries & Galloway, COPD- related hospital admission is amongst the highest in the UK.


‘This exciting new collaborative programme will provide major insights into lung disease in south west Scotland, help identify better treatments and possible preventions, and also enhance regional public awareness,’ said Professor John Lockhart, Director of University of the West of Scotland’s Institute of Biomedical and Environmental Health Research (IBEHR).


‘non-adherence’, means that the virus gets a chance to replicate again and can attack the immune system – potentially leading to AIDS.


Using a combination of self- management strategies, counselling and patients tracking their own medication use with electronic pill bottles, the study found an increase in treatment success rates of almost 18 per cent compared to patients who received regular care.


Health psychologists and clinicians from Aberdeen and the Netherlands carried out a trial of their intervention programme on more than two hundred patients over fifteen months in seven hospitals across the Netherlands.


Results showed a substantial reduction in treatment failure (over 60 per cent) in those who received the intervention, compared to those who had received regular care.


The team also performed an economic evaluation on the intervention and found that as well as improving patients’ quality- adjusted-life-years (the years people life in good health), it was also cost saving. If ten thousand patients would receive the intervention, it would save approximately five million


SMC ACCEPTS TREATMENT FOR FOLLICULAR LYMPHOMA


The Scottish Medicines Consortium (SMC) has published advice accepting a medicine used to treat follicular lymphoma for routine use by NHS Scotland.


Obinutuzumab (Gazyvaro) was accepted by SMC for use together with another medicine, bendamustine, for the treatment of patients with follicular lymphoma who don’t respond to or whose condition gets worse on other treatments. Obintuzumab was considered through SMC’s Patient and Clinician Engagement (PACE) process, which is used for medicines to treat end-of-life and very rare conditions.


Through the PACE process, patient groups and clinicians highlighted that follicular lymphoma is an incurable disease characterised by relapses. They also shared that the choice and efficacy of therapies that induce remission diminish as the condition progresses. Obinutuzumab may delay progression of the disease


Euro and lead to a gain of 340 quality-adjusted-life-years.


‘This is the first adherence intervention in HIV care that demonstrates clinical and cost effectiveness,’ said Professor Marijn de Bruin from the University of Aberdeen. ‘The intervention can be applied in routine clinical care, and the effects have been reproduced in consecutive trials.


‘Although today’s HIV medications are very effective, they can have quite a few side-effects and people with HIV don’t usually experience any symptoms of the disease, so – for these and other reasons - it is unsurprising that adherence among some patients is suboptimal.


‘As well as important for patients’ own health, having a very low viral load means that people are extremely unlikely to transmit the virus to other people. So not only is this a significant improvement to individual patients’ health, it is also important for public health because it may help to curb the pandemic by interrupting the transmission of the virus.’


and may spare patients from the burden of undergoing intensive chemotherapy.


Liposomal irinotecan (Onivyde) for the treatment of pancreatic cancer was not recommended for routine use following consideration through the PACE process. The Committee did not recommend liposomal irinotecan due to a lack of robust evidence from the submitting company about the clinical benefits and value for money of the medicine when compared to other currently available treatments.


‘It is disappointing that we were unable to accept liposomal irinotecan for the treatment of pancreatic cancer,’ said Dr Alan MacDonald, chair designate of the SMC. ‘While patient groups and clinicians presented a good case in the PACE meeting, the evidence provided by the company on the clinical benefits and value for money of liposomal irinotecan was not strong enough to justify making it available for routine use by NHS Scotland.’


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