Assistência farmacêutica a pacientes oncológicos em uso de anticorpos monoclonais em um hospital de referência do Oeste de Santa Catarina

Abstract

Introduction: The increase in the incidence of cancer, related to issues such as changes in lifestyle, demographic profile and increased life expectancy, raises a series of questions about new treatments and their impact, both on the quality / prognosis of the patient and on the cost to the Public Health System. The present study aims to characterize pharmaceutical assistance in the use of monoclonal antibodies, mainly related to adverse effects and the route of acquisition of these medications. Objectives: To describe the use of immunobiologicals with regard to the form of acquisition, regulation and judicialization, adverse effects and causes of interruption of therapy. In addition to the characterization of cancer patients and the main neoplasms and monoclonal antibodies used in the treatment of these patients. Methods: The study is a retrospective cross-sectional study, by consulting data from medical records in the sectors of Oncology and Hospital Pharmacy, from the period from August 1, 2017 to July 31, 2019, at Associação Lenoir Vargas Ferreira - Hospital Regional do Oeste - Chapecó-SC, with the sample consisting of 169 patients. Results: The studied population was mostly female (n = 115). The main neoplasms found were breast (n = 64, 36.16%), lymphomas (n = 53, 29.94%) and multiple plasmacytoma / plasmacytoma melanoma (n = 25, 14.12%). The most used mABs were trastuzumab (n = 65, 35.71%) and rituximab (n = 54, 29.67%). Four forms of drug acquisition were observed, with SUS (n = 110, 60.44%) and judicial (n = 65, 35.71%) being those with the highest percentage 60.3% of the patients had no adverse effect on therapy, but among those who did, the main ones were vomiting and nausea, asthenia, diarrhea, pain, neutropenia and mucositis. Adverse effects / toxicity (n = 15), lack of medication (n = 11) and delay in release (n = 10) are the most common causes of treatment interruption. Conclusion: The selectivity of therapies with mABs causes adverse effects to be minimized or even extinguished, which, together with increased survival, justifies their use. MABs not made available by SUS are demanded by the population, who resort to judicial measures to obtain their treatment by the Union, state or municipality. This form of acquisition implies questions related to the financial privilege of some, which favors them in obtaining such drugs. This justifies the importance of public policies to encourage the medical, scientific, social and legal community to send reviews with clinical evidence to CONITEC to approve the incorporation of these technologies in SUS.