Search

Objective: Evidence about drug use in pregnancy is scarce and often inconsistent. This study explored what questions women with rheumatic diseases have concerning drug use during pregnancy and their satisfaction with the answers they obtained. Design and methods: Through the website of the Dutch Rheumatism Patient Federation, a questionnaire was offered to women with rheumatic diseases who wish to become pregnant or had this wish in the past, who are pregnant, or who recently gave birth. The questionnaire asked questions on demographics, current and intended drug use, and on drug use during pregnancy. Results are reported in a descriptive way. Results: Of the fifty women returning the questionnaires 66% judged their questions had been answered satisfactorily. 61% reported that doubts and/or fears did not change or even increased after obtaining the information. Conclusion: Most women find their questions on drug use and pregnancy answered, but insufficient information is available to them. Doubts and/or fears remained or increased after obtaining the information.

This paper presents a cost analysis of the utilisation of infliximab for the treatment of Crohn's disease. The indication for infliximab for Dutch Crohn patients is an active disease with insufficient improvement on adequate therapy with corticosteroids and/or immunosuppressive therapy. We compared direct health-care costs (hospital and community pharmacy) before and after first infliximab treatment for 21 Crohn patients in the University Hospital Groningen who started infliximab during 1 January 2000 to 15 march 2001. Our study design was observational and patients served as their own controls with similar periods before and after infliximab per patient considered (minimally 3 months before and 3 months after infliximab). Drug costs for infliximab (including administration) were estimated at € 5800,- per patient-year. Excluding infliximab costs, costs per patient-year were € 6400,- and € 8600,-before and after first infliximab treatment, respectively. In both periods, the majority of the other costs was related to hospitalization. Also, drug costs in the community pharmacy were estimated to contribute relevant shares. Other researchers have found decreases in medical costs after the start of infliximab treatment. We found the opposite development. More experience and routine with infliximab treatment may lower costs in the future.

The Netherlands Pharmacovigilance Centre Lareb evaluates the reports as generated by the spontaneous adverse event reporting system in the Netherlands. This article describes the association between the adverse drug reactions (ADRs), headache and migraine and reported suspected drugs. In a case/non-case design, reporting odds ratios were calculated in order to analyse this association. Additionally the results of this analysis were compared with data from literature. Taken together, the ADRs headache and migraine are the second most reported ADR. The results of the analysis of the association between drugs and both ADRs in the Lareb data set are generally in accordance with literature data. Especially drugs causing vasodilative effects have often been associated with headache or migraine.

This article evaluates the efficacy, safety, incidence and reason of withdrawal of leflunomide in an outpatient population in Friesland (the Netherlands) with rheumatoid arthritis in a setting of care-as-usual. A large part of the population showed a good or moderate response on leflunomide. Adverse events were generally mild. Most frequently reported were gastrointestinal and dermal events. No potential risk factors for leflunomide withdrawal were found.