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3 results on '"Pekka, Kurki"'

1. Medication safety risks to be managed in national implementation of automatic substitution of biological medicines: a qualitative study

Author

Katri Hämeen-Anttila, Hanna M Tolonen, Marja SA Airaksinen, Päivi Ruokoniemi, Kenneth M Shermock, and Pekka Kurki

Subjects
Medicine
Abstract

Objectives To explore relevant Finnish stakeholders’ perceptions on the automatic substitution of biological medicines with particular focus on medication safety and issues that need to be considered to create an appropriate model for automatic biological product substitution.Design Qualitative interview study.Methods Data were collected in semistructured individual (n=17), pair (n=7) and group (n=8) interviews (32 interviews, 62 participants) in 2018. Participants represented a wide range of stakeholders involved in the pharmacotherapy process: community pharmacists (n=8 interviews), authorities (n=7), prescribers (n=7), pharmaceutical industry and wholesalers (n=6), patients/customers (n=2), hospital pharmacists (n=1) and nurses (n=1). Inductive content analysis was performed.Results Benefits of automatic substitution were identified as cost savings, more patients receiving biological treatments and enhanced continuity of treatment. Six major risk categories were identified: (1) the patient’s medication is interrupted or complicated temporarily or permanently, (2) the patient uses two products with the same active substance, (3) the traceability of the product is compromised, (4) the patient cannot get into healthcare in case of problems, (5) the patient does not receive substitution-related advice from a pharmacy and (6) the patient is distracted by the support material he/she receives. Several risk mitigation measures were commonly mentioned: medication and device counselling by pharmacists (n=23), infrequent substitution interval (n=15) and better knowledge on biosimilars among healthcare providers (n=13).Conclusion Automatic substitution of biologics is associated with risks that should be prospectively managed before implementing the procedure. The substitution also introduces new tasks and communication needs to those involved in actual medication use process, particularly to community pharmacists who will be responsible for substitution and counselling the patients.

Published
2019
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2. Association of autoantibodies to filaggrin with an active disease in early rheumatoid arthritis

Author

Kimmo Aho, T. Palosuo, M Lukka, Pekka Kurki, Marjatta Leirisalo-Repo, R von Essen, and Leena Paimela

Subjects
Adult, Male, Immunology, Arthritis, Enzyme-Linked Immunosorbent Assay, Filaggrin Proteins, Severity of Illness Index, General Biochemistry, Genetics and Molecular Biology, Arthritis, Rheumatoid, Rheumatology, Intermediate Filament Proteins, Rheumatoid Factor, Immunopathology, parasitic diseases, medicine, Immunology and Allergy, Rheumatoid factor, Humans, Clinical significance, Prospective Studies, Aged, Autoantibodies, Autoimmune disease, business.industry, Autoantibody, Middle Aged, medicine.disease, Connective tissue disease, Extended Report, Rheumatoid arthritis, Female, Epidermis, business, Biomarkers, Follow-Up Studies
Abstract

Objective—To evaluate the clinical significance of antifilaggrin antibodies (AFA) measured by an enzyme linked immunosorbent assay (ELISA) in serial specimens from patients with recent onset rheumatoid arthritis (RA). Methods—Filaggrin was purified from human skin and used as an antigen in ELISA. The AFA test was applied to five serial specimens from 78 patients with recent onset RA followed up for three years. Rheumatoid factor (RF) had been measured earlier from the same samples by quantitative immunoturbidimetry. Results—The mean AFA level was highest at entry (54% positive), followed by a statistically significant decline at six months and a slight increase at three years. AFA were persistently positive in 23 patients and persistently negative in 28 patients. Eleven of the latter patients were persistently negative for RF. At study entry AFA levels correlated to some degree with RF levels. In general, raised AFA levels at entry were associated with an active and treatment resistant disease, but they did not predict radiological progression. Conclusions—The test for AFA has potential for an additional immunological test for RA. (Ann Rheum Dis 2001;60:32‐35)

Published
2001

3. Screening test for rheumatic diseases: a combined enzyme immunoassay of rheumatoid factors and antibodies to DNA and extractable nuclear antigens

Author

Pekka Kurki, P Partanen, T Helve, and M Gripenberg

Subjects
musculoskeletal diseases, Adult, Anti-nuclear antibody, Adolescent, Extractable nuclear antigens, DNA, Single-Stranded, Fluorescent Antibody Technique, Pathology and Forensic Medicine, Immunoenzyme Techniques, 03 medical and health sciences, 0302 clinical medicine, Rheumatoid Factor, Sicca syndrome, Agglutination Tests, Rheumatic Diseases, medicine, Rheumatoid factor, Humans, Reactive arthritis, skin and connective tissue diseases, Aged, Autoantibodies, medicine.diagnostic_test, business.industry, Autoantibody, General Medicine, Middle Aged, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Immunoassay, Rheumatoid arthritis, Antibodies, Antinuclear, Immunology, business, 030215 immunology, Research Article
Abstract

Three hundred and one sera from patients with rheumatic and other diseases were investigated using a simple enzyme immunoassay for screening of rheumatoid factors and antinuclear antibodies. The assay had a sensitivity of 77% for systemic lupus erythematosus, 90% for the primary sicca syndrome, and 89% for rheumatoid arthritis. Only 13% of sera from patients with chronic non-rheumatic diseases were positive. The test was further evaluated in a group of patients with suspected rheumatic disease who were followed up for six to 12 months. The test was positive in 16 of 17 sera from patients with connective tissue diseases but in only seven of 36 sera (19%) from patients with non-inflammatory joint diseases. None of the four patients with reactive arthritis was positive by this test. The sensitivity of the assay was comparable with that of the agglutination and immunofluorescence tests for rheumatoid factors and antinuclear factors. For the screening of rheumatoid factor and antinuclear antibodies this kind of test panel offers a simple alternative to the conventional tests for small clinical laboratories and for those in which the autoantibody tests could be automated, as the assay can be performed in one working day and only one dilution of serum is needed to obtain a quantitative result.

Published
1987

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