b71bf4abd5d1585bd239fbf760ed4b28 289892.pdf 750505eea76a8721729090686582a2ad66ec0078 289892.pdf 3c40e792f311e34dd747f826d3b5ca6c0ad3e77e37e22e17c417ec552a5f19e6 289892.pdf Title: At-Home Foscarnet Administration in Patients with Cytomegalovirus Infection Post-Allogeneic Stem Cell Transplantation: A Unicentric, Safe, and Feasible Program Subject: Cytomegalovirus (CMV) infection is a relevant cause of morbimortality in patients receiving allogeneic stem cell transplantation (allo-HCT). Foscarnet (FCN) is an effective drug against CMV administered intravenously and usually on an inpatient basis. The Home Care Unit (HCU) for hematologic patients at our hospital designed an at-home FCN administration model to avoid the hospitalization of patients requiring FCN treatment. This study analyzes whether the at-home administration of FCN is as safe and effective as its hospital administration. We collected and compared demographic, clinical, analytical, and economic data of patients with CMV infection post-allo-HCT who received FCN in the hospital (n = 16, 17 episodes) vs. at-home (n = 67, 88 episodes). The proportions of patients with cured CMV infections were comparable between the two groups (65.9% vs. 76.5%, p = 0.395). The median duration of FCN treatment was 15 (interquartile range [IQR] 9–23) and 14 (IQR 11–19) days in the HCU and inpatient cohorts, respectively (p = 0.692). There were no significant differences in the FCN toxicities between groups except for hypocalcemia (26.1% vs. 58.8%, p = 0.007), which was more prevalent in the inpatient cohort. A significant cost-effectiveness was found in the HCU cohort, with a median savings per episode of EUR 5270. It may be concluded that home administration of FCN is a safe, effective, and cost-efficient therapeutic option for patients with CMV infection and disease. Keywords: Cytomegalovirus; allogeneic stem cell transplantation; foscarnet; at-home model Author: Sonia Ruiz-Boy, Alexandra Pedraza, Marta Prat, Maria Queralt Salas, Esther Carcelero, Gisela Riu-Viladoms, María Suárez-Lledó, Inés Monge-Escartín, Luis Gerardo Rodríguez-Lobato, Alexandra Martínez-Roca, Montserrat Rovira, Carmen Martínez, Cristina Gallego, Álvaro Urbano-Ispizua, Joan Sánchez, María Ángeles Marcos and Francesc Fernández-Avilés Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Dec 18 10:07:20 2023 CET ModDate: Mon Dec 18 10:14:13 2023 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 315607 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- FFAYKL+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 NFOMKB+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 XYGSAO+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 TZTIRI+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 EUNBMT+VnURWPalladioL Type 1 Custom yes yes no 28 0 VWRBXB+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 71 0 CZMDWU+CMSY10 Type 1 Builtin yes yes no 75 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-03-09 02:34:24 CET RepresentationInformation: 289892.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-03-08 11:03:09 CET Size: 315607 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 254 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Patient and Transplant Characteristics Destination: subsection.2.1 Item: Title: Antiviral Treatment Characteristics and Patient Outcomes Destination: subsection.2.2 Item: Title: Toxicity Outcomes Destination: subsection.2.3 Item: Title: Pharmacoeconomic Analysis Destination: subsection.2.4 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Patient Selection Destination: subsection.4.1 Children: Item: Title: HCU Cohort Criteria Destination: subsubsection.4.1.1 Item: Title: Inpatient Cohort Criteria Destination: subsubsection.4.1.2 Item: Title: Foscarnet Preparation Destination: subsection.4.2 Item: Title: Foscarnet Administration Model Destination: subsection.4.3 Item: Title: Foscarnet Treatment Scheme Destination: subsection.4.4 Item: Title: Data Collection Destination: subsection.4.5 Item: Title: Main Definitions Destination: subsection.4.6 Item: Title: Statistical Analysis Destination: subsection.4.7 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: At-Home Foscarnet Administration in Patients with Cytomegalovirus Infection Post-Allogeneic Stem Cell Transplantation: A Unicentric, Safe, and Feasible Program Author: Sonia Ruiz-Boy, Alexandra Pedraza, Marta Prat, Maria Queralt Salas, Esther Carcelero, Gisela Riu-Viladoms, María Suárez-Lledó, Inés Monge-Escartín, Luis Gerardo Rodríguez-Lobato, Alexandra Martínez-Roca, Montserrat Rovira, Carmen Martínez, Cristina Gallego, Álvaro Urbano-Ispizua, Joan Sánchez, María Ángeles Marcos and Francesc Fernández-Avilés Subject: Cytomegalovirus (CMV) infection is a relevant cause of morbimortality in patients receiving allogeneic stem cell transplantation (allo-HCT). Foscarnet (FCN) is an effective drug against CMV administered intravenously and usually on an inpatient basis. The Home Care Unit (HCU) for hematologic patients at our hospital designed an at-home FCN administration model to avoid the hospitalization of patients requiring FCN treatment. This study analyzes whether the at-home administration of FCN is as safe and effective as its hospital administration. We collected and compared demographic, clinical, analytical, and economic data of patients with CMV infection post-allo-HCT who received FCN in the hospital (n = 16, 17 episodes) vs. at-home (n = 67, 88 episodes). The proportions of patients with cured CMV infections were comparable between the two groups (65.9% vs. 76.5%, p = 0.395). The median duration of FCN treatment was 15 (interquartile range [IQR] 9 23) and 14 (IQR 11 19) days in the HCU and inpatient cohorts, respectively (p = 0.692). There were no significant differences in the FCN toxicities between groups except for hypocalcemia (26.1% vs. 58.8%, p = 0.007), which was more prevalent in the inpatient cohort. A significant cost-effectiveness was found in the HCU cohort, with a median savings per episode of EUR 5270. It may be concluded that home administration of FCN is a safe, effective, and cost-efficient therapeutic option for patients with CMV infection and disease. Keywords: Cytomegalovirus; allogeneic stem cell transplantation; foscarnet; at-home model Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Dec 18 10:07:20 CET 2023 ModDate: Mon Dec 18 10:14:13 CET 2023 ID: 0x884e229e78f5a504b9c86737b599f47b, 0x884e229e78f5a504b9c86737b599f47b Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: XYGSAO+URWPalladioL-Roma FontSubset: true FirstChar: 1 LastChar: 252 FontDescriptor: FontName: XYGSAO+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TZTIRI+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: TZTIRI+URWPalladioL-Ital Flags: Symbolic FontBBox: 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