Assist?ncia farmac?utica a pacientes oncol?gicos em uso de anticorpos monoclonais em um hospital de refer?ncia do Oeste de Santa Catarina

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 Associa??o Lenoir Vargas Ferreira - Hospital Regional do Oeste - Chapec?-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.Introdu??o: O aumento da incid?ncia de c?ncer, relacionado a quest?es como mudan?as nos h?bitos de vida, perfil demogr?fico e aumento da expectativa de vida, levanta uma s?rie de questionamentos sobre novos tratamentos e seu impacto, tanto na qualidade / progn?stico do paciente, quanto no custo ao sistema p?blico de sa?de. O presente estudo visa caracterizar a assist?ncia farmac?utica no uso de anticorpos monoclonais principalmente relacionado aos efeitos adversos e a via de aquisi??o dessas medica??es. Objetivos: Descrever a utiliza??o de imunobiol?gicos no que tange ? forma de aquisi??o, regula??o e judicializa??o, efeitos adversos e causas de interrup??o da terapia. Al?m da caracteriza??o dos pacientes com c?ncer e das principais neoplasias e anticorpos monoclonais utilizados nos tratamentos desses pacientes. Metodologia: O estudo ? do tipo transversal retrospectivo, por meio da consulta a dados dos prontu?rios nos setores de Oncologia e Farm?cia Hospitalar, do per?odo de 1 de agosto de 2017 at? 31 de julho de 2019, na Associa??o Lenoir Vargas Ferreira - Hospital Regional do Oeste - Chapec?-SC, sendo a amostra composta por 169 pacientes. Resultados: A popula??o estudada foi majoritariamente feminina (n=115). As principais neoplasias encontradas foram de mama (n=64, 36,16%), linfomas (n=53, 29,94%) e melanoma m?ltiplo de plasm?cito/ plasmocitoma (n=25, 14,12%). Os mABs mais utilizados foram o trastuzumabe (n=65, 35,71%) e rituximabe (n=54, 29,67%). Foram observadas quatro formas de aquisi??o dos f?rmacos, sendo via SUS (n=110, 60,44%) e judicial (n=65, 35,71%) as de maior porcentagem. 60,3% dos pacientes n?o apresentaram efeito adverso ? terapia, mas dentre os que apresentaram os principais foram v?mitos e n?useas, astenia, diarreia, dor, neutropenia e mucosite. Efeitos adversos/ toxicidade (n=15), falta de medicamento (n=11) e atraso na libera??o (n=10) s?o as causas mais comuns de interrup??o do tratamento. Conclus?o: A seletividade das terapias com mABs faz com que os efeitos adversos sejam minimizados ou at? extintos, o que, associado ao aumento de sobrevida, justifica seu uso. Os mABs n?o disponibilizados pelo SUS s?o demandados pela popula??o, que recorrem a medidas judiciais para conseguirem seu tratamento pela Uni?o, estado ou munic?pio. Essa forma de aquisi??o implica em questionamentos relacionados ao privil?gio financeiro de alguns, o que os favorece na obten??o de tais medicamentos. Isso justifica a import?ncia de pol?ticas p?blicas incentivarem a comunidade m?dica, cient?fica, social e jur?dica a enviarem revis?es com evid?ncias cl?nicas ? CONITEC para aprovar a incorpora??o de novas tecnologias em sa?de no SUS