(Adnkronos) - In questo numero:
Le esperte, Jak inibitori farmaci di grandissima efficacia su dermatite atopica, e non solo
Fecondazione eterologa: Pellicer (Ivi): “anche l’ovulo invecchia. Per mantenerne le capacità lo si può conservare congelato”
Lilly, l’Aifa approva mirikizumab: primo farmaco di una nuova classe rimborsato per il trattamento della colite ulcerosa
Milano FisioWeek 2024, sesto e ultimo evento formativo alla prestigiosa Fondazione Don Carlo Gnocchi
E per concludere lo Speciale Salus tv: Bilato dell’Anmco: “alti livelli di colestrolo Ldl causa principale di aterosclerosi” Ma è possibile limitarne le conseguenze
Le esperte, Jak inibitori farmaci di grandissima efficacia su dermatite atopica, e non solo
Fecondazione eterologa: Pellicer (Ivi): “anche l’ovulo invecchia. Per mantenerne le capacità lo si può conservare congelato”
Lilly, l’Aifa approva mirikizumab: primo farmaco di una nuova classe rimborsato per il trattamento della colite ulcerosa
Milano FisioWeek 2024, sesto e ultimo evento formativo alla prestigiosa Fondazione Don Carlo Gnocchi
E per concludere lo Speciale Salus tv: Bilato dell’Anmco: “alti livelli di colestrolo Ldl causa principale di aterosclerosi” Ma è possibile limitarne le conseguenze
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NewsTranscript
00:00In this number, the expert, Jackie Nibitori, drugs of great effect on atopic dermatitis
00:15and not only.
00:16Heterologous fertilization, Pellisier, even the old-age egg, to maintain its abilities,
00:20can be kept frozen.
00:22Lily, LIFE approves Mirichizumab, the first drug of a new class reimbursed for the treatment
00:28of ulcerative colitis, and again, Milano Fission Week 2024, sixth and last training event
00:34at the prestigious Don Carlo Gnocchi Foundation, and to conclude, the special Salus TV,
00:39Bilato dell'Anco, high levels of cholesterol, LDL, the main cause of atherosclerosis,
00:45but it is possible to limit the consequences.
00:47If in the past it was thought that atopic dermatitis was a disease more
00:55frequent in children, with a prevalence ranging from 8% to 20% depending on the country of origin,
01:00to affect a lot, in fact, are also different levels of industrialization.
01:04Today it has been understood that in reality, suffering from atopic dermatitis is also 8%
01:08of adults and 11% and more of the elderly.
01:11It is a disease as invalidating as possible, because beyond the typical clinical signs
01:15in visible or sensitive areas of the body, such as face, head, neck, hands or genitals,
01:20has as a more relevant symptom the pruritus, which in case of outbreak of the disease in
01:23childhood, will accompany those who suffer from atopic dermatitis for life, with negative consequences
01:28in study, work and social life.
01:31Today, however, as Silvia Mariel Ferrucci explains, responsible for the Center for Allergological Dermatology
01:36of the complex structure of Dermatology at the IRCS Foundation, a large polyclinic in Milan,
01:41the situation is radically improving thanks to a new class of drugs, the inhibitors.
01:46Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
01:52IRCS Foundation.
01:53Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
01:57IRCS Foundation.
01:58Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:02IRCS Foundation.
02:03Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:07IRCS Foundation.
02:08Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:12IRCS Foundation.
02:13Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:18IRCS Foundation.
02:19Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:23IRCS Foundation.
02:24Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:28IRCS Foundation.
02:29Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:33IRCS Foundation.
02:34Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:38IRCS Foundation.
02:39Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:43IRCS Foundation.
02:44Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:48IRCS Foundation.
02:49Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:53IRCS Foundation.
02:54Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
02:58IRCS Foundation.
02:59Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:03IRCS Foundation.
03:04Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:10IRCS Foundation.
03:11Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:15IRCS Foundation.
03:16Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:20IRCS Foundation.
03:21Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:25IRCS Foundation.
03:26Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:30IRCS Foundation.
03:31Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:35IRCS Foundation.
03:36Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:40IRCS Foundation.
03:41Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:45IRCS Foundation.
03:46Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:50IRCS Foundation.
03:51Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
03:55IRCS Foundation.
03:56Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:02IRCS Foundation.
04:03Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:07IRCS Foundation.
04:08Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:12IRCS Foundation.
04:13Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:17IRCS Foundation.
04:18Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:22IRCS Foundation.
04:24Dr. Silvia Mariel Ferrucci, Director of the Center for Allergological Dermatology at the
04:30IRCS Foundation.
04:32they still have an improvement of these comorbidities during the course of therapy with inhibitors.
04:46According to the data of the National Register of Medically Assisted Procreation at the Institute of Health,
04:52in 20 years this type of treatment and pregnancy rates in Italy have doubled
04:57and in this way more than 217,000 children were born.
05:01On the other hand, with the egg donation, today, in case it reaches the third attempt,
05:0699% of success is recorded.
05:09In our country, however, the age of women who decide to access
05:14assisted fertilization treatments for the first time is quite high,
05:18so much so that it gives us, at the European level, the first place in this special ranking,
05:23which highlights the need in Italy to address a very important issue
05:28such as education for fertility.
05:31In the last ten years, in particular, in fact, there has been a boom of over 40
05:36who decide to use it, with an increase of almost 15%.
05:40As Antonio Perlisier explains, first in Europe to do heterological fertilization
05:44and today led by a group, LIDI, founded by him, with 74 clinics distributed in 9 countries,
05:51of which 3 in Italy.
05:52However, this situation does not concern only our country.
05:55It is therefore good, as Perlisier underlines, that all, and in particular women,
05:59understand why it is important to try to have a child before the biological clock
06:04begins to create problems.
06:06This is a general problem in the world.
06:09These are women who come from us at an average age of around 37-38 years
06:15and often after 40 years.
06:18So what happens?
06:19Basically, the story is that the ovary is a cell that remains inside the ovary
06:25as if it were a basket, but it loses, it loses protection, it loses quality.
06:32And when you try to pull out that ovum, after 40-42 years you find ovules
06:40that do not have that protein protection that makes them normal.
06:44They become abnormal ovules.
06:47And what is the point?
06:48The point is to have children before the age of 35.
06:51And if they do not have children because they are making a career,
06:54they must preserve their fertility.
06:57And this is where the possibility of relying on ovules comes into play
07:00at a cryoconservation center, and then asking for employment even after many years.
07:06We freeze the ovules of women who come to us at 22, 25, 30, 35 years old
07:13and can come to me.
07:14They can come to me at 45 and become pregnant without any problem
07:19because the uterus does not age, it is the ovum.
07:22To negatively affect the course of heterological fertilization
07:26is the fear of having a twin birth.
07:28This risk has now been overcome.
07:31Today only one embryo is inserted.
07:34Why?
07:35Because we have reached a rate of implantation, of success,
07:39per embryo transferred of 65%.
07:42We have clinics that have 72, 75, but from there it does not pass.
07:48Now, as I say, insisting, it comes.
07:51If it does not come this month, this month will come next.
08:04Ulcerative colitis is an intestinal chronic disease
08:07that affects in Italy about 150,000 people
08:10with more than 4,000 new diagnoses per year,
08:13mainly in young people.
08:15Pathologies like this have a strong impact on the quality of life of those who suffer from it.
08:20It was discussed during the press conference of the pharmaceutical company Lilly
08:25Ulcerative colitis, from the needs of patients to new prospects,
08:29during which the importance of Miri Kizumab,
08:33the first antagonist of Interleukin 23p19,
08:37for the treatment of active ulcerative colitis, from moderate to severe, in adult patients,
08:42whose reimbursement has been approved by the Italian Pharmaceutical Agency.
08:46It is the first drug of the class that we can use for the management of this type of patients.
08:53It is an innovative drug because it acts on the differentiation of lymphocytes T,
08:58it acts quickly, effectively,
09:01especially by intervening on those symptoms,
09:06such as blood diarrhea and many other drugs,
09:10but also the evacuation urgency that greatly impacts on the quality of life of patients,
09:15with an excellent profile of safety.
09:17Miri Kizumab, therefore, as a response to an unmet need,
09:21acts on the key symptoms of ulcerative colitis
09:24that strongly impact on the life of patients,
09:27including the evacuation urgency.
09:30It is that symptom that relieves the patient at home,
09:33in the fear of needing a hygienic service,
09:37and therefore greatly reduces his or her working and productive capacity,
09:43in an age, which I remember,
09:45in which patients are most affected,
09:48is the age range that goes from 20 to 50 years.
09:52So we have a disease that impacts in the phase of greater productivity of each individual subject.
10:00The Director General of Amici Italia Salvo Leone
10:03explains the emotional impact of a chronic pathology such as ulcerative colitis.
10:08The word chronic means that those affected by this pathology
10:11will clearly have to live with it for life.
10:13They are diseases characterized by a non-visible disability,
10:17with very difficult symptoms to tell,
10:19with phases of activity and non-activity.
10:22So if I had to describe it with one word, I would say,
10:24it's like going on a trip with an unpleasant companion, hoping that he will always sleep.
10:29They are pathologies that have an emotional impact,
10:32because clearly the patient tends to isolate himself,
10:34not only from his own family context,
10:36but also from the more external context that surrounds him.
10:39So I am referring to the work environment,
10:42but also to the school environment,
10:44especially for the younger patients.
10:51Beyond the boundaries of the profession,
10:54this is the title of the sixth and last training event of the Milan Physio Week 2024,
10:59a series of events planned and organized by the Interprovincial Order of Physiotherapists of Milan,
11:05scheduled for September 7,
11:07which represents a unique opportunity to explore the future of physiotherapy
11:11in a context of excellence such as the one offered by the Don Carlo Gnocchi Foundation
11:15at the headquarters of Santa Maria Nascente in Milan.
11:18This final event aims to provide a panoramic view of the latest innovations in the field of physiotherapy,
11:24comparing European experiences to trace a path
11:27that allows Italian professionals to acquire advanced skills
11:31for the management of the health of patients.
11:33The goal is precisely to open a focus,
11:36to make a territory of confrontation,
11:38and to begin to confront ourselves both with other professions and with institutions
11:42within which we want to try to create a path
11:46to be able to structure new advanced skills for our profession
11:52in respect of professionalism and all other professionalism.
11:55But obviously the Milan Interprovincial Order
11:58is trying to look beyond what is our national border,
12:02because if the European will is to establish training courses
12:07that can be spent throughout the territory,
12:10we cannot have great differences in professional skills
12:15between Italian professionals and those who practice our profession in other states.
12:20The choice of the Don Carlo Gnocchi Foundation
12:23in the historic headquarters of Santa Maria Nascente in Milan
12:25underlines the importance of the event.
12:27The structure is in fact one of the heartbeats of physiotherapy in Meneghina and Lombarda,
12:31an ideal place to discuss the future prospects of the profession.
12:35Collaborating with OFI, with the physiotherapists' order,
12:40allows us to create a generation of physiotherapists, of professionals,
12:46who are at the forefront, who are ready to face the challenges of our system,
12:52of our national health system,
12:55and with a baggage of professionalism and technical aspects
13:01that can therefore provide our patient with a greater appropriateness of the treatment.
13:08The collaboration with them certainly aims to extend the professional baggage of the rehabilitators
13:16and consequently also to achieve efficiency and effectiveness goals for our service.
13:26What is hypercholesterolemia?
13:29Hypercholesterolemia, i.e. having high levels of LDL cholesterol,
13:33the so-called bad cholesterol in the blood,
13:35is the main cause of atherosclerosis,
13:37primary movement of myocardial infarction and ictus,
13:40responsible, together with other cardiovascular diseases,
13:43of about 250,000 deaths per year,
13:45equal to about 25 per hour,
13:47and the first cause of death in all Western countries,
13:49as explained by Claudio Bilato,
13:51Director of the Cardiology of the Hospitals of the Ovest in Vicentino
13:54and National Counsellor of ANCO,
13:56the National Association of Cardiologists and Hospitallers,
13:58there are several causes responsible for the obstruction of our arteries.
14:02Certainly age and sex are an unchangeable risk factor,
14:08but then there are a whole series of very important risk factors
14:12that are represented by high levels of pressure,
14:16diabetes, cigarette smoke,
14:19poor physical activity,
14:22body weight or an inadequate diet.
14:25And then there is a risk factor that is no longer a risk factor,
14:28but it is the cause of myocardial infarction,
14:31it is the cause of the cardiovascular disease
14:33that recognizes atherosclerosis as an element.
14:36Well, the cause of atherosclerosis
14:38is represented by the cholesterol of LDL,
14:41that is, that cholesterol that is conveyed by these plasma lipoproteins,
14:46low-density lipoproteins,
14:49which represents what is commonly called bad cholesterol.
14:52But what are the optimal levels of cholesterol
14:54and is it possible to prevent the consequences?
14:56First of all, there is generally no optimal or normal value of LDL cholesterol.
15:03The value is optimal depending on the cardiovascular risk of the patient.
15:08I give two examples.
15:09A patient who has no other risk factors,
15:12who has a very low cardiovascular risk,
15:15can afford to have LDL cholesterol below 115 mg deciliters.
15:22A patient who has already had a cardiovascular event,
15:26has a very high cardiovascular risk,
15:29must maintain LDL cholesterol below 55 mg deciliters
15:35and sometimes even below 40.
15:37So there is a spectrum of values
15:40that must be identified according to the cardiovascular risk.
15:44So a risk that increases
15:46if you have already had a cardiovascular event?
15:49Absolutely yes.
15:51There are different categories of risk.
15:54A patient who has already had a heart attack
15:56is a patient who, by definition,
15:58still has a very high, extreme cardiovascular risk.
16:02But a patient who also has diabetes with complications
16:06and who has not yet had a cardiovascular event
16:08or a patient who has a kidney failure
16:12are already elements that classify it as a very high risk.
16:16A patient, for example, who only has an arterial hypertension,
16:20who has not yet had a cardiovascular event,
16:22can be considered a patient with a moderate or high cardiovascular risk.
16:26Well, depending on the risk,
16:28we must identify the target of LDL cholesterol
16:31that this patient must reach.
16:33But is it difficult to keep cholesterol levels under control?
16:36Actually, we must say that everyone must pay attention
16:41to maintain cholesterol levels within the recommended values.
16:46Obviously, good habits of life,
16:48a correct dietetic attitude and physical activity help.
16:52And as far as anti-cholesterol drugs are concerned,
16:55what is the current situation?
16:56We certainly have pharmacological classes
16:58that we have used for many years,
17:00first the statins,
17:01then other important drugs have come,
17:03such as the Zetimibe, the L-Pedoic acid,
17:05and then we have an extremely innovative class of drugs
17:09that are the so-called inhibitors of this protein,
17:11which is called the inhibitor of PCSK9.
17:14In this case, we have two types of molecules,
17:17antibodies,
17:18and then we have an innovative molecule
17:21that inhibits,
17:22somehow silencing the production of this protein,
17:25the so-called RNA interference.
17:29Well, these SIRNAs are certainly very innovative drugs,
17:33also because they guarantee high levels of adherence.
17:37And this is for two reasons, basically.
17:39The first is that they are supplied by subcutaneous pathway,
17:43with a banal subcutaneous injection,
17:45at half-time intervals.
17:47So the patient must undergo treatment every six months,
17:51which is a great advantage compared to drugs
17:53as effective, but of greater use as statins,
17:56in which you have to take the pill every day.
17:58The second reason is that this supply
18:00must be done by a health worker,
18:02so this is a formidable guarantee
18:04as regards adherence.
18:06Drugs that, in combination,
18:08allow a reduction up to 85% of the initial values.
18:12So, very, very effective drugs,
18:15also because losing adherence means increasing,
18:18tripling the risk of having a new cardiovascular event,
18:22both ischemic, a brain ictus,
18:24and coronary, a heart attack.
18:26From a purely economic point of view,
18:28what advantages can these innovative drugs have?
18:31The classic example are these new drugs
18:34that silence the genes, these SIRNA.
18:37Obviously, in the short term,
18:39these are drugs that cost more
18:41than standard treatment,
18:43and in the short term, there is a slight increase in costs.
18:46But in the long term, having very effective
18:49and very adherent drugs means reducing
18:53the great expense related to cardiovascular disease,
18:57which is a direct expense, hospitalization,
19:00hospitalization, drugs, treatments,
19:03hyperfusion, etc.,
19:05but also an indirect expense that impacts
19:08on an economic level on the whole society.
19:17This was our latest news.
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19:23Thank you for following us and see you in the next episode.