Zeitschrift für Rheumatologie
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Comparative Study Clinical Trial
[The influence of depression on the effect of Tropisetron in the therapy of fibromyalgia].
As described elsewhere the oral administration of 5 mg of the 5-HT3-receptor-antagonist Tropisetron in fibromyalgia exhibited less amelioration of pain in patients with a depression in comparison to patients without depression. Since an intravenous treatment seems to increase the effect of Tropisetron, the question arises whether patients with depression profit from the intravenous therapy. Methods 68 out patients with fibromyalgia according to ACR-criteria were enrolled in the study. ⋯ There was a significant difference between the group with BDI<19 and the group with antidepressant drug in amelioration of pain (p=0.044). A significant correlation was found in group 2 with Beck > or = 19 between amelioration of pain and BDI after therapy (p=0.008, r=0.666). In this group a pain-reactive depression and in group 3 an endogenous depression must be discussed.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Costs and benefits of an education program for patients with ankylosing spondylitis as part of an inpatient rehabilitation programs-study design and first results].
The economic evaluation of a patient education program "ankylosing spondylitis"-based on a randomised controlled prospective multi-center study design-compares program costs and savings in direct and indirect follow-up costs. The collection of health services and cost data was conducted by questioning staff (education programme costs) and patients (follow-up costs). ⋯ Savings in indirect costs (unfitness to work) amount to 2500 euro and thus overcompensate program costs. Currently patient data are verified by sickness fund data and direct follow-up costs and qualitiy of life data are analysed.
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About 25% of administrations are for off-label indications. The treatment of many rheumatic diseases includes off-label use. Reimbursement from the health insurance is possible if no other approved therapy is available, and if scientific studies prove the effectiveness of the drug.