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Acesso a tratamento para câncer raro no sangue poderá ser ampliado no SUS, hoje cuidado é apenas paliativo

Novartis convida sociedade civil a participar de consulta pública para contribuir com a incorporação de medicamento que aumenta o tempo de vida dos pacientes


News provided by

Novartis

Mar 03, 2020, 07:52 ET

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SÃO PAULO, 3 de março de 2020 /PRNewswire/ -- A Comissão Nacional de Incorporação de Tecnologias (CONITEC) abriu consulta pública para avaliar a incorporação da terapia-alvo ruxolitinibe para o tratamento de adultos com mielofibrose, nos seguintes subtipos da doença: primária, pós-policitemia vera ou pós-trombocitemia essencial, no Sistema Único de Saúde (SUS), após petição realizada pela ABHH. Atualmente, contando apenas com opções pouco eficazes, a população atendida pela rede pública de saúde poderá ter o acesso a medicamento que contribui para o controle dos sintomas e aumenta o tempo de vida.

Com maior prevalência entre pessoas acima de 50 anos, estima-se que uma a cada 133 mil pessoas seja afetada pela mielofibrose1-2, tipo raro de câncer no sangue, desencadeado pelo mal funcionamento das células-tronco. A disfunção surge quando estas células sofrem uma mutação e formam uma fibrose (cicatriz) na medula óssea, prejudicando a produção das células sanguíneas. 

Entre os principais sintomas estão cansaço sem causa específica, fraqueza, anemia, palidez, suor noturno em excesso, palpitações, falta de ar, emagrecimento, perda de apetite, dor ou desconforto no abdômen e aumento do baço.3-4 Esses aspectos prejudicam bastante os pacientes que, raramente são elegíveis ao transplante de medula óssea, único tratamento curativo. Por conta disso, outras possibilidades terapêuticas, como o ruxolitinibe (inibidor do gene JAK2, presente em aproximadamente 50% dos casos da doença5-6), medicamento que melhor atende a esse perfil de paciente, são necessárias para melhorar a condição desses indivíduos.

"O medicamento é a opção terapêutica mais moderna, que está disponível no sistema privado de saúde desde 2018. Porém, infelizmente, quem depende do SUS ainda não tem acesso a essa terapia-alvo, a única capaz de contornar sintomas graves, como o aumento do baço, além de garantir melhora clinicamente significativa na qualidade de vida e sobrevida global dos pacientes. Precisamos muito da atenção de todos para mudar a realidade de tratamento dessa população hoje desassistida", afirma o diretor médico da Novartis, Dr. André Abrahão.

Por ser uma condição progressiva, os pacientes podem sofrer com condições debilitantes com o passar dos anos, tornando-se incapazes de seguir suas rotinas de forma funcional – especialmente se não estiverem sob cuidados e recebendo o tratamento adequado. A doença pode apresentar complicações graves, como hemorragias, tromboses, infecções e falência de órgãos, bem como evoluir para condições como a leucemia mieloide aguda, potencialmente fatal, e óbito.7-8-9-10

A maioria dos pacientes com mielofibrose são tratados com medicamentos citorredutores (responsáveis por diminuir a contagem das células do sangue), que são apenas paliativos, portanto, é necessário avaliar o papel do ruxolitinibe como recurso terapêutico padrão no Brasil. Ainda que a decisão preliminar da CONITEC seja pela 'não incorporação' do medicamento no SUS, as contribuições de toda sociedade civil (médicos, profissionais de saúde e pacientes, entre outros) podem influenciar a recomendação final do órgão e garantir o acesso das pessoas com mielofibrose a uma terapia comprovadamente eficaz.

Todos podem expressar sua opinião sobre a incorporação de ruxolitinibe para tratamento de pacientes com mielofibrose no SUS. Na consulta pública, a opção DISCORDO da recomendação da CONITEC é a favor da incorporação da nova terapia no sistema público. Já a opção CONCORDO é favorável a não inclusão desse medicamento.

As consultas públicas têm como objetivo promover a participação da sociedade nos processos de tomada de decisões do governo sobre políticas públicas de saúde. Esta consulta está aberta até 11 de março de 2020. Para o envio de contribuições, o interessado deve acessar o site http://conitec.gov.br/consultas-publicas, buscar a consulta sob o nome "Ruxolitinibe para tratamento de pacientes com mielofibrose primária, mielofibrose pós policitemia vera ou mielofibrose pós trombocitemia essencial, de risco intermediário-2 ou alto", número 04 – e seguir as instruções.

_________________________

Referências:

1 McNally RJQ, Rowland D, Roman E, Cartwright RA. Age and sex distributions of hematological malignancies in the U.K. Hematol Oncol. 1997; 15:173–189.
2 Girodon F, Bonicelli G, Schaeffer C, et al. Significant increase in the apparent incidence of essential thrombocythemia related to new WHO diagnostic criteria: a population-based study. Hematologica. 2009; 94(6):865-869.
3 Mayo Clinic. Myelofibrosis. Disponível em: www.mayoclinic.org/diseases-conditions/myelofibrosis/basics/symptoms/con-20027210. Acesso em julho de 2016.
4 Site MedlinePlus. Disponível em: www.nlm.nih.gov/medlineplus/ency/article/000531.htm. Último acesso 4/1/2015.
5 Leukemia & Lymphoma Foundation. Diagnosis. Disponível em: https://www.lls.org/myeloproliferative-neoplasms/myelofibrosis/diagnosis Acesso em julho de 2019.
6 MPN Research Foundation. How is MF diagnosed? Disponível em: http://www.mpnresearchfoundation.org/Primary-Myelofibrosis Acesso em julho de 2019.
7 Mayo Clinic. Myelofibrosis – overview. Disponível em: http://www.mayoclinic.org/diseases-conditions/myelofibrosis/home/ovc-20261141 Acesso em julho de 2019.
8 Oncolink. All about myelofibrosis. Disponível em: https://www.oncolink.org/cancers/leukemia/myelofibrosis/all-about-myelofibrosis Acesso em julho de 2019.
9 Leukemia & Lymphoma Society. Myelofibrosis. Disponível em: https://www.lls.org/myeloproliferative-neoplasms/myelofibrosis Acesso em julho de 2019.
10 International Journal of General Medicine. Myelofibrosis-associated complications: pathogenesis, clinical manifestations, and effects on outcomes. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912063/ Acesso em julho de 2019.

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