NOTA AIFA

L’11 settembre 2003, l’AIFA e l’EMA hanno rilasciato ed approvato una comunicazione relativa ai nuovi anticoagulanti orali Pradaxa®, Eliquis® e Xarelto® riguardante maggiori informazioni sui fattori di rischio di sanguinamento. Nella nota viene, anzitutto, specificato che questi tre nuovi farmaci, che vanno a sostituire gli AVK e le EBPM, per quanto vantaggiosi siano dal punto di vista farmacologico, possono comunque causare eventi di sanguinamento maggiore, in modo significativo, proprio come i “vecchi” anticoagulanti; in più, viene sottolineato la scarsa conoscenza che alcuni medici prescrittori hanno a

riguardo. Per tanto, i medici vengono invitati ad attenersi scrupolosamente alle informazioni contenute nel riassunto delle caratteristiche dei tre prodotti, con particolare attenzione alla posologia, alle controindicazioni, alle avvertenze speciali ed alle precauzioni d’utilizzo; bisogna, inoltre, considerare altri concomitanti trattamenti (con FANS ed antiaggreganti), che aumentano il rischio di sanguinamento maggiore. Non da meno sono le considerazioni che riguardano la funzionalità renale, perché, se compromessa, costituirebbe una controindicazione all’uso o addirittura un motivo per non utilizzare tali farmaci. La nota, infine, riporta una piccola sitografia, destinata ai medici che vogliono visionare con attenzione le caratteristiche dei tre anticoagulanti: ELIQUIS® http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/h uman/medicines/002148/human_med_001449.jsp&mid=WC0b01a c058001d124 PRADAXA® http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/h uman/medicines/000829/human_med_000981.jsp&mid=WC0b01a c058001d124 XARELTO® http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/h uman/medicines/000944/human_med_001155.jsp&mid=WC0b01a c058001d124

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SITOGRAFIA

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RINGRAZIAMENTI

Questo lavoro, che dedico ai miei genitori, è solo una piccola parte in confronto a tutto il percorso che mi ha portato fin qui oggi, per niente privo di difficoltà.

Sono stato incostante, scontroso, pessimista e, a volte, irrazionale, ma bastava la solita telefonata serale dei miei genitori per trovare una soluzione a tutti i problemi; ormai avevo capito che loro avevano la bacchetta magica. Dove arrivavano loro non potevo arrivare io! Tutt’ora non mi spiego come sia possibile.

Se dovessi continuare a ringraziarli non basterebbe un semplice paragrafo di tesi; mi fermo solo per questo.

Non posso tralasciare chi ha permesso che questo lavoro venisse portato a termine: il Professor Calderone, che si è dimostrato celere, disponibile e attento alla scelta del tema da trattare.

Ora devo concentrarmi, forse nemmeno troppo, data la loro importanza: anche se le nostre strade si separeranno, loro rappresenteranno sempre una parte di me, della mia mente, del mio cuore. Quasi tremo mentre scrivo. Ho passato con loro mattinate, pomeriggi, serate, notti pazze. È come se qualcuno, quando ero indeciso sull’università alla quale iscrivermi, mi diceva: “Senti, scegli Pisa, perché li conoscerai Alessio, Andrea, Carla, Diego e Martina” (se fate caso l’elenco è in ordine alfabetico). Ovviamente loro sono solo i cinque con cui, in questi anni, ho passato più tempo, ma la lista si allunga con mio cugino Francesco e Geny, con cui ho condiviso la casa nell’ultimo anno,

e voglio mettere anche Ciccio, con cui, invece, ho condiviso tantissimo tempo quando era ancora a Pisa. Non dimentico, infine, tutti gli amici di vecchia data che hanno fatto tanta strada per venire a supportarmi in questo giorno speciale.

Altra dedica è a mia sorella, che posso paragonare ai miei genitori: indispensabile, anche se non sembra per i continui litigi che ci caratterizzano.

Chiudo con un pensiero speciale ai miei due nonni che durante questo percorso sono scomparsi e con loro è andato via anche il piacere di farmi vedere farmacista da due persone a cui sono stato, fin da bambino, molto legato.