Atlas da Saúde

Segundo os últimos dados do INE, mais de metade da população adulta em Portugal (52,8%) sofre de pré-obesidade ou obesidade, situação que aumenta o risco de desenvolvimento de doenças crónicas como a diabetes ou doenças cardiovasculares.

Discutir a responsabilidade de uma doença incentivada pelos hábitos e comportamentos da nossa sociedade é o objetivo do evento que numa primeira parte expõe o tema “Prevenção, referenciação e seguimento” da obesidade e excesso de peso nas diferentes idades: pediátrica, adulta e no idoso. O debate “Uma responsabilidade de todos” tem depois início, com a moderação da Presidente da Sociedade Portuguesa para o Estudo da Obesidade (SPEO), a Professora Doutora Paula Freitas.

Vivemos numa sociedade que incentiva o consumo de comida rápida, altamente prejudicial para a saúde, e o sedentarismo das 8h de escritório. O resultado é simples: 16,4% da população portuguesa com idade igual ou superior a 18 anos sofre de obesidade, tornando esta enfermidade um dos principais problemas de saúde pública no nosso país e, desta forma, um problema de todos.

Alertar para as consequências desta doença, bem como para a necessidade de adotar estratégias que visem uma mudança de hábitos e comportamentos, para um estilo de vida saudável, é crucial dado o crescente impacto dos doentes obesos nos serviços de saúde.

Campanhas como “Comprometidos com um peso saudável”, com a colaboração e apoio da SPEO, assumem grande importância neste contexto, ao consciencializar não só sobre a necessidade de perder peso e adotar um estilo de vida saudável, mas também sobre a necessidade de fazê-lo com supervisão médica e o apoio de uma equipa multidisciplinar.

Consulte aqui o programa do evento.

Em comunicado, o Infarmed adianta ter dado início “ao mais vasto conjunto de sempre de inspeções no terreno a serviços farmacêuticos hospitalares”, estando planeadas ”inspeções a 31 serviços farmacêuticos, sejam públicos (24) ou privados (7), prevendo-se também ações a detentores de autorização de aquisição direta”.

Aquela entidade adiantou que já foram avaliadas 10 unidades, tendo sido detetadas diversas irregularidades e as instituições notificadas para encetar a sua correção.

“Depois de, no ano passado, se terem realizado cinco inspeções a estes serviços, foi decidido avançar com um programa mais alargado, com o objetivo de “verificar o circuito do medicamento (e também dispositivos médicos), garantindo que estes são administrados aos doentes com toda a qualidade, eficácia e segurança”, justificou a autoridade nacional do medicamento.

O Infarmed salienta também que “o cumprimento do que está previsto nas normas legais e na regulamentação aplicável é também verificado”.

“Até ao momento, as irregularidades mais frequentemente detetadas são relacionadas com o sistema de gestão de qualidade - nomeadamente ao nível dos procedimentos e registos - o sistema de monitorização das condições ambientais dos medicamentos e dos produtos de saúde, a preparação de medicação ou os circuitos dos medicamentos nas próprias instituições, havendo ainda irregularidades na dispensa de medicamentos ao público”, adiantou aquela entidade em comunicado.

O conjunto de ações deverá decorrer durante os próximos meses, ficando a cargo de uma equipa multidisciplinar do Infarmed.

Estas são as questões que colocam frente a frente a Educação em Saúde, os programas de literacia em saúde, as ações de promoção de estilos de vida saudáveis e o seu retorno nos ganhos em saúde.

Em depoimentos recolhidos junto do Secretário de Estado da Saúde, Manuel Delgado, no âmbito de uma iniciativa de prevenção de doenças cardiovasculares que decorreu em Setúbal, de 11 a 13 de maio, organizada por membros do departamento de Cardiologia do Centro Hospitalar de Setúbal EPE, e em colaboração com a Sociedade Portuguesa de Cardiologia, foram abraçadas estas e outras questões.

A literacia e o investimento público
Relativamente à importância da educação para a saúde, o Secretário de Estado concorda que “a literacia é uma forma de educar o cidadão para hábitos de vida saudáveis, evitar fatores de risco e alertar para os perigos de certo tipo de condutas da nossa vida quotidiana.”

Quanto ao impacto nos custos em saúde, Manuel Delgado acrescenta que “este é um fator decisivo para melhorar a saúde da nossa população, evitar consultas de especialidade e reduzir a despesa inerente à saúde.”

Por essa razão, justifica que o Ministério da Saúde veja “com muito interesse” o patrocínio de campanhas de literacia em saúde alavancadas por sociedades médicas. “O Ministério da Saúde tem grande responsabilidade na vigilância da saúde dos Portugueses, mas não pode fazer tudo sozinho. O estabelecimento de parcerias com sociedades científicas é absolutamente crucial para desenvolvermos a promoção e literacia em saúde. “

A Direção-Geral da Saúde (DGS), acrescenta, “tem tido um papel determinante para melhoria das condições de saúde dos Portugueses e para os resultados de saúde. Somos líderes em muitos indicadores fundamentais de saúde, mesmo quando comparados com países mais desenvolvidos, como por exemplo na vacinação das populações ou na taxa de mortalidade infantil.”Por isso, remata, “não tenho dúvidas de que a DGS é uma entidade de extrema importância para colaborar com sociedades científicas e levar para a frente projetos que tenham importância e impacto na vida dos Portugueses e que atinjam um grande número de cidadãos.”

A investigação clínica em Portugal
Quando confrontado com a importância da Investigação Clínica em Portugal, o Secretário de Estado comenta que “os ensaios clínicos, ao contrário do que anteriormente se pensava, são de extrema utilidade para os hospitais porque dão rendimento, permitem o acesso à investigação por parte de clínicos e também permitem que os doentes tenham acesso a terapias inovadoras.” Todavia, acrescenta “as terapias inovadoras têm de ser utilizadas segundo um critério de custo/efetividade, isto é, não podemos pegar nas terapias inovadoras e utilizá-las sem critério porque isso tem custos incomportáveis para o erário público e muitas vezes os benefícios são muito reduzidos.”

Porém, em comparação com as outras economias semelhantes à portuguesa a taxa de acesso à investigação clínica é muito superior e Portugal apresenta alguns entraves à inovação.

Em comentário a esta afirmação, Manuel Delgado justifica que “Portugal, não tendo uma indústria farmacológica muito desenvolvida, tem mais dificuldade em incorporar terapêuticas inovadoras, visto que essas chegam a Portugal um pouco mais tarde.”

Quando chegam, adianta o Secretário de Estado, “tentamos agilizar a avaliação das terapêuticas.”

Quando se trata de aprovar uma nova tecnologia, “a única questão que se coloca é a importância de avaliar e testar a validade das terapêuticas para todos os doentes, ou para o nicho de doentes aos quais essas terapêuticas se destinam.”

Por fim, e realçando a importância do trabalho em conjunto, entre a tutela e as sociedades médicas, o Secretário de Estado confessa o seu interesse “em colaborar na componente científica e técnica para a promoção de campanhas através de uma parceria com a Direção-Geral da Saúde, como por exemplo, através da criação de protocolos.” Do ponto de vista financeiro, atenta “temos de avaliar individualmente cada projeto e verificar quais os que apresentam maior impacto. E a Cardiologia claramente que é uma área importante.”

Nelson Pires, diretor-geral da Jaba Recordati, afirma que “o sucesso da nossa empresa alinhado com o posicionamento internacional do grupo Recordati, assenta em três pressupostos, internamente apelidados de ‘3 P’s’ (pessoas, produtos e processos). Acrescenta ainda que a “estratégia da multinacional sempre foi “glocal”, mas assente em variáveis da cultura e enquadramento local permitindo o crescimento do empreendedorismo de cada país onde a companhia opera. Realça na impressão digital da empresa a inovação na qual o grupo Recordati investe mais de 8% do seu turnover anual (mais de 80 milhões de euros em I&D de produto)”.

Para assinalar os 90 anos, a Jaba Recordati apresenta-se ao mercado com um site totalmente renovado com o objetivo de oferecer uma “navegação” mais dinâmica e user friendly para o cliente e público em geral, permitindo proceder a uma pesquisa pelas diferentes patologias e áreas terapêuticas a que a companhia se dedica. 

História de uma marca com ADN português e inovação global
Em 1926, foi fundado o Laboratório de Farmacologia Reggiano em Milão por Giovanni Recordati. Em 1927, foi fundada a Farmácia Universal, em Lisboa pelo farmacêutico José António Baptista d'Almeida (J.A.B.A.). Apenas um ano de diferença separa a história das duas empresas que em comum têm a sua génese na área farmacológica. Em 2006, o Grupo português Jaba é adquirido pelo grupo italiano Recordati, que representou a consolidação das suas áreas de negócio e dos centros de I&D. A Jaba Recordati é, desde dezembro de 2006, a subsidiária em Portugal do grupo Recordati fundado em 1926. A marca Jaba evoluiu para Jaba Recordati com o processo de aquisição pela Recordati. Com esta mudança, a empresa, além de comercializar produtos farmacêuticos sob licença, iniciou a comercialização de produtos inovadores.

A inovação representa um dos principais drivers de crescimento a médio e longo prazo que permitirá à empresa atingir o objetivo de crescimento superior a 7% anual nos próximos três anos. Findo este prazo estima-se que os produtos inovadores representem mais de 70% do turnover da Jaba Recordati. Prevê-se no futuro, para além do crescimento orgânico em I&D, a aquisição de novas empresas. O sucesso da empresa assenta não só na história da sua marca, mas também na resiliência demonstrada pelos resultados que demonstrou pelos objetivos financeiros atingidos pela Jaba Recordati no seio do grupo Recordati nos últimos seis anos, em contraciclo com a conjuntura económica nacional e inflexão do sector farmacêutico.

De acordo com a Universidade do Porto (U.Porto), o novo “superlaboratório” foi a unidade científica que garantiu o maior valor de financiamento anual na mais recente avaliação ao sistema científico nacional realizada pela Fundação para a Ciência e Tecnologia – 6,19 milhões de euros – e uma das 11 unidades a receber a classificação máxima de Excecional.

Resultando da união de três dos mais conceituados centros científicos da Universidade do Porto – o Instituto de Biologia Molecular e Celular (IBMC), o Instituto Nacional de Engenharia Biomédica (INEB) e o Instituto de Patologia e Imunologia Molecular (Ipatimup) –, o i3S assume-se como o maior instituto de investigação português na área das Ciências da Saúde.

O i3S de investigação agrega mais de 1000 colaboradores, 800 dos quais cientistas dedicados ao desenvolvimento de respostas aos maiores desafios da saúde da atualidade: Cancro, Neurobiologia e Doenças Neurológicas e Interação e Resposta do Hospedeiro.

Para albergar este novo “superlaboratório”, a Universidade do Porto construiu de raiz, no polo universitário da Asprela, um novo edifício de 18 mil metros quadrados, uma empreitada orçada em 21,5 milhões de euros, financiada em 18 milhões por fundos comunitários no âmbito do Programa Operacional Regional do Norte, o “ON.2 – O Novo Norte”.

Totalmente dedicado a laboratórios e serviços de investigação, o novo espaço tem ligação direta com o antigo edifício do IPATIMUP, agora reconvertido para salas de aulas de pós-graduações, auditórios e serviços administrativos do i3S.

A construção do novo edifício teve início em 2013, com o lançamento oficial da primeira pedra a 04 de abril desse ano, tendo ficado concluída com a instalação de todos os grupos de investigação em dezembro de 2015.

Contudo, a criação do i3S começou a tomar forma já em 2003, com a instituição do protocolo de cooperação entre IBMC, INEB e Ipatimup, e transformou-se em realidade a 28 de janeiro de 2008, quando os diretores daqueles três centros assinaram o protocolo de estabelecimento do consórcio perante uma plateia onde pontuavam o primeiro-ministro e o ministro da Ciência da altura, José Sócrates e Mariano Gago.

O edifício-sede do i3S é oficialmente inaugurado com a presença do Presidente da República, Marcelo Rebelo de Sousa, do primeiro-ministro, António Costa, e dos ministros da Ciência, Tecnologia e Ensino Superior e da Saúde.

No final da cerimónia de inauguração realiza-se uma homenagem a Mariano Gago e a Corino de Andrade, com a atribuição dos nomes destes cientistas aos dois auditórios existentes no complexo do i3S.

“Isso é um problema e nós temos que preencher logo que possível as vagas de médicos de família. E aqui, a boa notícia, é que nós vamos ter médicos de família novos, a sair da sua formação, durante o mês de junho”, disse.

Em declarações aos jornalistas, durante uma visita ao hospital de Portalegre, o governante afirmou que, “até agosto/setembro”, vão ser colocados profissionais de norte a sul do país e que “alguns deles” vão exercer no Alentejo. Manuel Delgado não especificou quantos médicos de família vão entrar no Serviço Nacional de Saúde (SNS), assegurando apenas que será um “número significativo”.

Lamentando a existência de utentes sem médico de família, o secretário de Estado sublinhou que no Alentejo vive-se “alguma discrepância” nesta matéria.

“Aqui no Alentejo há alguma discrepância. Por exemplo, na Unidade Local de Saúde do Norte Alentejano só oito por cento da população é que não tem médico de família, o que é muito bom”, enalteceu.

O secretário de Estado da Saúde, que iniciou hoje uma visita de dois dias ao Alentejo, dando “ênfase” aos cuidados de saúde primários, explicou que a sua deslocação pretende “não só identificar os sucessos, mas também identificar os problemas” relacionados com o setor.

“Há aqui um sinal, no Alentejo, desde o ano passado para este que é positivo. Em termos gerais, diminuiu o número de atendimentos nas urgências, o que é sinal de que, eventualmente, do ponto de vista da resposta mais programada, as coisas melhoraram”, afirmou.

Hoje em Portalegre, o governante inaugurou as novas instalações do hospital de dia do Hospital José Maria Grande, unidade que está em funcionamento desde novembro de 2015, visitando de seguida o serviço de cirurgia.

Manuel Delgado visitou depois a Unidade de Saúde Familiar (USF) “Raia Maior", em Campo Maior, fechando a manhã com a apresentação de um projeto de intervenção, relativo a clínica de alta resolução, no Hospital de Santa Luzia, em Elvas.

Durante a tarde de hoje, o governante visita, no hospital de Beja, os serviços de consulta externa, imagiologia e de psiquiatria.

Na quinta-feira, Manuel Delgado tem agendada uma reunião com o conselho diretivo da Administração Regional de Saúde do Alentejo e uma visita ao Laboratório de Saúde Pública de Évora.

À tarde, marca presença na tomada de posse do novo conselho de Administração da Unidade Local de Saúde do Litoral Alentejano e visita os serviços de urgência e de consultas externas do Hospital do Litoral Alentejano, no concelho de Santiago do Cacém.

This approval allows for the marketing of the Opdivo + Yervoy Regimen in all 28 Member States of the EU. Approval was based on CheckMate -067, the first Phase 3, double-blind, randomized study, in which the Opdivo + Yervoy Regimen and Opdivo monotherapy demonstrated superior progression-free survival (PFS) and objective response rates (ORR) in patients with advanced melanoma, regardless of BRAF mutational status, versus Yervoy alone. The safety profile was consistent with previously reported studies evaluating the Opdivo + Yervoy Regimen, and most treatment-related adverse events were managed using established algorithms.

Dr. James Larkin, from The Royal Marsden and lead author on CheckMate -067, the trial that led to this approval, commented, “Historically, advanced melanoma has been a very difficult-to-treat disease. Now, with this approval, patients in Europe will have a treatment option combining two Immuno-Oncology therapies, Opdivo and Yervoy, which in a Phase 3 randomized trial has shown its ability to deliver superior efficacy versus Yervoy monotherapy in progression-free survival and response.

This is truly good news for healthcare providers and the patients they treat, as it represents an importante new treatment option with the potential for improved outcomes.”

In study CheckMate -067, the Opdivo + Yervoy Regimen demonstrated a 58% reduction in the risk of disease progression versus Yervoy monotherapy in previously untreated patients with advanced melanoma (HR=0.42 [99.5% CI: 0.32-0.56; p<0.0001]), while Opdivo monotherapy demonstrated a 45% risk reduction versus Yervoy monotherapy (HR=0.55 [99.5% CI: 0.42-0.73; p<0.0001]). The median PFS for the Opdivo + Yervoy Regimen was 11.5 months (95% CI: 8.9-22.18) and 6.9 months (95% CI: 4.3-9.5) for Opdivo monotherapy versus 2.89 months (95% CI: 2.8-3.4) for Yervoy monotherapy, at a minimum follow-up of 18 months. The Opdivo + Yervoy Regimen and Opdivo monotherapy also demonstrated a higher ORR (ORR: 58% and 44%, p<0.0001, respectively) versus Yervoy monotherapy (19%). Median duration of response was not reached for the Opdivo + Yervoy Regimen and was 22.3 months for Opdivo monotherapy, versus 14.4 months for Yervoy alone.

Based on a pre-planned, descriptive analysis of data from CheckMate -067, the EC adopted the Committee for Medicinal Products for Human Use (CHMP) recommendation to add an informative statement to the broad indication that relative to Opdivo monotherapy, an increase in PFS for the combination of Opdivo with Yervoy is established only in patients with low tumor PD-L1 expression. In the study, overall response rates were higher for the combination of Opdivo and Yervoy relative to Opdivo monotherapy across tumor PD-L1 expression levels.

The approval was also based on supportive data from the Phase 2 study, CheckMate -069, in which the Opdivo + Yervoy Regimen demonstrated an ORR, the primary endpoint, of 61% (95% CI: 48.9-72.4) in patients with BRAF wild-type advanced melanoma, versus 11% (95% CI: 3-25.4) ORR in the Yervoy monotherapy arm, with a minimum follow-up of 11 months. The estimated 12- and 18-month overall survival (OS) rates were 79% (95% CI: 67, 87) and 73% (95% CI: 61, 82), respectively, for the Opdivo + Yervoy Regimen, and 62% (95% CI: 44, 75) and 56% (95% CI: 39, 70), respectively, for Yervoy monotherapy. The OS data are based on an exploratory, pre-planned analysis of patients with BRAF wild-type advanced melanoma.

Emmanuel Blin, senior vice president, Head of Commercialization, Policy and Operations, Bristol-Myers Squibb, commented, “Today’s approval of the Opdivo + Yervoy Regimen for advanced melanoma patients supports our goal of developing innovative treatment approaches that have the potential to improve patient outcomes. The Opdivo + Yervoy Regimen is the first and only approved Immuno-Oncology combination, and only Regimen to deliver superior efficacy compared to Yervoy, and we are thrilled to make this novel combination treatment available to patients with advanced melanoma in Europe.”

Approval Based on Superior Efficacy Demonstrated Versus Yervoy In Pivotal Phase 3 Study
CheckMate -067 is a Phase 3, double-blind, randomized study that evaluated the Opdivo + Yervoy Regimen or Opdivo monotherapy versus Yervoy alone in patients with previously untreated advanced melanoma, including both BRAF V600 mutation positive or BRAF wild-type advanced melanoma. A total of 945 patients were randomized to receive the Opdivo + Yervoy Regimen (Opdivo 1 mg/kg plus Yervoy 3 mg/kg every 3 weeks for 4 doses followed by Opdivo 3 mg/kg every 2 weeks thereafter; n=314), Opdivo monotherapy (Opdivo 3 mg/kg every 2 weeks; n=316) or Yervoy monotherapy (Yervoy 3 mg/kg every 3 weeks for 4 doses followed by placebo every 2 weeks; n=315).

Randomization was stratified by PD-L1 expression (≥5% vs. <5%), BRAF status, and M stage per the American Joint Committee on Cancer (AJCC) staging system. Patients were treated until progression or unacceptable toxicity. The co-primary endpoints were progression-free survival (PFS) and overall survival (OS); the study is ongoing and patients continue to be followed for OS. Objective response rate (ORR) and the duration of response were also assessed.

Results from the trial demonstrated a statistically significant improvement in PFS in patients with advanced melanoma treated with the Opdivo + Yervoy Regimen (p<0.0001) and with Opdivo as a single agent (p<0.0001) versus Yervoy monotherapy. At a minimum follow-up of 18 months, the Opdivo + Yervoy Regimen demonstrated a 58% reduction in the risk of disease progression versus Yervoy monotherapy in previously untreated patients with advanced melanoma (HR=0.42 [99.5% CI: 0.32-0.56; p<0.0001]), while Opdivo monotherapy demonstrated a 45% risk reduction versus Yervoy monotherapy (HR=0.55 [99.5% CI: 0.42-0.73; p<0.0001]). The median PFS for the Opdivo + Yervoy Regimen was 11.5 months (95% CI: 8.9-22.18) and 6.9 months (95% CI: 4.3-9.5) for Opdivo monotherapy versus 2.89 months (95% CI: 2.8-3.4) for Yervoy monotherapy, at a minimum follow-up of 18 months.

The Opdivo + Yervoy Regimen and Opdivo monotherapy also demonstrated a higher ORR (ORR: 58% and 44%, p<0.0001, respectively) versus Yervoy monotherapy (19%). There were 38 (12%) complete responses and 143 (46%) partial responses seen in patients treated with the Opdivo + Yervoy Regimen, and 31 (10%) complete responses and 107 (34%) partial responses seen in patients treated with Opdivo monotherapy, versus 7 (2%) complete responses and 53 (17%) partial responses seen in patients treated with Yervoy alone. Median duration of response was not reached (0+ - 24+ months) for the Opdivo + Yervoy Regimen and was 22.3 months (0+ - 23+) for Opdivo monotherapy, versus 14.4 months (1.4 - 22.3+) for Yervoy alone.

CheckMate -069 is a Phase 2, double-blind, randomized study evaluating the Opdivo + Yervoy Regimen versus Yervoy monotherapy in 142 patients with previously untreated unresectable or metastatic melanoma. The trial included patients with BRAF V600 mutation positive and BRAF wildtype advanced melanoma, and randomization was stratified by BRAF mutation status. The primary endpoint was ORR in patients with BRAF wild-type tumors. Secondary endpoints included PFS in patients with BRAF wild-type tumors, ORR in patients with BRAF V600 mutation positive tumors and safety. Overall survival was an exploratory endpoint. Treatment was continued until progression or unacceptable toxicity. In this study, the Opdivo + Yervoy Regimen demonstrated a response rate of 61% (95% CI: 48.9-72.4) in patients with BRAF wild-type advanced melanoma, versus 11% (95% CI: 3-25.4)

ORR in the Yervoy monotherapy arm, with a minimum follow-up of 11 months. The estimated 12- and 18-month OS rates were 79% (95% CI: 67, 87) and 73% (95% CI: 61, 82), respectively, for the Opdivo + Yervoy Regimen, and 62% (95% CI: 44, 75) and 56% (95% CI: 39, 70), respectively, for Yervoy.

In a pooled dataset of the Opdivo + Yervoy Regimen, based on three studies of the combination, the most frequent adverse reactions (>10%) were rash (51%), fatigue (43%), diarrhea (42%), pruritus (35%), nausea (25%), pyrexia (19%), decreased appetite (15%), hypothyroidism (15%), vomiting (14%), colitis (14%), abdominal pain (13%), anthralgia (11%) and headache (11%). The majority of adverse reactions were mild to moderate (Grade 1 or 2). Among the patients treated with Opdivo in combination with Yervoy in CheckMate -067, 151/313 (48%) had the first onset of Grade 3 or 4 adverse reactions during the initial combination phase. Among the 147 patients in this group who continued treatment in the single-agent phase, 37 (25%) experienced at least one Grade 3 or 4 adverse reaction during the single-agent phase.

About Advanced Melanoma
Melanoma is a form of skin cancer characterized by the uncontrolled growth of pigmentproducing cells (melanocytes) located in the skin. Metastatic melanoma is the deadliest form of the disease, and occurs when cancer spreads beyond the surface of the skin to the other organs, such as the lymph nodes, lungs, brain or other areas of the body. Melanoma is the ninth most common cancer in Europe, with an estimated 100,000 new cases diagnosed annually and more than 20,000 deaths.

Bristol-Myers Squibb & Immuno-Oncology: Advancing Oncology Research
At Bristol-Myers Squibb, we have a vision for the future of cancer care that is focused on Immuno-Oncology, now considered a major treatment modality alongside surgery, radiation and chemotherapy for certain types of cancer.

We have a comprehensive clinical portfolio of investigational and approved Immuno-Oncology agents, many of which were discovered and developed by our scientists. We pioneered the research leading to the first regulatory approval for the combination of two Immuno-Oncology agents, and continue to study the role of combinations in cancer.

Our collaboration with academia, as well as small and large biotech companies is responsible for researching the potential of Immuno-Oncology and non-Immuno-Oncology combinations, with the goal of providing new treatment options in clinical practice.

At Bristol-Myers Squibb, we are committed to changing expectations in hard-to-treat cancers and the way patients live with cancer.

About Opdivo
Cancer cells may exploit “regulatory” pathways, such as checkpoint pathways, to hide from the immune system and shield the tumor from immune attack. Opdivo is a PD-1 immune checkpoint inhibitor that binds to the checkpoint receptor PD-1 expressed on activated T-cells, and blocks the binding of PD-L1 and PD-L2, preventing the PD-1 pathway’s suppressive signaling on the imune system, including the interference with an anti-tumor immune response.

Opdivo’s broad global development program is based on Bristol-Myers Squibb’s understanding of the biology behind Immuno-Oncology. Our company is at the forefront of researching the potential of Immuno-Oncology to extend survival in hard-to-treat cancers. This scientific expertise serves as the basis for the Opdivo development program, which includes a broad range of Phase 3 clinical trials evaluating overall survival as the primary endpoint across a variety of tumor types. The Opdivo trials have also contributed toward the clinical and scientific understanding of the role of biomarkers and how patients may benefit from Opdivo across the continuum of PD-L1 expression. To date, the Opdivo clinical development program has enrolled more than 18,000 patients.

Opdivo was the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world in July 2014, and currently has regulatory approval in 50 countries including the United States, Japan, and in the European Union.

U.S. FDA APPROVED INDICATIONS

OPDIVO® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 wild-type unresectable or metastatic melanoma.

OPDIVO® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingente upon verification and description of clinical benefit in confirmatory trials.

OPDIVO® (nivolumab), in combination with YERVOY® (ipilimumab), is indicated for the treatment of patients with unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingente upon verification and description of clinical benefit in the confirmatory trials.

OPDIVO® (nivolumab) is indicated for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving OPDIVO.

OPDIVO® (nivolumab) is indicated for the treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy.

IMPORTANT SAFETY INFORMATION

WARNING: IMMUNE-MEDIATED ADVERSE REACTIONS

YERVOY can result in severe and fatal immune-mediated adverse reactions. These immunemediated reactions may involve any organ system; however, the most common severe immunemediated adverse reactions are enterocolitis, hepatitis, dermatitis (including toxic epidermal necrolysis), neuropathy, and endocrinopathy. The majority of these immune-mediated reactions initially manifested during treatment; however, a minority occurred weeks to months after discontinuation of YERVOY.

Assess patients for signs and symptoms of enterocolitis, dermatitis, neuropathy, and endocrinopathy and evaluate clinical chemistries including liver function tests (LFTs), adrenocorticotropic hormone (ACTH) level, and thyroid function tests at baseline and before each dose.

Permanently discontinue YERVOY and initiate systemic high-dose corticosteroid therapy for severe immune-mediated reactions.

Immune-Mediated Pneumonitis
Immune-mediated pneumonitis, including fatal cases, occurred with OPDIVO treatment. Across the clinical trial experience with solid tumors, fatal immune-mediated pneumonitis occurred with OPDIVO.

In addition, in Checkmate 069, there were six patients who died without resolution of abnormal respiratory findings. Monitor patients for signs with radiographic imaging and symptoms of pneumonitis. Administer corticosteroids for Grade 2 or greater pneumonitis. Permanently discontinue for Grade 3 or 4 and withhold until resolution for Grade 2. In Checkmate 069 and 067, immunemediated pneumonitis occurred in 6% (25/407) of patients receiving OPDIVO with YERVOY: Fatal (n=1), Grade 3 (n=6), Grade 2 (n=17), and Grade 1 (n=1). In Checkmate 037, 066, and 067, immunemediated pneumonitis occurred in 1.8% (14/787) of patients receiving OPDIVO: Grade 3 (n=2) and Grade 2 (n=12). In Checkmate 057, immune-mediated pneumonitis, including interstitial lung disease, occurred in 3.4% (10/287) of patients: Grade 3 (n=5), Grade 2 (n=2), and Grade 1 (n=3). In Checkmate 025, pneumonitis, including interstitial lung disease, occurred in 5% (21/406) of patients receiving OPDIVO and 18% (73/397) of patients receiving everolimus. Immune-mediated pneumonitis occurred in 4.4% (18/406) of patients receiving OPDIVO: Grade 4 (n=1), Grade 3 (n=4), Grade 2 (n=12), and Grade 1 (n=1).

Immune-Mediated Colitis
Immune-mediated colitis can occur with OPDIVO treatment. Monitor patients for signs and symptoms of colitis. Administer corticosteroids for Grade 2 (of more than 5 days duration), 3, or 4 colitis. As a single agent, withhold OPDIVO for Grade 2 or 3 and permanently discontinue for Grade 4 or recurrent colitis upon restarting OPDIVO. When administered with YERVOY, withhold OPDIVO for Grade 2 and permanently discontinue for Grade 3 or 4 or recurrent colitis upon restarting OPDIVO. In Checkmate 069 and 067, diarrhea or colitis occurred in 56% (228/407) of patients receiving OPDIVO with YERVOY. Immune-mediated colitis occurred in 26% (107/407) of patients: Grade 4 (n=2), Grade 3 (n=60), Grade 2 (n=32), and Grade 1 (n=13). In Checkmate 037, 066, and 067, diarrhea or colitis occurred in 31% (242/787) of patients receiving OPDIVO. Immune-mediated colitis occurred in 4.1% (32/787) of patients: Grade 3 (n=20), Grade 2 (n=10), and Grade 1 (n=2). In Checkmate 057, diarrhea or colitis occurred in 17% (50/287) of patients receiving OPDIVO. Immune-mediated colitis occurred in 2.4% (7/287) of patients: Grade 3 (n=3), Grade 2 (n=2), and Grade 1 (n=2). In Checkmate 025, diarrhea or colitis occurred in 25% (100/406) of patients receiving OPDIVO and 32% (126/397) of patients receiving everolimus. Immune-mediated diarrhea or colitis occurred in 3.2% (13/406) of patients receiving OPDIVO: Grade 3 (n=5), Grade 2 (n=7), and Grade 1 (n=1).

In a separate Phase 3 study of YERVOY 3 mg/kg, severe, life-threatening, or fatal (diarrhea of ≥7 stools above baseline, fever, ileus, peritoneal signs; Grade 3-5) immune-mediated enterocolitis occurred in 34 (7%) patients. Across all YERVOY-treated patients in that study (n=511), 5 (1%) developed intestinal perforation, 4 (0.8%) died as a result of complications, and 26 (5%) were hospitalized for severe enterocolitis.

Immune-Mediated Hepatitis
Immune-mediated hepatitis can occur with OPDIVO treatment. Monitor patients for abnormal liver tests prior to and periodically during treatment. Administer corticosteroids for Grade 2 or greater transaminase elevations. Withhold for Grade 2 and permanently discontinue for Grade 3 or 4 immunemediated hepatitis. In Checkmate 069 and 067, immune-mediated hepatitis occurred in 13% (51/407) of patients receiving OPDIVO with YERVOY: Grade 4 (n=8), Grade 3 (n=37), Grade 2 (n=5), and Grade 1 (n=1). In Checkmate 037, 066, and 067, immune-mediated hepatitis occurred in 2.3% (18/787) of patients receiving OPDIVO: Grade 4 (n=3), Grade 3 (n=11), and Grade 2 (n=4). In Checkmate 057, one patient (0.3%) developed immune-mediated hepatitis. In Checkmate 025, there was an increased incidence of liver test abnormalities compared to baseline in AST (33% vs 39%), alkaline phosphatase (32% vs 32%), ALT (22% vs 31%), and total bilirubin (9% vs 3.5%) in the OPDIVO and everolimus arms, respectively. Immune-mediated hepatitis requiring systemic immunosuppression occurred in 1.5% (6/406) of patients receiving OPDIVO: Grade 3 (n=5) and Grade 2 (n=1).

In a separate Phase 3 study of YERVOY 3 mg/kg, severe, life-threatening, or fatal hepatotoxicity (AST or ALT elevations >5x the ULN or total bilirubin elevations >3x the ULN; Grade 3-5) occurred in 8 (2%) patients, with fatal hepatic failure in 0.2% and hospitalization in 0.4%.

Immune-Mediated Dermatitis
In a separate Phase 3 study of YERVOY 3 mg/kg, severe, life-threatening, or fatal immune-mediated dermatitis (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash complicated by full thickness dermal ulceration, or necrotic, bullous, or hemorrhagic manifestations; Grade 3-5) occurred in 13 (2.5%) patients. 1 (0.2%) patient died as a result of toxic epidermal necrolysis. 1 additional patient required hospitalization for severe dermatitis.

Immune-Mediated Neuropathies
In a separate Phase 3 study of YERVOY 3 mg/kg, 1 case of fatal Guillain-Barré syndrome and 1 case of severe (Grade 3) peripheral motor neuropathy were reported.

Immune-Mediated Endocrinopathies
Hypophysitis, adrenal insufficiency, thyroid disorders, and type 1 diabetes mellitus can occur with OPDIVO treatment. Monitor patients for signs and symptoms of hypophysitis, signs and symptoms of adrenal insufficiency during and after treatment, thyroid function prior to and periodically during treatment, and hyperglycemia. Administer corticosteroids for Grade 2 or greater hypophysitis. Withhold for Grade 2 or 3 and permanently discontinue for Grade 4 hypophysitis. Administer corticosteroids for Grade 3 or 4 adrenal insufficiency. Withhold for Grade 2 and permanently discontinue for Grade 3 or 4 adrenal insufficiency. Administer hormone-replacement therapy for hypothyroidism. Initiate medical management for control of hyperthyroidism. Administer insulin for type 1 diabetes. Withhold OPDIVO for Grade 3 and permanently discontinue for Grade 4 hyperglycemia.

In Checkmate 069 and 067, hypophysitis occurred in 9% (36/407) of patients receiving OPDIVO with YERVOY: Grade 3 (n=8), Grade 2 (n=25), and Grade 1 (n=3). In Checkmate 037, 066, and 067, hypophysitis occurred in 0.9% (7/787) of patients receiving OPDIVO: Grade 3 (n=2), Grade 2 (n=3), and Grade 1 (n=2). In Checkmate 025, hypophysitis occurred in 0.5% (2/406) of patients receiving OPDIVO: Grade 3 (n=1) and Grade 1 (n=1). In Checkmate 069 and 067, adrenal insufficiency occurred in 5% (21/407) of patients receiving OPDIVO with YERVOY: Grade 4 (n=1), Grade 3 (n=7), Grade 2 (n=11), and Grade 1 (n=2). In Checkmate 037, 066, and 067, adrenal insufficiency occurred in 1% (8/787) of patients receiving OPDIVO: Grade 3 (n=2), Grade 2 (n=5), and Grade 1 (n=1). In Checkmate 057, 0.3% (1/287) of OPDIVO-treated patients developed adrenal insufficiency. In Checkmate 025, adrenal insufficiency occurred in 2.0% (8/406) of patients receiving OPDIVO: Grade 3 (n=3), Grade 2 (n=4), and Grade 1 (n=1). In Checkmate 069 and 067, hypothyroidism or thyroiditis occurred in 22% (89/407) of patients receiving OPDIVO with YERVOY: Grade 3 (n=6), Grade 2 (n=47), and Grade 1 (n=36). Hyperthyroidism occurred in 8% (34/407) of patients: Grade 3 (n=4), Grade 2 (n=17), and Grade 1 (n=13). In Checkmate 037, 066, and 067, hypothyroidism or thyroiditis occurred in 9% (73/787) of patients receiving OPDIVO: Grade 3 (n=1), Grade 2 (n=37), Grade 1 (n=35). Hyperthyroidism occurred in 4.4% (35/787) of patients receiving OPDIVO: Grade 3 (n=1), Grade 2 (n=12), and Grade 1 (n=22). In Checkmate 057, Grade 1 or 2 hypothyroidism, including thyroiditis, occurred in 7% (20/287) and elevated thyroid stimulating hormone occurred in 17% of patients receiving OPDIVO. Grade 1 or 2 hyperthyroidism occurred in 1.4% (4/287) of patients. In Checkmate 025, thyroid disease occurred in 11% (43/406) of patients receiving OPDIVO, including one Grade 3 event, and in 3.0% (12/397) of patients receiving everolimus. Hypothyroidism/thyroiditis occurred in 8% (33/406) of patients receiving OPDIVO: Grade 3 (n=2), Grade 2 (n=17), and Grade 1 (n=14). Hyperthyroidism occurred in 2.5% (10/406) of patients receiving OPDIVO: Grade 2 (n=5) and Grade 1 (n=5). In Checkmate 069 and 067, diabetes mellitus or diabetic ketoacidosis occurred in 1.5% (6/407) of patients: Grade 4 (n=3), Grade 3 (n=1), Grade 2 (n=1), and Grade 1 (n=1). In Checkmate 037, 066, and 067, diabetes mellitus or diabetic ketoacidosis occurred in 0.8% (6/787) of patients receiving OPDIVO: Grade 3 (n=2), Grade 2 (n=3), and Grade 1 (n=1). In Checkmate 025, hyperglycemic adverse events occurred in 9% (37/406) patients.

Diabetes mellitus or diabetic ketoacidosis occurred in 1.5% (6/406) of patients receiving OPDIVO: Grade 3 (n=3), Grade 2 (n=2), and Grade 1 (n=1).

In a separate Phase 3 study of YERVOY 3 mg/kg, severe to life-threatening immune-mediated endocrinopathies (requiring hospitalization, urgent medical intervention, or interfering with activities of daily living; Grade 3-4) occurred in 9 (1.8%) patients. All 9 patients had hypopituitarism, and some had additional concomitant endocrinopathies such as adrenal insufficiency, hypogonadism, and hypothyroidism. 6 of the 9 patients were hospitalized for severe endocrinopathies.

Immune-Mediated Nephritis and Renal Dysfunction
Immune-mediated nephritis can occur with OPDIVO treatment. Monitor patients for elevated sérum creatinine prior to and periodically during treatment. For Grade 2 or 3 increased serum creatinine, withhold and administer corticosteroids; if worsening or no improvement occurs, permanently discontinue. Administer corticosteroids for Grade 4 serum creatinine elevation and permanently discontinue. In Checkmate 069 and 067, immune-mediated nephritis and renal dysfunction occurred in 2.2% (9/407) of patients: Grade 4 (n=4), Grade 3 (n=3), and Grade 2 (n=2). In Checkmate 037, 066, and 067, nephritis and renal dysfunction of any grade occurred in 5% (40/787) of patients receiving OPDIVO. Immune-mediated nephritis and renal dysfunction occurred in 0.8% (6/787) of patients: Grade 3 (n=4) and Grade 2 (n=2). In Checkmate 057, Grade 2 immune-mediated renal dysfunction occurred in 0.3% (1/287) of patients receiving OPDIVO. In Checkmate 025, renal injury occurred in 7% (27/406) of patients receiving OPDIVO and 3.0% (12/397) of patients receiving everolimus. Immune-mediated nephritis and renal dysfunction occurred in 3.2% (13/406) of patients receiving OPDIVO: Grade (n=1), Grade 4 (n=1), Grade 3 (n=5), and Grade 2 (n=6).

Immune-Mediated Rash
Immune-mediated rash can occur with OPDIVO treatment. Severe rash (including rare cases of fatal toxic epidermal necrolysis) occurred in the clinical program of OPDIVO. Monitor patients for rash.

Administer corticosteroids for Grade 3 or 4 rash. Withhold for Grade 3 and permanently discontinue for Grade 4. In Checkmate 069 and 067, immune-mediated rash occurred in 22.6% (92/407) of patients receiving OPDIVO with YERVOY: Grade 3 (n=15), Grade 2 (n=31), and Grade 1 (n=46). In Checkmate 037, 066, and 067, immune-mediated rash occurred in 9% (72/787) of patients receiving OPDIVO: Grade 3 (n=7), Grade 2 (n=15), and Grade 1 (n=50). In Checkmate 057, immune-mediated rash occurred in 6% (17/287) of patients receiving OPDIVO including four Grade 3 cases. In Checkmate 025, rash occurred in 28% (112/406) of patients receiving OPDIVO and 36% (143/397) of patients receiving everolimus. Immune-mediated rash, defined as a rash treated with systemic or topical corticosteroids, occurred in 7% (30/406) of patients receiving OPDIVO: Grade 3 (n=4), Grade 2 (n=7), and Grade 1 (n=19).

Immune-Mediated Encephalitis
Immune-mediated encephalitis can occur with OPDIVO treatment. Withhold OPDIVO in patients with new-onset moderate to severe neurologic signs or symptoms and evaluate to rule out other causes. If other etiologies are ruled out, administer corticosteroids and permanently discontinue OPDIVO for immune-mediated encephalitis. In Checkmate 067, encephalitis was identified in one patient (0.2%) receiving OPDIVO with YERVOY. In Checkmate 057, fatal limbic encephalitis occurred in one patient (0.3%) receiving OPDIVO.

Other Immune-Mediated Adverse Reactions
Based on the severity of adverse reaction, permanently discontinue or withhold treatment, administer high-dose corticosteroids, and, if appropriate, initiate hormone-replacement therapy. In < 1.0% of patients receiving OPDIVO, the following clinically significant, immune-mediated adverse reactions occurred: uveitis, pancreatitis, facial and abducens nerve paresis, demyelination, polymyalgia rheumatica, autoimmune neuropathy, Guillain-Barré syndrome, hypopituitarism, systemic inflammatory response syndrome, gastritis, duodenitis, and sarcoidosis. Across clinical trials of OPDIVO as a single agent administered at doses of 3 mg/kg and 10 mg/kg, additional clinically significant, immunemediated adverse reactions were identified: motor dysfunction, vasculitis, and myasthenic syndrome.

Infusion Reactions
Severe infusion reactions have been reported in <1.0% of patients in clinical trials of OPDIVO.

Discontinue OPDIVO in patients with Grade 3 or 4 infusion reactions. Interrupt or slow the rate of infusion in patients with Grade 1 or 2. In Checkmate 069 and 067, infusion- related reactions occurred in 2.5% (10/407) of patients receiving OPDIVO with YERVOY: Grade 2 (n=6) and Grade 1 (n=4). In Checkmate 037, 066, and 067, Grade 2 infusion related reactions occurred in 2.7% (21/787) of patients receiving OPDIVO: Grade 3 (n=2), Grade 2 (n=8), and Grade 1 (n=11). In Checkmate 057, Grade 2 infusion reactions requiring corticosteroids occurred in 1.0% (3/287) of patients receiving OPDIVO. In Checkmate 025, hypersensitivity/infusion-related reactions occurred in 6% (25/406) of patients receiving OPDIVO and 1.0% (4/397) of patients receiving everolimus.

Embryo-fetal Toxicity
Based on their mechanisms of action, OPDIVO and YERVOY can cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with an OPDIVO- or YERVOYcontaining regimen and for at least 5 months after the last dose of OPDIVO.

Lactation
It is not known whether OPDIVO or YERVOY is present in human milk. Because many drugs, including antibodies, are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from an OPDIVO-containing regimen, advise women to discontinue breastfeeding during treatment. Advise women to discontinue nursing during treatment with YERVOY and for 3 months following the final dose.

Serious Adverse Reactions
In Checkmate 067, serious adverse reactions (73% and 37%), adverse reactions leading to permanente discontinuation (43% and 14%) or to dosing delays (55% and 28%), and Grade 3 or 4 adverse reactions (72% and 44%) all occurred more frequently in the OPDIVO plus YERVOY arm relative to the OPDIVO arm. The most frequent (≥10%) serious adverse reactions in the OPDIVO plus YERVOY arm and the OPDIVO arm, respectively, were diarrhea (13% and 2.6%), colitis (10% and 1.6%), and pyrexia (10% and 0.6%). In Checkmate 037, serious adverse reactions occurred in 41% of patients receiving OPDIVO. Grade 3 and 4 adverse reactions occurred in 42% of patients receiving OPDIVO. The most frequent Grade 3 and 4 adverse drug reactions reported in 2% to <5% of patients receiving OPDIVO were abdominal pain, hyponatremia, increased aspartate aminotransferase, and increased lipase. In Checkmate 066, serious adverse reactions occurred in 36% of patients receiving OPDIVO. Grade 3 and 4 adverse reactions occurred in 41% of patients receiving OPDIVO. The most frequent Grade 3 and 4 adverse reactions reported in ≥2% of patients receiving OPDIVO were gamma-glutamyltransferase increase (3.9%) and diarrhea (3.4%). In Checkmate 057, serious adverse reactions occurred in 47% of patients receiving OPDIVO. The most frequent serious adverse reactions reported in ≥2% of patients were pneumonia, pulmonary embolism, dyspnea, pleural effusion, and respiratory failure. In Checkmate 025, serious adverse reactions occurred in 47% of patients receiving OPDIVO. The most frequente serious adverse reactions reported in ≥2% of patients were acute kidney injury, pleural effusion, pneumonia, diarrhea, and hypercalcemia.

Common Adverse Reactions
In Checkmate 067, the most common (≥20%) adverse reactions in the OPDIVO plus YERVOY arm were fatigue (59%), rash (53%), diarrhea (52%), nausea (40%), pyrexia (37%), vomiting (28%), and dyspnea (20%). The most common (≥20%) adverse reactions in the OPDIVO arm were fatigue (53%), rash (40%), diarrhea (31%), and nausea (28%). In Checkmate 037, the most common adverse reaction (≥20%) reported with OPDIVO was rash (21%). In Checkmate 066, the most common adverse reactions (≥20%) reported with OPDIVO vs dacarbazine were fatigue (49% vs 39%), musculoskeletal pain (32% vs 25%), rash (28% vs 12%), and pruritus (23% vs 12%). In Checkmate 057, the most common adverse reactions (≥20%) reported with OPDIVO were fatigue (49%), musculoskeletal pain (36%), cough (30%), decreased appetite (29%), and constipation (23%). In Checkmate 025, the most common adverse reactions (≥20%) reported in patients receiving OPDIVO vs everolimus were asthenic conditions (56% vs 57%), cough (34% vs 38%), nausea (28% vs 29%), rash (28% vs 36%), dyspnea (27% vs 31%), diarrhea (25% vs 32%), constipation (23% vs 18%), decreased appetite (23% vs 30%), back pain (21% vs 16%), and arthralgia (20% vs 14%).

In a separate Phase 3 study of YERVOY 3 mg/kg, the most common adverse reactions (≥5%) in patients who received YERVOY at 3 mg/kg were fatigue (41%), diarrhea (32%), pruritus (31%), rash (29%), and colitis (8%).

About the Bristol-Myers Squibb and Ono Pharmaceutical Co., Ltd. Collaboration
In 2011, through a collaboration agreement with Ono Pharmaceutical Co., Ltd (Ono) Bristol-Myers Squibb expanded its territorial rights to develop and commercialize Opdivo globally except in Japan, South Korea and Taiwan, where Ono had retained all rights to the compound at the time. On July 23, 2014, Bristol-Myers Squibb and Ono further expanded the companies’ strategic collaboration agreement to jointly develop and commercialize multiple immunotherapies – as single agents and combination regimens – for patients with cancer in Japan, South Korea and Taiwan.

A Liga Mundial de Hipertensão desenvolveu este prémio para distinguir indivíduos e organizações cujos progressos foram notáveis ao nível da prevenção e do controlo da hipertensão e da redução do consumo de sal na alimentação. A Sociedade Portuguesa de Hipertensão (SPH) foi a única vencedora na categoria que diz respeito à redução do consumo de sal.

Para o presidente da SPH, José Mesquita Bastos “ganhar este prémio é motivo de grande orgulho para todos, embora saibamos que a nossa atuação não termina aqui. Ainda há um longo caminho a percorrer no que diz respeito à redução do consumo de sal.” Essa linha estratégia política ficou bem definida no documento apresentado no Auditório da Assembleia da República a 25 de Novembro de 2015, aquando do Fórum do Sal.

Para alcançar uma redução significativa do consumo de sal na alimentação dos portugueses a SPH definiu objetivos fulcrais para os próximos cinco anos. O primeiro prende-se com a reformulação no propósito da redução do consumo médio de sal na população portuguesa abaixo de 10 gramas/dia até 2020. Essa redução irá provocar uma diminuição da pressão arterial, da mortalidade por acidente vascular cerebral e da incidência do cancro do estômago que, como consequência, vai reduzir os gastos em saúde relacionados com a doença cardiovascular.

Sensibilizar a população e aumentar a literacia da saúde pública relativamente aos riscos do consumo excessivo de sal e às formas de o combater, um exemplo disso será a política da rotulagem dos alimentos embalados com o semáforo de cores que indica a quantidade de sal presente em cada produto. A SPH acredita que esta medida iria ter um impacto muito positivo na vida dos portugueses, tanto ao nível do conhecimento como ao nível da saúde.

Por fim, atuar a nível educacional em cada faixa etária.

Há mais de uma década que a SPH centra a sua atuação na redução do consumo de sal na alimentação dos portugueses. Como resultado da sua atuação, em 2010 a SPH viu aprovada a lei que limita a quantidade de sal no pão, feito que muito contribuiu para este reconhecimento internacional. O constante envolvimento político, assim como as estreitas relações com o sector da grande distribuição e as muitas ações de sensibilização fazem parte do trabalho diário da SPH para conseguir que o consumo de sal se aproxime da recomendação da Organização Mundial de Saúde que são 5,5 gramas por dia.

Reduzir o sal na alimentação é apontado pela maioria como um dos meios mais eficazes para reduzir custos com a saúde, assim como para reduzir a incidência da hipertensão e doenças relacionadas.