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"ABSTRAKBackground Aim of this research is to assess the efficacy and safety of tocilizumab in combination with methotrexate in Indonesian patients with moderate to severe active rheumatoid arthritis who have an inadequate response to non biologic DMARDs.Methods This was a interventional, prospective, single arm, multicenter, study in Indonesian male or female patients aged > 18 years old, with a diagnosis of RA for > 6 months based on ACR 1987 revised criteria with moderate to severe disease activity DAS28 score > 3.2 after > 12 weeks of non biologic DMARDs treatment. The treatment consisted of tocilizumab, 8 mg/kg, intravenous, every 4 weeks for a total of 6 infusion in combination with oral MTX 10 until 25 mg every week. Efficacy was assessed based on the percentage of patients achieving low disease activity state DAS28 < 3.2, percentage of patients achieving reduction > 1.2 point of DAS28, percentage of patients achieving remission DAS28 < 2.6, and percentage of patients with ACR20, ACR50, and ACR70 responses. Descriptive statistics will be used for presentation of results.Results 100 percent patients reached low disease activity DAS28 < 3.2 at last study visit week 24 and clinically significant improvement reduction at least 1.2 units at every visit in DAS28, both for ITT or PP patients. Remission DAS28 < 2.6 was observed in 82.1 percent ITT patients and 93.1 percent PP patients on last study visit. ACR20, ACR50, and ACR70 were achieved in 20 percent, 34 percent, and 34 percent ITT patients, and 7 percent, 24 percent, and 62 percent PP patients on week 24. There were 3 out of 39 patients 7.69 percent with adverse events and serious adverse events that resulted in discontinuation of TCZ treatment, consisting of 1 patient with SAE of sepsis ec acquired community pneumonia, 1 patient with SAE of pneumonia tuberculosis, and 1 patient with AE of candidiasis. Most common adverse events were hepatic dysfunction 30.7 percent, hypercholesterolemia 23.1 percent, followed by arthralgia 20.5 percent Twelve percent of patients needed dose modification due to elevated liver enzyme elevated ALT/SGPT level. Conclusion Tocilizumab seems to be efficacious and likely to have good safety profile in non biologic DMARD nonresponsive RA patients of PICTURE INA study. "

"Latar BelakangBiosimilar merupakan produk bioterapeutik yang memiliki kemiripan/kesetaraan mutu, dengan originator, sedangkan biobetter merupakan versi produk biologis lain yang dimodifikasi. Tocilizumab (TCZ) merupakan rekombinan antibodi monoklonal manusia yang dapat menghambat interaksi IL6R dengan IL6 saat inflamasi kronis seperti pada penyakit Rhematoid Arthritis (RA). Saat ini, paten TCZ telah habis, oleh karena itu penelitian ini akan dikembangkan kandidat biosimilar dan biobetter TCZ.MetodePenelitian ini merupakan studi in silico dan in vitro untuk pengembangan kandidat biosimilar dan biobetter TCZ dengan mendesain gen kandidat biosimilar TCZ yang dapat terekspresi di sel mamalia dan dilakukan pengujian hasil transfeksi dengan immunofluorescence, pemeriksaan ELISA, SDS-PAGE dan SPR.HasilHasil penelitian didapatkan struktur 3D kandidat biosimilar TCZ nilai Ramachandran Plot 97.16%, score molecular docking biosimilar TCZ light chain dengan IL6R sebesar -16.0 kcal mol-1 dan lebih besar dari nilai kontrol yaitu -12.5 kcal mol-1. Didapatkan nilai RMSF antara IL6R dengan kandidat biosimilar TCZ rerata <2. Hasil transfeksi kandidatbiosimilar TCZ yang dinilai menggunakan ratio of fluorescence intensity memiliki nilai intensitas diatas 2 sedangkan kontrol memiliki nilai 0. Terdapat dua pita pada 50kDa dan 25 kDa sesuai dengan ukuran protein TCZ reference. Koofisien afinitas IL6R dengan kandidat biosimilar TCZ 9.44e-8 dan menyerupai dengan koofisien afinitas IL6R dengan TCZ Actemra® yaitu sebesar 2.64e-8. Dilakukan modifikasi asam amino pada TCZ light chain paten 1 untuk membuat kandidat biobetter yaitu Ala43, Tyr87 dan Gly41. Hasil validasi 3D kandidat biobetter TCZ dengan hasil 96.70% pada Ramachandran Plot, energi bebas TCZ light chain biobetter sebesar -18.7 kcal mol-1.KesimpulanProduk kandidat biosimilar TCZ memiliki ukuran molekul protein yang sesuai dengan originator TCZ (Actemra®). Selain itu produk biosimilar ini terbukti dapat berikatan spesifik dengan IL6R alfa dengan koofisien afinitas menyerupai Actemra® secara in vitro. Desain in silico kandidat biobetter TCZ dengan modifikasi asam amino Ala43, Tyr87 dan Gly41 menunjukkan afinitas ikatan IL6R alfa lebih kuat dibandingkan Actemra® sehingga diharapkan dapat meningkatkan potensi dalam mengatasi badai sitokin.

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Background

A biosimilar is a biotherapeutic product that closely matches the quality of the original product, while a biobetter is a modified version of another biological product. Tocilizumab (TCZ) is a synthetic antibody derived from human cells that can block the binding of IL6R to IL6, hence reducing chronic inflammation in conditions like rheumatoid arthritis (RA). At now, the patent for TCZ has lapsed, thus this study aims to create biosimilar candidates and improved versions of TCZ, known as TCZ biobetter candidates.

Method

This research involves both in silico and in vitro methods to produce biosimilar and biobetter TCZ candidates. The aim is to build a biosimilar candidate TCZ gene that can be expressed in mammalian cells. The transfection results will be tested using immunofluorescence, ELISA, SDS-PAGE, and SPR investigations.

Results

The research results showed that the TCZ biosimilar candidate possessed a Ramachandran Plot value of 97.16% for its 3D structure. Additionally, the molecular docking score of the TCZ light chain biosimilar with IL6R was -16.0 kcal mol-1, which was higher than the control value of - 12.5 kcal mol-1. The analysis showed that the average Root Mean Square Fluctuation (RMSF) value between IL6R and TCZ of the biosimilar candidate was less than 2. The TCZ transfection results of the biosimilar candidate were evaluated by measuring the ratio of fluorescence intensity. The biosimilar candidate had an intensity value more than 2, while the control had a value of 0. Two bands were observed at 50 kilodaltons (kDa) and 25 kDa, corresponding to the size of the reference TCZ protein. The IL6R signal affinity of the biosimilar candidate TCZ is 9.44e-8, which is comparable to the IL6R signal affinity of Actemra® TCZ, which is 2.64e-8. The TCZ light chain patent 1 underwent amino acid changes to generate improved biobetter candidates, specifically Ala43, Tyr87, and Gly41. The 3D validation results of TCZ biobetter show a yield of 96.70% on the Ramachandran Plot. Additionally, the free energy of TCZ light chain biobetter is -18.7 kcal mol-1.

Conclusion

The TCZ biosimilar candidate product has a protein molecular size that is identical to the TCZ (Actemra®). Furthermore, this biosimilar product has demonstrated the ability to selectively attach to IL6R alfa with a signal affinity comparable to Actemra® in laboratory tests. The computational design of the biobetter TCZ candidate, incorporating alterations to the amino acids Ala43, Tyr87, and Gly41, demonstrates an enhanced affinity for IL6R alfa compared to Actemra®. This raises the expectation that it may enhance its efficacy in mitigating cytokine storms."

"Latar Belakang: COVID-19 menyebabkan penyakit kritis dan kematian dengan manifestasi utama sindrom pernafasan akut. Prediktor kematian pada kasus COVID-19, seperti IL-6 berperan dalam mengatur respon imun dan inflamasi. Pada kasus berat, peningkatan IL-6 dapat menyebabkan sepsis dan kegagalan multi-organ. CRP juga berkontribusi signifikan terhadap peradangan. Keparahan derajat COVID-19 dipengaruhi oleh komorbiditas seperti penyakit kardiovaskular, diabetes melitus tipe II, dan hipertensi. Tocilizumab, penghambat reseptor IL-6 merupakan terapi baru untuk pasien COVID-19 berat dan kritis. Penelitian ini menilai mortalitas pasien COVID-19 berat yang diberikan dan tidak diberikan terapi tocilizumab setelah dikontrol oleh variabel perancu. Tujuan: Menganalisis pengaruh terapi tocilizumab terhadap kematian pada pasien COVID-19 berat. Metode: Desain penelitian kohort retrospektif, menggunakan data rekam medis pasien COVID-19 di ICU RSCM selama dua tahun. Data dianalisis menggunakan SPSS. Hasil: Total 80 subjek, 52 pasien meninggal dan 28 pasien hidup. Mayoritas pasien memiliki CRP tinggi, IL-6 meningkat, serta tidak memiliki komorbid hipertensi, diabetes mellitus tipe II, dan penyakit kardiovaskular. Analisis statistik menunjukkan tidak ada hubungan yang signifikan antara pemberian terapi tocilizumab dan kematian, serta tidak terdapat perancu dalam penelitian ini. Kesimpulan: Pemberian terapi tocilizumab tidak memperbaiki kejadian mortalitas pada pasien COVID-19 berat.

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Background: COVID-19 causes critical illness and death with the main manifestation of acute respiratory syndrome. Predictors of death in COVID-19 cases, such as IL-6, play a role in regulating the immune response and inflammation. In severe cases, increased IL-6 can cause sepsis and multi-organ failure. CRP also contributes significantly to inflammation. The severity of COVID-19 is influenced by comorbidities such as cardiovascular disease, type II diabetes mellitus, and hypertension. Tocilizumab, an IL-6 receptor inhibitor, is a new therapy for severe and critical COVID-19 patients. This study assessed the mortality of severe COVID-19 patients who were and were not given tocilizumab therapy after controlling for confounding variables. Objective: To analyze the effect of tocilizumab therapy on mortality in severe COVID-19 patients. Methods: Retrospective cohort study design, using medical record data of COVID-19 patients in the ICU RSCM for two years. Data were analyzed using SPSS. Results: A total of 80 subjects, 52 patients died and 28 patients survived. The majority of patients had high CRP, increased IL-6, and did not have comorbid hypertension, type II diabetes mellitus, and cardiovascular disease. Statistical analysis showed no significant association between tocilizumab therapy and mortality, and there were no confounders in this study. Conclusion: Administration of tocilizumab therapy does not reducing mortality rates in severe COVID-19 patients."

"Infeksi Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pada derajat berat dan kritis dapat menyebabkan kejadian sindrom badai sitokin, dimana jika tidak ditangani secara tepat dapat menyebabkan kegagalan multiorgan. Tocilizumab merupakan antagonis reseptor IL-6 yang telah disetujui dan disarankan sebagai pengobatan untuk menurunkan mortalitas yang disebabkan oleh kejadian sindrom badai sitokin. Penelitian ini bertujuan untuk menganalisis efektivitas dan kejadian peningkatan enzim transaminase pada pasien terkonfirmasi COVID-19 di Rumah Sakit Universitas Indonesia dengan terapi tocilizumab. Penelitian ini dilakukan secara observasional retrospektif dengan desain cross-sectional di Rumah Sakit Universitas Indonesia tahun 2020-2021 dengan teknik total sampling. Pada penelitian ini sejumlah 68 pasien memenuhi kriteria inklusi dan eksklusi, sebagian besar pasien yang menerima terapi tocilizumab adalah laki-laki (58.8%), bergolongan darah B dan O (masing-masing 33.8%), memiliki komorbid hipertensi (47.1%), dan menerima terapi remdesivir (69.1%). Sebanyak 47 dari 68 pasien (69.12%) mengalami kejadian peningkatan enzim transaminase setelah pemberian tocilizumab. Pasien yang menerima terapi tocilizumab lebih banyak mengalami perburukan (55.9%) berdasarkan WHO Clinical Progression Scale tetapi lebih banyak yang mengalami perbaikan (66.2%) berdasarkan nilai CRP. Karakteristik pasien yang berpengaruh terhadap keberhasilan terapi tocilizumab adalah komorbid obesitas (OR: 1.745, 95% CI: 1.196-2.546; P = 0.015) berdasarkan WHO Clinical Progression Scale, golongan darah AB (OR: 3.647, 95% CI: 2.433-5.468; P = 0.001) dan O (OR: 5.333, 95% CI: 1.385-10.541; P = 0.014), serta terapi remdesivir (OR: 3.208, 95% CI: 1.091-9.434; P = 0.050) berdasarkan nilai CRP, serta terapi komorbid diabetes mellitus (OR: 0.208, 95% CI: 0.071-0.610; P = 0.005) berdasarkan Length of Stay (LOS).

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in severe and critical state can cause the occurrence of cytokine storm syndrome, if this condition not treated properly it can cause multi-organ failure. Tocilizumab is an IL-6 receptor antagonist that has been approved and suggested as a treatment to reduce mortality caused by the occurrence of cytokine storm syndrome. This study aims to analyze the effectiveness and incidence of elevated transaminase enzymes in COVID-19 patients at Universitas Indonesia Hospital receiving tocilizumab therapy. This research was conducted retrospectively observational with cross-sectional design at Universitas Indonesia Hospital in 2020-2021 using total sampling. In this study a total of 68 patients met the inclusion and exclusion criteria, the majority of patients who received tocilizumab therapy were male (58.8%), blood group B and O (33.8% each), had comorbid hypertension (47.1%), and receiving remdesivir therapy (69.1%). 47 of 68 patients (69.12%) experienced elevated transaminase enzymes after tocilizumab administration. Patients who received tocilizumab therapy experienced more worsening (55.9%) based on the WHO Clinical Progression Scale but more experienced improvements (66.2%) based on CRP values. Patient characteristics that influence the effectiveness of tocilizumab therapy are comorbidities, obesity (OR: 1.745, 95% CI: 1.196-2.546; P = 0.015) based on WHO Clinical Progression Scale, blood type AB (OR: 3.647, 95% CI: 2.433-5.468; P = 0.001) and O (OR: 5.333, 95% CI: 1.385-10.541; P = 0.014), remdesivir therapy (OR: 3.208, 95% CI: 1.091-9.434; P = 0.050) based on CRP level, and diabetes mellitus (OR: 0.208, 95% CI: 0.071-0.610; P = 0.005) based on Length of Stay (LOS)."

"Tocilizumab merupakan antibodi monoklonal yang bekerja dengan menginhibisi ikatan antara interleukin-6 (IL-6) dengan reseptornya. Pemberiannya pada pasien COVID-19 bertujuan untuk menekan dampak IL-6 terhadap inflamasi yang terjadi pada pasien COVID-19 derajat berat atau kritis yang dirawat di Intensive Care Unit (ICU). Pasien ICU umumnya memiliki kondisi yang berisiko tinggi terhadap terjadinya perburukan dan disertai penyakit penyerta sehingga membutuhkan terapi yang kompleks antara tocilizumab dengan obat-obatan lain. Penelitian ini bertujuan utuk menganalisis masalah terkait obat (MTO) tocilizumab pada pasien COVID-19 di ICU Rumah Sakit Universitas Indonesia (RSUI) tahun 2020-2021. Penelitian ini bersifat deskriptif dengan desain penelitian cross-sectional. Data yang digunakan merupakan data sekunder yang diambil secara retrospektif dari resep dan rekam medis pasien. Klasifikasi MTO yang digunakan pada penelitian ini mengacu pada klasifikasi yang dibuat oleh Hepler dan Strand. Analisis dilakukan pada 50 pasien yang merupakan total sampel penelitian. Hasil dari analisis menunjukkan adanya MTO tocilizumab pada pasien COVID-19 di ICU RSUI sebanyak 52 kejadian dengan persentase potensi interaksi 86,27% dan reaksi obat tidak diinginkan 13,72%. Oleh karena itu, dapat disimpulkan bahwa terapi pengobatan pada pasien COVID-19 di ICU RSUI dengan tocilizumab pada tahun 2020-2021 menyebabkan masalah terkait obat dengan MTO yang terjadi berupa potensi interaksi obat dan reaksi obat tidak diinginkan.

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Tocilizumab is a monoclonal antibody that inhibits interleukin-6 (IL-6) from its receptor. The administration to COVID-19 patients aims to suppress the impact of IL-6 to inflammation that occurs in severe COVID-19 patients in the Intensive Care Unit (ICU). ICU patients generally have conditions that are at higher risk of worsening and are followed by comorbidities that require complex therapy between tocilizumab and other drugs. This study aims to analyze the Drug-related Problems (DRP) of tocilizumab in COVID-19 patients in the ICU of Rumah Sakit Universitas Indonesia (RSUI) in 2020-2021. This study is a descriptive study with a cross-sectional study design. The data used in this study are secondary data taken retrospectively from prescriptions, and medical records. The DRP classification used in this study refers to the classification made by Hepler and Strand. Analysis was carried out on 50 patients which constituted the total sample of the study. The results of the analysis showed the presence of DRP of Tocilizumab in COVID-19 patients in the ICU RSUI as many as 52 events with the percentage of interactions is 86,27% and adverse drug reactions is 13,72%. Therefore, it can be concluded that tocilizumab as the treatment therapy for COVID-19 patients in the ICU RSUI in 2020-2021 experience DRP in drug interaction potentials and adverse drug reactions."

"Coronavirus disease 19 (COVID-19) which is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has been a problem worldwide, particularly due to the high rate of transmission and wide range of clinical manifestations. Acute respiratory distress syndrome (ARDS) and multiorgan failure are the most common events observed in severe cases and can be fatal. Cytokine storm syndrome emerges as one of the possibilities for the development of ARDS and multiorgan failure in severe cases of COVID-19. This case report describes a case of a 53-year-old male patient who has been diagnosed with COVID-19. Further evaluation in this patient showed that there was a marked increase in IL-6 level in blood accompanied with hyperferritinemia, which was in accordance with the characteristic of cytokine storm syndrome. Patient was treated with tocilizumab, a monoclonal antibody and is an antagonist to IL-6 receptor. The binding between tocilizumab and IL-6 receptors effectively inhibit and manage cytokine storm syndrome. Although this case report reported the efficacy of tocilizumab in managing cytokine storm syndrome, tocilizumab has several adverse effects requiring close monitoring. Further clinical randomized control trial is required to evaluate the efficacy and safety of tocilizumab administration in participants with various clinical characteristics and greater number of subjects. "

"Latar Belakang COVID-19 berdampak secara signifikan bagi dunia. Tingginya prevalensi dan insidensi, serta banyaknya kasus berderajat keparahan sedang-berat, mendorong dunia dan Indonesia untuk mencari terapi yang tepat. Salah satunya adalah anti-interleukin-6 untuk mengatasi badai sitokin yang kerap terjadi pada pasien COVID-19. Anti-interleukin-6 berupa Tocilizumab yang digunakan untuk mengatasi COVID-19 derajat sedang-berat hingga saat ini masih minim diteliti di dunia maupun di Indonesia. Maka, Peneliti berharap penelitian ini dapat berkontribusi pada perkembangan dunia medis di Indonesia. Metode Penelitian ini dilakukan dengan desain kohort retrospektif yang dilakukan di Rumah Sakit Universitas Indonesia. Penelitian ini menggunakan rekam medis pasien COVID-19 berderajat sedang-berat guna menilai hubungan antara pemberian Tocilizumab dengan tingkat mortalitas, lama rawat, dan kadar biomarker inflamasi yaitu C-reactive protein dan D-dimer. Hasil Diperoleh 52 pasien yang diberikan obat Tocilizumab dan 52 pasien kontrol. Pada kelompok pasien yang diberikan Tocilizumab, 48 pasien dirawat pada bulan Januari-Juni dan 4 pasien dirawat pada bulan Juli-Desember. Pada kelompok kontrol, 32 pasien dirawat pada bulan Januari-Juni dan 20 pasien dirawat pada bulan Juli-Desember. Ditemukan sebanyak 40,4% pasien yang memperoleh Tocilizumab hidup dan sembuh, sedangkan pada kelompok kontrol hanya 16,4% pasien yang sembuh (p=0,014). Rata-rata lama rawat pasien kelompok uji mencapai 20,9±11,5 hari, lebih lama dibandingkan kelompok kontrol yaitu 16,5±12,4 hari (p=0,007). Rata-rata penurunan kadar CRP pada kelompok uji adalah -74,65±72,59 mg/L, sedangkan pada kelompok kontrol meningkat (p=0,001). Kadar D-dimer pasien yang diberikan Tocilizumab mengalami penurunan namun tidak signifikan. Kesimpulan Tocilizumab terbukti menurunkan angka mortalitas, menurunkan kadar CRP, dan cenderung menurunkan kadar D-dimer pada pasien COVID-19 derajat sedang-berat.

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Introduction COVID-19 has a significant impact globally. The high prevalence and incidence, also the large number of moderate-severe cases, encouraged the world and Indonesia to look a better therapy. One of them is anti-interleukin-6 to overcome cytokine storm that occurs in COVID-19 patients. Today, there is minimal research that learn about anti-interleukin-6, Tocilizumab. This research hope could contribute to the development of the medical sector in Indonesia. Method This research conducted with a retrospective cohort design at Universitas Indonesia Hospital. This study used medical records of COVID-19 moderate-severe patients to assess the relation between Tocilizumab administration and mortality, length of stay, and levels of C-reactive protein and D-dimer. Result There were 52 moderate-severe COVID-19 patients receiving Tocilizumab and 52 control patients. In the test group, 48 patients treated in January-June and 4 patients treated in July-December. In the control group, 32 patients treated in January-June and 20 patients treated in July-December. It was found that 40,4% of patients who were given Tocilizumab survived, while in the control group only 16,4% of patients survived (p=0,014). The average length of stay for test group reached 20,9±11,5 days, longer than the control group, which was 16,5±12,4 days (p=0,007). The average CRP levels decrease in test group was -74.,65±72,59 mg/L, while it increased in the control group (p=0,001). The D-dimer levels of patients given Tocilizumab decreased but not significant. Conclusion Tocilizumab has been proven to reduce mortality rates, lower CRP levels, and tends to reduce D-dimer levels in moderate-severe COVID-19 patients."

"Corona Virus 2019 (COVID-19) ialah penyakit menular yang berkembang sejak bulan Desember 2019 di Wuhan, ibu kota Provinsi Hubei China, sejak itu virus ini menyebar keseluruh dunia dan menjadi global pandemi. Di Indonesia, pada Juli 2021, dikeluarkanlah surat edaran tentang Pelaksanaan Distribusi Obat dengan Persetujuan Darurat untuk penanganan terapi COVID-19 yaitu; Remdesivir, Favipiravir, Oseltamivir, Immunoglobulin, Ivermectin, Tocilizumab, Azithromycin dan Dexamethasone. Pasien yang ingin membeli obat yang mengindikasikan COVID-19 diwajibkan membawa resep dokter. Analisis resep dilakukan sesuai dengan Surat Edaran (SE), meninjau aspek administratif, aspek farmasetik dan aspek klinis. Hasil penelitian ini dapat disimpulkan bahwa terdapat 11 resep pengobatan COVID-19 pada bulan Juli 2021. Terjadi ketidaklengkapan kajian resep baik secara administrasi, farmasetik, serta aspek klinis. Namun seluruh resep telah memiliki ketepatan indikasi dan dosis.

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Corona Virus 2019 (COVID-19) is an infectious disease that developed in December 2019 in Wuhan, the capital of China's Hubei Province, since then this virus has spread throughout the world and has become a global pandemic. In Indonesia, in July 2021, a circular letter regarding the Implementation of Drug Distribution with Emergency Approval was issued for the handling of COVID-19 therapy, namely; Remdesivir, Favipiravir, Oseltamivir, Immunoglobulin, Ivermectin, Tocilizumab, Azithromycin, and Dexamethasone. Patients who want to buy drugs that indicate COVID-19 are required to bring a doctor's prescription. Prescription analysis was carried out by the Circular Letter, reviewing administrative aspects, pharmaceutical aspects, and clinical aspects. The results of this study can be concluded that there were 11 prescriptions for COVID-19 treatment in July 2021. There were incomplete prescription studies both administratively, pharmaceutically, and clinically. However, all prescriptions have accurate indications and dosages.

Vitacimin is a lozenge product containing vitamin C, produced by PT Takeda Indonesia. The high demand for Vitamin C products has continued to surge dramatically since the global entry of the COVID-19 pandemic in Indonesia in early 2020. With the increasing market demand for Vitacimin, it is also necessary to analyze and optimize the duties and work of employees (packers) in packaging Vitacimin products. This observation is focused on line 3 secondary packaging using machine vision tools that have optical functions, namely object inspection and inspection and pattern recognition. The machine vision tool used is Camera Vision Baumer, which is currently running on a trial period by placing employees who serve as selectors and back up the Camera Vision function. In this study, it can be concluded that the Camera Vision Baumer tool works well and the selector in charge of performing the back up function of the Camera Vision Baumer task can be switched."