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[PMID]:29025670
[Au] Autor:Martin V; Bettencourt A
[Ad] Endereço:Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Portugal.
[Ti] Título:Bone regeneration: Biomaterials as local delivery systems with improved osteoinductive properties.
[So] Source:Mater Sci Eng C Mater Biol Appl;82:363-371, 2018 Jan 01.
[Is] ISSN:1873-0191
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Bone is a mineralized conjunctive tissue, with a unique trauma healing capability. However, the replacement or regeneration of lost bone is not always successful and becomes more difficult the wider the bone defect. A significant growth in the demand for orthopedic and maxillofacial surgical procedures as a result of population aging and increase in chronic diseases as diabetes is a fact and successful approaches for bone regeneration are still needed. Until today, autogenous bone graft continues to be the best solution even with important limitations, as quantity and the requirement of a donator area. Alternatively, local delivery systems combining an osteoconductive biomaterial with osteoinductive compounds as hormones, growth factors or drugs is a popular approach aiming to replace the need for autogenous bone grafts. Nevertheless, in spite of the intense research in the area, presently there is no system that can mimic all the biological functions of the autogenous bone grafts. In this context, the present work provides an overview of the most recent advances in the field of synthetic bone grafts. The opportunities and limitations are detailed along with the remaining gaps in the research that are still preventing the successful translation of more products into the market able to be a valuable option in comparison to the autogenous bone grafts.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/química
Regeneração Óssea/fisiologia
Osso e Ossos/fisiologia
[Mh] Termos MeSH secundário: Alendronato/química
Alendronato/farmacologia
Antibacterianos/química
Antibacterianos/farmacologia
Materiais Biocompatíveis/farmacologia
Plaquetas/metabolismo
Regeneração Óssea/efeitos dos fármacos
Portadores de Fármacos/química
Seres Humanos
Peptídeos e Proteínas de Sinalização Intercelular/química
Peptídeos e Proteínas de Sinalização Intercelular/farmacologia
Cloridrato de Raloxifeno/química
Cloridrato de Raloxifeno/farmacologia
Sinvastatina/química
Sinvastatina/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Biocompatible Materials); 0 (Drug Carriers); 0 (Intercellular Signaling Peptides and Proteins); 4F86W47BR6 (Raloxifene Hydrochloride); AGG2FN16EV (Simvastatin); X1J18R4W8P (Alendronate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171014
[St] Status:MEDLINE


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[PMID]:29025668
[Au] Autor:Mu C; Hu Y; Huang L; Shen X; Li M; Li L; Gu H; Yu Y; Xia Z; Cai K
[Ad] Endereço:Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044, China.
[Ti] Título:Sustained raloxifene release from hyaluronan-alendronate-functionalized titanium nanotube arrays capable of enhancing osseointegration in osteoporotic rabbits.
[So] Source:Mater Sci Eng C Mater Biol Appl;82:345-353, 2018 Jan 01.
[Is] ISSN:1873-0191
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:To enhance the localized bone remodeling at titanium-based implants under osteoporotic conditions, TiO nanotube arrays (TNT) were used as nanoreserviors for raloxifene (Ral) and then covered with the hybrid multilayered coating of chitosan and alendronate grafted hyaluronic acid (HA-Aln) via a spin-assisted layer-by-layer technique. The fabrication of this system (TNT/Ral/LBL-Aln) was characterized by field emission scanning electron microscopy (SEM), atomic force microscope (AFM) and X-ray photoelectron spectroscopy (XPS), respectively. The release test showed that the composited multilayers onto Ral-loaded TiO nanotube substrate (TNT/Ral) could prevent the burst release of Ral from TiO nanotube arrays and maintain stable Ral concentration at the implant site even after 192h. The TNT/Ral/LBL-Aln system demonstrated higher alkaline phosphatase (ALP) activity, mineralization capability in osteoblasts as well as lower tartrate-resistant acid phosphatase (TRAP) activity in osteoclasts compared to both bare TiO nanotube and TNT/Ral substrate, respectively. Moreover, the in vivo tests of micro-CT, histological staining and push-out testing showed that TNT/Ral/LBL-Aln implant could efficiently enhance the formation of new bone around the implant and promote bone binding in osteoporotic rabbits. The study indicated the potential application of TNT/Ral/LBL-Aln system for bone remodeling under osteoporotic condition.
[Mh] Termos MeSH primário: Alendronato/química
Portadores de Fármacos/química
Ácido Hialurônico/química
Nanotubos/química
Cloridrato de Raloxifeno/química
Titânio/química
[Mh] Termos MeSH secundário: Fosfatase Alcalina/metabolismo
Animais
Osso e Ossos/diagnóstico por imagem
Osso e Ossos/patologia
Diferenciação Celular/efeitos dos fármacos
Sobrevivência Celular/efeitos dos fármacos
Células Cultivadas
Camundongos
Microscopia de Força Atômica
Osseointegração/efeitos dos fármacos
Osteoblastos/citologia
Osteoblastos/efeitos dos fármacos
Osteoblastos/metabolismo
Próteses e Implantes
Células RAW 264.7
Coelhos
Cloridrato de Raloxifeno/farmacologia
Propriedades de Superfície
Fosfatase Ácida Resistente a Tartarato/metabolismo
Microtomografia por Raio-X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drug Carriers); 15FIX9V2JP (titanium dioxide); 4F86W47BR6 (Raloxifene Hydrochloride); 9004-61-9 (Hyaluronic Acid); D1JT611TNE (Titanium); EC 3.1.3.1 (Alkaline Phosphatase); EC 3.1.3.2 (Tartrate-Resistant Acid Phosphatase); X1J18R4W8P (Alendronate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171014
[St] Status:MEDLINE


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[PMID]:28793321
[Au] Autor:Allen MR; McNerny E; Aref M; Organ JM; Newman CL; McGowan B; Jang T; Burr DB; Brown DM; Hammond M; Territo PR; Lin C; Persohn S; Jiang L; Riley AA; McCarthy BP; Hutchins GD; Wallace JM
[Ad] Endereço:Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
[Ti] Título:Effects of combination treatment with alendronate and raloxifene on skeletal properties in a beagle dog model.
[So] Source:PLoS One;12(8):e0181750, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A growing number of studies have investigated combination treatment as an approach to treat bone disease. The goal of this study was to investigate the combination of alendronate and raloxifene with a particular focus on mechanical properties. To achieve this goal we utilized a large animal model, the beagle dog, used previously by our laboratory to study both alendronate and raloxifene monotherapies. Forty-eight skeletally mature female beagles (1-2 years old) received daily oral treatment: saline vehicle (VEH), alendronate (ALN), raloxifene (RAL) or both ALN and RAL. After 6 and 12 months of treatment, all animals underwent assessment of bone material properties using in vivo reference point indentation (RPI) and skeletal hydration using ultra-short echo magnetic resonance imaging (UTE-MRI). End point measures include imaging, histomorphometry, and mechanical properties. Bone formation rate was significantly lower in iliac crest trabecular bone of animals treated with ALN (-71%) and ALN+RAL (-81%) compared to VEH. In vivo assessment of properties by RPI yielded minimal differences between groups while UTE-MRI showed a RAL and RAL+ALN treatment regimens resulted in significantly higher bound water compared to VEH (+23 and +18%, respectively). There was no significant difference among groups for DXA- or CT-based measures lumbar vertebra, or femoral diaphysis. Ribs of RAL-treated animals were smaller and less dense compared to VEH and although mechanical properties were lower the material-level properties were equivalent to normal. In conclusion, we present a suite of data in a beagle dog model treated for one year with clinically-relevant doses of alendronate and raloxifene monotherapies or combination treatment with both agents. Despite the expected effects on bone remodeling, our study did not find the expected benefit of ALN to BMD or structural mechanical properties, and thus the viability of the combination therapy remains unclear.
[Mh] Termos MeSH primário: Alendronato/farmacologia
Conservadores da Densidade Óssea/farmacologia
Densidade Óssea/efeitos dos fármacos
Diáfises/fisiologia
Fêmur/fisiologia
Vértebras Lombares/fisiologia
Cloridrato de Raloxifeno/farmacologia
[Mh] Termos MeSH secundário: Alendronato/efeitos adversos
Animais
Remodelação Óssea/efeitos dos fármacos
Diáfises/efeitos dos fármacos
Cães
Quimioterapia Combinada/efeitos adversos
Feminino
Fêmur/efeitos dos fármacos
Vértebras Lombares/efeitos dos fármacos
Imagem por Ressonância Magnética
Modelos Animais
Osteoporose/tratamento farmacológico
Cloridrato de Raloxifeno/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4F86W47BR6 (Raloxifene Hydrochloride); X1J18R4W8P (Alendronate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181750


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[PMID]:28711499
[Au] Autor:Shi W; Yan D; Zhao C; Xiao M; Wang Y; Ma H; Liu T; Qin H; Zhang C; Li C; Lin J; Li S; Lv J; Lin L
[Ad] Endereço:Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
[Ti] Título:Inhibition of IL-6/STAT3 signaling in human cancer cells using Evista.
[So] Source:Biochem Biophys Res Commun;491(1):159-165, 2017 Sep 09.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Persistent activation of IL-6/STAT3 signaling pathway has been frequently detected in human cancer including breast cancer, colon cancer and multiple myeloma. IL-6/STAT3 can be a promising target for cancer prevent and treatment. However, few STAT3 inhibitors with high efficiency, specificity and safety is available for present clinical cancer therapy. Evista (Raloxifene·HCl) is known as selective estrogen receptor modulator which has been used for the prevention and treatment of osteoporosis and was approved for reducing the risk of invasive breast cancer. Our previous study found that Raloxifene inhibited IL-6/GP130 interaction, resulting in blockade of STAT3 phosphorylation. In our present study, we examined the effect on IL-6/GP130/STAT3 signaling pathway and cancer cell viability with Evista. We first demonstrated Evista inhibited constitutive activation of STAT3 in breast cancer cell line MDB-MB-231, colon cancer cell line HCT116 and multiple myeloma cancer cell line U266. Evista also inhibited phosphorylation of STAT3 induced by IL-6 in MCF-7, HT29 and MM.1S cancer cell lines. Induction of apoptosis was exerted in MDA-MB-231, HCT116 and U266 as evidenced by increased caspase-3 cleavage. However, Evista did not inhibit STAT1, STAT2, STAT4 or STAT6 phosphorylation elicited by IFN-α, IFN-γ and IL-4, nor phosphorylation of STAT3 induced by LIF in MCF-7 cell lines. Evista attenuated STAT3 phosphorylation, decreased STAT3 transcriptional activity but much less in pGL3 and AP1 transcriptional luciferase activity, and decreased cell viability in vitro. These results suggest that it may be possible for Evista to emerge as a chemoprevention agent for breast cancer and other cancers such as colon cancer or multiple myeoloma by targeting IL-6/STAT3 signaling.
[Mh] Termos MeSH primário: Sobrevivência Celular/efeitos dos fármacos
Interleucina-6/metabolismo
Neoplasias Experimentais/tratamento farmacológico
Neoplasias Experimentais/metabolismo
Cloridrato de Raloxifeno/administração & dosagem
Cloridrato de Raloxifeno/farmacologia
Fator de Transcrição STAT3/metabolismo
[Mh] Termos MeSH secundário: Antineoplásicos/administração & dosagem
Antineoplásicos/farmacologia
Relação Dose-Resposta a Droga
Células HCT116
Células HT29
Seres Humanos
Células MCF-7
Terapia de Alvo Molecular
Neoplasias Experimentais/patologia
Transdução de Sinais/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (IL6 protein, human); 0 (Interleukin-6); 0 (STAT3 Transcription Factor); 0 (STAT3 protein, human); 4F86W47BR6 (Raloxifene Hydrochloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170717
[St] Status:MEDLINE


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[PMID]:28637206
[Au] Autor:Shao Y; Hernandez-Buquer S; Childress P; Stayrook KR; Alvarez MB; Davis H; Plotkin LI; He Y; Condon KW; Burr DB; Warden SJ; Robling AG; Yang FC; Wek RC; Allen MR; Bidwell JP
[Ad] Endereço:Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202.
[Ti] Título:Improving Combination Osteoporosis Therapy in a Preclinical Model of Heightened Osteoanabolism.
[So] Source:Endocrinology;158(9):2722-2740, 2017 Sep 01.
[Is] ISSN:1945-7170
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Combining anticatabolic agents with parathyroid hormone (PTH) to enhance bone mass has yielded mixed results in osteoporosis patients. Toward the goal of enhancing the efficacy of these regimens, we tested their utility in combination with loss of the transcription factor Nmp4 because disabling this gene amplifies PTH-induced increases in trabecular bone in mice by boosting osteoblast secretory activity. We addressed whether combining a sustained anabolic response with an anticatabolic results in superior bone acquisition compared with PTH monotherapy. Additionally, we inquired whether Nmp4 interferes with anticatabolic efficacy. Wild-type and Nmp4-/- mice were ovariectomized at 12 weeks of age, followed by therapy regimens, administered from 16 to 24 weeks, and included individually or combined PTH, alendronate (ALN), zoledronate (ZOL), and raloxifene (RAL). Anabolic therapeutic efficacy generally corresponded with PTH + RAL = PTH + ZOL > PTH + ALN = PTH > vehicle control. Loss of Nmp4 enhanced femoral trabecular bone increases under PTH + RAL and PTH + ZOL. RAL and ZOL promoted bone restoration, but unexpectedly, loss of Nmp4 boosted RAL-induced increases in femoral trabecular bone. The combination of PTH, RAL, and loss of Nmp4 significantly increased bone marrow osteoprogenitor number, but did not affect adipogenesis or osteoclastogenesis. RAL, but not ZOL, increased osteoprogenitors in both genotypes. Nmp4 status did not influence bone serum marker responses to treatments, but Nmp4-/- mice as a group showed elevated levels of the bone formation marker osteocalcin. We conclude that the heightened osteoanabolism of the Nmp4-/- skeleton enhances the effectiveness of diverse osteoporosis treatments, in part by increasing hyperanabolic osteoprogenitors. Nmp4 provides a promising target pathway for identifying barriers to pharmacologically induced bone formation.
[Mh] Termos MeSH primário: Osso e Ossos/efeitos dos fármacos
Osso e Ossos/metabolismo
Difosfonatos/administração & dosagem
Imidazóis/administração & dosagem
Osteoporose/tratamento farmacológico
Hormônio Paratireóideo/administração & dosagem
Cloridrato de Raloxifeno/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Reabsorção Óssea/tratamento farmacológico
Reabsorção Óssea/genética
Reabsorção Óssea/metabolismo
Modelos Animais de Doenças
Avaliação Pré-Clínica de Medicamentos
Quimioterapia Combinada
Feminino
Camundongos
Camundongos Knockout
Proteínas Associadas à Matriz Nuclear/genética
Osteoporose/genética
Osteoporose/patologia
Fatores de Transcrição/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Diphosphonates); 0 (Imidazoles); 0 (Nuclear Matrix-Associated Proteins); 0 (Parathyroid Hormone); 0 (Transcription Factors); 0 (Zfp384 protein, mouse); 4F86W47BR6 (Raloxifene Hydrochloride); 6XC1PAD3KF (zoledronic acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1210/en.2017-00355


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[PMID]:28585373
[Au] Autor:Buckley L; Guyatt G; Fink HA; Cannon M; Grossman J; Hansen KE; Humphrey MB; Lane NE; Magrey M; Miller M; Morrison L; Rao M; Robinson AB; Saha S; Wolver S; Bannuru RR; Vaysbrot E; Osani M; Turgunbaev M; Miller AS; McAlindon T
[Ad] Endereço:Yale University, New Haven, Connecticut.
[Ti] Título:2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.
[So] Source:Arthritis Rheumatol;69(8):1521-1537, 2017 Aug.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. RESULTS: Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Glucocorticoides/efeitos adversos
Osteoporose/prevenção & controle
Fraturas por Osteoporose/prevenção & controle
Doenças Reumáticas/tratamento farmacológico
[Mh] Termos MeSH secundário: Cálcio na Dieta/uso terapêutico
Consenso
Denosumab/uso terapêutico
Difosfonatos/uso terapêutico
Seres Humanos
Osteoporose/induzido quimicamente
Osteoporose/tratamento farmacológico
Fraturas por Osteoporose/induzido quimicamente
Fraturas por Osteoporose/tratamento farmacológico
Cloridrato de Raloxifeno/uso terapêutico
Reumatologia
Sociedades Médicas
Teriparatida/uso terapêutico
Estados Unidos
Vitamina D/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Calcium, Dietary); 0 (Diphosphonates); 0 (Glucocorticoids); 10T9CSU89I (Teriparatide); 1406-16-2 (Vitamin D); 4EQZ6YO2HI (Denosumab); 4F86W47BR6 (Raloxifene Hydrochloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE
[do] DOI:10.1002/art.40137


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[PMID]:28541645
[Au] Autor:Weiser M; Levi L; Burshtein S; Hagin M; Matei VP; Podea D; Micluția I; Tiugan A; Pacala B; Grecu IG; Noy A; Zamora D; Davis JM
[Ad] Endereço:Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel. mweiser@netvision.net.il.
[Ti] Título:Raloxifene Plus Antipsychotics Versus Placebo Plus Antipsychotics in Severely Ill Decompensated Postmenopausal Women With Schizophrenia or Schizoaffective Disorder: A Randomized Controlled Trial.
[So] Source:J Clin Psychiatry;78(7):e758-e765, 2017 Jul.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Several single-center studies have found raloxifene, an estrogen agonist, to be effective in ameliorating symptoms of schizophrenia in stable patients as augmentation of antipsychotics. This multicenter study assessed whether raloxifene plus antipsychotic treatment, in comparison to placebo plus antipsychotics, improves symptoms or cognition in severely ill decompensated schizophrenia patients. METHODS: In this 16-week, double-blind, randomized, placebo-controlled study, 200 severely ill, decompensated postmenopausal women who met DSM-IV-TR criteria for schizophrenia or schizoaffective disorder were recruited from January 2011 to December 2012 and were randomized to receive either raloxifene 120 mg/d plus antipsychotics or placebo plus antipsychotics. The primary outcome measure was Positive and Negative Syndrome Scale (PANSS) total score at the end of the trial. RESULTS: The placebo plus antipsychotics group experienced statistically significant improvement in PANSS total score (P < .001) compared to the raloxifene plus antipsychotics group, using mixed models for repeated measures, with results favoring placebo by 4.5 points (95% CI, 2.3-6.7). These results were clearly outside the 95% confidence interval. This negative effect was more pronounced in patients who had more frequent relapses and in those with baseline PANSS scores of 100 or higher. There were no differences between groups in Clinical Global Impression Scale-Severity scores or Composite Brief Assessment of Cognition in Schizophrenia scores at 16 weeks (P > .3). Baseline follicle-stimulating hormone and estradiol levels did not alter the drug-placebo differences. CONCLUSIONS: Individuals in the active treatment arm showed worse outcome than those in the placebo arm, most likely as a result of chance variation, but the results unequivocally show no benefit of antipsychotics plus raloxifene versus antipsychotics plus placebo in this large randomized, double-blind, placebo-controlled trial in postmenopausal women. These data do not support the use of raloxifene in severely decompensated schizophrenia patients until reliable research identifies what subgroup of patients or domain of outcome is benefited. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01280305.
[Mh] Termos MeSH primário: Antipsicóticos/uso terapêutico
Pós-Menopausa/efeitos dos fármacos
Pós-Menopausa/psicologia
Transtornos Psicóticos/tratamento farmacológico
Transtornos Psicóticos/psicologia
Cloridrato de Raloxifeno/uso terapêutico
Esquizofrenia/tratamento farmacológico
Psicologia do Esquizofrênico
[Mh] Termos MeSH secundário: Idoso
Antipsicóticos/efeitos adversos
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Seres Humanos
Meia-Idade
Escalas de Graduação Psiquiátrica
Transtornos Psicóticos/diagnóstico
Cloridrato de Raloxifeno/efeitos adversos
Esquizofrenia/diagnóstico
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antipsychotic Agents); 4F86W47BR6 (Raloxifene Hydrochloride)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:28492856
[Au] Autor:Qaseem A; Forciea MA; McLean RM; Denberg TD; Clinical Guidelines Committee of the American College of Physicians
[Ad] Endereço:From the American College of Physicians and University of Pennsylvania Health System, Philadelphia, Pennsylvania, and Yale School of Medicine, New Haven, Connecticut.
[Ti] Título:Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians.
[So] Source:Ann Intern Med;166(11):818-839, 2017 Jun 06.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Description: This guideline updates the 2008 American College of Physicians (ACP) recommendations on treatment of low bone density and osteoporosis to prevent fractures in men and women. This guideline is endorsed by the American Academy of Family Physicians. Methods: The ACP Clinical Guidelines Committee based these recommendations on a systematic review of randomized controlled trials; systematic reviews; large observational studies (for adverse events); and case reports (for rare events) that were published between 2 January 2005 and 3 June 2011. The review was updated to July 2016 by using a machine-learning method, and a limited update to October 2016 was done. Clinical outcomes evaluated were fractures and adverse events. This guideline focuses on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density, including pharmaceutical prescriptions, calcium, vitamin D, and estrogen. Evidence was graded according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Target Audience and Patient Population: The target audience for this guideline includes all clinicians. The target patient population includes men and women with low bone density and osteoporosis. Recommendation 1: ACP recommends that clinicians offer pharmacologic treatment with alendronate, risedronate, zoledronic acid, or denosumab to reduce the risk for hip and vertebral fractures in women who have known osteoporosis. (Grade: strong recommendation; high-quality evidence). Recommendation 2: ACP recommends that clinicians treat osteoporotic women with pharmacologic therapy for 5 years. (Grade: weak recommendation; low-quality evidence). Recommendation 3: ACP recommends that clinicians offer pharmacologic treatment with bisphosphonates to reduce the risk for vertebral fracture in men who have clinically recognized osteoporosis. (Grade: weak recommendation; low-quality evidence). Recommendation 4: ACP recommends against bone density monitoring during the 5-year pharmacologic treatment period for osteoporosis in women. (Grade: weak recommendation; low-quality evidence). Recommendation 5: ACP recommends against using menopausal estrogen therapy or menopausal estrogen plus progestogen therapy or raloxifene for the treatment of osteoporosis in women. (Grade: strong recommendation; moderate-quality evidence). Recommendation 6: ACP recommends that clinicians should make the decision whether to treat osteopenic women 65 years of age or older who are at a high risk for fracture based on a discussion of patient preferences, fracture risk profile, and benefits, harms, and costs of medications. (Grade: weak recommendation; low-quality evidence).
[Mh] Termos MeSH primário: Doenças Ósseas Metabólicas/complicações
Doenças Ósseas Metabólicas/tratamento farmacológico
Fraturas Ósseas/prevenção & controle
Osteoporose/complicações
Osteoporose/tratamento farmacológico
[Mh] Termos MeSH secundário: Cálcio na Dieta/uso terapêutico
Denosumab/uso terapêutico
Difosfonatos/uso terapêutico
Terapia de Reposição de Estrogênios
Exercício
Feminino
Seres Humanos
Masculino
Osteoporose Pós-Menopausa/complicações
Osteoporose Pós-Menopausa/tratamento farmacológico
Cloridrato de Raloxifeno/uso terapêutico
Fatores de Risco
Teriparatida/uso terapêutico
Vitamina D/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Calcium, Dietary); 0 (Diphosphonates); 10T9CSU89I (Teriparatide); 1406-16-2 (Vitamin D); 4EQZ6YO2HI (Denosumab); 4F86W47BR6 (Raloxifene Hydrochloride)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.7326/M15-1361


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[PMID]:28489426
[Au] Autor:Golmohammadzadeh S; Farhadian N; Biriaee A; Dehghani F; Khameneh B
[Ad] Endereço:a Nanotechnology Research Center, School of Pharmacy , Mashhad University of Medical Sciences , Mashhad , Iran.
[Ti] Título:Preparation, characterization and in vitro evaluation of microemulsion of raloxifene hydrochloride.
[So] Source:Drug Dev Ind Pharm;43(10):1619-1625, 2017 Oct.
[Is] ISSN:1520-5762
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Raloxifene hydrochloride (RLX) is a selective estrogen receptor modulator which is orally used for treatment of osteoporosis and prevention of breast cancer. The drug has low aqueous solubility and bioavailability. The aim of the present study is to formulate and characterize oil-in-water microemulsion systems for oral delivery of RLX. To enhance the drug aqueous solubility, microemulsion based on sesame oil was prepared. Sesame oil and Tween 80 were selected as the drug solvent oil and surfactant, respectively. In the first and second formulations, Edible glycerin and Span 80 were applied as co-surfactant, respectively. Pseudo-ternary phase diagrams showed that the best surfactant/co-surfactant ratios in the first and second formulations were 4:1 and 9:1, respectively. The particle size of all free drug-loaded and drug loaded samples were in the range of 31.25 ± 0.3 nm and 60.9 ± 0.1 nm, respectively. Electrical conductivity coefficient and refractive index of all microemulsion samples confirmed the formation of oil-in-water type of microemulsion. In vitro drug release profile showed that after 24 hours, 46% and 63% of the drug released through the first formulation in 0.1% (w/v) Tween 80 in distilled water as a release medium and phosphate buffer solution (PBS) at pH = 5.5, respectively. These values were changed to 57% and 98% for the second formulation. Results confirmed that the proposed microemulsion system containing RLX could improve and control the drug release profile in comparison to conventional dosage form.
[Mh] Termos MeSH primário: Emulsões/química
Glicerol/química
Polissorbatos/química
Cloridrato de Raloxifeno/química
Tensoativos/química
[Mh] Termos MeSH secundário: Disponibilidade Biológica
Química Farmacêutica
Liberação Controlada de Fármacos
Cloridrato de Raloxifeno/antagonistas & inibidores
Solubilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Emulsions); 0 (Polysorbates); 0 (Surface-Active Agents); 4F86W47BR6 (Raloxifene Hydrochloride); PDC6A3C0OX (Glycerol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1080/03639045.2017.1328430


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[PMID]:28395318
[Au] Autor:Wilson LM; Rebholz CM; Jirru E; Liu MC; Zhang A; Gayleard J; Chu Y; Robinson KA
[Ad] Endereço:From Johns Hopkins University Bloomberg School of Public Health and Johns Hopkins University School of Medicine, Baltimore, Maryland; Mount Sinai St. Luke's and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York; and University of Vermont College of Medicine, Burlington, V
[Ti] Título:Benefits and Harms of Osteoporosis Medications in Patients With Chronic Kidney Disease: A Systematic Review and Meta-analysis.
[So] Source:Ann Intern Med;166(9):649-658, 2017 May 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Complications of chronic kidney disease (CKD) include weak bones and increased fracture risk. Purpose: To review the benefits and harms of osteoporosis medications (bisphosphonates, teriparatide, raloxifene, and denosumab) compared with placebo, usual care, or active control in terms of bone mineral density (BMD), fractures, and safety in patients with CKD. Data Sources: PubMed and the Cochrane Central Register of Controlled Trials from December 2006 through December 2016. Study Selection: Paired reviewers independently screened abstracts and full-text articles for English-language, randomized, controlled trials that had at least 6 months of follow-up; evaluated osteoporosis medications among patients with CKD; and reported on BMD, fractures, or safety (mortality and adverse events). Data Extraction: Two reviewers serially abstracted data and independently assessed risk of bias and graded the strength of evidence (SOE). Data Synthesis: There were 13 trials (n = 9850) that included kidney transplant recipients (6 trials), patients who had stage 3 to 5 CKD or were receiving dialysis (3 trials), or postmenopausal women with CKD (4 trials). Evidence showed that bisphosphonates may slow loss of BMD among transplant recipients (moderate SOE), but their effects on fractures and safety in transplant recipients and others with CKD are unclear. Raloxifene may prevent vertebral fractures but may not improve BMD (low SOE). Effects of teriparatide and denosumab on BMD and fractures are unclear (very low SOE), and these medications may increase risk for some safety outcomes. Limitation: Unclear rigor of evidence, possible reporting biases, and scant evidence among patients with stage 3 to 5 CKD. Conclusion: Effects of osteoporosis medications on BMD, fracture risk, and safety among patients with CKD are not clearly established. Primary Funding Source: Kidney Disease: Improving Global Outcomes.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/efeitos adversos
Conservadores da Densidade Óssea/uso terapêutico
Osteoporose/complicações
Osteoporose/tratamento farmacológico
Insuficiência Renal Crônica/complicações
[Mh] Termos MeSH secundário: Denosumab/efeitos adversos
Denosumab/uso terapêutico
Difosfonatos/efeitos adversos
Difosfonatos/uso terapêutico
Feminino
Seres Humanos
Cloridrato de Raloxifeno/efeitos adversos
Cloridrato de Raloxifeno/uso terapêutico
Teriparatida/efeitos adversos
Teriparatida/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Diphosphonates); 10T9CSU89I (Teriparatide); 4EQZ6YO2HI (Denosumab); 4F86W47BR6 (Raloxifene Hydrochloride)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.7326/M16-2752



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