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[PMID]:29378528
[Au] Autor:Elwes F; Borooah S; Aspinall P; Sim PY; Loo CY; Armbrecht AM; Dhillon B; Cackett P
[Ad] Endereço:Royal Infirmary of Edinburgh, Edinburgh, UK.
[Ti] Título:Clinical outcomes of switching to aflibercept using a pro re nata treatment regimen in patients with neovascular age-related macular degeneration who incompletely responded to ranibizumab.
[So] Source:BMC Ophthalmol;18(1):20, 2018 Jan 30.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To assess the effect of switching patients previously incompletely treated with ranibizumab (RBZ) to aflibercept (AFL) using a pro re nata (PRN) treatment strategy in neovascular age-related macular degeneration (nvAMD). METHODS: A retrospective case series was conducted on patients who had persistent or recurrent intra- and/or sub-retinal fluid treated initially with RBZ and subsequently switched to AFL. The main outcome measures were best corrected visual acuity (BCVA) and central retinal thickness (CRT) measured at different stages of the study. Friedman analysis of variance and Wilcoxon test were used to examine differences in BCVA and CRT. RESULTS: Two hundred and seven eyes from 182 patients were included. BCVA and CRT improved significantly initially following 3 RBZ injections with a mean gain of 3.7 letters (p < 0.001) and a mean loss of 69 µm (p < 0.001) respectively. Following PRN RBZ therapy and immediately prior to switching to AFL (mean 129 weeks), there was a mean loss of 6.7 letters (p < 0.001) BCVA and a mean gain of 24 µm (p < 0.001) CRT. AFL loading resulted in a mean improvement of 0.7 letters (p = 0.28) BCVA and 55 µm (p < 0.001) CRT. At final follow-up following AFL PRN therapy (mean 85 weeks), there was a mean loss of 8.9 letters (p < 0.001) BCVA and a mean gain of 12 µm (p < 0.05) CRT. CONCLUSION: AFL loading resulted in a significant anatomical improvement but no significant change in visual acuity. However, the benefits of switching were gradually lost over time with AFL PRN dosing despite an increased injection rate when compared with RBZ PRN treatment. TRIAL REGISTRATION: Not applicable.
[Mh] Termos MeSH primário: Protocolos Clínicos
Substituição de Medicamentos/métodos
Ranibizumab/administração & dosagem
Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem
Proteínas Recombinantes de Fusão/administração & dosagem
Acuidade Visual
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Inibidores da Angiogênese/administração & dosagem
Feminino
Seguimentos
Seres Humanos
Injeções Intravítreas
Masculino
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Estudos Retrospectivos
Fatores de Tempo
Tomografia de Coerência Óptica
Resultado do Tratamento
Degeneração Macular Exsudativa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0688-3


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[PMID]:27771126
[Au] Autor:Davis ID; Xie W; Pezaro C; Donskov F; Wells JC; Agarwal N; Srinivas S; Yuasa T; Beuselinck B; Wood LA; Ernst DS; Kanesvaran R; Knox JJ; Pantuck A; Saleem S; Alva A; Rini BI; Lee JL; Choueiri TK; Heng DYC
[Ad] Endereço:Monash University and Eastern Health, Box Hill. Victoria, Australia. Electronic address: ian.davis@monash.edu.
[Ti] Título:Efficacy of Second-line Targeted Therapy for Renal Cell Carcinoma According to Change from Baseline in International Metastatic Renal Cell Carcinoma Database Consortium Prognostic Category.
[So] Source:Eur Urol;71(6):970-978, 2017 Jun.
[Is] ISSN:1873-7560
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We hypothesized that changes in International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic category at start of second-line therapy (2L) for metastatic renal cell carcinoma (mRCC) might predict response. OBJECTIVE: To assess outcomes of 2L according to type of therapy and change in IMDC prognostic category. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective review of the IMDC database for mRCC patients who received first-line (1L) VEGF inhibitors (VEGFi) and then 2L with VEGFi or mTOR inhibitors (mTORi). IMDC prognostic categories were defined before each line of therapy (favorable, F; intermediate, I; poor, P). Data were analyzed for 1516 patients, of whom 89% had clear cell histology. INTERVENTION: All included patients received targeted therapy for mRCC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS), time to treatment failure, and response to 2L were analyzed using Cox or logistic regression. RESULTS AND LIMITATIONS: At start of 2L, 60% of patients remained in the same prognostic category; 9.0% improved (3% I → F; 6% P → I); 31% deteriorated (15% F → I or P; 16% I → P). Patients with the same or better IMDC prognostic category had a longer time to treatment failure if they remained on VEGFi compared to those who switched to mTORi (adjusted hazard ratio [AHR] ranging from 0.33 to 0.78, adjusted p<0.05). Patients who deteriorated from F to I appeared more likely to benefit from switching to mTORi (median OS 16.5 mo, 95% confidence interval [CI] 12.0-19.0 for VEGFi; 20.2 mo, 95% CI 14.3-26.1 for mTORi; AHR 1.53, 95% CI 1.04-2.24; adjusted p=0.03). CONCLUSIONS: Changes in IMDC prognostic category predict the subsequent clinical course for patients with mRCC and provide a rational basis for selection of subsequent therapy. PATIENT SUMMARY: The pattern of treatment failure might help to predict what the next treatment should be for patients with metastatic renal cell carcinoma.
[Mh] Termos MeSH primário: Inibidores da Angiogênese/uso terapêutico
Carcinoma de Células Renais/tratamento farmacológico
Neoplasias Renais/tratamento farmacológico
Terapia de Alvo Molecular
Inibidores de Proteínas Quinases/uso terapêutico
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/efeitos adversos
Carcinoma de Células Renais/enzimologia
Carcinoma de Células Renais/secundário
Bases de Dados Factuais
Progressão da Doença
Intervalo Livre de Doença
Substituição de Medicamentos
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Renais/enzimologia
Neoplasias Renais/patologia
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Modelos de Riscos Proporcionais
Inibidores de Proteínas Quinases/efeitos adversos
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo
Estudos Retrospectivos
Transdução de Sinais/efeitos dos fármacos
Serina-Treonina Quinases TOR/antagonistas & inibidores
Serina-Treonina Quinases TOR/metabolismo
Fatores de Tempo
Resultado do Tratamento
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Fator A de Crescimento do Endotélio Vascular/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Protein Kinase Inhibitors); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); EC 2.7.1.1 (MTOR protein, human); EC 2.7.1.1 (TOR Serine-Threonine Kinases); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29269694
[Au] Autor:Matsui T; Nakagawa K; Yamazaki K; Wada T; Kadoya M; Kaida K
[Ad] Endereço:Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College.
[Ti] Título:[An anti-RNP antibody-positive case of aseptic meningitis induced by non-steroidal anti-inflammatory drugs in a young woman].
[So] Source:Rinsho Shinkeigaku;58(1):25-29, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 19-year-old woman developed high fever, headache, and nausea after taking Loxoprofen for pharyngitis, followed by disturbed consciousness and nuchal stiffness. The patient and her mother had a history of Raynaud's phenomenon. Cerebrospinal fluid (CSF) examination indicated a diagnosis of aseptic meningitis and revealed high levels of Q albumin and IgG index. Anti-RNP antibodies were positive in serum and CSF. Her symptoms disappeared immediately after cessation of Loxoprofen and a drug lymphocyte stimulation test was negative, confirming a diagnosis of non-steroidal anti-inflammatory drugs (NSAIDs)-induced aseptic meningitis. It should be kept in mind that an immune abnormality such as serum and CSF anti-RNP antibodies may play a role in development of NSAIDs-induced aseptic meningitis. A history of usage of NSAIDs and a thorough examination of collagen diseases are useful for identification of the origin of aseptic meningitis in a young woman.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/efeitos adversos
Anticorpos Antinucleares/sangue
Anticorpos Antinucleares/líquido cefalorraquidiano
Meningite Asséptica/diagnóstico
Meningite Asséptica/etiologia
Fenilpropionatos/efeitos adversos
Ribonucleoproteínas/imunologia
[Mh] Termos MeSH secundário: Acetaminofen/administração & dosagem
Adulto
Anti-Inflamatórios não Esteroides/administração & dosagem
Doenças Autoimunes/complicações
Doenças Autoimunes/diagnóstico
Autoimunidade
Biomarcadores/sangue
Biomarcadores/líquido cefalorraquidiano
Diagnóstico Diferencial
Substituição de Medicamentos
Feminino
Seres Humanos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antibodies, Antinuclear); 0 (Biomarkers); 0 (Phenylpropionates); 0 (Ribonucleoproteins); 3583H0GZAP (loxoprofen); 362O9ITL9D (Acetaminophen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001085


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[PMID]:29311459
[Au] Autor:Mitsuboshi S; Yamada H; Nagai K; Okajima H
[Ad] Endereço:Department of Pharmacy, Kaetsu Hospital.
[Ti] Título:[Low Continuity Rate of Sucroferric Oxyhydroxide among Japanese Hemodialysis Patients with High Phosphate Binder Pill Burden].
[So] Source:Yakugaku Zasshi;138(1):135-139, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:This prospective observational study was conducted to evaluate the continuity, efficacy, and tolerability of sucroferric oxyhydroxide (SO) among hemodialysis (HD) patients who switched to SO from sevelamer hydrochloride (SH) or bixalomer (BX). Participants were 9 HD patients in Kaetsu Hospital who had been receiving more than 9 tablets/d of SH or BX and were switched to SO 750 mg/d. All the participants were men. Over a 6-month observational period, 6 of the 9 patients (67%) discontinued SO because of adverse events, including diarrhea, atheroma, and polycythemia. Although the diarrhea and atheroma were mild, the affected patients did not wish to restart SO. On the other hand, 3 of the 9 patients (33%) continued taking SO throughout the observation period. These patients tended to have increased levels of serum calcium, hematocrit, and serum ferritin; a decreased number of phosphate binder tablets (from 21 tablets/d to 8 tablets/d); and a decreased dosage of erythropoiesis-stimulating agents. Serum phosphate levels tended to decrease in continuers, but tended to increase in discontinuers. It may be preferable to increase the SO dosage gradually rather than switching from SH or BX all at once, and patients who switch to SO should be carefully monitored.
[Mh] Termos MeSH primário: Quelantes/administração & dosagem
Esquema de Medicação
Substituição de Medicamentos/métodos
Compostos Férricos/administração & dosagem
Poliaminas
Diálise Renal
Sevelamer
Sacarose/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Grupo com Ancestrais do Continente Asiático
Quelantes/efeitos adversos
Combinação de Medicamentos
Compostos Férricos/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Fosfatos/sangue
Estudos Prospectivos
Sacarose/efeitos adversos
Comprimidos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Chelating Agents); 0 (Drug Combinations); 0 (Ferric Compounds); 0 (Phosphates); 0 (Polyamines); 0 (Tablets); 0 (sucroferric oxyhydroxide); 3160WY51LV (bixalomer); 57-50-1 (Sucrose); 9YCX42I8IU (Sevelamer)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00180


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[PMID]:27778525
[Au] Autor:Brice AE; Hernandez GA; Sanchez M; Haynick M; Mendoza CE
[Ad] Endereço:a Division of Cardiology, Jackson Memorial Hospital , University of Miami Miller School of Medicine , Miami , FL , USA.
[Ti] Título:In-stent thrombosis when switching ticagrelor to clopidogrel after percutaneous coronary intervention.
[So] Source:Platelets;28(3):305-309, 2017 May.
[Is] ISSN:1369-1635
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker has been proven to reduce subsequent cardiovascular events and in-stent thrombosis in patients undergoing percutaneous coronary intervention. Newer P2Y12 antagonists with faster onset and greater inhibition of platelet activity have improved cardiovascular outcomes but have created uncertainty with the appropriate dosing when switching between agents. Currently, there are no evidence-based guidelines to aid clinicians when switching between P2Y12 receptor blockers. Here we describe two patients that developed in-stent thrombosis when switching from ticagrelor to clopidogrel using a 300 mg clopidogrel loading dose. Both patients presented with ST elevation myocardial infarction and underwent stent placement but then developed in-stent thrombosis 48 hours after switching from ticagrelor to clopidogrel. These cases illustrate the severe consequences of suboptimal platelet inhibition and the need for prospective trials thoroughly powered to assess clinical outcomes in order to determine the most appropriate strategy when switching from ticagrelor to clopidogrel.
[Mh] Termos MeSH primário: Adenosina/análogos & derivados
Substituição de Medicamentos/efeitos adversos
Intervenção Coronária Percutânea
Inibidores da Agregação de Plaquetas/uso terapêutico
Antagonistas do Receptor Purinérgico P2Y/uso terapêutico
Trombose/diagnóstico
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Adenosina/uso terapêutico
Plaquetas/efeitos dos fármacos
Plaquetas/metabolismo
Plaquetas/patologia
Esquema de Medicação
Cálculos da Dosagem de Medicamento
Feminino
Seres Humanos
Masculino
Meia-Idade
Ativação Plaquetária/efeitos dos fármacos
Agregação Plaquetária/efeitos dos fármacos
Guias de Prática Clínica como Assunto
Infarto do Miocárdio com Supradesnível do Segmento ST/sangue
Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia
Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia
Stents
Trombose/etiologia
Trombose/patologia
Ticlopidina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); 0 (Purinergic P2Y Receptor Antagonists); A74586SNO7 (clopidogrel); GLH0314RVC (Ticagrelor); K72T3FS567 (Adenosine); OM90ZUW7M1 (Ticlopidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1080/09537104.2016.1235687


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Registro de Ensaios Clínicos
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[PMID]:27771544
[Au] Autor:Miyamura K; Miyamoto T; Tanimoto M; Yamamoto K; Kimura S; Kawaguchi T; Matsumura I; Hata T; Tsurumi H; Saito S; Hino M; Tadokoro S; Meguro K; Hyodo H; Yamamoto M; Kubo K; Tsukada J; Kondo M; Aoki M; Okada H; Yanada M; Ohyashiki K; Taniwaki M
[Ad] Endereço:Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital, 3-35 Michisita-cho, Nakamura-ku, Nagoya 453-8511, Japan. Electronic address: miyamu@nagoya-1st.jrc.or.jp.
[Ti] Título:Switching to nilotinib in patients with chronic myeloid leukemia in chronic phase with molecular suboptimal response to frontline imatinib: SENSOR final results and BIM polymorphism substudy.
[So] Source:Leuk Res;51:11-18, 2016 12.
[Is] ISSN:1873-5835
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Optimal management of patients with chronic myeloid leukemia in chronic phase with suboptimal molecular response (MR) to frontline imatinib is undefined. We report final results from SENSOR, which evaluated efficacy/safety of nilotinib in this setting. A substudy assessed whether BIM polymorphisms impacted response to nilotinib. In this single-arm, multicenter study, Japanese patients with suboptimal MR per European LeukemiaNet 2009 criteria (complete cytogenetic response, but not major MR [MMR]) after ≥18 months of frontline imatinib received nilotinib 400mg twice daily for 24 months. MR, BCR-ABL1 mutations/variants, and BIM polymorphisms were evaluated in a central laboratory. Primary endpoint was the MMR rate at 12 months (null hypothesis of 40%). Of 45 patients (median exposure, 22.08 months), 39 completed the study and six discontinued. At 12 and 24 months, 51.1% (95% CI, 35.8%-66.3%) and 66.7% (95% CI, 51.0%-80.0%) achieved MMR, respectively. Cumulative MMR incidence by 24 months was 75.6%. Of 40 patients analyzed, 10 of 12 (83.3%) with and 17 of 28 (60.7%) without BIM polymorphisms achieved MMR at 24 months. The safety profile was manageable with dose reductions and interruptions. Nilotinib provided clinical benefit for patients with suboptimal response to imatinib, and BIM polymorphisms did not influence MMR achievement. ClinicalTrials.gov: NCT01043874.
[Mh] Termos MeSH primário: Substituição de Medicamentos/métodos
Mesilato de Imatinib/administração & dosagem
Leucemia Mieloide de Fase Crônica/tratamento farmacológico
Polimorfismo Genético
Pirimidinas/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/uso terapêutico
Feminino
Seres Humanos
Leucemia Mieloide de Fase Crônica/genética
Masculino
Meia-Idade
Inibidores de Proteínas Quinases/uso terapêutico
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide); 0 (Antineoplastic Agents); 0 (Protein Kinase Inhibitors); 0 (Pyrimidines); 8A1O1M485B (Imatinib Mesylate)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:29269711
[Au] Autor:Kiuchi S; Hisatake S; Kabuki T; Oka T; Dobashi S; Fujii T; Ikeda T
[Ad] Endereço:Department of Cardiovascular Medicine, Toho University Faculty of Medicine.
[Ti] Título:Effect of Switching from Cilnidipine to Azelnidipine on Cardiac Sympathetic Nerve Function in Patients with Heart Failure Preserved Ejection Fraction.
[So] Source:Int Heart J;59(1):120-125, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Cardiac sympathetic nerve activity is known to play a key role in the development and progression of heart failure (HF). Azelnidipine, an L-type calcium channel blocker (CCB), inhibits the sympathetic nerve activity of the central system. In contrast, cilnidipine, an N-type CCB, inhibits the sympathetic nerve activity of the peripheral system. CCBs are recommended as class IIa in patients with HF preserved ejection fraction (HFpEF); however, there are no comparative data on the difference in effect of cilnidipine and azelnidipine in patients with HFpEF and hypertension. We investigated the difference in effect of azelnidipine compared with cilnidipine in patients with HFpEF. Twenty-four consecutive HF patients who received angiotensin II type1a receptor blocker and beta blocker from April 2013 to January 2015 were enrolled. Cilnidipine was switched to azelnidipine during the follow-up period. Blood pressures, heart rate, blood tests, echocardiography, and I-metaiodobenzylguanidine (MIBG) cardiac-scintigraphy were measured before and after 6 months from azelnidipine administration. B-type natriuretic peptide tended to decrease after switching to azelnidipine; however, there were no significant differences between the pre-state and post-state (pre-state: 118.5 pg/mL and post-state: 78.4 pg/mL, P = 0.137). Other laboratory findings, including catecholamine, also did not change significantly. In echocardiography, there were no significant differences in systolic and diastolic functions at the pre-state and post-state. As for MIBG, there were no significant changes in heart/mediastinum ratio. However, washout rate was significantly reduced (pre-state: 42.9 and post-state: 39.6, P = 0.030). Azelnidipine improved the dysfunction of cardiac sympathetic nerve activity compared with cilnidipine in patients with HFpEF.
[Mh] Termos MeSH primário: Ácido Azetidinocarboxílico/análogos & derivados
Di-Hidropiridinas/administração & dosagem
Substituição de Medicamentos
Insuficiência Cardíaca/tratamento farmacológico
Coração/inervação
Volume Sistólico/efeitos dos fármacos
Sistema Nervoso Simpático/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Ácido Azetidinocarboxílico/administração & dosagem
Bloqueadores dos Canais de Cálcio/administração & dosagem
Relação Dose-Resposta a Droga
Ecocardiografia
Feminino
Seguimentos
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Cintilografia/métodos
Estudos Retrospectivos
Sistema Nervoso Simpático/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcium Channel Blockers); 0 (Dihydropyridines); 2517-04-6 (Azetidinecarboxylic Acid); 97T5AZ1JIP (cilnidipine); PV23P19YUG (azelnidipine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.17-024


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[PMID]:28466399
[Au] Autor:Rosenson RS; Gandra SR; McKendrick J; Dent R; Wieffer H; Cheng LI; Catapano AL; Oh P; Kees Hovingh G; Stroes ES
[Ad] Endereço:Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, MC1 Level, New York, NY, 10029, USA. robert.rosenson@mssm.edu.
[Ti] Título:Identification and Management of Statin-Associated Symptoms in Clinical Practice: Extension of a Clinician Survey to 12 Further Countries.
[So] Source:Cardiovasc Drugs Ther;31(2):187-195, 2017 Apr.
[Is] ISSN:1573-7241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Statins are the first-choice pharmacological treatment for patients with hypercholesterolemia and at risk for cardiovascular disease; however, a minority of patients experience statin-associated symptoms (SAS) and are considered to have reduced statin tolerance. The objective of this study was to establish how patients with SAS are identified and managed in clinical practice in Austria, Belgium, Colombia, Croatia, the Czech Republic, Denmark, Portugal, Switzerland, Russia, Saudi Arabia, Turkey, and the United Arab Emirates. METHODS: A cross-sectional survey was conducted (2015-2016) among clinicians (n = 60 per country; Croatia: n = 30) who are specialized/experienced in the treatment of hypercholesterolemia. Participants were asked about their experience of patients presenting with potential SAS and how such patients were identified and treated. RESULTS: Muscle-related symptoms were the most common presentation of potential SAS (average: 51%; range across countries [RAC] 17-74%); other signs/symptoms included persistent elevation in transaminases. To establish whether symptoms are due to statins, clinicians required rechallenge after discontinuation of statin treatment (average: 77%; RAC 40-90%); other requirements included trying at least one alternative statin. Clinicians reported that half of high-risk patients with confirmed SAS receive a lower-dose statin (average: 53%; RAC 43-72%), and that most receive another non-statin lipid-lowering therapy with or without a concomitant statin (average: 65%; RAC 52-83%). CONCLUSIONS: The specialists and GPs surveyed use stringent criteria to establish causality between statin use and signs or symptoms, and persevere with statin treatment where possible.
[Mh] Termos MeSH primário: Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos
Hipercolesterolemia/tratamento farmacológico
Músculo Esquelético/efeitos dos fármacos
Doenças Musculares/diagnóstico
Doenças Musculares/terapia
Padrões de Prática Médica
[Mh] Termos MeSH secundário: Colômbia/epidemiologia
Estudos Transversais
Relação Dose-Resposta a Droga
Substituição de Medicamentos
Europa (Continente)/epidemiologia
Pesquisas sobre Serviços de Saúde
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem
Hipercolesterolemia/diagnóstico
Hipercolesterolemia/epidemiologia
Doenças Musculares/induzido quimicamente
Doenças Musculares/epidemiologia
Valor Preditivo dos Testes
Prevalência
Medição de Risco
Fatores de Risco
Arábia Saudita/epidemiologia
Emirados Árabes Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1007/s10557-017-6727-0


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[PMID]:27776039
[Au] Autor:Brennan AT; Davies MA; Bor J; Wandeler G; Stinson K; Wood R; Prozesky H; Tanser F; Fatti G; Boulle A; Sikazwe I; Wool-Kaloustian K; Yuannoutsos C; Leroy V; de Rekeneire N; Fox MP
[Ad] Endereço:aDepartment of Global Health, Boston University, Boston, Massachusetts, USA bHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa cDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA dCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa eDepartment of Infectious Diseases, Bern University Hospital, University of Bern fInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland gThe Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town hDivision of Infectious Diseases, Department of Medicine, University of Stellenbosch & Tygerberg Academic Hospital, Cape Town iAfrica Center for Health and Population Studies, University of Kwazulu-Natal jKheth'Impilo AIDS Free Living, Cape Town kDepartment of Health, Provincial Government of the Western Cape, Cape Town, South Africa lCenter for Infectious Disease Research in Zambia, Lusaka, Zambia mIndiana University School of Medicine, Indianapolis nRichard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA oINSERM U1027, Université Paul Sabatier Toulouse 3, Toulouse pUniversité Bordeaux, ISPED, Centre INSERM U1219 Epidémiologie-Biostatistique, Bordeaux, France.
[Ti] Título:Has the phasing out of stavudine in accordance with changes in WHO guidelines led to a decrease in single-drug substitutions in first-line antiretroviral therapy for HIV in sub-Saharan Africa?
[So] Source:AIDS;31(1):147-157, 2017 Jan 02.
[Is] ISSN:1473-5571
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We assessed the relationship between phasing out stavudine in first-line antiretroviral therapy (ART) in accordance with WHO 2010 policy and single-drug substitutions (SDS) (substituting the nucleoside reverse transcriptase inhibitor in first-line ART) in sub-Saharan Africa. DESIGN: Prospective cohort analysis (International epidemiological Databases to Evaluate AIDS-Multiregional) including ART-naive, HIV-infected patients aged at least 16 years, initiating ART between January 2005 and December 2012. Before April 2010 (July 2007 in Zambia) national guidelines called for patients to initiate stavudine-based or zidovudine-based regimen, whereas thereafter tenofovir or zidovudine replaced stavudine in first-line ART. METHODS: We evaluated the frequency of stavudine use and SDS by calendar year 2004-2014. Competing risk regression was used to assess the association between nucleoside reverse transcriptase inhibitor use and SDS in the first 24 months on ART. RESULTS: In all, 33 441 (8.9%; 95% confience interval 8.7-8.9%) SDS occurred among 377 656 patients in the first 24 months on ART, close to 40% of which were amongst patients on stavudine. The decrease in SDS corresponded with the phasing out of stavudine. Competing risks regression models showed that patients on tenofovir were 20-95% less likely to require a SDS than patients on stavudine, whereas patients on zidovudine had a 75-85% decrease in the hazards of SDS when compared to stavudine. CONCLUSION: The decline in SDS in the first 24 months on treatment appears to be associated with phasing out stavudine for zidovudine or tenofovir in first-line ART in our study. Further efforts to decrease the cost of tenofovir and zidovudine for use in this setting is warranted to substitute all patients still receiving stavudine.
[Mh] Termos MeSH primário: Antirretrovirais/uso terapêutico
Terapia Antirretroviral de Alta Atividade/métodos
Substituição de Medicamentos
Infecções por HIV/tratamento farmacológico
Estavudina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
África ao Sul do Saara
Uso de Medicamentos
Feminino
Política de Saúde
Seres Humanos
Masculino
Estudos Prospectivos
Tenofovir/uso terapêutico
Zidovudina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Retroviral Agents); 4B9XT59T7S (Zidovudine); 99YXE507IL (Tenofovir); BO9LE4QFZF (Stavudine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29204996
[Au] Autor:Curry B; Bylsma G; Hewitt AW; Verma N
[Ad] Endereço:Hobart Eye Surgeons, Hobart, Australia.
[Ti] Título:The VEGF Treatment of AMD Switch Study (The vTAS Study).
[So] Source:Asia Pac J Ophthalmol (Phila);6(6):481-487, 2017 Nov-Dec.
[Is] ISSN:2162-0989
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the effect of aflibercept on anatomic and visual outcomes in patients with choroidal neovascularization (CNV) previously treated with intravitreal ranibizumab with persistent fluid on optical coherence tomography (OCT). DESIGN: Prospective, open-label study. METHODS: Eighteen patients (19 eyes) with CNV being treated with monthly ranibizumab, with persistent fluid on OCT, were switched to intravitreal aflibercept injections at intervals of up to 8 weeks. The primary outcome was the proportion of patients maintaining vision [<5 letter loss in visual acuity (VA)] at week 48. Secondary outcomes included the change in VA and central macular thickness (CMT) and the frequency of treatment necessary along with the safety of intravitreal aflibercept. RESULTS: Forty-eight weeks after switching to aflibercept, 16/19 eyes had maintained VA. There was a median increase in vision of 5 letters [interquartile range (IQR): 0, 15; = 0.06)] and median CMT was reduced from 313 µm (IQR: 214, 334) to 258 µm (IQR: 200, 299; = 0.02). After stratification by fluid location the reduction in CMT was statistically significant for eyes with intraretinal fluid (IRF) at baseline [median change, -25 µm (IQR: -14, -64); = 0.01]. Macular volume within 6 mm of the fovea (CMTVol) was significantly reduced in eyes with subretinal fluid (SRF) [-0.20 mm³ (IQR: -1.45, -0.05); = 0.03]. CONCLUSIONS: In this small cohort of eyes, switching to aflibercept seemed beneficial. The majority maintained or improved vision and eyes with IRF or SRF had significant reductions in macular edema. However, visual improvement was not always indicative of anatomical improvement.
[Mh] Termos MeSH primário: Inibidores da Angiogênese/uso terapêutico
Neovascularização de Coroide/tratamento farmacológico
Substituição de Medicamentos
Ranibizumab/uso terapêutico
Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico
Proteínas Recombinantes de Fusão/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Neovascularização de Coroide/patologia
Feminino
Seres Humanos
Injeções Intravítreas
Edema Macular/patologia
Masculino
Meia-Idade
Estudos Prospectivos
Líquido Sub-Retiniano/metabolismo
Tomografia de Coerência Óptica
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Recombinant Fusion Proteins); 0 (Vascular Endothelial Growth Factor A); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.22608/APO.2017364



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