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  • Pharmacy  (15)
  • Medicine  (15)
  • 1
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 88, No. 3 ( 2022-03), p. 1202-1210
    Abstract: Data regarding clinical pharmacokinetic/toxicodynamic (PK/TD) of polymyxin B is short of direct quantitative data. This study aims to investigate the risk factors of polymyxin B associated acute kidney injury (AKI) and to assess the relationship between polymyxin B plasma levels and its nephrotoxicity. Methods A retrospective study was performed in adult patients treated with polymyxin B. Risk factors associated with AKI and plasma trough concentrations of polymyxin B were identified via medical record review. A multivariate logistic regression model was established and the risk of polymyxin B‐associated AKI were predicted by a receiver operating characteristic curve, with maximal Youden index used to identify safety thresholds among the study population. Results Fifty‐four adult patients were included in the study. AKI was detected in 14 patients during polymyxin B treatment (25.9%, 14 out of 54). C min (odds ratio [OR] 2.071; 95% confidence interval [CI] 1.235–3.472) and baseline serum creatinine (OR 1.024; 95% CI 1.005–1.043) were significant independent risk factors for developing AKI. The area under the ROC curve of the combined predictor was larger based on the above factors. When the Youden index was at maximum, the optimal cut‐off point was 6.678 of the ROC curve. When C min  ≥ 3.13 mg/L, the probability of AKI was more than 50%. Conclusion In this study, when the calculated combined predictor value was 〉 6.678, there was an increased risk of AKI. Maintaining a polymyxin B C min level below 3.13 mg/L may be helpful in reducing the incidence of polymyxin B associated nephrotoxicity.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1498142-7
    SSG: 15,3
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  • 2
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 87, No. 4 ( 2021-04), p. 1869-1877
    Abstract: Current FDA‐approved label recommends that the dosage of polymyxin B should be adjusted according to renal function. However, the correlation between polymyxin B pharmacokinetics (PK) and creatinine clearance (CrCL) is poor. This study aimed to develop a population PK model of polymyxin B in adult patients with various renal functions and to identify a dosing strategy. Methods A retrospective PK study was performed in 32 adult patients with various renal function. Nonlinear mixed effects modelling was applied to build a population PK model of polymyxin B followed by Monte Carlo simulations which designed polymyxin B dosing regimens across various renal function. Results Polymyxin B PK analyses included 112 polymyxin B concentrations at steady state from 32 adult patients, in which 71.9% of them were critically ill. In the final PK model, CrCL was the significant covariate on CL (typical value 1.59 L/h; between‐subject variability 13%). The mean (SD) individual empirical Bayesian estimate of CL was 1.75 (0.43) L/h. In addition, a new dosing strategy combining the PK/pharmacodynamic (PD) targets and Monte Carlo simulation indicated that the reduction of polymyxin B dose in patients with renal insufficiency improved the probability of achieving optimal exposure. For severe infections caused by organisms with minimum inhibitory concentration (MIC) ≥ 2 mg/L, a high daily dose of polymyxin B might be possible for bacterial eradication, but the risk of nephrotoxicity is increased. Conclusions Renal function plays a significant role in polymyxin B PK, and the dose of polymyxin B should be adjusted according to CrCL in patients with renal insufficiency.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1498142-7
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  • 3
    In: CNS Drugs, Springer Science and Business Media LLC, Vol. 36, No. 11 ( 2022-11), p. 1217-1227
    Type of Medium: Online Resource
    ISSN: 1172-7047 , 1179-1934
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2043806-0
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  • 4
    In: Schizophrenia Bulletin, Oxford University Press (OUP)
    Type of Medium: Online Resource
    ISSN: 0586-7614 , 1745-1701
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2180196-4
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  • 5
    Online Resource
    Online Resource
    American Society for Microbiology ; 2013
    In:  Antimicrobial Agents and Chemotherapy Vol. 57, No. 5 ( 2013-05), p. 2422-2423
    In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 57, No. 5 ( 2013-05), p. 2422-2423
    Type of Medium: Online Resource
    ISSN: 0066-4804 , 1098-6596
    RVK:
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2013
    detail.hit.zdb_id: 1496156-8
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Schizophrenia Bulletin Vol. 46, No. Supplement_1 ( 2020-05-18), p. S63-S63
    In: Schizophrenia Bulletin, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2020-05-18), p. S63-S63
    Abstract: Schizotypy, a subclinical group at risk for schizophrenia, have been found to show impairments in response inhibition. Recent studies differentiated proactive inhibition (a preparatory process before the stimuli appears) and reactive inhibition (the inhibition of a pre-potent or already initiated response). However, it remains unclear whether both proactive and reactive inhibition are impaired in schizotypy and what are the neural mechanisms. The present event-related potential study used an adapted stop-signal task to examine the two inhibition processes and the underlying neural mechanisms in schizotypy compared to healthy controls (HC). Methods A total of 21 individuals with schizotypy and 25 matched HC participated in this study. To explore different degrees of proactive inhibition, we set three conditions: a “certain” go condition which no stop signal occurred, a “17% no go” condition in which stop signal would appear in 17% of trials, and a “33% no go” condition in which stop signal would appear in 33% of trials. All participants completed all the conditions, and EEG was recorded when participants completed the task. Results Behavioral results showed that in both schizotypy and HC, the reaction times (RT) of go trials were significantly prolonged as the no go percentage increased, and HC showed significantly longer go RT compared with schizotypy in both “17% no go” and “33% no go” conditions, suggesting greater proactive inhibition in HC. Stop signal reaction times (SSRTs) in “33% no go” condition was shorter than “17% no go” condition in both groups. Schizotypy showed significantly longer SSRTs in both “17% no go” and “33% no go” conditions than HC, indicating schizotypy relied more on reactive inhibition. ERP results showed that schizotypy showed larger overall N1 for go trials than HC irrespective of condition, which may indicate a compensation process in schizotypy. Schizotypy showed smaller N2 on both successful and unsuccessful stop trials in “17% no go” conditions than HC, while no group difference was found in “33% no go” conditions for stop trials, which may indicate impaired error processing. Discussion These results suggested that schizotypy tended to be impaired in both proactive control and reactive control processes.
    Type of Medium: Online Resource
    ISSN: 0586-7614 , 1745-1701
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2180196-4
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  • 7
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 89, No. 1 ( 2023-01), p. 372-379
    Abstract: As one of the mainstays of breast cancer therapy, chemotherapy inevitably induces neutropenia. In this study, we explored the role of PEG‐rhG‐CSF (pegylated recombinant human granulocyte colony‐stimulating factor) in the emergency treatment of chemotherapy‐induced grades 3–4 neutropenia. Methods A total of 100 patients with breast cancer were randomized (1:1) into the study. Fifty patients randomized to the experimental group were treated with PEG‐rhG‐CSF after grades 3–4 neutropenia following the first cycle of chemotherapy, while 50 patients randomized to the control group received a daily injection of rhG‐CSF (recombinant human granulocyte colony‐stimulating factor). The primary endpoint was the recovery time of grades 3–4 neutropenia. Results Compared with patients in the control group, the mean ± SD recovery time of grades 3–4 neutropenia and febrile neutropenia (FN) was significantly shorter for patients in the experimental group (grades 3–4, P  = .000; grade 4, P  = .000; FN, P  = .038). There is no significant difference in the incidence of FN for the two groups. In the experimental group, the duration of grades 3–4 neutropenia in patients aged 〈 60 years and ≥60 years was 2.15 and 3.20 days, respectively ( P  = .037). Adverse events (AEs) of any grade were reported in 37 (75.5%) and 28 (59.6%) patients from the two groups, respectively. No grade ≥3 AEs were reported. Conclusion This study supported that the PEG‐rhG‐CSF was more effective and convenient than rhG‐CSF for treating grades 3–4 neutropenia and FN in patients with breast cancer and had manageable toxicity.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1498142-7
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  • 8
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 74, No. 3 ( 2012-09), p. 501-509
    Abstract: WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Repaglinide is an insulin secretagogue agent widely used in the treatment of type 2 diabetes mellitus (T2DM). Obvious interindividual differences in the therapeutic efficacy of and adverse reactions to repaglinide were observed in Chinese T2DM patients. • There are no reports showing the influence of genetic variations of NeuroD1/BETA2 A45T and PAX4 R121W on repaglinide response in Chinese T2DM patients. WHAT THIS STUDY ADDS • This study aimed to investigate the association of genetic polymorphisms of NeuroD1/BETA2 A45T and PAX4 R121W with T2DM susceptibility and repaglinide therapeutic efficacy in Chinese T2DM patients. • The NeuroD1/BETA2 A45T and PAX4 R121W polymorphisms were correlated with repaglinide therapeutic efficacy in Chinese T2DM patients. AIMS We aimed to determine whether NeuroD1/BETA2 and PAX4 polymorphisms were associated with the therapeutic efficacy of repaglinide in Chinese type 2 diabetes mellitus (T2DM) patients. METHODS Three hundred and sixty‐eight T2DM patients and 132 healthy control subjects were genotyped by restriction fragment length polymorphism. Forty‐three patients with various genotypes were randomly selected to undergo 8 weeks of repaglinide treatment (3 mg day −1 ). Fasting plasma glucose, postprandial plasma glucose, glycated haemoglobin, fasting and postprandial serum insulin (FINS, PINS), homeostasis model assessment for insulin resistance, serum triglyceride, total cholesterol, low‐density lipoprotein‐cholesterol and high‐density lipoprotein‐cholesterol were determined before and after repaglinide treatment. RESULTS The allelic frequency of NeuroD1/BETA2 T45 was higher in T2DM patients than in the control subjects [13.45 vs. 6.82%, P 〈 0.01, odds ratios = 2.342 (1.365, 4.019), P = 0.002]. Type 2 diabetes mellitus patients with the mutated allele of NeuroD1/BETA2 A45T polymorphism showed higher FINS (13.46 ± 12.57 vs. 10.04 ± 7.09 mU l −1 , P 〈 0.05) (11.67, 14.83 vs. 8.38, 11.37) and PINS (52.11 ± 40.93 vs. 68.66 ± 43.87 mU l −1 , P 〈 0.05) (44.89, 58.35 vs. 55.35, 88.87) than individuals with the T allele. The PAX4 R121W R allele carriers had higher PINS (52.11 ± 40.93 vs. 68.66 ± 43.87 mU l −1 , P 〈 0.05) (44.89, 58.35 vs. 55.35, 88.87) than subjects with the W allele. After repaglinide treatment, patients with the T allele of NeuroD1/BETA2 A45T polymorphisms had attenuated efficacy on fasting plasma glucose (−2.79 ± 2.14 vs. −0.99 ± 1.80 mmol l −1 , P 〈 0.01) (−3.53, −1.84 vs. −1.99, −0.13) and postprandial plasma glucose (−6.71 ± 5.90 vs. −2.54 ± 3.39 mmol l −1 , P 〈 0.01) (−9.28, −4.62 vs. −4.34, −0.84). Patients with the RR genotype of PAX4 R121W showed better efficacy with respect to the level of postprandial plasma glucose than R/W genotypes (−6.53 ± 6.52 vs. −2.95 ± 1.17 mmol l −1 , P 〈 0.05) (−8.20, −4.89 vs. −3.92, −1.20). CONCLUSIONS The NeuroD1/BETA2 and PAX4 polymorphisms were substantially associated with plasma glucose level after repaglinide monotherapy.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2012
    detail.hit.zdb_id: 1498142-7
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  • 9
    In: The Journal of Clinical Pharmacology, Wiley
    Abstract: Tezepelumab is a human monoclonal antibody that blocks the activity of thymic stromal lymphopoietin. This analysis assessed the suitability of a fixed‐dose regimen of tezepelumab 210 mg every 4 weeks (Q4W) in adults and adolescents with severe, uncontrolled asthma. A population pharmacokinetic model was developed using data from 1368 patients with asthma or healthy participants enrolled in 8 clinical studies (phases 1‐3). Tezepelumab exposure‐efficacy relationships were analyzed in the phase 3 NAVIGATOR study (NCT03347279), using asthma exacerbation rates over 52 weeks and changes in pre‐bronchodilator forced expiratory volume in 1 s at week 52. Tezepelumab pharmacokinetics were well characterized by a 2‐compartment linear disposition model with first‐order absorption and elimination following subcutaneous and intravenous administration at 2.1‐420 and 210‐700 mg, respectively. There were no clinically relevant effects on tezepelumab pharmacokinetics from age (≥12 years), sex, race/ethnicity, renal or hepatic function, disease severity (inhaled corticosteroid dose level), concomitant asthma medication use, smoking history, or anti‐drug antibodies. Body weight was the most influential covariate on tezepelumab exposure, but no meaningful differences in efficacy or safety were observed across body weight quartiles in patients with asthma who received tezepelumab 210 mg subcutaneously Q4W. There was no apparent relationship between tezepelumab exposure and efficacy at this dose regimen, suggesting that it is on the plateau of the exposure‐response curve of tezepelumab. In conclusion, a fixed‐dose regimen of tezepelumab 210 mg subcutaneously Q4W is appropriate for eligible adults and adolescents with severe, uncontrolled asthma.
    Type of Medium: Online Resource
    ISSN: 0091-2700 , 1552-4604
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2010253-7
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  • 10
    Online Resource
    Online Resource
    American Society for Microbiology ; 2019
    In:  Antimicrobial Agents and Chemotherapy Vol. 63, No. 5 ( 2019-05)
    In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 63, No. 5 ( 2019-05)
    Abstract: The riminophenazine agent clofazimine (CFZ) is repurposed as an important component of the new short-course multidrug-resistant tuberculosis regimen and significantly shortens first-line regimen for drug-susceptible tuberculosis in mice. However, CFZ use is hampered by its unwelcome skin discoloration in patients. A new riminophenazine analog, TBI-166, was selected as a potential next-generation antituberculosis riminophenazine following an extensive medicinal chemistry effort. Here, we evaluated the activity of TBI-166 against Mycobacterium tuberculosis and its potential to accumulate and discolor skin. The in vitro activity of TBI-166 against both drug-sensitive and drug-resistant M. tuberculosis is more potent than that of CFZ. Spontaneous mutants resistant to TBI-166 were found at a frequency of 2.3 × 10 −7 in wild strains of M. tuberculosis . TBI-166 demonstrates activity at least equivalent to that of CFZ against intracellular M. tuberculosis and in low-dose aerosol infection models of acute and chronic murine tuberculosis. Most importantly, TBI-166 causes less skin discoloration than does CFZ despite its higher tissue accumulation. The efficacy of TBI-166, along with its decreased skin pigmentation, warrants further study and potential clinical use.
    Type of Medium: Online Resource
    ISSN: 0066-4804 , 1098-6596
    RVK:
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2019
    detail.hit.zdb_id: 1496156-8
    SSG: 12
    SSG: 15,3
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