Drug Design, Development and Therapy最新文献

{"title":"Ternary Solid Dispersions as an Alternative Approach to Enhance Pharmacological Activity.","authors":"Salma Amaliah, Diah Lia Aulifa, Amirah Mohd Gazzali, Arif Budiman","doi":"10.2147/DDDT.S533359","DOIUrl":"10.2147/DDDT.S533359","url":null,"abstract":"<p><p>Poor solubility and limited bioavailability remain significant challenges in developing oral drugs, affecting the clinical efficacy of many active pharmaceutical ingredients (APIs). Enhancing solubility has become a primary focus in improving API bioavailability. Among the most commonly employed strategies are amorphous solid dispersions (ASDs) and co-amorphous systems, collectively called binary systems. However, these systems often suffer from wettability and physicochemical limitations, which can hinder drug release. Adding a third component to form ternary solid dispersions (TSDs) significantly enhance drug release and bioavailability, ultimately improving therapeutic outcomes. While numerous studies have investigated the application of TSDs in enhancing API pharmacological activity, only limited studies have a comprehensive analysis of this approach. Therefore, this review aims to summarize and elucidate the mechanisms of TSD systems in improving pharmacological activity. The review includes available literature from Scopus, PubMed, and Google Scholar that utilizes the keywords \"ternary solid dispersion\" and \"pharmacological activity\", summarizing the importance of TSDs in therapeutic formulations for enhancing pharmacological activity. Various in vitro and in vivo studies consistently demonstrate that TSDs outperform binary systems by significantly enhancing the pharmacological effects of diverse therapeutic agents, including those with antioxidant, anti-inflammatory, anticancer, antibacterial, anticholinesterase, antihyperlipidemic, anti-hypoglycemic, anti-Alzheimer's, antidiabetic, and hepatoprotective properties. This approach holds significant promise as an alternative for the formulation of low-solubility pharmaceuticals.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5663-5684"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide Therapy and Accelerated Sarcopenia in Older Adults with Type 2 Diabetes: A 24-Month Retrospective Cohort Study.","authors":"Qingjuan Ren, Lei Zhi, Hongfang Liu","doi":"10.2147/DDDT.S531778","DOIUrl":"10.2147/DDDT.S531778","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate changes in muscle mass and strength among older adults with type 2 diabetes who were treated with Semaglutide.</p><p><strong>Methods: </strong>This was a retrospective cohort study comparing elderly patients with type 2 diabetes receiving Semaglutide to a matched control group. Changes in muscle mass and function over 24 months were assessed. Muscle mass was measured using the appendicular skeletal muscle mass index (ASMI), while muscle function was evaluated through grip strength and gait speed measurements. Differences between the two groups and changes before and after treatment were analyzed using the <i>t</i>-test. Additionally, multivariable linear regression models were constructed to identify clinical predictors of accelerated muscle loss during Semaglutide treatment.</p><p><strong>Results: </strong>The study involved 220 patients treated with Semaglutide and 212 control subjects. The prevalence of sarcopenia among participants was 27.7%. Semaglutide treatment significantly reduced both body mass index and muscle mass compared to controls. Notably, divergent patterns emerged in functional measures. Grip strength initially improved but then declined in men, while it continued to decrease in women. Gait speed significantly reduced in both genders. Multivariable analysis identified Semaglutide dosage, baseline ASMI, and gait speed as independent predictors of muscle loss.</p><p><strong>Conclusion: </strong>The use of Semaglutide is associated with muscle loss and functional decline in older adults with type 2 diabetes, particularly at higher doses. This effect is especially significant in patients with sarcopenia. Consequently, it is crucial to assess the risks and benefits for each elderly patient individually and to implement appropriate monitoring and interventions. The potential for nutritional supplementation and targeted exercise regimens to counteract semaglutide-associated muscle decline merits systematic investigation.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5645-5652"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alfentanil Enhanced the Sedation of Remimazolam During Anaesthesia Induction in Patients Undergoing Urological Day Surgery: A Randomised Controlled Trial.","authors":"Yuliu Lin, Qiuling Chen, Yeqing Liao, Bing Xu, Cuiwen Zhang, Jiaxin Luo, Susu Liu, Xiaoshan Wu, Xuehai Guan","doi":"10.2147/DDDT.S508941","DOIUrl":"10.2147/DDDT.S508941","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam is a novel benzodiazepine sedative agent. Combining opioids with sedatives exerts a synergistic effect. The aim is to investigate whether alfentanil enhances sedative effects of remimazolam during anaesthesia induction in patients undergoing urological day surgery.</p><p><strong>Methods: </strong>This was a single-centre, single-blinded, randomised clinical trial. The study was conducted between 1 September 2022 and 31 December 2023. We included 114 patients undergoing urological day surgery under general anaesthesia. Patients were randomly assigned to the RMZ-AF or AF-RMZ group (n=57). During induction, the RMZ-AF group received remimazolam then alfentanil, and the AF-RMZ group received alfentanil then remimazolam. Primary outcome was the time from remimazolam administration to loss of consciousness (LOC) during induction. Secondary outcomes included anaesthetic and surgical characteristics, vital signs, and adverse events.</p><p><strong>Results: </strong>The time from remimazolam administration to LOC was shorter in the AF-RMZ group compared with the RMZ-AF group (87.3 [25.7] s vs 132.3 [32.3] s, <i>P</i><0.0001). Similarly, the time from remimazolam administration to a bispectral index (BIS) ≤ 60 was shorter in the AF-RMZ group compared with the RMZ-AF group (168.2 [58.1] s vs 207.8 [61.6] s, <i>P</i>=0.0006). Although no significant difference in the total amount of remimazolam administration between groups was observed, the RMZ-AF group required a higher dose of remimazolam to achieve LOC (<i>P</i><0.0001) and to reach a BIS of ≤ 60 (<i>P</i>=0.0058). No significant differences were observed between groups in the total administration of alfentanil, ephedrine, rocuronium, or crystalloid infusion volumes. The most common adverse events were hypotension, hypertension, and tachycardia, with no significant difference between groups.</p><p><strong>Conclusion: </strong>Alfentanil enhanced remimazolam's sedative effects during anaesthesia induction in patients undergoing urological day surgery. The combination of remimazolam and alfentanil for general anaesthesia would improve efficacy, reducing the adverse effects and dosage of drug. But the potential mechanisms need further study.</p><p><strong>Clinical trial registration: </strong>The trial was registered before patient enrolment at http://www.chictr.org.cn (ChiCTR2200064130, principal investigator: Xuehai Guan; date of registration: 27 September 2022, https://www.chictr.org.cn/showproj.html?proj=179023).</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5653-5662"},"PeriodicalIF":4.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Antihypertensive Drug Use and Irrational Prescriptions Among Elderly Patients in China (2016-2023): A Nationwide Multi-Center Cross-Sectional Survey Study.","authors":"Dongsheng Hong, Weihao Chen, Shuangshuang Du, Jinshuai Ren, Duo Lv, Wenya Shan, Xiaoyang Lu, Qingwei Zhao","doi":"10.2147/DDDT.S518377","DOIUrl":"10.2147/DDDT.S518377","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension is a common chronic condition among the elderly, and the rational use of antihypertensive medications is critical for blood pressure control. This study aimed to investigate trends in the use and irrational prescription of antihypertensive medications among elderly patients with hypertension in China from 2016 to 2023.</p><p><strong>Patients and methods: </strong>A retrospective cross-sectional design was applied to analyze the prescription of antihypertensive drugs in hypertensive patients aged 65 years and above, utilizing outpatient electronic medical record data from 78 hospitals in nine cities in China from 2016 to 2023. Antihypertensive medications were categorized into nine classes based on hypertension treatment guidelines. Annual trends in the use of these medications were analyzed using Annual Percentage Change (APC). Irrational prescriptions were defined as contraindicated medication prescriptions and inappropriate combination medication. Poisson regression models were employed to analyze trends and influencing factors for irrational prescriptions.</p><p><strong>Results: </strong>The number of patients increased from 396,408 to 542,215 during the study period. Calcium Channel Blockers had the highest usage but showed a slight decrease (APC=-3.46%, <i>P</i>=0.011), while <i>β</i>-blockers showed a slight increase (APC=1.48%, <i>P</i>=0.028). The overall proportion of first-line antihypertensive prescriptions was 97.47% but showed a slight declining trend (APC=-0.66%, <i>P</i>=0.004). The rates of inappropriate combination medication and overall irrational prescriptions decreased, while the rate of contraindicated medication prescriptions increased (<i>P</i><0.001). Factors including male gender, advanced age (≥85 years), northern regions, primary healthcare settings, and geriatrics departments were associated with higher risks of contraindicated medications.</p><p><strong>Conclusion: </strong>This study reveals the trends and patterns in antihypertensive medication use among elderly hypertensive patients in China from 2016 to 2023. While the overall use of first-line antihypertensive drugs remained high, there were differences across subgroups. The increasing rate of contraindicated medications and the identification of high-risk groups and clinical settings provide important insights for optimizing antihypertensive treatment in elderly populations.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5633-5644"},"PeriodicalIF":4.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"An Effective Solution to Accelerate the Healing of Complex Ulcers Using Recombinant Human Epidermal Growth Factor (Intralesional Application): A Review\".","authors":"Maria Teresa Cacua Sánchez, Carlos Alberto Carillo Bravo","doi":"10.2147/DDDT.S517489","DOIUrl":"10.2147/DDDT.S517489","url":null,"abstract":"<p><p>Chronic and complex ulcers of the lower limbs constitute a common, persistent, and clinically significant complication, particularly in patients with diabetes, peripheral vascular disease, and other dermatological conditions. These lesions are characterized by impaired healing, high recurrence rates, and a substantial risk of infection, amputation, and functional decline, thereby posing a considerable burden on both patients and healthcare systems. In response to this unresolved clinical need, recombinant human epidermal growth factor (rhEGF) has emerged as an innovative and effective therapeutic strategy. By stimulating cell proliferation, angiogenesis, and tissue regeneration, rhEGF reactivates essential biological processes that are typically impaired in such lesions, thereby promoting accelerated and functional wound healing. Additionally, its anti-inflammatory and antioxidant properties contribute to reducing associated complications, such as infection. Accumulated scientific evidence over recent years has strengthened the support for its clinical use, with multiple studies-including controlled trials, retrospective analyses, and systematic reviews-demonstrating consistent outcomes across various clinical settings. In practice, rhEGF has been established as a safe and effective therapeutic tool with the potential to transform the conventional management of chronic and complex ulcers, improving clinical outcomes and enhancing patients' quality of life.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5615-5631"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Insights into Flavonoid Subclasses as Cardioprotective Agents Against Doxorubicin-Induced Cardiotoxicity: A Comprehensive Review.","authors":"Wei Shang, Xin-Hui Li, Lang-Hong Zeng, Zhi Li, Yu Hu, Hui-Min Wen, Feng-Jun Cao, Guo-Xing Wan","doi":"10.2147/DDDT.S535517","DOIUrl":"10.2147/DDDT.S535517","url":null,"abstract":"<p><p>Doxorubicin (DOX) is an anthracycline chemotherapeutic agent widely used for treating various malignancies due to its remarkable efficacy. However, the dose-limiting cardiotoxicity induced by DOX remains a critical clinical concern with limited therapeutic strategy. Several molecular mechanisms underlying the pathogenesis of doxorubicin-induced cardiotoxicity (DIC) have been proposed, including oxidative stress, dysregulation of Top2β, mitochondrial damage, imbalance of calcium homeostasis, ferroptosis, and inflammatory responses. Increasing studies have posed the promise of the natural products flavonoids against DIC attributed to its advantages in antioxidant activity as well as anti-cancer properties. This paper reviews relevant publications to date and comprehensively summarizes the evidence from preclinical and clinical studies in support of the cardioprotective effect of seven flavonoids subclasses against DIC, including flavones with 18 compounds, flavonols with 11 compounds, isoflavones with 7 compounds, flavanones with 6 compounds, chalcones with 3 compounds, flavanols with 2 compounds and anthocyanins with 2 compounds. Specially, several lines of evidence have also demonstrated the anti-cancer property of flavonoids in addition to the cardioprotective property. This review synthesizes comprehensive mechanistic and translational insights to inform future preclinical and clinical investigations aiming at integrating flavonoid-based interventions into oncotherapeutic regimens. The accumulated evidence underscores flavonoids as promising candidates for DIC as well as adjuvant cancer therapy.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5553-5596"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Traditional Chinese Medicine for Managing Diminished Ovarian Reserve: Mechanisms and Clinical Insights.","authors":"Yonghui Liu, Mingchan Wei, Yasheng Deng, Yanping Fan, Yiqing Zheng, Zhaobing Ni, Jiang Lin","doi":"10.2147/DDDT.S505689","DOIUrl":"10.2147/DDDT.S505689","url":null,"abstract":"<p><p>Diminished Ovarian Reserve (DOR) is characterised by a decrease in the number and quality of oocytes, accompanied by biological markers such as a decrease in anti-Müllerian hormone (AMH), a decrease in the sinus follicle count (AFC), and an increase in follicle stimulating hormone (FSH). In response to the limitations of modern medical treatments, traditional Chinese medicine (TCM) has demonstrated unique advantages in the treatment of DOR. In this paper, we systematically reviewed the literature in the past decade to analyse the scientific content of TCM intervention in DOR from the dimensions of molecular mechanism and clinical application. It was found that single components (paeoniflorin, <i>Epimedium</i> glycosides, etc.), TCM pairs (<i>Cuscuta chinensis-Sambucus nigra and Semencuspidatae</i>-<i>Epimedium</i>), TCM combinations (Liuweidihuangwan, Haifuyuyuyuitang, <i>Angelica sinensis-Paeonia lactiflora</i>, etc.), and a variety of acupuncture therapies can improve the ovarian function through a multi-targeted modulation mechanism: ① regulating the signalling pathways, such as PI3K/AKT, to promote the development of the follicle; ②regulating the hypothalamic-pituitary-ovarian axis balance hormone levels; ③enhance anti-oxidative stress through Nrf2/HO-1/NLRP3 signalling; ④inhibit the expression of granulosa cell apoptosis-related factors (Bax/Caspase-3). Clinical data showed that TCM interventions significantly increased AMH levels, increased AFC and decreased FSH levels in patients. The study confirms that TCM exerts therapeutic advantages through multi-component synergistic effects, from improving the ovarian microenvironment, regulating reproductive endocrinology, delaying follicular atresia, etc. which provides a theoretical basis and practical reference for the integrated treatment of DOR. It is suggested that standardised clinical studies should be carried out to establish an evaluation system for the efficacy of TCM and to promote the development of precise treatment options.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5597-5614"},"PeriodicalIF":4.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric and Visualized Analysis of Artemisinin and Its Derivatives in Cancer.","authors":"Jiaming Feng, Yuqing He, Ting Bai, Qianhui You, Huici Zhu, Chengyao Jia, Baonian Liu, Shaoling Li","doi":"10.2147/DDDT.S514219","DOIUrl":"10.2147/DDDT.S514219","url":null,"abstract":"<p><strong>Background: </strong>Artemisinin, found in the traditional Chinese medicine (TCM) <i>Artemisia annua</i>, has demonstrated remarkable efficacy in therapeutics and holds significant potential as a pharmaceutical drug in cancer. Until now, there have been no systematic scientometrics studies to analyze the research trend of artemisinin and its derivatives in cancer.</p><p><strong>Aim of the study: </strong>We conducted this bibliometric study with the aim of providing researchers in the field with an all-around summary of artemisinin and its derivatives in cancer, visualizing current research advances, identifying hotspots, and ultimately outlining cutting-edge trends for future development.</p><p><strong>Methods: </strong>A total of 927 relevant publications from 1990 to 2023 were accessed from the WOSCC database and analyzed bibliometrically utilizing software including CiteSpace VOSviewer and Microsoft Excel.</p><p><strong>Results: </strong>Global publications in artemisinin and tumor therapy have steadily increased. China is considered the leading country in terms of publication numbers, and Chinese scholars have been influential in the field of artemisinin and its derivatives in the prevention and treatment of cancer. Cluster analysis of co-cited references depicted artemisinin-type drugs, bax-mediated intrinsic pathways, and infected erythrocytes as the most noteworthy topics. In contrast, the keywords analysis revealed a strong emphasis on the issues of cancer, in-vitro, cycle arrest, anticancer activity, and plasmodium-falciparum.</p><p><strong>Conclusion: </strong>This study provides a comprehensive overview of relevant research trends by explicitly analyzing the published literature associated with artemisinin and its derivatives in cancer. The results of this multifaceted analysis can provide valuable data that offers ample insights for the field and for researchers wishing to venture into the field.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5517-5538"},"PeriodicalIF":4.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Controlled Pilot Study Evaluating the Safety and Efficacy of Nifuroxazide in Patients with Ulcerative Colitis.","authors":"Hayam Ali AlRasheed, Mahmoud S Abdallah, Eman El-Khateeb, Marwa Kamal, Sarah Alrubia, Amsha S Alsegiani, Tarek I Ahmed, Mostafa M Bahaa","doi":"10.2147/DDDT.S522755","DOIUrl":"10.2147/DDDT.S522755","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic potential of nifuroxazide in colitis has been explored in several experimental studies of ulcerative colitis (UC).</p><p><strong>Aim: </strong>To evaluate the efficacy of nifuroxazide in patients with UC.</p><p><strong>Methods: </strong>Fifty patients with mild to moderate UC were randomly assigned into two groups (n = 25 each). The placebo group received a placebo alongside mesalamine (1 g three times daily [t.i.d.]) for six months. The nifuroxazide group received nifuroxazide (200 mg twice daily) in combination with mesalamine (1 g t.i.d). A gastroenterologist assessed disease severity using the partial Mayo score (PMS). Serum levels of C-reactive protein (CRP), nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), and signal transducer and activator of transcription 3 (STAT3) were measured before and after treatment. Quality of life was evaluated using the Inflammatory Bowel Disease Questionnaire (IBDQ-32). Primary outcomes: Change in PMS. Secondary outcomes: change in IBDQ-32 and in the level of measured biomarkers.</p><p><strong>Results: </strong>Baseline measurements were comparable between groups (p > 0.05). Post-treatment values showed significant improvements within both groups compared to baseline. However, the nifuroxazide group demonstrated significantly greater improvements than the placebo group, including reductions in PMS (p = 0.005) and increases in IBDQ scores (p = 0.002). Additionally, significant decreases were observed in IL-6 (p = 0.03), NF-κB (p = 0.03), CRP (p = 0.02), and STAT3 (p = 0.03) levels. The placebo group had a response rate of 56% (14/25) and a remission rate of 24% (6/25), whereas the nifuroxazide group achieved a response rate of 76% (19/25) and a remission rate of 56% (14/25), based on PMS.</p><p><strong>Conclusion: </strong>Co-administration of nifuroxazide with mesalamine improved clinical outcomes, including higher response and remission rates, reduced inflammation by reducing IL-6/STAT3, and enhanced quality of life in patients with UC, compared to mesalamine alone.</p><p><strong>Trial registration identifier: </strong>NCT05988528.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5539-5552"},"PeriodicalIF":4.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-Dependent Effects of Remimazolam on Early Perioperative Neurocognitive Disorders in Elderly Colorectal Cancer Patients Undergoing Laparoscopic Surgery.","authors":"Zhenqi Liu, Xinyu Zhang, Xuebing Wang, Ziyang Liu, Yong Pang","doi":"10.2147/DDDT.S502910","DOIUrl":"10.2147/DDDT.S502910","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of different doses of remimazolam on the maintenance of anesthesia and its impact on postoperative cognitive function in elderly patients undergoing laparoscopic colorectal surgery.</p><p><strong>Methods: </strong>A total of 120 elderly patients scheduled for laparoscopic colorectal surgery under general anesthesia (both sexes included, ASA grade (II-III) were randomly assigned to experimental groups (R1-R3) and control group (P), with 30 cases per group. The experimental groups received different remimazolam maintenance doses: R1 (0.5 mg/kg/h), R2 (1.0 mg/kg/h), and R3 (1.5 mg/kg/h), while the control group received propofol for sedation. Perioperative cognitive function was evaluated using MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) preoperatively, and on postoperative days 3 and 7, to analyze differences in cognitive effects and safety profiles of remimazolam across the four groups.</p><p><strong>Results: </strong>A total of 117 patients were ultimately included, with 3 excluded due to intraoperative conversion to open surgery. Participants were randomly allocated into four groups according to remimazolam maintenance dosing regimens: 30 in the R1 group, 28 in the R2 group, 30 in the R3 group, and 29 in the P group.There was no statistically significant difference in postoperative cognitive function scores between the R2 and R3 groups, and both groups had scores that were significantly higher than those of the R1 and P groups, with statistically significant differences.</p><p><strong>Conclusion: </strong>Compared to propofol, remimazolam at medium and high doses can reduce the incidence of perioperative neurocognitive dysfunction in elderly patients. High-dose remimazolam anesthesia maintenance may prolong extubation time, increase the incidence of postoperative shivering, and potentially lead to re-sedation after awakening, so medium-dose remimazolam is more suitable for intraoperative anesthesia maintenance in elderly patients without increasing the incidence of adverse events.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"5507-5516"},"PeriodicalIF":4.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}