International journal of clinical pharmacology and therapeutics最新文献

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Balancing efficacy and adverse reactions using everolimus in a patient with metastatic malignant insulinoma: Case report. 平衡依维莫司在转移性恶性胰岛素瘤患者中的疗效和不良反应:病例报告。
IF 0.9 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-06-01 DOI: 10.5414/CP204503
Siham Rouf, Khadija Boujtat, Tijani El Harroudi, Hanane Latrech
{"title":"Balancing efficacy and adverse reactions using everolimus in a patient with metastatic malignant insulinoma: Case report.","authors":"Siham Rouf, Khadija Boujtat, Tijani El Harroudi, Hanane Latrech","doi":"10.5414/CP204503","DOIUrl":"10.5414/CP204503","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant insulinoma is a rare neuroendocrine tumor responsible for excessive insulin secretion and life-threatening hypoglycemia episodes. Computed tomography (CT) of the abdomen can identify a pancreatic tumor corresponding to insulinoma. Loco-regional metastases define the metastatic cases. The first-line therapeutic approach is surgery, while other medical treatments like diazoxide and everolimus play also a role. These treatments have shown efficacy in regulating blood glucose and, to some extent, controlling tumor progression.</p><p><strong>Case presentation: </strong>We present the case of a 48-year-old female who was admitted for severe hypoglycemia episodes. She presented neuroglycopenic symptoms without any other clinical features. High levels of C-peptide and insulin during severe hypoglycemia confirmed the presence of endogenous hyperinsulinism. The CT scan of the abdomen confirmed the existence of an insulinoma along with several hepatic metastases. Surgery was proposed as a first-line approach. However, due to the persistent occurrence of severe hypoglycemia episodes, other treatment options were necessary such as diazoxide and everolimus. Diazoxide caused a significant improvement in the patient's blood glucose levels. Nonetheless, glycemic control was unsustainable, obligating the switch to everolimus, which showed better control of blood glucose levels with challenging management due to the appearance of grade 3 stomatitis as a side effect. The patient died 1 year after the diagnosis due to tumor progression.</p><p><strong>Conclusion: </strong>Balancing the benefits of enhanced glycemic control with the difficulties posed by side effect management of everolimus underscores the need to carefully consider both efficacy and potential adverse events.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"278-283"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and safety of antiplatelet therapy in COVID-19: Insights from a meta-analysis of randomized controlled trials. COVID-19中抗血小板治疗的有效性和安全性:随机对照试验荟萃分析的启示。
IF 0.9 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204497
Guoying Kao, Yunlin Chen, Jinqi Fan
{"title":"Efficacy and safety of antiplatelet therapy in COVID-19: Insights from a meta-analysis of randomized controlled trials.","authors":"Guoying Kao, Yunlin Chen, Jinqi Fan","doi":"10.5414/CP204497","DOIUrl":"10.5414/CP204497","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 induces a pro-coagulant state with thrombotic events. This meta-analysis explores the efficacy and safety of antiplatelet-based therapy in COVID-19 patients through randomized controlled trials (RCTs).</p><p><strong>Materials and methods: </strong>A systematic literature search until March 10, 2023, identified 7 RCTs involving 23,415 inpatients. Of these, 11,891 received antiplatelet-based treatment, and 11,524 received placebo/other drugs. Statistical analysis was performed using Review Manager 5.4.</p><p><strong>Results: </strong>The included trials involved patients with a mean age ranging from 54.3 to 62.0 years and a prevalence of hypertension ranging from 10.9 to 65.0% and coronary artery disease ranging from 3.2 to 32.7%. The pooled analysis showed no significant difference in overall mortality between groups (RR 1.0, 95% CI 0.99 - 1.01, p = 0.76). However, antiplatelet therapy significantly reduced major thrombotic events (RR 0.86, 95% CI 0.75 - 0.99, p = 0.04). Conversely, it increased major bleeding risks (RR 1.62, 95% CI 1.24 - 2.12, p = 0.0005). There was no significant difference in the incidence of invasive mechanical ventilation and respiratory death.</p><p><strong>Conclusion: </strong>Antiplatelet therapy does not confer mortality benefit in COVID-19 patients but lowers major thrombotic events while increasing major bleeding risks. Ongoing large RCTs will provide more information on the therapeutic value of this therapy.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"195-203"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low albumin combined with low-molecular-weight heparin as risk factors for liver injury using azvudine: Evidence from an analysis of COVID-19 patients in a national prospective pharmacovigilance database. 低白蛋白合并低分子量肝素是阿兹夫定导致肝损伤的风险因素:来自国家前瞻性药物警戒数据库中 COVID-19 患者分析的证据。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204544
Hong Lu, Ying Zeng, Qun-Zhi Shi, Lin Liu, Yong-Qing Gong, Sen Li, Pan Yan
{"title":"Low albumin combined with low-molecular-weight heparin as risk factors for liver injury using azvudine: Evidence from an analysis of COVID-19 patients in a national prospective pharmacovigilance database.","authors":"Hong Lu, Ying Zeng, Qun-Zhi Shi, Lin Liu, Yong-Qing Gong, Sen Li, Pan Yan","doi":"10.5414/CP204544","DOIUrl":"10.5414/CP204544","url":null,"abstract":"<p><strong>Objective: </strong>Azvudine is an effective treatment for patients infected with common COVID-19. However, physicians have reported a series of adverse reactions, including multiple cases of liver injury, caused by azvudine in clinical practice. This study assessed the incidence, clinical features, and associated risk factors of liver injury induced by azvudine in real-world settings, offering guidance for safe clinical use.</p><p><strong>Materials and methods: </strong>This study utilized the Chinese Hospital Pharmacovigilance System (CHPS) to retrospectively analyze the treatment of COVID-19 patients with azvudine at Changsha Central Hospital from December 19, 2022, to June 6, 2023. A case-control study was conducted to analyze the occurrence of azvudine-induced liver injury in COVID-19 patients who triggered a CHPS alert compared to normal COVID-19 patients.</p><p><strong>Results: </strong>Among the total of 2,141 COVID-19 patients, 31 (1.45%) developed azvudine-induced liver injury, which is classified as an occasional adverse reaction. Liver injury was observed in 93.55% of patients between days 4 and 12 of the azvudine treatment, with elevated transaminases as the primary clinical manifestation. Univariate and binary logistic regression analyses indicated that low albumin levels and co-administration of low-molecular-weight heparin were statistically significant risk factors (p < 0.05).</p><p><strong>Conclusion: </strong>This study represents the first investigation of azvudine-induced liver injury and high-risk patients using the CHPS. The findings provide valuable insights to promote the safety of anti-COVID-19 drugs, serving as an important reference for future drug safety measures.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"222-228"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of vancomycin area under the curve calculated based on Bayesian approach versus equation-based approach. 基于贝叶斯方法计算的万古霉素曲线下面积与基于方程方法计算的万古霉素曲线下面积的比较。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204508
Eojin Lee, Uijeong Yu, Ji In Park, Sang-In Park
{"title":"Comparison of vancomycin area under the curve calculated based on Bayesian approach versus equation-based approach.","authors":"Eojin Lee, Uijeong Yu, Ji In Park, Sang-In Park","doi":"10.5414/CP204508","DOIUrl":"10.5414/CP204508","url":null,"abstract":"<p><strong>Objective: </strong>Area under the curve (AUC)-based vancomycin dose adjustment is recommended to treat methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections. AUC estimation methods include Bayesian software programs and simple analytical equations. This study compared the AUC obtained using the Bayesian approach with that obtained using an equation-based approach.</p><p><strong>Materials and methods: </strong>Patients receiving intravenous vancomycin for MRSA infection were included. Peak and trough levels were measured for each patient on days 3, 7, and 10 post vancomycin dosing (day 1). AUC was calculated using software based on the Bayesian method (MwPharm Online) and an equation-based calculator, Stanford Health Care (SHC) calculator.</p><p><strong>Results: </strong>The AUC estimated using MwPharm Online was similar to that estimated using the SHC calculator. The geometric mean ratio (GMR) and their 90% confidence intervals (90% CI) were 1.08 (1.05 - 1.11), 1.03 (0.99 - 1.07), and 0.99 (0.94 - 1.05) at days 3, 7, and 10, respectively. Furthermore, according to the software used, there were no significant differences in the proportions of patients in the categories \"within\" and \"below or above\" the AUC target range. Additionally, trough levels predicted by both software programs were lower than the observed ones. Still, there was no significant difference between the predicted and observed peak levels for both software programs on day 10.</p><p><strong>Conclusion: </strong>AUC calculated using the Bayesian software allows for calculation with samples at a non-steady state, can integrate covariates, and is interconvertible with that estimated using an equation-based calculator, which is simpler and relies on fewer assumptions. Therefore, either method can be used, considering each method's strengths and limitations.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"204-212"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the risk factors for the failure of a single prophylactic dose of anticholinergic drugs for irinotecan-induced cholinergic symptoms. 评估针对伊立替康诱发的胆碱能症状单次预防性服用抗胆碱能药物失败的风险因素。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204531
Takuya Watanabe, Yoshitaka Saito, Yoh Takekuma, Yasushi Shimizu, Ichiro Kinoshita, Yoshito Komatsu, Mitsuru Sugawara
{"title":"Evaluation of the risk factors for the failure of a single prophylactic dose of anticholinergic drugs for irinotecan-induced cholinergic symptoms.","authors":"Takuya Watanabe, Yoshitaka Saito, Yoh Takekuma, Yasushi Shimizu, Ichiro Kinoshita, Yoshito Komatsu, Mitsuru Sugawara","doi":"10.5414/CP204531","DOIUrl":"10.5414/CP204531","url":null,"abstract":"<p><strong>Objective: </strong>Irinotecan (IRI) is an anticancer drug that is frequently used to treat colorectal, gastric, and pancreatic cancers. Its side effects include cholinergic symptoms, such as diarrhea, abdominal pain, nausea, and hyperhidrosis. Anticholinergic medicines are frequently used for treatment or prophylaxis; however, the risk factors for the failure of a single prophylactic anticholinergic administration remain unclear. Moreover, an appropriate anticholinergic drug for prophylaxis remains unknown. Thus, we aimed to identify the risk factors associated with the failure of a single prophylactic dose of anticholinergic drugs for IRI-induced cholinergic symptoms and to evaluate the usefulness of multiple prophylactic doses of anticholinergic drugs.</p><p><strong>Materials and methods: </strong>Patients who underwent IRI treatment for colorectal, gastric, or pancreatic cancer and received prophylactic anticholinergic drugs for IRI-induced cholinergic symptoms (n = 135) were retrospectively evaluated. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for failure of a single prophylactic dose of anticholinergic drugs. We also evaluated the efficacy of multiple prophylactic anticholinergic drug administration.</p><p><strong>Results: </strong>Based on univariate and multivariate analyses, colorectal cancer, female sex, and prophylactic use of scopolamine butyl bromide were identified as risk factors for failure of a single prophylactic dose of anticholinergic drugs. The efficacy of multiple prophylactic doses was confirmed to be 95% of the patients who had a single prophylactic failure due to temporary effect but symptom appearance after a certain period of time (wearing-off).</p><p><strong>Conclusion: </strong>We determined that colorectal cancer, female sex, and prophylactic use of scopolamine butyl bromide were risk factors associated with the failure of a single prophylactic dose of anticholinergic drugs, and that multiple prophylactic doses for wearing-off can be a promising method.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"213-221"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical implications and future prospects of levonorgestrel and piroxicam as a combined emergency contraceptive regimen. 左炔诺孕酮和吡罗昔康作为联合紧急避孕方案的临床意义和未来前景。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204537
Jiawei Ke, Jingrui Cai, Xiaolin Liu, Liwen Chen, Tianhui Liu, Zhipeng Ruan, Chengfei Zhao
{"title":"Clinical implications and future prospects of levonorgestrel and piroxicam as a combined emergency contraceptive regimen.","authors":"Jiawei Ke, Jingrui Cai, Xiaolin Liu, Liwen Chen, Tianhui Liu, Zhipeng Ruan, Chengfei Zhao","doi":"10.5414/CP204537","DOIUrl":"10.5414/CP204537","url":null,"abstract":"","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"229-230"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of SB17 and reference ustekinumab in healthy adults: A randomized, double-blind, single-dose, phase I study. 在健康成人中比较 SB17 和参考药物乌司替尼:随机、双盲、单剂量 I 期研究。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2024-05-01 DOI: 10.5414/CP204492
Hansol Jeong, Taeseung Kang, Jiyoon Lee, Seongsik Im
{"title":"Comparison of SB17 and reference ustekinumab in healthy adults: A randomized, double-blind, single-dose, phase I study.","authors":"Hansol Jeong, Taeseung Kang, Jiyoon Lee, Seongsik Im","doi":"10.5414/CP204492","DOIUrl":"10.5414/CP204492","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the pharmacokinetic (PK) characteristics of SB17 (Samsung Bioepis, Incheon, Republic of Korea), a proposed biosimilar of ustekinumab (UST) against reference UST (Stelara, Janssen Biotech, Horsham, PA, USA).</p><p><strong>Materials and methods: </strong>This double-blind, three-arm, parallel-group, single-dose study randomized 201 healthy adult subjects 1 : 1 : 1 to receive 45 mg of SB17, European Union-sourced UST (EU-UST) or United States of America-sourced UST (US-UST) via subcutaneous (SC) injection. Primary endpoints were area under the concentration-time curve from time zero to infinity (AUC<sub>inf</sub>) and maximum serum concentration (C<sub>max</sub>). Safety, tolerability, and immunogenicity were investigated.</p><p><strong>Results: </strong>All 90% confidence intervals (CIs) for the ratios of AUC<sub>inf</sub> and C<sub>max</sub> between groups were within the predefined bioequivalence margin of 0.8 - 1.25. The geometric LSMeans ratios of AUC<sub>inf</sub> and C<sub>max</sub> were 0.99 and 0.90 for SB17/EU-UST, 1.01 and 0.94 for SB17/US-UST, and 1.02 and 1.05 for EU-UST/US-UST, respectively. The proportion of subjects with treatment-emergent adverse events (TEAEs) was comparable between SB17, EU-UST, and US-UST (68.7, 58.2, and 65.7%). No deaths, serious adverse events (SAEs), or severe TEAEs were reported. The incidence of subjects testing positive for post-dose anti-drug antibodies (ADAs) was 26.9%, 34.3%, and 34.3% in the SB17, EU-UST, and US-UST groups, respectively. Among the subjects with a positive ADA result at day 99/end of study, 53.8% (SB17 n = 5, EU-UST n = 12, and US-UST n = 11) were positive for neutralizing antibodies (NAbs).</p><p><strong>Conclusion: </strong>This study demonstrated bioequivalence of SB17, EU-UST, and US-UST in terms of PK. Safety, tolerability, and immunogenicity were also comparable between all groups.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":" ","pages":"231-240"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The characteristics and regulations of adaptive designs from 2008 to 2020: An overview of European Medicines Agency approvals. 适应性设计的特点和法规,从2008年到2020年:欧洲药品管理局批准概述。
IF 0.9 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2023-10-01 DOI: 10.5414/CP204422
Xiaowei Huang, Jianbin Ma, Zhenzhen Lu, Lihong Huang
{"title":"The characteristics and regulations of adaptive designs from 2008 to 2020: An overview of European Medicines Agency approvals.","authors":"Xiaowei Huang, Jianbin Ma, Zhenzhen Lu, Lihong Huang","doi":"10.5414/CP204422","DOIUrl":"10.5414/CP204422","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify and characterize all European Medicines Agency (EMA) approvals derived from adaptive designs in clinical trials and to provide an update of the current status of these drugs.</p><p><strong>Materials and methods: </strong>Relevant files were identified in the EMA database for annual reports for the period between 2008 and 2020 using a list of suitable keywords related to adaptive designs. We recorded trial characteristics from drug approvals and used Fisher exact test to compare the characteristics.</p><p><strong>Results: </strong>A total of 1,054 EMA approvals were identified, and the percentage of EMA approvals planned with adaptive trial designs increased from 1.85% in the period 2008 - 2012 to 6.19% in between 2017 - 2020. A total of 41 approvals were identified among 91 original EMA files that contained adaptive designs. The types of adaptive designs used in clinical trials increased after 2017 where the most common type used was the most common (17/41). Most approvals (32/41) comprised pivotal trials, and most assessments had not been accelerated (38/41). Of 32 confirmatory trials planned with adaptive designs, the proportion of those with additional monitoring (AM) increased significantly (p < 0.0001) from 0% in the 2008 - 2012 period to 90.48% in the 2017 - 2020 period. The percentage of approved antitumor drugs in approved drugs in ongoing clinical trials was 82.35%, compared to 20.83% in trials that were completed (p = 0.0001). The proportion of drug approved but where clinical trials were still ongoing in companies requiring post-authorization safety studies (PASSs) or post-authorization efficacy studies (PAESs) or who were granted conditional marketing authorization (CMA) significantly differed from the group of drugs approved where clinical trials were completed (p = 0.0230).</p><p><strong>Conclusion: </strong>A trend showing an increased number of EMA approvals related to adaptive designs was observed for the period from 2008 to 2020. Different types of adaptive trial designs could be encouraged for the designation of clinical trials, especially for antitumor drugs; meanwhile, more stringent monitoring regulations seemed to be conducted for ongoing trials of antitumor drugs with adaptive design.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":"61 10","pages":"445-454"},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10230115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risks of malignant lymphoma in rheumatoid arthritis patients receiving methotrexate-alone and in combination therapy compared with the general population: A study based on a Japanese medical claims database. 与普通人群相比,接受甲氨蝶呤单独和联合治疗的类风湿性关节炎患者患恶性淋巴瘤的风险:一项基于日本医疗索赔数据库的研究。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2023-10-01 DOI: 10.5414/CP204372
Ryo Inose, Arisa Nakamura, Rina Omi, Shujiro Takeno, Yuichi Muraki
{"title":"Risks of malignant lymphoma in rheumatoid arthritis patients receiving methotrexate-alone and in combination therapy compared with the general population: A study based on a Japanese medical claims database.","authors":"Ryo Inose,&nbsp;Arisa Nakamura,&nbsp;Rina Omi,&nbsp;Shujiro Takeno,&nbsp;Yuichi Muraki","doi":"10.5414/CP204372","DOIUrl":"10.5414/CP204372","url":null,"abstract":"<p><strong>Objective: </strong>The risk of malignancy in patients with rheumatoid arthritis (RA) treated with methotrexate (MTX) and biological disease-modifying antirheumatic drug (bDMARD) combination therapy is unknown. This study aimed to clarify the incidence of malignancy and the recommended monitoring period in patients receiving this combination therapy.</p><p><strong>Materials and methods: </strong>A retrospective, observational study based on a large Japanese medical claims database was conducted between April 2013 and February 2020. Patients with RA were classified into MTX-alone and combination therapy groups, and the standardized incidence rates (SIR) of malignancy were calculated. The time of onset of malignancy in both groups was calculated.</p><p><strong>Results: </strong>In total, 2,052 patients received MTX-alone and 782 received combination therapy. The incidence of malignant lymphoma was significantly higher with MTX-alone therapy (SIR: 6.09, 95% confidence interval (CI): 1.58 - 10.61) and combination therapy (SIR: 20.86, 95% CI: 8.53 - 33.19) than in the general Japanese population. Furthermore, the combination therapy had a significantly higher risk of malignant lymphoma than the MTX-alone therapy (adjusted odds ratio: 4.27, 95% CI: 1.64 - 11.12). The median time from MTX prescription to the onset of malignant lymphoma was 3.58 years (interquartile range (IQR): 2.00 - 5.34 years) for MTX-alone and 3.42 years (IQR: 1.25 - 4.92 years) for combination therapy.</p><p><strong>Conclusion: </strong>The incidence of malignant lymphoma in the combination therapy group was extensively higher than that in the general Japanese population. Special attention is required for early symptoms of malignant lymphoma, particularly in the 3<sup>rd</sup> - 4<sup>th</sup> year after initiating MTX therapy.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":"61 10","pages":"430-436"},"PeriodicalIF":0.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Platelet count and dose, but not comorbidities, predict severe neutropenia in cabazitaxel-treated prostate cancer patients: A retrospective observational study. 血小板计数和剂量,而非合并症,预测卡巴他赛治疗的前列腺癌患者严重中性粒细胞减少:一项回顾性观察研究。
IF 0.8 4区 医学
International journal of clinical pharmacology and therapeutics Pub Date : 2023-09-01 DOI: 10.5414/CP204393
Noriaki Kataoka, Takeo Hata, Kouichi Hosomi, Atsushi Hirata, Emi Goto, Masami Nishihara, Teruo Inamoto, Haruhito Azuma, Masashi Neo
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