Medicines (Basel, Switzerland)最新文献

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Evaluation of Nutritional Status in an Acute Geriatric Unit: Retrospective Study and Analysis of Frailty Syndrome. 急性老年病房的营养状况评估:衰弱综合征的回顾性研究和分析。
Medicines (Basel, Switzerland) Pub Date : 2023-03-08 DOI: 10.3390/medicines10030022
Abrar-Ahmad Zulfiqar, Ibrahima Amadou Dembele, Emmanuel Andres
{"title":"Evaluation of Nutritional Status in an Acute Geriatric Unit: Retrospective Study and Analysis of Frailty Syndrome.","authors":"Abrar-Ahmad Zulfiqar,&nbsp;Ibrahima Amadou Dembele,&nbsp;Emmanuel Andres","doi":"10.3390/medicines10030022","DOIUrl":"https://doi.org/10.3390/medicines10030022","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of our study is to evaluate the nutritional status of patients in an acute geriatric unit.</p><p><strong>Methods: </strong>Patients included in the study were hospitalized in an acute geriatric unit over a period of 6 months. The nutritional status of each patient was evaluated with anthropometric measurements (the BMI and MNA scales), and biological measurements (albumin). Frailty was evaluated using three scales: the Fried scale, the CFS and the modified SEGA scale.</p><p><strong>Results: </strong>A total of 359 patients were included, comprising 251 women (70%) with an average age of 85.28 years. The study showed that 102 elderly subjects were considered undernourished according to the BMI scale, 52 subjects were undernourished according to the MNA scale, and 50 subjects were undernourished according to their albumin levels. The relationships between undernutrition and frailty syndrome studied in our work show that elderly subjects who are undernourished according to the BMI and MNA scales are significantly frail according to Fried and Rockwood, whereas those who are undernourished according to their albumin levels are significantly frail according to Fried and the modified SEGA scale.</p><p><strong>Conclusion: </strong>The relationship between undernutrition and the frailty syndrome is close, and their joint screening is necessary, whether on an outpatient or in-hospital basis, in order to prevent negative events related to comorbidities and geriatric syndromes.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Dexamethasone on Abiraterone Pharmacokinetics in Mice: Determined by LC/MS Analysis. 地塞米松对阿比特龙在小鼠体内药动学的影响:LC/MS分析。
Medicines (Basel, Switzerland) Pub Date : 2023-03-06 DOI: 10.3390/medicines10030021
Subrata Deb, Mohamed Ben-Eltriki, Hans Adomat, Mei Y Chin, Emma S Tomlinson Guns
{"title":"Effect of Dexamethasone on Abiraterone Pharmacokinetics in Mice: Determined by LC/MS Analysis.","authors":"Subrata Deb,&nbsp;Mohamed Ben-Eltriki,&nbsp;Hans Adomat,&nbsp;Mei Y Chin,&nbsp;Emma S Tomlinson Guns","doi":"10.3390/medicines10030021","DOIUrl":"https://doi.org/10.3390/medicines10030021","url":null,"abstract":"<p><p><b>Background:</b> Abiraterone acetate is a cytochrome P450 17A1 (CYP17A1) inhibitor that is indicated for use in both castration-resistant and castration-sensitive prostate cancer patients. To manage the mineralocorticoid effects of CYP17A1 inhibition, a glucocorticoid such as dexamethasone is co-administered with abiraterone. The goal of the present study was to understand the effect of dexamethasone on the disposition of abiraterone. <b>Methods:</b> Adult male CD-1 mice were treated with either dexamethasone (80 mg/kg/day) or vehicle for three consecutive days, followed by the administration of a single dose of abiraterone acetate (180 mg/kg) as an oral gavage. Blood samples were collected by tail bleeding at timepoints between 0 to 24 h. Subsequently, abiraterone was extracted from the mouse serum using a neutral pH condition and serum abiraterone levels were determined using a liquid chromatography-mass spectrometry assay. <b>Results:</b> Our results demonstrated that dexamethasone lowered the maximum plasma concentration and area under the curve parameters by approximately five- and ten-fold, respectively. Similar effects were also observed on the plasma half-life and oral clearance parameters. This is the first report of dexamethasone effect on abiraterone disposition in vivo. <b>Conclusions:</b> We conclude that dexamethasone has the potential to reduce the plasma abiraterone level and thus compromise its CYP17A1 inhibitory ability in the procancerous androgen biosynthesis pathway. Thus, use of a higher abiraterone dose may be warranted when used alongside dexamethasone.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Everyday Evaluation of Herb/Dietary Supplement-Drug Interaction: A Pilot Study. 草药/膳食补充剂-药物相互作用的日常评估:一项初步研究。
Medicines (Basel, Switzerland) Pub Date : 2023-02-28 DOI: 10.3390/medicines10030020
Joao Victor Souza-Peres, Kimberly Flores, Bethany Umloff, Michelle Heinan, Paul Herscu, Mary Beth Babos
{"title":"Everyday Evaluation of Herb/Dietary Supplement-Drug Interaction: A Pilot Study.","authors":"Joao Victor Souza-Peres,&nbsp;Kimberly Flores,&nbsp;Bethany Umloff,&nbsp;Michelle Heinan,&nbsp;Paul Herscu,&nbsp;Mary Beth Babos","doi":"10.3390/medicines10030020","DOIUrl":"https://doi.org/10.3390/medicines10030020","url":null,"abstract":"<p><p>A lack of reliable information hinders the clinician evaluation of suspected herb-drug interactions. This pilot study was a survey-based study conceived as a descriptive analysis of real-life experiences with herb-drug interaction from the perspective of herbalists, licensed health-care providers, and lay persons. Reported dietary supplement-drug interactions were evaluated against the resources most commonly cited for the evaluation of potential supplement-drug interactions. Disproportionality analyses were performed using tools available to most clinicians using data from the U.S. Federal Adverse Event Reporting System (FAERS) and the US Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System (CAERS). Secondary aims of the study included exploration of the reasons for respondent use of dietary supplements and qualitative analysis of respondent's perceptions of dietary supplement-drug interaction. While agreement among reported supplement-drug interactions with commonly cited resources for supplement-drug interaction evaluation and via disproportionality analyses through FAERS was low, agreement using data from CAERS was high.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10055849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Benefit of Autologous Platelet-Rich Plasma Infusion in Ovarian Function Rejuvenation: Evidence from a Before-After Prospective Pilot Study. 自体富血小板血浆输注在卵巢功能恢复中的临床益处:来自前后前瞻性先导研究的证据。
Medicines (Basel, Switzerland) Pub Date : 2023-02-27 DOI: 10.3390/medicines10030019
Athanasios Garavelas, Panagiotis Mallis, Efstathios Michalopoulos, Eros Nikitos
{"title":"Clinical Benefit of Autologous Platelet-Rich Plasma Infusion in Ovarian Function Rejuvenation: Evidence from a Before-After Prospective Pilot Study.","authors":"Athanasios Garavelas,&nbsp;Panagiotis Mallis,&nbsp;Efstathios Michalopoulos,&nbsp;Eros Nikitos","doi":"10.3390/medicines10030019","DOIUrl":"https://doi.org/10.3390/medicines10030019","url":null,"abstract":"<p><p><b>Background</b>: The intraovarian administration of autologous platelet-rich plasma (PRP) acts beneficially for the stimulation of follicle production in women presenting different forms of ovarian dysfunction. This pilot study aimed to evaluate and provide significant data regarding the efficacy of PRP to rejuvenate the ovaries. <b>Methods:</b> A total of 253 women aged 22-56 years, were divided into five groups, based on their status. All participants signed for informed consent for the current study. Blood sampling, preparation of PRP and intraovarian infusion of the latter were performed on all participants. The evaluation of PRP efficacy, a two-month follow-up detecting the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-mullerian hormone (AMH), was performed for all participants. For women with advanced ages (>48 years), the restoration and regularity of the menstrual cycle were additionally evaluated. <b>Results:</b> After the two-month follow-up, the majority of the participants presented improvement in their hormonal profiles. Additionally, 17% of the women in this pilot study successfully conceived. The restoration of the menstrual cycle was detected in 15% of the women with advanced ages. <b>Conclusions:</b> Intraovarian infusion of autologous PRP exhibited remarkable evidence and promising results to restore ovarian insufficiency.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Fasting Protocols Do Not Improve Intestinal Architecture and Immune Parameters in C57BL/6 Male Mice Fed a High Fat Diet. 禁食方案无法改善以高脂肪饮食为食的 C57BL/6 雄性小鼠的肠道结构和免疫参数。
Medicines (Basel, Switzerland) Pub Date : 2023-02-17 DOI: 10.3390/medicines10020018
Raed Y Ageeli, Sunita Sharma, Melissa Puppa, Richard J Bloomer, Randal K Buddington, Marie van der Merwe
{"title":"Fasting Protocols Do Not Improve Intestinal Architecture and Immune Parameters in C57BL/6 Male Mice Fed a High Fat Diet.","authors":"Raed Y Ageeli, Sunita Sharma, Melissa Puppa, Richard J Bloomer, Randal K Buddington, Marie van der Merwe","doi":"10.3390/medicines10020018","DOIUrl":"10.3390/medicines10020018","url":null,"abstract":"<p><strong>Background: </strong>The intestinal ecosystem, including epithelium, immune cells, and microbiota, are influenced by diet and timing of food consumption. The purpose of this study was to evaluate various dietary protocols after ad libitum high fat diet (HFD) consumption on intestinal morphology and mucosal immunity.</p><p><strong>Methods: </strong>C57BL/6 male mice were fed a 45% high fat diet (HFD) for 6 weeks and then randomized to the following protocols; (1) chow, (2) a purified high fiber diet known as the Daniel Fast (DF), HFD consumed (3) ad libitum or in a restricted manner; (4) caloric-restricted, (5) time-restricted (six hours of fasting in each 24 h), or (6) alternate-day fasting (24 h fasting every other day). Intestinal morphology and gut-associated immune parameters were investigated after 2 months on respective protocols.</p><p><strong>Results: </strong>Consuming a HFD resulted in shortening of the intestine and reduction in villi and crypt size. Fasting, while consuming the HFD, did not restore these parameters to the extent seen with the chow and DF diet. Goblet cell number and regulatory T cells had improved recovery with high fiber diets, not seen with the HFD irrespective of fasting.</p><p><strong>Conclusion: </strong>Nutritional content is a critical determinant of intestinal parameters associated with gut health.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Low- and High-Frequency Auricular Stimulation with Electro-Acupuncture on Cutaneous Microcirculation: A Cross-Over Study in Healthy Subjects. 低频率和高频耳穴电刺激对皮肤微循环的影响:健康受试者的交叉研究。
Medicines (Basel, Switzerland) Pub Date : 2023-02-13 DOI: 10.3390/medicines10020017
Veronica Gagliardi, Giuseppe Gagliardi, Francesco Ceccherelli, Antonello Lovato
{"title":"Effect of Low- and High-Frequency Auricular Stimulation with Electro-Acupuncture on Cutaneous Microcirculation: A Cross-Over Study in Healthy Subjects.","authors":"Veronica Gagliardi,&nbsp;Giuseppe Gagliardi,&nbsp;Francesco Ceccherelli,&nbsp;Antonello Lovato","doi":"10.3390/medicines10020017","DOIUrl":"https://doi.org/10.3390/medicines10020017","url":null,"abstract":"<p><p><b>Background:</b> The regulation of microcirculation depends on the dynamic interaction of different factors: the autonomic nervous system plays a pivotal role in the blood flow and acupuncture can modulate it, obtaining different results depending on the site, the frequency, and the intensity of the stimulation. <b>Methods:</b> 18 healthy subjects have been enrolled and have undergone two sessions of electroacupuncture stimulations: one session using high frequency and one with low frequency. Microcirculation has been monitored continuously during stimulation using the laser Doppler method. <b>Results:</b> The microcirculatory parameters have shown a significant difference between high and low-frequency stimulation, suggesting that low-frequency stimulation is more effective for obtaining a vasodilator effect. <b>Discussion:</b> Our results show that low-frequency stimulation can increase the cutaneous microcirculatory flux, without significantly modifying blood pressure and heart rate. The auricular stimulation causes an increase in the activity of the vagus nerve, increasing the cholinergic activity without acting on post-junctional muscarinic receptors. <b>Conclusion:</b> Auricular acupuncture has a significant impact on the regulation of microcirculation.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Music Therapy in Global Aphasia: A Case Report. 音乐治疗在全球失语症:一个病例报告。
Medicines (Basel, Switzerland) Pub Date : 2023-01-23 DOI: 10.3390/medicines10020016
Adriana Piccolo, Francesco Corallo, Davide Cardile, Michele Torrisi, Chiara Smorto, Simona Cammaroto, Viviana Lo Buono
{"title":"Music Therapy in Global Aphasia: A Case Report.","authors":"Adriana Piccolo,&nbsp;Francesco Corallo,&nbsp;Davide Cardile,&nbsp;Michele Torrisi,&nbsp;Chiara Smorto,&nbsp;Simona Cammaroto,&nbsp;Viviana Lo Buono","doi":"10.3390/medicines10020016","DOIUrl":"https://doi.org/10.3390/medicines10020016","url":null,"abstract":"<p><p>Patients affected by global aphasia are no longer able to understand, produce, name objects, write and read. It occurs as a result of functional damage of ischemic or hemorrhagic origin affecting the entire peri-silvan region and frontal operculum. Rehabilitation training aims to promote an early intervention in the acute phase. We described a case of a 57-year-old female patient with left intraparenchymal fronto-temporo-parietal cerebral hemorrhage and right hemiplegia. After admission to clinical rehabilitative center, the patient was not able to perform simple orders and she presented a severe impairment of auditory and written comprehension. Eloquence was characterized by stereotypical emission of monosyllabic sounds and showed compromised praxis-constructive abilities. Rehabilitation included a program of Neurologic Music Therapy (NMT), specifically Symbolic Communication Training Through Music (SYCOM) and Musical Speech Stimulation (MUSTIM). Rehabilitative treatment was measured by improved cognitive and language performance of the patient from T0 to T1. Music rehabilitative interventions and continuous speech therapy improve visual attention and communicative intentionality. In order to confirm the effectiveness of data presented, further extensive studies of the sample would be necessary, to assess the real role of music therapy in post-stroke global aphasia.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Blessed Union of Glycobiology and Immunology: A Marriage That Worked. 糖生物学和免疫学的幸福结合:一个成功的婚姻。
Medicines (Basel, Switzerland) Pub Date : 2023-01-19 DOI: 10.3390/medicines10020015
Jhenifer Santos Dos Reis, Israel Diniz-Lima, Marcos André Rodrigues da Costa Santos, Pedro Marçal Barcelos, Kelli Monteiro da Costa, Raphael do Carmo Valente, Lorrane de Souza Chaves, Luma Petel de Campos, Ariely Costa Dos Santos, Rafaela Gomes Correia de Lima, Debora Decote-Ricardo, Alexandre Morrot, Jose Osvaldo Previato, Lucia Mendonça-Previato, Celio Geraldo Freire-de-Lima, Leonardo Marques da Fonseca, Leonardo Freire-de-Lima
{"title":"The Blessed Union of Glycobiology and Immunology: A Marriage That Worked.","authors":"Jhenifer Santos Dos Reis,&nbsp;Israel Diniz-Lima,&nbsp;Marcos André Rodrigues da Costa Santos,&nbsp;Pedro Marçal Barcelos,&nbsp;Kelli Monteiro da Costa,&nbsp;Raphael do Carmo Valente,&nbsp;Lorrane de Souza Chaves,&nbsp;Luma Petel de Campos,&nbsp;Ariely Costa Dos Santos,&nbsp;Rafaela Gomes Correia de Lima,&nbsp;Debora Decote-Ricardo,&nbsp;Alexandre Morrot,&nbsp;Jose Osvaldo Previato,&nbsp;Lucia Mendonça-Previato,&nbsp;Celio Geraldo Freire-de-Lima,&nbsp;Leonardo Marques da Fonseca,&nbsp;Leonardo Freire-de-Lima","doi":"10.3390/medicines10020015","DOIUrl":"https://doi.org/10.3390/medicines10020015","url":null,"abstract":"<p><p>In this article, we discuss the main aspects regarding the recognition of cell surface glycoconjugates and the immunomodulation of responses against the progression of certain pathologies, such as cancer and infectious diseases. In the first part, we talk about different aspects of glycoconjugates and delve deeper into the importance of N-glycans in cancer immunotherapy. Then, we describe two important lectin families that have been very well studied in the last 20 years. Examples include the sialic acid-binding immunoglobulin (Ig)-like lectins (siglecs), and galectins. Finally, we discuss a topic that needs to be better addressed in the field of glycoimmunology: the impact of oncofetal antigens on the cells of the immune system. New findings in this area are of great importance for advancement, especially in the field of oncology, since it is already known that cellular interactions mediated by carbohydrate-carbohydrate and/or carbohydrate proteins are able to modulate the progression of different types of cancer in events that compromise the functionality of the immune responses.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9348024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Acknowledgment to the Reviewers of Medicines in 2022. 对2022年药品审稿人的感谢。
Medicines (Basel, Switzerland) Pub Date : 2023-01-18 DOI: 10.3390/medicines10020014
Medicines Editorial Office
{"title":"Acknowledgment to the Reviewers of <i>Medicines</i> in 2022.","authors":"Medicines Editorial Office","doi":"10.3390/medicines10020014","DOIUrl":"https://doi.org/10.3390/medicines10020014","url":null,"abstract":"<p><p>High-quality academic publishing is built on rigorous peer review [...].</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10784024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Efficacy and Safety of Renal Function on Edoxaban Versus Warfarin for Atrial Fibrillation: A Systematic Review and Meta-Analysis. 依多沙班与华法林治疗心房颤动的疗效和肾功能安全性:一项系统综述和荟萃分析。
Medicines (Basel, Switzerland) Pub Date : 2023-01-16 DOI: 10.3390/medicines10010013
Yapeng Wang, Li Li, Zhanlan Wei, Shan Lu, Wenxue Liu, Janghui Zhang, Junbo Feng, Dongjin Wang
{"title":"Efficacy and Safety of Renal Function on Edoxaban Versus Warfarin for Atrial Fibrillation: A Systematic Review and Meta-Analysis.","authors":"Yapeng Wang,&nbsp;Li Li,&nbsp;Zhanlan Wei,&nbsp;Shan Lu,&nbsp;Wenxue Liu,&nbsp;Janghui Zhang,&nbsp;Junbo Feng,&nbsp;Dongjin Wang","doi":"10.3390/medicines10010013","DOIUrl":"https://doi.org/10.3390/medicines10010013","url":null,"abstract":"<p><p>Background: Edoxaban is a novel oral anticoagulant which may decrease the risk of stroke and systemic embolism in patients suffering from atrial fibrillation (AF). However, the decreased efficacy of edoxaban versus warfarin for the avoidance of stroke and systemic embolism in AF with creatinine clearance (CrCl) > 95 mL/min has been reported. The purpose of this meta-analysis is to further clarify the safety (major bleeding) and efficacy (stroke or systemic embolism) of edoxaban for AF patients with various CrCl. Methods: A systematic search of studies on edoxaban and warfarin in AF patients related to renal function was conducted in PubMed, Medline, Web of Science databases, EBSCO, Embase, and the Cochrane Central Register of Controlled Trials. In this meta-analysis (protocol number: PROSPERO CRD 42021245512), we included studies that provide specific data on three outcomes: ischemic stroke or systemic embolism (S/SE), bleeding, and all-cause mortality. Results: This meta-analysis enrolled two randomized controlled trials (RCTs) studies and two retrospective studies that enrolled 28,065 patients. According to CrCl, subjects are divided into three groups (CrCl 30−50 mL/min, CrCl 50−95 mL/min, CrCl > 95 mL/min). In AF patients with CrCl 30−50 mL/min, edoxaban 30 mg daily is similar to warfarin in the prevention of ischemic S/SE and all-cause mortality, resulting in lower bleeding rate and better net clinical outcome (ischemic S/SE: hazard ratio (HR), 0.85, 95% confidence interval (CI), 0.19−1.87; all-cause mortality: HR, 0.65, 95% CI, 0.35−1.19; bleeding: HR, 0.75, 95% CI, 0.60−0.93; net clinical outcome: HR, 0.75, 95% CI, 0.63−0.90). In the group of CrCl 50−95 mL/min, the net clinical outcome was more favorable with edoxaban 60 mg daily than warfarin (HR, 0.81, 95% CI: 0.68−0.96), and there was no significant difference between edoxaban 60 mg daily and warfarin in terms of prevention of bleeding, ischemic S/SE, and all-cause mortality. For AF patients with CrCl > 95 mL/min, there was a statistically significant difference in lower bleeding rate between edoxaban 60 mg daily and warfarin (bleeding: HR: 0.70, 95% CI: 0.58−0.84). There was no differential safety in ischemic S/SE, all-cause mortality, and net clinical outcome. Conclusion: Overall, edoxaban was superior to warfarin in terms of net clinical outcome in various groups of CrCl with AF patients. Although there was no significant difference in net clinical outcome between edoxaban and warfarin for AF patients with CrCl > 95 mL/min, edoxaban is not inferior to warfarin in safety and effectiveness in the various levels of CrCl. Edoxaban may be a more effective and safe treatment than warfarin for patients with chronic kidney disease (CKD) who require anticoagulation. More high-quality and long-term clinical research are needed to further estimate the effects of edoxaban.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10830534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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