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Uspenskaya EV, Kuzmina E, Quynh HTN, Komkova MA, Kazimova IV, Timofeev AA. Influence of Mechanical Loading on the Process of Tribochemical Action on Physicochemical and Biopharmaceutical Properties of Substances, Using Lacosamide as an Example: From Micronisation to Mechanical Activation. Pharmaceutics 2024; 16:798. [PMID: 38931919 PMCID: PMC11207894 DOI: 10.3390/pharmaceutics16060798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Many physical and chemical properties of solids, such as strength, plasticity, dispersibility, solubility and dissolution are determined by defects in the crystal structure. The aim of this work is to study in situ dynamic, dispersion, chemical, biological and surface properties of lacosamide powder after a complete cycle of mechanical loading by laser scattering, electron microscopy, FR-IR and biopharmaceutical approaches. The SLS method demonstrated the spontaneous tendency toward surface-energy reduction due to aggregation during micronisation. DLS analysis showed conformational changes of colloidal particles as supramolecular complexes depending on the loading time on the solid. SEM analysis demonstrated the conglomeration of needle-like lacosamide particles after 60 min of milling time and the transition to a glassy state with isotropy of properties by the end of the tribochemistry cycle. The following dynamic properties of lacosamide were established: elastic and plastic deformation boundaries, region of inhomogeneous deformation and fracture point. The ratio of dissolution-rate constants in water of samples before and after a full cycle of loading was 2.4. The lacosamide sample, which underwent a full cycle of mechanical loading, showed improved kinetics of API release via analysis of dissolution profiles in 0.1 M HCl medium. The observed activation-energy values of the cell-death biosensor process in aqueous solutions of the lacosamide samples before and after the complete tribochemical cycle were 207 kJmol-1 and 145 kJmol-1, respectively. The equilibrium time of dissolution and activation of cell-biosensor death corresponding to 20 min of mechanical loading on a solid was determined. The current study may have important practical significance for the transformation and management of the properties of drug substances in solid form and in solutions and for increasing the strength of drug matrices by pre-strain hardening via structural rearrangements during mechanical loading.
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Affiliation(s)
- Elena V. Uspenskaya
- Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia; (E.K.); (H.T.N.Q.); (M.A.K.); (I.V.K.)
| | - Ekaterina Kuzmina
- Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia; (E.K.); (H.T.N.Q.); (M.A.K.); (I.V.K.)
| | - Hoang Thi Ngoc Quynh
- Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia; (E.K.); (H.T.N.Q.); (M.A.K.); (I.V.K.)
| | - Maria A. Komkova
- Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia; (E.K.); (H.T.N.Q.); (M.A.K.); (I.V.K.)
| | - Ilaha V. Kazimova
- Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia; (E.K.); (H.T.N.Q.); (M.A.K.); (I.V.K.)
| | - Aleksey A. Timofeev
- Scientific and Educational Resource Centre “Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis”, Peoples’ Friendship University of Russia Named after Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia;
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Chen Y, Li W, Lu C, Gao X, Song H, Zhang Y, Zhao S, Cai G, Guo Q, Zhou D, Chen Y. Efficacy, tolerability and safety of add-on third-generation antiseizure medications in treating focal seizures worldwide: a network meta-analysis of randomised, placebo-controlled trials. EClinicalMedicine 2024; 70:102513. [PMID: 38449838 PMCID: PMC10915785 DOI: 10.1016/j.eclinm.2024.102513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024] Open
Abstract
Background Adjunctive newer antiseizure medications (ASMs) are being used in patients with treatment-resistant focal-onset seizures (FOS). An updated network meta-analysis (NMA) was necessary to compile evidence in this critical area. Methods We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus from their inception until 17 January 2024, evaluating the efficacy, tolerability, and safety of rufinamide (RUF), brivaracetam (BRV), cenobamate (CNB), eslicarbazepine (ESL), lacosamide (LCM), retigabine (RTG), and perampanel (PER) as adjunctive treatments for FOS. Efficacy outcomes included seizure response and seizure freedom. Tolerability was assessed by discontinuation due to adverse events (AEs). Safety outcomes were evaluated based on the number of patients experiencing at least one AE and serious adverse events (SAEs). This review is registered with PROSPERO (CRD42023485130). Findings A total of 29 studies involving 11,750 participants were included. For seizure response, all ASMs were significantly superior to placebo, with RTG ranking highest, followed by CNB. Considering dosage, CNB 400 mg/d was top-ranked, followed by RTG 1200 mg/d. For seizure freedom, BRV was highest-ranked, followed by CNB, with BRV 100 mg/d leading, followed by CNB 400 mg/d. Regarding tolerability, LCM 600 mg/d had the lowest ranking, followed by CNB 400 mg/d. For the safety outcome of AEs, ESL 1200 mg/d was ranked lowest, followed by CNB 400 mg/d. Regarding SAEs, LCM 400 mg/d was ranked lowest, followed by RTG 1200 mg/d. Interpretation ASMs at different dosages have varying efficacy and tolerability profiles. We have provided hierarchical rankings of ASMs for efficacy and safety outcomes. Our findings offer the most comprehensive evidence available to inform patients, families, physicians, guideline developers, and policymakers about the choice of ASMs in patients with treatment-resistant FOS. Funding None.
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Affiliation(s)
- Yankun Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Wenze Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Chenfei Lu
- Department of Respiratory, The Ninth People's Hospital of Chongqing, Chongqing, 400700, China
| | - Xinxia Gao
- Department of Medical Records, Heze Municipal Hospital, Heze, 274000, China
| | - Huizhen Song
- Department of Neurology, Heze Third People's Hospital, Heze, 274000, China
| | - Yanli Zhang
- Department of Neurology, Shandong Provincial Hospital Heze Branch, Heze, 274000, China
| | - Sihao Zhao
- Department of Neurology, Heze Mudan District People's Hospital, Heze, 274000, China
| | - Gaoang Cai
- Department of Neurology, Juancheng County People's Hospital, Juancheng, 274600, China
| | - Qing Guo
- Department of Neurology, Heze Municipal Hospital Brain Hospital, Heze, 274000, China
| | - Dongdong Zhou
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Yangmei Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
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Hentschel M, Stoffel-Wagner B, Surges R, von Wrede R, Dolscheid-Pommerich RC. Value of drug level concentrations of brivaracetam, lacosamide, and perampanel in care of people with epilepsy. Epilepsia 2024; 65:620-629. [PMID: 38158709 DOI: 10.1111/epi.17873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The aim of this study was to determine whether clinical efficacy and reported adverse effects (AEs) of the newer antiseizure medications (ASMs) brivaracetam (BRV), lacosamide (LCM), and perampanel (PER) have been associated with plasma levels of these ASMs. We also investigated whether plasma levels outside the reference range has led to dose adjustments. METHODS Plasma levels of 300 people with epilepsy (PWE) seen at our tertiary epilepsy center were determined by liquid chromatography-tandem mass spectrometry. PWE received BRV (n = 100), LCM (n = 100), or PER (n = 100), in most cases in polytherapy. Demographic and clinical data were retrospectively analyzed and related to plasma levels. Clinical efficacy of BRV, LCM, or PER was assessed retrospectively by comparing seizure frequency at the time of current blood draw with seizure frequency at the time of first administration. AEs were also recorded and, if reported, compared retrospectively with the time of first administration. RESULTS No significant associations were found between plasma levels of BRV, LCM, or PER and seizure freedom (BRV, p = 1.000; LCM, p = .243; PER, p = .113) or responder status (BRV, p = .118; LCM, p = .478; PER, p = .069) at presentation. There was also no pattern between plasma levels and the occurrence of AEs. In the majority of cases, drug levels outside the reference ranges have not led to adjustments in the daily doses of BRV (93.5%), LCM (93.9%), or PER (89.1%). SIGNIFICANCE Plasma levels at a given time point did not allow conclusions to be drawn about seizure control or the occurrence of AEs. Our findings indicate that efficacy and tolerability cannot be predicted based on averaged data from a single plasma measurement due to high interindividual variability. Instead, individual reference values should be established when sufficient clinical data are available, in line with the 2008 International League Against Epilepsy position paper on therapeutic drug monitoring.
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Affiliation(s)
- Matthias Hentschel
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Birgit Stoffel-Wagner
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Rainer Surges
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Randi von Wrede
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
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Yajima T, Katayama A, Ito T, Kawada T, Yabushita K, Yasuda T, Ohta T, Katayama T, Utsumi N, Kayaki Y, Kuwata S. Asymmetric Reductive Amination of α-Keto Acids Using Ir-Based Hydrogen Transfer Catalysts: An Access to Unprotected Unnatural α-Amino Acids. Org Lett 2024; 26:1426-1431. [PMID: 38334425 DOI: 10.1021/acs.orglett.3c04378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
A direct asymmetric reductive amination of α-keto acids catalyzed by Cp*Ir complexes bearing a chiral N-(2-picolyl)sulfonamidato ligand is described. The combined use of optically active 2-phenyglycinol as an aminating agent is effective for the chemo- and stereoselective transfer hydrogenation using formic acid. The subsequent elimination of the hydroxyethyl moiety by orthoperiodic acid can afford various unprotected α-amino acids in satisfactory isolated yields (20 examples) with excellent optical purities (up to >99% ee).
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Affiliation(s)
- Takaaki Yajima
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Akito Katayama
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Tsubasa Ito
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Takuma Kawada
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Kenya Yabushita
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Toshihisa Yasuda
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Takeshi Ohta
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Takeaki Katayama
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Noriyuki Utsumi
- Central Research Laboratory, Technology & Development Division, Kanto Chemical Company, Inc., 7-1, Inari 1-chome, Soka-city, Saitama 340-0003, Japan
| | - Yoshihito Kayaki
- Department of Chemical Science and Engineering, School of Materials and Chemical Technology, Tokyo Institute of Technology, 2-12-1-E4-1 O-okayama, Meguro-ku, Tokyo 152-8552, Japan
| | - Shigeki Kuwata
- Department of Applied Chemistry, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga 525-8577, Japan
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Zhou R, Qu R, Liu M, Huang DP, Zhou JY, Chen Y, Chen XQ. Perampanel and lacosamide monotherapy in pediatric patients with newly diagnosed focal epilepsy: A prospective study evaluating efficacy, tolerability, and behavior. Epilepsy Behav 2023; 146:109353. [PMID: 37481960 DOI: 10.1016/j.yebeh.2023.109353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/24/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE Perampanel (PER) and lacosamide (LCM) are the new third-generation anti-seizure medications (ASMs) that were approved for the monotherapy of focal epilepsy in children over four years of age in China, in 2021. Very few studies have analyzed the application of PER monotherapy among pediatric patients aged ≥four years, and no study compared the efficacy and tolerability of PER monotherapy with LCM monotherapy in pediatric patients with focal epilepsy. The present study aimed to investigate the efficacy, tolerability, and effect on behavior and emotion of PER and LCM as monotherapy in pediatric patients with newly diagnosed focal epilepsy, which is beneficial for clinicians to have more choices to treat pediatric patients with focal epilepsy. METHODS This was a prospective, single-center, observational study that involved pediatric patients (disease onset age ≥four years) with newly diagnosed focal epilepsy treated with PER or LCM as primary monotherapy. Outcomes included retention, being responders, and seizure-free rates after 3, 6, and 12 months. Adverse events (AEs) were noticed throughout the follow-up period. Behavioral outcomes were evaluated with Achenbach Child Behavior Checklist (CBCL/4-16) at baseline and after three and six months. RESULTS Using randomization, 60 patients receiving PER (31 females, 29 males, median age: 7.79 [5.34, 10.16] years, median dose: 3.0 [2.0, 4.0] mg/day) and 60 patients receiving LCM (25 females, 35 males, median age: 7.72 [5.91, 10.72] years, median dose: 150.0 [100.0, 200.0] mg/day) were enrolled in the study. At the 12-month follow-up, the retention rates in the PER and LCM groups, both were 90.4%, and the responder rates were 65.4% and 71.2%, while seizure-free rates were 57.7% and 67.3%, respectively. There were no significant differences in the retention, responder and seizure-free rates between the two groups (P > 0.05). There were no significant differences in the responder rates between patients with BECTS, abnormal brain magnetic resonance imaging (MRI), or types of seizure in the two groups (P > 0.05). In the PER group, 28.8% (15/52) of patients experienced AEs, of which the most frequently reported were irritability (n = 7; 13.5%), dizziness (n = 5; 9.6%), somnolence (n = 3; 5.8%), ataxia (n = 1; 1.9%), headache (n = 1; 1.9%), and rash (n = 1; 1.9%). In the LCM group, 15.4% (8/52) of the patients had AEs, including headache (n = 4; 7.5%), dizziness (n = 4; 7.5%), nausea (n = 2; 3.8%), somnolence (n = 2; 3.8%), irritability (n = 1; 1.9%), stomach ache (n = 1; 1.9%), and vomiting (n = 1; 1.9%). The incidence of irritability was significantly higher in the PER group than in the LCM group (13.5% vs. 1.9%, P = 0.031), which occurred mainly within eight weeks after drug administration. Patients with irritability were not dangerous to surrounding people by the assessment of parental observation in the life. And the symptoms were relieved spontaneously within a few months. The outcomes of total scores, internalizing scores, and externalizing scores of the CBCL did not show statistically significant differences in the PER and LCM groups between baseline and three and six months. Characteristics of behavior and emotion did not have substantial changes in patients treated with PER and LCM monotherapy. CONCLUSIONS The present study documented similar good effectiveness and good tolerance of PER and LCM as monotherapy in pediatric patients with newly diagnosed focal epilepsy and showed no behavioral or emotional impact, as assessed by the CBCL. Though the incidence of irritability with PER monotherapy may be higher than that with LCM monotherapy soon after medication initiation, this side effect appears to resolve spontaneously within a few months. At present, this study was the first research about PER and LCM monotherapy in pediatric patients with newly diagnosed focal epilepsy evaluating efficacy, tolerability, and behavior in China.
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Affiliation(s)
- Rui Zhou
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China
| | - Rui Qu
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China; Department of Pediatric Neurology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Min Liu
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China
| | - Dan-Ping Huang
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China
| | - Jin-Yi Zhou
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China
| | - Yan Chen
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China
| | - Xu-Qin Chen
- Department of Neurology, Children's Hospital of Soochow University, Suzhou, China.
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Lupo C, Fernandes M, Spanetta M, Sarbu OE, Carnovale C, Di Gioia B, Placidi F, Izzi F, Mercuri NB, Liguori C. The effect of lacosamide monotherapy on sleep architecture in patients with epilepsy: a preliminary evidence. J Neural Transm (Vienna) 2023; 130:87-95. [PMID: 36592241 DOI: 10.1007/s00702-022-02581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/23/2022] [Indexed: 01/03/2023]
Abstract
Lacosamide (LCM) is a third-generation antiseizure medication (ASM), and its effect on sleep architecture was supported by a few studies in patients with drug-resistant epilepsy in which LCM was used as an add-on treatment. To gather knowledge on ASMs effects on sleep, this study aimed at evaluating the effects of LCM monotherapy on sleep in patients with focal epilepsy. Ten patients diagnosed with epilepsy (mean age 58.00 ± 14.77, 60.0% female, mean monthly seizure frequency 1.20 ± 2.48) starting LCM as monotherapy were included. Sleep architecture was assessed through polysomnography at baseline and at the 6-month follow-up visit. A significant decrease was observed in seizure frequency (p = 0.004), being all patients seizure-free at follow-up. At baseline, eight patients had poor sleep efficiency (< 85%). Sleep efficiency increased at follow-up, with only three patients having an index < 85% (p = 0.022). From baseline to follow-up, a significant decrease was observed in sleep latency (p = 0.022) and wakefulness after sleep onset (p = 0.047). Moreover, a significant decrease was observed in the percentage of stage 1 (Md = 6.70 vs Md = 3.85, p = 0.005) and stage 3 (Md = 27.70 vs Md = 22.35, p = 0.01) of Non-REM sleep. This study suggests that LCM monotherapy may positively impact sleep architecture in patients with epilepsy. The sleep efficiency improvement and the decrease of sleep latency and wakefulness after sleep onset observed at follow-up highlight better sleep stability and continuity in patients treated with LCM. Notably, all patients were seizure-free at follow-up, and seizure freedom may also concur to sleep structure improvement.
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Affiliation(s)
- Clementina Lupo
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy
| | - Matteo Spanetta
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy
| | - Oana Elena Sarbu
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy
| | - Carola Carnovale
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy
| | - Battista Di Gioia
- Neurology Unit, Department of Systems Medicine, Epilepsy Centre, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy.,Neurology Unit, Department of Systems Medicine, Epilepsy Centre, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Izzi
- Neurology Unit, Department of Systems Medicine, Epilepsy Centre, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, Epilepsy Centre, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome 'Tor Vergata", Rome, Italy. .,Neurology Unit, Department of Systems Medicine, Epilepsy Centre, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
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Zhu H, Wang J, Lu Y, Soloshonok VA, Lan L, Xu J, Liu H. Cu(II) Complexes with Proline-Derived Schiff Base Ligand: Chemical Resolution of N, C-Unprotected α-Amino Acids and Their Antibacterial Activity. J Org Chem 2022; 87:12900-12908. [PMID: 36153987 DOI: 10.1021/acs.joc.2c01481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An operationally simple and convenient resolution method via Cu(II) complexes was reported, efficiently providing valuable enantiopure N,C-unprotected α-amino acids. This protocol features synthetically attractive yields and a stereochemical outcome, using a recyclable Schiff base ligand and inexpensive easily accessible metal copper salts. These novel Cu(II) complexes can be obtained in an enantiopure state by means of column chromatography or recrystallization. Furthermore, all the Cu(II) complexes were evaluated for their antibacterial activities. Among them, complexes (S,2S)-3a, (S,2S)-3g, and (S,2S)-3o showed significant antibacterial activities against Staphylococcus aureus Mu50. Further biological evaluation indicated that they were effective against most of Gram-positive bacteria. It is the first study on the biological activities of transition metal complexes with this type of proline-derived Schiff base ligand.
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Affiliation(s)
- Huajian Zhu
- State Key Laboratory of Natural Medicines and Department of Medicinal Chemistry, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, P. R. China
| | - Jiang Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences 555 Zu Chong Zhi Road, Shanghai 201203, P. R. China.,Lingang Laboratory, Shanghai 200031, P. R. China
| | - Yunfu Lu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences 555 Zu Chong Zhi Road, Shanghai 201203, P. R. China
| | - Vadim A Soloshonok
- Department of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, San Sebastian 20018, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao 48013, Spain
| | - Lefu Lan
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences 555 Zu Chong Zhi Road, Shanghai 201203, P. R. China
| | - Jinyi Xu
- State Key Laboratory of Natural Medicines and Department of Medicinal Chemistry, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, P. R. China
| | - Hong Liu
- State Key Laboratory of Natural Medicines and Department of Medicinal Chemistry, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, P. R. China.,State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences 555 Zu Chong Zhi Road, Shanghai 201203, P. R. China
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Kitano Y, Shinozuka T. Inhibition of Na V1.7: the possibility of ideal analgesics. RSC Med Chem 2022; 13:895-920. [PMID: 36092147 PMCID: PMC9384491 DOI: 10.1039/d2md00081d] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/25/2022] [Indexed: 08/03/2023] Open
Abstract
The selective inhibition of NaV1.7 is a promising strategy for developing novel analgesic agents with fewer adverse effects. Although the potent selective inhibition of NaV1.7 has been recently achieved, multiple NaV1.7 inhibitors failed in clinical development. In this review, the relationship between preclinical in vivo efficacy and NaV1.7 coverage among three types of voltage-gated sodium channel (VGSC) inhibitors, namely conventional VGSC inhibitors, sulphonamides and acyl sulphonamides, is discussed. By demonstrating the PK/PD discrepancy of preclinical studies versus in vivo models and clinical results, the potential reasons behind the disconnect between preclinical results and clinical outcomes are discussed together with strategies for developing ideal analgesic agents.
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Affiliation(s)
- Yutaka Kitano
- R&D Division, Daiichi Sankyo Co., Ltd. 1-2-58 Hiromachi Shinagawa-ku Tokyo 140-8710 Japan
| | - Tsuyoshi Shinozuka
- R&D Division, Daiichi Sankyo Co., Ltd. 1-2-58 Hiromachi Shinagawa-ku Tokyo 140-8710 Japan
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Çarçak N, Karanfil C, Akat Ş, Akman Ö, Onat F. The effect of chronic treatment with sodium channel blocker lacosamide on early development of absence seizures in genetic absence epilepsy rats. Epilepsy Res 2022; 182:106896. [DOI: 10.1016/j.eplepsyres.2022.106896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 02/07/2022] [Accepted: 03/04/2022] [Indexed: 11/03/2022]
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10
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Li Y, Guo HL, Zhang YY, Dong N, Hu YH, Chen J, Lu XP, Chen F. Plasma lacosamide monitoring in children with epilepsy: Focus on reference therapeutic range and influencing factors. Front Pediatr 2022; 10:949783. [PMID: 36160782 PMCID: PMC9490115 DOI: 10.3389/fped.2022.949783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lacosamide (LCM) is a newer anti-seizure medication (ASM) that was approved in China in 2018, but its real-world clinical data and plasma concentrations in Chinese children with epilepsy are very limited. Of note, the reference range for routine LCM therapeutic drug monitoring is still unknown. The purpose of this study was to investigate the efficacy and safety of LCM as a monotherapy or an adjunctive treatment with other ASMs and to evaluate the potential factors affecting its efficacy and variable LCM plasma concentrations in Chinese children with epilepsy. METHODS Children with epilepsy (<18 years) with routine plasma LCM monitoring from March 2019 to December 2021 at the Department of Pharmacy, Children's Hospital of Nanjing Medical University were retrospectively collected. Clinical data were obtained from the hospital information system. RESULTS 76 pediatric patients (52 males) were finally enrolled. Mean age was 7.9 years (1.3-17.3 years) with a mean dose of LCM 6.3 mg/kg/day (2.0-11.3 mg/kg/day). The TDM data as a whole showed that the median plasma trough concentration (C 0) was 3.42 μg/mL (1.25-8.31 μg/mL). A 6-month LCM add-on therapy produced 70% of patients achieving ≥50% seizure frequency reductions, and the number was 81% for the one-year follow-up findings. Interestingly, more patients who took LCM monotherapy achieved seizure freedom over the same periods of follow-up observations. Under maintenance dosages, approximately 92.1% of the C 0 values were 2.0-7.0 μg/mL. The plasma-C 0-to-daily dose (C 0/Dose) ratio was significantly associated with age and body weight (BW). The C 0/Dose ratio in patients aged 1- ≤ 6 and 6- ≤ 12 years was significantly higher by 81% and 29% than those aged 12- ≤ 18 years, respectively. The C 0/Dose ratio in patients with a BW of ≥40 kg was 1.7-fold lower than in patients with a BW of ≤ 20 kg. In addition, complex LCM-ASMs interactions were observed. Oxcarbazepine significantly decreased the C 0/Dose ratio of LCM by 28%. CONCLUSION This retrospective study confirmed the effectiveness and tolerability of the LCM treatment used alone or with other ASMs in children with focal epilepsy. Children with higher BW and older age have lower C 0/Dose ratio. Complex drug interactions between LCM and other concomitant ASMs were revealed. Notably, based on the data in our hands, the reference range, i.e., 2.0-7.0 μg/mL, for routine LCM monitoring may be feasible. The real-world evidence of this study supports LCM as a promising option in children with focal epilepsy.
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Affiliation(s)
- Yue Li
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hong-Li Guo
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yuan-Yuan Zhang
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Na Dong
- Institute of Pharmaceutical Sciences, China Pharmaceutical University, Nanjing, China
| | - Ya-Hui Hu
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Chen
- Department of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Peng Lu
- Department of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
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11
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Hou L, Peng B, Zhang D, Yang J, Wang Y, Tong L, Li S, Wang Q, Zhao J. Clinical Efficacy and Safety of Lacosamide as an Adjunctive Treatment in Adults With Refractory Epilepsy. Front Neurol 2021; 12:712717. [PMID: 34925202 PMCID: PMC8677652 DOI: 10.3389/fneur.2021.712717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/05/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Lacosamide (LCM), a novel AED (antiepileptic drug), was used as an adjunctive treatment in patients with partial-onset seizures or without secondary generalization. However, no meta-analysis was performed to evaluate the efficacy of LCM as an adjunctive treatment in post-marketing clinical studies. Aims: To assess the safety and efficacy of LCM as an adjunctive treatment in adults with refractory epilepsy, a systematic review and meta-analysis of randomized controlled trials (RCTs) and real-world studies were performed. Methods: All studies were identified from electronic databases. Both RCTs and observational prospective studies were included. Primary outcomes included responder rate, adverse effects (AEs) and withdraw rate. The pooled rates (PR) with their corresponding 95% confidence intervals (CI) were calculated. Publication bias was assessed with Begg's or Egger's tests. Results: Total 16 studies (3,191 patients) including 5 RCTs and 11 real-word studies were enrolled. The pooled 50% responder rate and seizure-free rate were 48% (95% CI: 0.42, 0.54) and 9% (95% CI: 0.06, 0.11) in all studies, respectively. Subgroup analysis showed that the pooled 50% responder rate were 53% (95% CI: 0.44, 0.62) from observational studies and 38% (95% CI: 0.35, 0.42) from RCTs, respectively; the pooled seizure-free rate were 13% (95% CI: 0.09, 0.18) from observational studies and 4% (95% CI: 0.06, 0.11) from RCTs, respectively. Similar incidence of AEs were reported in real-world studies (0.57, 95% CI: 0.43, 0.72) and RCTs (0.59, 95% CI: 0.42–0.76). Finally, a total of 13% (95%CI: 0.09, 0.16) and 13% (95% CI: 0.08, 0.16) of all patients prescribed with LCM was withdrawn in RCTs and real-world studies, respectively, due to the occurrence of AEs. Furthermore, similar to the 50% responder rate, seizure-free rate, incidence of AEs and withdraw rate were reported at 6-month or at least 12-month of LCM adjunction. Publication bias was not detected in these studies. Conclusions: Our results revealed that LCM adjunctive therapy even with long-term treatment was efficacious and well tolerated in adults with refractory epilepsy.
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Affiliation(s)
- Liyan Hou
- School of Public Health, Dalian Medical University, Dalian, China
| | - Bingjie Peng
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Dalian, China
| | - Defu Zhang
- Office of Academic Affairs, Dalian Medical University, Dalian, China
| | - Jingjing Yang
- Department of Neurology, The First Affiliated Hospital of DaLian Medical University, Dalian, China
| | - Ying Wang
- Department of Neurology, The First Affiliated Hospital of DaLian Medical University, Dalian, China
| | - Li Tong
- School of Public Health, Dalian Medical University, Dalian, China
| | - Sheng Li
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Qingshan Wang
- School of Public Health, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Jie Zhao
- National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
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Ion-Channel Antiepileptic Drugs: An Analytical Perspective on the Therapeutic Drug Monitoring (TDM) of Ezogabine, Lacosamide, and Zonisamide. ANALYTICA 2021. [DOI: 10.3390/analytica2040016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The term seizures includes a wide array of different disorders with variable etiology, which currently represent one of the most important classes of neurological illnesses. As a consequence, many different antiepileptic drugs (AEDs) are currently available, exploiting different activity mechanisms and providing different levels of performance in terms of selectivity, safety, and efficacy. AEDs are currently among the psychoactive drugs most frequently involved in therapeutic drug monitoring (TDM) practices. Thus, the plasma levels of AEDs and their metabolites are monitored and correlated to administered doses, therapeutic efficacy, side effects, and toxic effects. As for any analytical endeavour, the quality of plasma concentration data is only as good as the analytical method allows. In this review, the main techniques and methods are described, suitable for the TDM of three AEDs belonging to the class of ion channel agents: ezogabine (or retigabine), lacosamide, and zonisamide. In addition to this analytical overview, data are provided, pertaining to two of the most important use cases for the TDM of antiepileptics: drug–drug interactions and neuroprotection activity studies. This review contains 146 references.
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13
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Peng YS, Wu HT, Lai YC, Chen JL, Yang YC, Kuo CC. Inhibition of neuronal Na+ currents by lacosamide: Differential binding affinity and kinetics to different inactivated states. Neuropharmacology 2020; 179:108266. [DOI: 10.1016/j.neuropharm.2020.108266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/06/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
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14
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Khanna R, Moutal A, Perez-Miller S, Chefdeville A, Boinon L, Patek M. Druggability of CRMP2 for Neurodegenerative Diseases. ACS Chem Neurosci 2020; 11:2492-2505. [PMID: 32693579 DOI: 10.1021/acschemneuro.0c00307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Collapsin response mediator proteins (CRMPs) are ubiquitously expressed phosphoproteins that coordinate cytoskeletal formation and regulate cellular division, migration, polarity, and synaptic connection. CRMP2, the most studied of the five family members, is best known for its affinity for tubulin heterodimers and function in regulating the microtubule network. Accumulating evidence has also demonstrated a key role for CRMP2 in trafficking of voltage- and ligand-gated ion channels. These functions are tightly regulated by post-translational modifications including phosphorylation and SUMOylation (addition of a small ubiquitin like modifier). Over the past decade, it has become increasingly clear that dysregulated post-translational modifications of CRMP2 contribute to the pathomechanisms of diverse diseases, including cancer, neurodegenerative diseases, chronic pain, and bipolar disorder. Here, we review the discovery, functions, and current putative preclinical and clinical therapeutics targeting CRMP2. These potential therapeutics include CRMP2-based peptides that inhibit protein-protein interactions and small-molecule compounds. Capitalizing on the availability of structural information, we identify druggable pockets on CRMP2 and predict binding modes for five known CRMP2-targeting compounds, setting the stage for optimization and de novo drug discovery targeting this multifunctional protein.
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Affiliation(s)
- Rajesh Khanna
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
- Graduate Interdisciplinary Program in Neuroscience, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
- The Center for Innovation in Brain Sciences, The University of Arizona Health Sciences, Tucson, Arizona 85724, United States
- Regulonix LLC, Tucson, Arizona 85718, United States
| | - Aubin Moutal
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
| | - Samantha Perez-Miller
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
| | - Aude Chefdeville
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
| | - Lisa Boinon
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona 85724, United States
| | - Marcel Patek
- BrightRock Path, LLC, Tucson, Arizona 85704, United States
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15
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Choi HS, Kim SH, Kang HC, Lee JS, Kim HD. Efficacy and Safety of Lacosamide in Adolescents with Lennox-Gastaut Syndrome. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2020.00080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Yadlapalli SSR, Katari NK, Manabolu Surya SB. Determination of lacosamide in human plasma by LC–MS/MS and its application to a human pharmacokinetic study. SEPARATION SCIENCE PLUS 2020. [DOI: 10.1002/sscp.202000004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Aratikatla EK, Bhattacharya AK. A Short Review of Synthetic Routes for the Antiepileptic Drug ( R)-Lacosamide. Org Process Res Dev 2020. [DOI: 10.1021/acs.oprd.9b00373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Eswar K. Aratikatla
- Division of Organic Chemistry, CSIR-National Chemical Laboratory (CSIR-NCL), Dr. Homi Bhabha Road, Pune-411 008, India
- Academy of Scientific and Innovative Research (AcSIR), CSIR-NCL, Pune-411 008, India
| | - Asish K. Bhattacharya
- Division of Organic Chemistry, CSIR-National Chemical Laboratory (CSIR-NCL), Dr. Homi Bhabha Road, Pune-411 008, India
- Academy of Scientific and Innovative Research (AcSIR), CSIR-NCL, Pune-411 008, India
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18
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Geitona M, Stamuli E, Giannakodimos S, Kimiskidis VK, Kountouris V, Charokopou M, Christou P. Lacosamide as a first-line treatment option in focal epilepsy: a cost-utility analysis for the Greek healthcare system. J Med Econ 2019; 22:359-364. [PMID: 30652931 DOI: 10.1080/13696998.2019.1571499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND AIMS Epilepsy is the most common serious neurological disorder worldwide. Approximately 40% of patients with focal epileptic seizures remain uncontrolled with antiepileptic drug (AED) monotherapy or polytherapy. Lacosamide has been recently approved by the European Medicines Agency as monotherapy for the treatment of focal seizures. The aim of this study was to estimate the cost-effectiveness of lacosamide compared with zonisamide as first-line treatment of focal epilepsy in patients with epilepsy aged ≥ 16 years to inform clinical decision-making in Greece. METHODS A discrete event simulation model was adapted to reflect treatment pathways and resource use within the Greek national healthcare system, as specified by clinical experts. The model captures time-varying events and patient characteristics. Clinical inputs were sourced from pivotal trials and a network meta-analysis comparing lacosamide with other AEDs. The model predicts disease progression and seizures, relevant and most common adverse events, withdrawal due to lack of efficacy or adverse events, and epilepsy-specific and all-cause mortality over a 2-year time horizon. Unit costs were retrieved from published Greek sources. Health outcomes were measured as quality-adjusted life years (QALYs); secondary outcome was the cost per seizure avoided. Robustness of the results was tested with univariate and probabilistic sensitivity analyses. RESULTS The lacosamide treatment pathway was associated with higher costs (i.e. €1,064) and an additional 0.119 QALYs when compared with zonisamide, resulting in an incremental cost-effectiveness ratio of €8,938 per QALY gained. The sensitivity analyses demonstrated that the results are most sensitive to the efficacy and utility estimates. LIMITATIONS There are a number of limitations which stem from the process of model adaptation and lack of local real-world evidence. CONCLUSIONS Lacosamide is a cost-effective option at a willingness-to-pay threshold of €30,000 per QALY, representing a valuable monotherapy treatment option for patients with focal epileptic seizures in the Greek setting.
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Affiliation(s)
- Mary Geitona
- a School of Social & Political Sciences, Department of Social & Educational Policy , University of Peloponnese , Corinth , Greece
| | - Eugena Stamuli
- b Research Fellow Department of Health Sciences , University of York , York , UK
| | | | - Vasileios K Kimiskidis
- d Laboratory of Clinical Neurophysiology , AHEPA University Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece
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19
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20
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Sun W, Zhu ZL, Zuo LM, Zhao T, Zhu MH, Shan GZ. Crystal structure of tert-butyl (R)-(1-(benzylamino)-3-methoxy-1-oxopropan-2-yl)carbamate, C16H24N2O4. Z KRIST-NEW CRYST ST 2018. [DOI: 10.1515/ncrs-2018-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractC16H24N2O4, monoclinic, P21 (no. 4), a = 10.7872(2) Å, b = 5.02626(11) Å, c = 15.5479(3) Å, β = 94.2278(17)°, V = 840.70(3) Å3, Z = 2, Rgt(F) = 0.0337, wRref(F2) = 0.0871, T = 293(2) K.
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Affiliation(s)
- Wei Sun
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Zhi-Ling Zhu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Li-Min Zuo
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Ting Zhao
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Ming-Hui Zhu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Guang-Zhi Shan
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
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21
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Newey CR, Le NM, Ahrens C, Sahota P, Hantus S. The Safety and Effectiveness of Intravenous Lacosamide for Refractory Status Epilepticus in the Critically Ill. Neurocrit Care 2017; 26:273-279. [PMID: 27844464 DOI: 10.1007/s12028-016-0322-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Status epilepticus (SE) often does not respond to initial treatment. A second-line agent with a less established safety and efficacy profile is then required. This study examined the safety of intravenous (IV) lacosamide (LCM) in a critically ill population and obtained an estimate of effectiveness in patients with refractory SE on continuous video EEG monitoring (cEEG). METHODS Retrospective review of critically ill patients in SE on cEEG treated with IV LCM from June 2009 to April 2011. RESULTS Eighty-four patients in SE (43 F/41 M), mean age 59.6 years, were identified; and 59.5 % had nonconvulsive SE. The most common etiologies were ischemic and hemorrhagic strokes. There were no significant changes in serial blood pressure monitoring, PR prolongation, aspartate aminotransferase (AST), or creatinine pre- and post-LCM. There was a significant increase in alanine aminotransferase (ALT) from days 1-7 (p = 0.031). Fifty-one patients were LCM-naïve. In these patients, cessation of SE on cEEG after LCM occurred in 15.7, 25.5, 58.8, and 82.4 % by 4, 12, 24, and 48 h, respectively. CONCLUSION IV LCM appears safe short term in critically ill patients with SE. The retrospective estimate of effectiveness for LCM appears promising for management in SE. Prospective, randomized controlled studies are needed to better determine the role of LCM in treating SE.
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Affiliation(s)
- C R Newey
- Department of Neurology, University of Missouri, 5 Hospital Drive, CE 540, Columbia, MO, 65211, USA.
| | - N M Le
- Pediatric Neurology, Orlando Health System, 7485 Sand Lake Commons Blvd, Orlando, FL, 32819, USA
| | - C Ahrens
- Department of Pharmacy, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA
| | - P Sahota
- Department of Neurology, University of Missouri, 5 Hospital Drive, CE 540, Columbia, MO, 65211, USA
| | - S Hantus
- Cerebrovascular Center, Neurologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA.,Epilepsy Center, Neurologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA
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22
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Nemes AD, O'Dwyer R, Najm IM, Ying Z, Gonzalez-Martinez J, Alexopoulos AV. Treatment with lacosamide impedes generalized seizures in a rodent model of cortical dysplasia. Epilepsia 2017; 58:1755-1761. [PMID: 28833036 DOI: 10.1111/epi.13856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Epilepsy is a common neurologic disorder resulting in spontaneous, recurrent seizures. About 30-40% of patients are not responsive to pharmacologic therapies. This may be due to the differences between individual patients such as etiology, underlying pathophysiology, and seizure focus, and it highlights the importance of new drug discovery and testing in this field. Our goal was to determine the efficacy of lacosamide (LCM), a drug approved for the treatment of focal seizures, in a model of generalized epilepsy with cortical dysplasia (CD). We sought to compare LCM to levetiracetam (LEV), a drug that is currently used for the treatment of both partial and generalized epilepsy and to test its proficiency. METHODS Pregnant rats were irradiated to produce pups with malformed cortices in a model of CD, which will be referred to as the "first hit." Adult animals, developed normally (NL) and irradiated (XRT), were surgically implanted with electroencephalography (EEG) electrodes. Baseline EEG was recorded on all rats prior to pretreatments with either LCM, LEV, or placebo (PBO). After 30 min, all rats were injected with a subconvulsive dose of pentylenetetrazole (PTZ), a γ-aminobutyric acid receptor A (GABAA ) antagonist used to provoke generalized seizures as a "second hit." RESULTS LCM and LEV were both effective against seizures induced by PTZ. XRT rats had a higher seizure incidence with longer and more severe seizures than NL rats. Seizure duration was decreased with both LCM and LEV in all animals. In XRT rats, there was a significant reduction in acute seizure incidence and severity with both LCM and LEV after PTZ injection. SIGNIFICANCE Our results suggest that LCM could be used as a potential treatment option for generalized epilepsy with CD as the underlying pathology.
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Affiliation(s)
- Ashley D Nemes
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Rebecca O'Dwyer
- Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, U.S.A
| | - Imad M Najm
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Zhong Ying
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
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McGinty RN, Costello DJ. Long-term lacosamide retention-Real-world experience at a tertiary epilepsy center in Ireland. Epilepsy Behav 2017; 68:141-145. [PMID: 28183037 DOI: 10.1016/j.yebeh.2016.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/12/2016] [Accepted: 10/12/2016] [Indexed: 01/19/2023]
Abstract
PURPOSE To estimate the rate of long-term lacosamide retention among a real-world group of patients at a tertiary epilepsy center in Ireland. METHODS One-hundred adults first prescribed lacosamide for epilepsy between January 2010 and August 2014 at Cork University Hospital were randomly selected for a retrospective analysis of medical records covering two years of subsequent epilepsy clinic follow-up to ascertain whether lacosamide was continued or withdrawn. RESULTS Of 100 patients, (51 males, mean age 40.8years, 94 with drug-resistant epilepsy, 76 with focal epilepsy, 25 with intellectual disabilities, 34 with mental health disorders, and 42 with medical comorbidities), lacosamide was prescribed as an adjunct in 85. Lacosamide retention at 12 and 24months was 76% and 71%, respectively. Twenty-five patients stopped lacosamide due to ineffective seizure control. Adverse-effects were responsible for lacosamide discontinuation in three patients and one patient stopped lacosamide pre-pregnancy. CONCLUSION The relatively high retention rate at two years suggests that lacosamide is generally well tolerated among people with a range of different epilepsy subtypes, intellectual disabilities, medical comorbidities, and mental health disorders, and can aid seizure control in adult patients with a range of difficult-to-treat epilepsies.
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Affiliation(s)
- Ronan N McGinty
- Epilepsy Service, Department of Neurology, Cork University Hospital, Cork, Ireland.
| | - Daniel J Costello
- Epilepsy Service, Department of Neurology, Cork University Hospital, Cork, Ireland
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Liu F, Laguesse S, Legastelois R, Morisot N, Ben Hamida S, Ron D. mTORC1-dependent translation of collapsin response mediator protein-2 drives neuroadaptations underlying excessive alcohol-drinking behaviors. Mol Psychiatry 2017; 22:89-101. [PMID: 26952865 PMCID: PMC5097030 DOI: 10.1038/mp.2016.12] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 01/01/2023]
Abstract
Mammalian target of rapamycin complex 1 (mTORC1) has an essential role in dendritic mRNA translation and participates in mechanisms underlying alcohol-drinking and reconsolidation of alcohol-related memories. Here, we report that excessive alcohol consumption increases the translation of downstream targets of mTORC1, including collapsin response mediator protein-2 (CRMP-2), in the nucleus accumbens (NAc) of rodents. We show that alcohol-mediated induction of CRMP-2 translation is mTORC1-dependent, leading to increased CRMP-2 protein levels. Furthermore, we demonstrate that alcohol intake also blocks glycogen synthase kinase-3β (GSK-3β)-phosphorylation of CRMP-2, which results in elevated binding of CRMP-2 to microtubules and a concomitant increase in microtubule content. Finally, we show that systemic administration of the CRMP-2 inhibitor lacosamide, or knockdown of CRMP-2 in the NAc decreases excessive alcohol intake. These results suggest that CRMP-2 in the NAc is a convergent point that receives inputs from two signaling pathways, mTORC1 and GSK-3β, that in turn drives excessive alcohol-drinking behaviors.
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Affiliation(s)
- F Liu
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - S Laguesse
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - R Legastelois
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - N Morisot
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - S Ben Hamida
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - D Ron
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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Abstract
Unusual amino acids are fundamental building blocks of modern medicinal chemistry. The combination of readily functionalized amine and carboxyl groups attached to a chiral central core along with one or two potentially diverse side chains provides a unique three-dimensional structure with a high degree of functionality. This makes them invaluable as starting materials for syntheses of complex molecules, highly diverse elements for SAR campaigns, integral components of peptidomimetic drugs, and potential drugs on their own. This Perspective highlights the diversity of unnatural amino acid structures found in hit-to-lead and lead optimization campaigns and clinical stage and approved drugs, reflecting their increasingly important role in medicinal chemistry.
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Affiliation(s)
- Mark A T Blaskovich
- Institute for Molecular Bioscience, The University of Queensland , Brisbane, Queensland Australia 4072
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Aratikatla EK, Bhattacharya AK. Chiral pool approach for the synthesis of functionalized amino acids: synthesis of antiepileptic drug ( R )-lacosamide. Tetrahedron Lett 2015. [DOI: 10.1016/j.tetlet.2015.08.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Wang S, Zhou S, Wang J, Nian Y, Kawashima A, Moriwaki H, Aceña JL, Soloshonok VA, Liu H. Chemical Dynamic Thermodynamic Resolution and S/R Interconversion of Unprotected Unnatural Tailor-made α-Amino Acids. J Org Chem 2015; 80:9817-30. [DOI: 10.1021/acs.joc.5b01292] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shuni Wang
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
| | - Shengbin Zhou
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
| | - Jiang Wang
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
| | - Yong Nian
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
| | - Aki Kawashima
- Hamari Chemicals Ltd., 1-4-29
Kunijima, Higashi-Yodogawa-ku, Osaka 533-0024, Japan
| | - Hiroki Moriwaki
- Hamari Chemicals Ltd., 1-4-29
Kunijima, Higashi-Yodogawa-ku, Osaka 533-0024, Japan
| | - José L. Aceña
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel Lardizábal 3, 20018 San Sebastián, Spain
| | - Vadim A. Soloshonok
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel Lardizábal 3, 20018 San Sebastián, Spain
- IKERBASQUE, Basque Foundation for Science, Alameda Urquijo 36-5, Plaza Bizkaia, 48011 Bilbao, Spain
| | - Hong Liu
- CAS
Key Laboratory of Receptor Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
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Torregrosa R, Yang XF, Dustrude ET, Cummins TR, Khanna R, Kohn H. Chimeric derivatives of functionalized amino acids and α-aminoamides: compounds with anticonvulsant activity in seizure models and inhibitory actions on central, peripheral, and cardiac isoforms of voltage-gated sodium channels. Bioorg Med Chem 2015; 23:3655-66. [PMID: 25922183 PMCID: PMC4461516 DOI: 10.1016/j.bmc.2015.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/26/2015] [Accepted: 04/03/2015] [Indexed: 10/23/2022]
Abstract
Six novel 3″-substituted (R)-N-(phenoxybenzyl) 2-N-acetamido-3-methoxypropionamides were prepared and then assessed using whole-cell, patch-clamp electrophysiology for their anticonvulsant activities in animal seizure models and for their sodium channel activities. We found compounds with various substituents at the terminal aromatic ring that had excellent anticonvulsant activity. Of these compounds, (R)-N-4'-((3″-chloro)phenoxy)benzyl 2-N-acetamido-3-methoxypropionamide ((R)-5) and (R)-N-4'-((3″-trifluoromethoxy)phenoxy)benzyl 2-N-acetamido-3-methoxypropionamide ((R)-9) exhibited high protective indices (PI=TD50/ED50) comparable with many antiseizure drugs when tested in the maximal electroshock seizure test to mice (intraperitoneally) and rats (intraperitoneally, orally). Most compounds potently transitioned sodium channels to the slow-inactivated state when evaluated in rat embryonic cortical neurons. Treating HEK293 recombinant cells that expressed hNaV1.1, rNaV1.3, hNaV1.5, or hNaV1.7 with (R)-9 recapitulated the high levels of sodium channel slow inactivation.
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Affiliation(s)
- Robert Torregrosa
- NeuroGate Therapeutics, Inc., 150 Fayetteville Street, Suite 2300, Raleigh, NC 27601, United States
| | - Xiao-Fang Yang
- Department of Pharmacology and Neuroscience Graduate Interdisciplinary Program, College of Medicine, University of Arizona, Tucson, AZ 85742, United States
| | - Erik T Dustrude
- Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Theodore R Cummins
- Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, United States; Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Rajesh Khanna
- Department of Pharmacology and Neuroscience Graduate Interdisciplinary Program, College of Medicine, University of Arizona, Tucson, AZ 85742, United States
| | - Harold Kohn
- NeuroGate Therapeutics, Inc., 150 Fayetteville Street, Suite 2300, Raleigh, NC 27601, United States; Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, United States; Department of Chemistry, University of North Carolina, Chapel Hill, NC 27599, United States
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IJff DM, van Veenendaal TM, Majoie HJM, de Louw AJA, Jansen JFA, Aldenkamp AP. Cognitive effects of lacosamide as adjunctive therapy in refractory epilepsy. Acta Neurol Scand 2015; 131:347-54. [PMID: 25630655 DOI: 10.1111/ane.12372] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lacosamide (LCM) is a novel antiepileptic drug (AED) with potential benefit as adjunctive treatment in patients with partial-onset seizures. As yet, limited information on cognitive effects of LCM is available, especially in real-life settings. AIMS In this open clinical prospective study, the cognitive effects of LCM were evaluated when used as adjunctive antiepileptic therapy in patients with refractory epilepsy. METHODS We included 33 patients aged between 16 and 74 years (mean: 37 years). All patients had a localization-related epilepsy. Patients were assessed at baseline before starting LCM treatment and during follow-up when the optimal clinical dose was achieved. MATERIALS Subjective complaints were evaluated using the SIDAED; effects on cognition were evaluated using the computerized visual searching task (CVST). RESULTS The CVST showed significant faster information processing reaction times at the second evaluation (P = 0.013), which was not correlated with seizure control, type of epilepsy, age, gender, drug load, number of concomitant drugs, dose or duration of LCM treatment. On the SIDAED, patients complained more about their cognitive function at the second evaluation (P = 0.005). For the SIDAED, a positive correlation at follow-up was found between the total severity score and higher age (r = 0.375, P = 0.031), but not with epilepsy factors or treatment characteristics. DISCUSSION/CONLUSION Screening of the cognitive effects of LCM showed that LCM does not have negative effects on information processing speed. As this is the most sensitive function for cognitive side effects of AEDs, LCM does not seem to induce the common negative cognitive effects. Remarkably, patients complained more, especially about their cognitive function, which is possible the 'doing better, feeling worse phenomenon'.
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Affiliation(s)
- D. M. IJff
- Departments of Neurology and Neuropsychology Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - T. M. van Veenendaal
- School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
- Department of Radiology; Maastricht University Medical Centre; Maastricht The Netherlands
| | - H. J. M. Majoie
- Departments of Neurology and Neuropsychology Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - A. J. A. de Louw
- Departments of Neurology and Neuropsychology Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
| | - J. F. A. Jansen
- School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
- Department of Radiology; Maastricht University Medical Centre; Maastricht The Netherlands
| | - A. P. Aldenkamp
- Departments of Neurology and Neuropsychology Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
- Department of Neurology; Maastricht University Medical Centre; Maastricht The Netherlands
- Department of Neurology; Gent University Hospital; Gent Belgium
- Faculty of Electrical Engineering; University of Technology; Eindhoven The Netherlands
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Park KD, Yang XF, Dustrude ET, Wang Y, Ripsch MS, White FA, Khanna R, Kohn H. Chimeric agents derived from the functionalized amino acid, lacosamide, and the α-aminoamide, safinamide: evaluation of their inhibitory actions on voltage-gated sodium channels, and antiseizure and antinociception activities and comparison with lacosamide and safinamide. ACS Chem Neurosci 2015; 6:316-30. [PMID: 25418676 PMCID: PMC4372064 DOI: 10.1021/cn5002182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
![]()
The functionalized amino acid, lacosamide
((R)-2), and the α-aminoamide,
safinamide ((S)-3), are neurological
agents that have been extensively
investigated and have displayed potent anticonvulsant activities in
seizure models. Both compounds have been reported to modulate voltage-gated
sodium channel activity. We have prepared a series of chimeric compounds,
(R)-7–(R)-10, by merging key structural units in these two clinical
agents, and then compared their activities with (R)-2 and (S)-3. Compounds
were assessed for their ability to alter sodium channel kinetics for
inactivation, frequency (use)-dependence, and steady-state activation
and fast inactivation. We report that chimeric compounds (R)-7–(R)-10 in catecholamine A-differentiated (CAD) cells and embryonic rat
cortical neurons robustly enhanced sodium channel inactivation at
concentrations far lower than those required for (R)-2 and (S)-3, and that
(R)-9 and (R)-10, unlike (R)-2 and (S)-3, produce sodium channel frequency (use)-dependence
at low micromolar concentrations. We further show that (R)-7–(R)-10 displayed
excellent anticonvulsant activities and pain-attenuating properties
in the animal formalin model. Of these compounds, only (R)-7 reversed mechanical hypersensitivity in the tibial-nerve
injury model for neuropathic pain in rats.
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Affiliation(s)
| | - Xiao-Fang Yang
- Department
of Pharmacology and Neuroscience Graduate Interdisciplinary Program,
College of Medicine, University of Arizona, Tucson, Arizona 85742, United States
| | | | - Yuying Wang
- Department
of Pharmacology and Neuroscience Graduate Interdisciplinary Program,
College of Medicine, University of Arizona, Tucson, Arizona 85742, United States
| | | | | | - Rajesh Khanna
- Department
of Pharmacology and Neuroscience Graduate Interdisciplinary Program,
College of Medicine, University of Arizona, Tucson, Arizona 85742, United States
| | - Harold Kohn
- NeuroGate Therapeutics, Inc., 150
Fayetteville Street, Suite 2300, Raleigh, North Carolina 27601, United States
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Lee H, Park KD, Torregrosa R, Yang XF, Dustrude ET, Wang Y, Wilson SM, Barbosa C, Xiao Y, Cummins TR, Khanna R, Kohn H. Substituted N-(biphenyl-4'-yl)methyl (R)-2-acetamido-3-methoxypropionamides: potent anticonvulsants that affect frequency (use) dependence and slow inactivation of sodium channels. J Med Chem 2014; 57:6165-82. [PMID: 25004277 PMCID: PMC4111400 DOI: 10.1021/jm500707r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
We
prepared 13 derivatives of N-(biphenyl-4′-yl)methyl
(R)-2-acetamido-3-methoxypropionamide that differed
in type and placement of a R-substituent in the terminal aryl unit.
We demonstrated that the R-substituent impacted the compound’s
whole animal and cellular pharmacological activities. In rodents,
select compounds exhibited excellent anticonvulsant activities and
protective indices (PI = TD50/ED50) that compared
favorably with clinical antiseizure drugs. Compounds with a polar,
aprotic R-substituent potently promoted Na+ channel slow
inactivation and displayed frequency (use) inhibition of Na+ currents at low micromolar concentrations. The possible advantage
of affecting these two pathways to decrease neurological hyperexcitability
is discussed.
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Affiliation(s)
- Hyosung Lee
- Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, and ‡Department of Chemistry, University of North Carolina , Chapel Hill, North Carolina 27599, United States
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Specific binding of lacosamide to collapsin response mediator protein 2 (CRMP2) and direct impairment of its canonical function: implications for the therapeutic potential of lacosamide. Mol Neurobiol 2014; 51:599-609. [PMID: 24944082 DOI: 10.1007/s12035-014-8775-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/01/2014] [Indexed: 12/22/2022]
Abstract
The novel antiepileptic drug lacosamide (LCM; SPM927, Vimpat®) has been heralded as having a dual-mode of action through interactions with both the voltage-gated sodium channel and the neurite outgrowth-promoting collapsin response mediator protein 2 (CRMP2). Lacosamide's ability to dampen neuronal excitability through the voltage-gated sodium channel likely underlies its efficacy in attenuating the symptoms of epilepsy (i.e., seizures). While the role of CRMP2 in epilepsy has not been well studied, given the proposed involvement of circuit reorganization in epileptogenesis, the ability of lacosamide to alter CRMP2 function may prove disease modifying. Recently, however, the validity of lacosamide's interaction with CRMP2 has come under scrutiny. In this review, we address the contradictory reports concerning the binding of lacosamide to CRMP2 as well as the ability of lacosamide to directly impact CRMP2 function. Additionally, we address similarly the contradicting reports regarding the potential disease-modifying effect of lacosamide on the development and progression of epilepsy. As the vast majority of antiepileptic drugs influences only the symptoms of epilepsy, the ability to hinder disease progression would be a major breakthrough in efforts to cure or prevent this debilitating syndrome.
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Ahuja P, Husain A, Siddiqui N. Essential aminoacid incorporated GABA–phthalimide derivatives: synthesis and anticonvulsant evaluation. Med Chem Res 2014. [DOI: 10.1007/s00044-014-0949-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Yang X, Fan L, Xue Y. Mechanistic insights into l-proline-catalyzed transamidation of carboxamide with benzylamine from density functional theory calculations. RSC Adv 2014. [DOI: 10.1039/c4ra04105d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Density functional theory was used to study mechanism of transamidation of carboxamides with amines catalysed by l-proline in three different solvents.
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Affiliation(s)
- Xin Yang
- Key Laboratory of Green Chemistry and Technology in Ministry of Education
- College of Chemistry Sichuan University
- Chengdu 610064, P.R. China
| | - Linlin Fan
- Key Laboratory of Green Chemistry and Technology in Ministry of Education
- College of Chemistry Sichuan University
- Chengdu 610064, P.R. China
| | - Ying Xue
- Key Laboratory of Green Chemistry and Technology in Ministry of Education
- College of Chemistry Sichuan University
- Chengdu 610064, P.R. China
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What are the arguments for and against rational therapy for epilepsy? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 813:295-308. [PMID: 25012386 DOI: 10.1007/978-94-017-8914-1_24] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although more than a dozen new anti-seizure drugs (ASDs) have entered the market since 1993, a substantial proportion of patients (~30 %) remain refractory to current treatments. Thus, a concerted effort to identify and develop new therapies that will help these patients continues. Until this effort succeeds, it is reasonable to re-assess the use of currently available therapies and to consider how these therapies might be utilized in a more efficacious manner. This applies to the selection of monotherapies in newly-diagnosed epilepsy, but perhaps, more importantly, to the choice of combination treatments in otherwise drug-refractory epilepsy. Rational polytherapy is a concept that is predicated on the combination of drugs with complementary mechanisms of action (MoAs) that work synergistically to maximize efficacy and minimize the potential for adverse events. Furthermore, rational polytherapy requires a detailed understanding of the MoA subclasses amongst available ASDs and an appreciation of the empirical evidence that supports the use of specific combinations. The majority of ASDs can be loosely categorized into those that target neurotransmission and network hyperexcitability, modulate intrinsic neuronal properties through ion channels, or possess broad-spectrum efficacy as a result of multiple mechanisms. Within each of these categories, there are discrete pharmacological profiles that differentiate individual ASDs. This chapter will consider how knowledge of MoA can help guide therapy in a rational manner, both in the selection of monotherapies for specific seizure types and syndromes, but also in the choice of drug combinations for patients whose epilepsy is not optimally controlled with a single ASD.
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36
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Luk ME, Tatum WO, Patel AV, Nau KM, Freeman WD. The safety of lacosamide for treatment of seizures and seizure prophylaxis in adult hospitalized patients. Neurohospitalist 2013; 2:77-81. [PMID: 23983867 DOI: 10.1177/1941874412446200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lacosamide (LCM) is a newer antiepileptic drug (AED) with favorable properties for hospitalized patients including intravenous formulation, minimal hepatic metabolism, and no adverse respiratory effects. We sought to determine the safety profile of LCM in hospitalized patients. METHODS We performed a retrospective medical record review of patients who received LCM between July 1, 2009, and January 31, 2010, at Mayo Clinic Hospital. Data included demographics, LCM dosing, concomitant AED therapy, documented seizure activity, hemodynamic variables, electrocardiogram (ECG), and laboratory data. Adverse drug reaction and drug-drug interactions were reviewed. RESULTS Thirty-two patients were identified. No major hypotension or serious cardiac arrhythmias occurred. Heart rate increased, however, in seizure group compared with the prophylaxis group 2 hours postdrug infusion (median heart rate = 86 vs 164). The ECGs demonstrated a mean PR interval prolongation of about 6 milliseconds (ms) after LCM initiation (mean PR 185.5 ms, compared with baseline ECG mean of 179.3 ms). Laboratory data revealed no clinically significant changes 24 hours after LCM initiation. Three patients developed adverse events (9.4%): One with altered mental state and exceptionally prolonged ECG PR interval (212 vs 178 ms baseline); One with unexplained thrombocytopenia; and a third patient with dizziness, all of which resolved after drug discontinuation. CONCLUSION The LCM demonstrated ECG PR prolongation as previously reported without systemic hypotension, with no discernable drug-drug interactions in hospitalized patients. About 9% of patients had transient adverse drug reactions after LCM, namely alteration in mental state, unexplained thrombocytopenia, and dizziness, which stopped after discontinuation of the drug.
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Affiliation(s)
- Marilyn E Luk
- Hospital Pharmacy Department, Banner Good Samaritan Medical Center, Phoenix, AZ, USA
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37
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Sawh SC, Newman JJ, Deshpande S, Jones PM. Lacosamide adjunctive therapy for partial-onset seizures: a meta-analysis. PeerJ 2013; 1:e114. [PMID: 23940830 PMCID: PMC3740140 DOI: 10.7717/peerj.114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/04/2013] [Indexed: 01/22/2023] Open
Abstract
Background. The relative efficacy and safety of lacosamide as adjunctive therapy compared to other antiepileptic drugs has not been well established. Objective. To determine if lacosamide provides improved efficacy and safety, reduced length of hospital stay and improved quality of life compared with other anti-epileptic therapies for adults with partial-onset seizures. Data Sources. A systematic review of the medical literature using Medline (1946-Week 4, 2012), EMBASE (1980-Week 3, 2012), Cochrane Central Register of Controlled Trials (Issue 1 of 12, January 2012). Additional studies were identified (through to February 7, 2012) by searching bibliographies, the FDA drug approval files, clinical trial registries and major national and international neurology meeting abstracts. No restrictions on publication status or language were applied. Study Selection. Randomized controlled trials of lacosamide in adults with partial-onset seizures were included. Data Extraction. Study selection, extraction and risk of bias assessment were performed independently by two authors. Authors of studies were contacted for missing data. Data Synthesis. All pooled analyses used the random effects model. Results. Three trials (1311 patients) met inclusion criteria. Lacosamide increased the 50% responder rate compared to placebo (RR 1.68 [95% CI 1.36 to 2.08]; I(2) = 0%). Discontinuation due to adverse events was statistically significantly higher in the lacosamide arm (RR3.13 [95% CI 1.94 to 5.06]; I(2) = 0%). Individual adverse events (ataxia, dizziness, fatigue, and nausea) were also significantly higher in the lacosamide group. Limitations. All dosage arms from the included studies were pooled to make a single pair-wise comparison to placebo. Selective reporting of outcomes was found in all of the included RCTs. Conclusions. Lacosamide as adjunctive therapy in patients with partial-onset seizures increases the 50% responder rate but with significantly more adverse events compared to the placebo.
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Affiliation(s)
- Sonja C. Sawh
- Evidence-Based Medicine/Drug & Therapeutics Committee Resource, London Health Sciences Centre, Pharmacy Department, University Hospital, London, ON, Canada
| | - Jennifer J. Newman
- Evidence-Based Medicine, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | - Santosh Deshpande
- Evidence-Based Medicine/Drug & Therapeutics Committee Resource, London Health Sciences Centre, Pharmacy Department, University Hospital, London, ON, Canada
| | - Philip M. Jones
- Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, ON, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, ON, Canada
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38
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Lee H, Park KD, Yang XF, Dustrude ET, Wilson SM, Khanna R, Kohn H. (Biphenyl-4-yl)methylammonium chlorides: potent anticonvulsants that modulate Na+ currents. J Med Chem 2013; 56:5931-9. [PMID: 23772678 DOI: 10.1021/jm4007092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have reported that compounds containing a biaryl linked unit (Ar-X-Ar') modulated Na(+) currents by promoting slow inactivation and fast inactivation processes and by inducing frequency (use)-dependent inhibition of Na(+) currents. These electrophysiological properties have been associated with the mode of action of several antiepileptic drugs. In this study, we demonstrate that the readily accessible (biphenyl-4-yl)methylammonium chlorides (compound class B) exhibited a broad range of anticonvulsant activities in animal models, and in the maximal electroshock seizure test the activity of (3'-trifluoromethoxybiphenyl-4-yl)methylammonium chloride (8) exceeded that of phenobarbital and phenytoin upon oral administration to rats. Electrophysiological studies of 8 using mouse catecholamine A-differentiated cells and rat embryonic cortical neurons confirmed that 8 promoted slow and fast inactivation in both cell types but did not affect the frequency (use)-dependent block of Na(+) currents.
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Affiliation(s)
- Hyosung Lee
- Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy and ⊥Department of Chemistry, University of North Carolina , Chapel Hill, North Carolina 27599, United States
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Etayo P, Vidal-Ferran A. Rhodium-catalysed asymmetric hydrogenation as a valuable synthetic tool for the preparation of chiral drugs. Chem Soc Rev 2013; 42:728-54. [PMID: 23132556 DOI: 10.1039/c2cs35410a] [Citation(s) in RCA: 289] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
During the last few decades, rhodium-catalysed asymmetric hydrogenation of diverse alkene classes has emerged as a powerful synthetic tool in the pharmaceutical industry, contributing to the manufacturing of chiral drugs, recent drug candidates for clinical trials, and major synthetic precursors of drugs. Numerous efficient chiral rhodium complexes, most of which are derived from enantiopure phosphorus ligands, have been employed for the preparation of chiral drugs and intermediates thereof. This review article is intended to provide an updated overview of the most striking contributions in this field, organised according to substrate class: acrylate derivatives, itaconate derivatives, α-substituted enamides, α-arylenol acetates, and minimally functionalised olefins.
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Affiliation(s)
- Pablo Etayo
- Institute of Chemical Research of Catalonia (ICIQ), Avgda. Països Catalans 16, E-43007 Tarragona, Spain
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40
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Park KD, Yang XF, Lee H, Dustrude ET, Wang Y, Khanna R, Kohn H. Discovery of lacosamide affinity bait agents that exhibit potent voltage-gated sodium channel blocking properties. ACS Chem Neurosci 2013; 4:463-74. [PMID: 23509982 DOI: 10.1021/cn300188h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Lacosamide ((R)-1) is a recently marketed, first-in-class, antiepileptic drug. Patch-clamp electrophysiology studies are consistent with the notion that (R)-1 modulates voltage-gated Na(+) channel function by increasing and stabilizing the slow inactivation state without affecting fast inactivation. The molecular pathway(s) that regulate slow inactivation are poorly understood. Affinity baits are chemical reactive units, which when appended to a ligand (drug) can lead to irreversible, covalent modification of the receptor thus permitting drug binding site identification including, possibly, the site of ligand function. We describe, herein, the synthesis of four (R)-1 affinity baits, (R)-N-(4″-isothiocyanatobiphenyl-4'-yl)methyl 2-acetamido-3-methoxypropionamide ((R)-8), (S)-N-(4″-isothiocyanatobiphenyl-4'-yl)methyl 2-acetamido-3-methoxypropionamide ((S)-8), (R)-N-(3″-isothiocyanatobiphenyl-4'-yl)methyl 2-acetamido-3-methoxypropionamide ((R)-9), and (R)-N-(3″-acrylamidobiphenyl-4'-yl)methyl 2-acetamido-3-methoxypropionamide ((R)-10). The affinity bait compounds were designed to interact with the receptor(s) responsible for (R)-1-mediated slow inactivation. We show that (R)-8 and (R)-9 are potent inhibitors of Na(+) channel function and function by a pathway similar to that observed for (R)-1. We further demonstrate that (R)-8 function is stereospecific. The calculated IC50 values determined for Na(+) channel slow inactivation for (R)-1, (R)-8, and (R)-9 were 85.1, 0.1, and 0.2 μM, respectively. Incubating (R)-9 with the neuronal-like CAD cells led to appreciable levels of Na(+) channel slow inactivation after cellular wash, and the level of slow inactivation only modestly decreased with further incubation and washing. Collectively, these findings have identified a promising structural template to investigate the voltage-gated Na(+) channel slow inactivation process.
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Affiliation(s)
- Ki Duk Park
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Xiao-Fang Yang
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Hyosung Lee
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Erik T. Dustrude
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Yuying Wang
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Rajesh Khanna
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
| | - Harold Kohn
- Departments of Pharmacology and
Toxicology, ‡Biochemistry and Molecular Biology, and §Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis,
Indiana 46202, United States
- Division of Chemical Biology and Medicinal
Chemistry, UNC Eshelman School of Pharmacy, and ⊥Department of Chemistry, University of North Carolina, Chapel
Hill, North Carolina 27599, United States
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41
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Vanjari R, Kumar Allam B, Nand Singh K. Hypervalent iodine catalyzed transamidation of carboxamides with amines. RSC Adv 2013. [DOI: 10.1039/c2ra22459c] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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King AM, Yang XF, Wang Y, Dustrude ET, Barbosa C, Due MR, Piekarz AD, Wilson SM, White FA, Salomé C, Cummins TR, Khanna R, Kohn H. Identification of the benzyloxyphenyl pharmacophore: a structural unit that promotes sodium channel slow inactivation. ACS Chem Neurosci 2012; 3:1037-49. [PMID: 23259039 DOI: 10.1021/cn300129d] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 09/19/2012] [Indexed: 11/28/2022] Open
Abstract
Four compounds that contained the N-benzyl 2-amino-3-methoxypropionamide unit were evaluated for their ability to modulate Na(+) currents in catecholamine A differentiated CAD neuronal cells. The compounds differed by the absence or presence of either a terminal N-acetyl group or a (3-fluoro)benzyloxy moiety positioned at the 4'-benzylamide site. Analysis of whole-cell patch-clamp electrophysiology data showed that the incorporation of the (3-fluoro)benzyloxy unit, to give the (3-fluoro)benzyloxyphenyl pharmacophore, dramatically enhanced the magnitude of Na(+) channel slow inactivation. In addition, N-acetylation markedly increased the stereoselectivity for Na(+) channel slow inactivation. Furthermore, we observed that Na(+) channel frequency (use)-dependent block was maintained upon inclusion of this pharmacophore. Confirmation of the importance of the (3-fluoro)benzyloxyphenyl pharmacophore was shown by examining compounds where the N-benzyl 2-amino-3-methoxypropionamide unit was replaced by a N-benzyl 2-amino-3-methylpropionamide moiety, as well as examining a series of compounds that did not contain an amino acid group but retained the pharmacophore unit. Collectively, the data indicated that the (3-fluoro)benzyloxyphenyl unit is a novel pharmacophore for the modulation of Na(+) currents.
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Affiliation(s)
- Amber M. King
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Xiao-Fang Yang
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Yuying Wang
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Erik T. Dustrude
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Cindy Barbosa
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Michael R. Due
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Andrew D. Piekarz
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Sarah M. Wilson
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Fletcher A. White
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Christophe Salomé
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Theodore R. Cummins
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Rajesh Khanna
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
| | - Harold Kohn
- Division
of Chemical Biology and Medicinal Chemistry, UNC Eshelman
School of Pharmacy, and ‡Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina 27599, United
States
- Departments of Pharmacology & Toxicology, ∥Biochemistry & Molecular Biology, and ⊥Anesthesia and #Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana 46202, United States
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Verrotti A, Loiacono G, Olivieri C, Zulli E, Zaccara G. Lacosamide in patients with pharmacoresistant epilepsy. Expert Opin Pharmacother 2012; 13:2065-72. [DOI: 10.1517/14656566.2012.713347] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alberto Verrotti
- University of Chieti, Department of Paediatrics, Ospedale policlinico, Via dei vestini 5, 66100 Chieti, Italy.
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Baruah PK, Dinsmore J, King AM, Salomé C, De Ryck M, Kaminski R, Provins L, Kohn H. Synthesis, anticonvulsant activity, and neuropathic pain-attenuating activity of N-benzyl 2-amino-2-(hetero)aromatic acetamides. Bioorg Med Chem 2012; 20:3551-64. [DOI: 10.1016/j.bmc.2012.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 03/30/2012] [Accepted: 04/03/2012] [Indexed: 11/24/2022]
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Wilson SM, Xiong W, Wang Y, Ping X, Head JD, Brittain JM, Gagare PD, Ramachandran PV, Jin X, Khanna R. Prevention of posttraumatic axon sprouting by blocking collapsin response mediator protein 2-mediated neurite outgrowth and tubulin polymerization. Neuroscience 2012; 210:451-66. [PMID: 22433297 DOI: 10.1016/j.neuroscience.2012.02.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 02/16/2012] [Accepted: 02/17/2012] [Indexed: 01/12/2023]
Abstract
Epileptogenesis following traumatic brain injury (TBI) is likely due to a combination of increased excitability, disinhibition, and increased excitatory connectivity via aberrant axon sprouting. Targeting these pathways could be beneficial in the prevention and treatment of posttraumatic epilepsy. Here, we tested this possibility using the novel anticonvulsant (R)-N-benzyl 2-acetamido-3-methoxypropionamide ((R)-lacosamide [LCM]), which acts on both voltage-gated sodium channels and collapsin response mediator protein 2 (CRMP2), an axonal growth/guidance protein. LCM inhibited CRMP2-mediated neurite outgrowth, an effect phenocopied by CRMP2 knockdown. Mutation of LCM-binding sites in CRMP2 reduced the neurite inhibitory effect of LCM by ∼8-fold. LCM also reduced CRMP2-mediated tubulin polymerization. Thus, LCM selectively impairs CRMP2-mediated microtubule polymerization, which underlies its neurite outgrowth and branching. To determine whether LCM inhibits axon sprouting in vivo, LCM was injected into rats subjected to partial cortical isolation, an animal model of posttraumatic epileptogenesis that exhibits axon sprouting in cortical pyramidal neurons. Two weeks following injury, excitatory synaptic connectivity of cortical layer V pyramidal neurons was mapped using patch clamp recordings and laser scanning photostimulation of caged glutamate. In comparison with injured control animals, there was a significant decrease in the map size of excitatory synaptic connectivity in LCM-treated rats, suggesting that LCM treatment prevented enhanced excitatory synaptic connectivity due to posttraumatic axon sprouting. These findings suggest, for the first time, that LCM's mode of action involves interactions with CRMP2 to inhibit posttraumatic axon sprouting.
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Affiliation(s)
- S M Wilson
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Mnatsakanyan L, Chung JM, Tsimerinov EI, Eliashiv DS. Intravenous Lacosamide in refractory nonconvulsive status epilepticus. Seizure 2012; 21:198-201. [PMID: 22244046 DOI: 10.1016/j.seizure.2011.12.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 12/15/2011] [Accepted: 12/16/2011] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Many patients present with refractory Status epilepticus (SE) despite multiple anti-epileptic drugs (AEDs). Lacosamide (LCM) was recently approved as an adjunct AED for partial-onset seizures. It has unique mechanism of modulating voltage-gated sodium channels by enhancing their slow inactivation. LCM has demonstrated efficacy in animal models of pharmacoresistant seizures. To date, there are isolated anecdotal reports of LCM use in SE. OBJECTIVE To report a single center experience with IV Lacosamide in patients with NCSE. METHODS Pharmacy records were reviewed to identify patients with SE who received IV LCM in our institution. Data on demographics, response to therapy and adverse effects/outcomes were analyzed. All patients had continuous EEG monitoring. RESULTS 10 patients (4 men, 6 women), age 16-90 years with refractory SE were given LCM. Eight patients were in focal non-convulsive SE (NCSE), 2 were in generalized non-convulsive SE. The etiologies included anoxic brain injury, idiopathic, encephalitis, tumor, posterior reversible encephalopathy syndrome (PRES), stroke, and AVM. IV LCM was added after traditional AEDs, including drug-induced coma in some, failed to control the SE. NCSE resolved in 7/10 patients whereas 1/10 patient showed partial response with cessation of NCSE but still frequent electrographic seizures and 2/10 patients were resistant to therapy. CONCLUSIONS LCM is a useful adjunct in refractory NCSE. The IV formulation allows prompt administration in the intensive care unit setting. Response was seen especially in focal SE. Similar to other AEDs, response was poor in patients with postanoxic injury. Our data is limited by the small number of patients. Larger controlled studies are necessary to assess accurately the efficacy of IV LCM as an early treatment of SE.
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Affiliation(s)
- L Mnatsakanyan
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
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Heyman E, Lahat E, Levin N, Berkovitch M, Gandelman-Marton R. Preliminary efficacy and safety of lacosamide in children with refractory epilepsy. Eur J Paediatr Neurol 2012; 16:15-9. [PMID: 21924653 DOI: 10.1016/j.ejpn.2011.08.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 07/28/2011] [Accepted: 08/21/2011] [Indexed: 01/15/2023]
Abstract
BACKGROUND Despite the introduction of multiple new antiepileptic drugs (AEDs) in the past 20 years, about 30% of patients with epilepsy continue to experience uncontrolled seizures or significant side effects. AIMS To present our experience with lacosamide therapy in children with drug-resistant epilepsy. METHODS We retrospectively reviewed the medical charts of all patients receiving oral lacosamide until October 2010. Efficacy was determined according to seizure frequency during the week prior to treatment initiation and the week after the maximal dosage of lacosamide was attained. RESULTS Seventeen patients (10 boys) aged 1.5-16 (mean - 8 ± 4.7) years were identified. Nine patients had epilepsy attributed to a structural cause, six patients had epilepsy of unknown cause, and two had Lennox-Gastaut syndrome. Mean epilepsy duration was 5.4 ± 3.3 years. The mean number of previous AEDs was 6.6 ± 2. Lacosamide was added to the baseline AEDs in13 patients. The mean duration of follow-up was 9.1 ± 4.4 months. Six (35%) patients had at least a 50%.seizure reduction (mean - 76%). Social, behavioral, and/or motor improvement were noted in seven (41%) patients. Lacosamide was discontinued in six (35%) patients because of inefficacy. Side effects were reported in 10 (59%) patients. CONCLUSIONS Lacosamide seems to be effective and safe according to the data in our small cohort. Further prospective studies on lacosamide efficacy and safety in a large number of children are warranted.
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Affiliation(s)
- Eli Heyman
- Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel
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48
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Etayo P, Núñez-Rico JL, Vidal-Ferran A. Chiral Rhodium Complexes Derived From Electron-Rich Phosphine-Phosphites as Asymmetric Hydrogenation Catalysts. Organometallics 2011. [DOI: 10.1021/om200933b] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Pablo Etayo
- Institute of Chemical Research of Catalonia (ICIQ), Avgda. Paı̈sos
Catalans 16, 43007 Tarragona, Spain
| | - José L. Núñez-Rico
- Institute of Chemical Research of Catalonia (ICIQ), Avgda. Paı̈sos
Catalans 16, 43007 Tarragona, Spain
| | - Anton Vidal-Ferran
- Institute of Chemical Research of Catalonia (ICIQ), Avgda. Paı̈sos
Catalans 16, 43007 Tarragona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís
Companys 23, 08010 Barcelona, Spain
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de Leon-Casasola O. New developments in the treatment algorithm for peripheral neuropathic pain. PAIN MEDICINE 2011; 12 Suppl 3:S100-8. [PMID: 21752181 DOI: 10.1111/j.1526-4637.2011.01160.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neuropathic pain often imposes a substantial and unrelenting burden on those individuals who have it; single-agent analgesics typically only reduce pain at best. Worldwide, five sets of treatment recommendations offer insight into managing neuropathic pain, including two European guidelines, one Canadian, one Latin American, and another constructed under the auspices of the International Association for the Study of Pain (IASP). The analgesics common to these guidelines are topical lidocaine, secondary amine tricyclic antidepressants, serotonin and norepinephrine dual reuptake inhibitors, calcium channel α(2)-δ ligands, tramadol, and opioid antagonists. Still, significant knowledge gaps in the treatment of neuropathic pain conditions have hampered the development of algorithms and multimodal approaches. As the evidence base expands, the addition of new comparative trial data will further refine the development of new guidance for clinical management of neuropathic pain. New alternatives for managing neuropathic pain, such as the high-concentration capsaicin patch, will enlarge the treatment armamentarium and potentially impact therapeutic guidelines.
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Affiliation(s)
- Oscar de Leon-Casasola
- School of Medicine and Biomedical Sciences, University at Buffalo, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
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50
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Krasowski MD, Hopfinger AJ. The discovery of new anesthetics by targeting GABAAreceptors. Expert Opin Drug Discov 2011; 6:1187-201. [DOI: 10.1517/17460441.2011.627324] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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