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Govada GV, Rajasekhara Reddy S. Synthesis and in Silico Study of Novel Benzisoxazole-Chromene Derivatives as Potent Inhibitors of Acetylcholinesterase: Metal-Free Site-Selective C-N Bond Formation via Aza-Michael Reaction. Chem Biodivers 2023; 20:e202300573. [PMID: 37415329 DOI: 10.1002/cbdv.202300573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/08/2023]
Abstract
An efficient metal-free approach for site selective C-N coupling reaction of benzo[d]isoxazole and 2H-chromene derivatives has been designed and developed against AchE. This nitrogen containing organo-base promoted methodology, which is both practical and environmentally friendly, provides an easy and suitable pathway for synthesizing Benzisoxazole-Chromene (BC) possessing poly heteroaryl moieties. The synthesized BC derivatives 4 a-n was docked into the active sites of AChE to obtain more perception into the binding modes of the compounds. Out of them, compound 4 a and 4 l displayed potent activity and high selectivity against the AChE inhibition. Final docking results indicates that compound 4 l showed the lowest binding energy of -11.2260 kcal/mol with AChE. The synthesized BC analogs would be potential candidates for promoting suitable studies in medicinal chemistry research.
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Affiliation(s)
- Grace Victoria Govada
- Advanced Catalysis laboratory, Vellore Institute of Technology (VIT), 632014, Vellore, India
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2
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Pal R, Singh K, Khan SA, Chawla P, Kumar B, Akhtar MJ. Reactive metabolites of the anticonvulsant drugs and approaches to minimize the adverse drug reaction. Eur J Med Chem 2021; 226:113890. [PMID: 34628237 DOI: 10.1016/j.ejmech.2021.113890] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 12/22/2022]
Abstract
Several generations of antiepileptic drugs (AEDs) are available in the market for the treatment of seizures, but these are amalgamated with acute to chronic side effects. The most common side effects of AEDs are dose-related, but some are idiosyncratic adverse drug reactions (ADRs) that transpire due to the formation of reactive metabolite (RM) after the bioactivation process. Because of the adverse reactions patients usually discontinue the medication in between the treatment. The AEDs such as valproic acid, lamotrigine, phenytoin etc., can be categorized under such types because they form the RM which may prevail with life-threatening adverse effects or immune-mediated reactions. Hepatotoxicity, teratogenicity, cutaneous hypersensitivity, dizziness, addiction, serum sickness reaction, renal calculi, metabolic acidosis are associated with the metabolites of drugs such as arene oxide, N-desmethyldiazepam, 2-(1-hydroxyethyl)-2-methylsuccinimide, 2-(sulphamoy1acetyl)-phenol, E-2-en-VPA and 4-en-VPA and carbamazepine-10,11-epoxide, etc. The major toxicities are associated with the moieties that are either capable of forming RM or the functional groups may itself be too reactive prior to the metabolism. These functional groups or fragment structures are typically known as structural alerts or toxicophores. Therefore, minimizing the bioactivation potential of lead structures in the early phases of drug discovery by a modification to low-risk drug molecules is a priority for the pharmaceutical companies. Additionally, excellent potency and pharmacokinetic (PK) behaviour help in ensuring that appropriate (low dose) candidate drugs progress into the development phase. The current review discusses about RMs in the anticonvulsant drugs along with their mechanism vis-a-vis research efforts that have been taken to minimize the toxic effects of AEDs therapy.
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Affiliation(s)
- Rohit Pal
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, G.T. Road, Moga, 142001, Punjab, India
| | - Karanvir Singh
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, G.T. Road, Moga, 142001, Punjab, India
| | - Shah Alam Khan
- Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, PO 620, PC 130, Azaiba, Bousher, Muscat, Oman
| | - Pooja Chawla
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, G.T. Road, Moga, 142001, Punjab, India
| | - Bhupinder Kumar
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, G.T. Road, Moga, 142001, Punjab, India.
| | - Md Jawaid Akhtar
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, G.T. Road, Moga, 142001, Punjab, India; Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, PO 620, PC 130, Azaiba, Bousher, Muscat, Oman.
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3
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Shao LY, Xu Z, Wang CY, Fu XP, Chen MM, Liu HW, Ji YF. Palladium-catalyzed direct mono-aroylation of O-arylmethyl and aryl-substituted acetoxime ethers. Org Biomol Chem 2018; 16:6284-6294. [PMID: 30116808 DOI: 10.1039/c8ob01400k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An efficient palladium-catalyzed ortho-aroylation of O-arylmethyl and aryl-substituted acetoxime ethers has been developed; this method has high mono-site selectivity and does not require exogenous ligands. Under the direction of a simple exo-acetoxime auxiliary, a broad scope of masked arylmethyl alcohols and phenols as well as various aromatic aldehydes are compatible with this transformation, which probably follows a mechanistic pathway involving a six- or five-membered exo-cyclopalladated intermediate. The strategy can be expediently adopted to prepare synthetically valuable 1H-benzo[d][1,2]oxazines and benzo[d]isoxazoles. The directing group can be easily removed from the products to afford the functionalized diaryl ketones.
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Affiliation(s)
- Ling-Yan Shao
- School of Pharmacy, East China University of Science & Technology, 130 Meilong Road, Shanghai 200237, P. R. China.
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4
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Martínez-Ávila JC, García Bartolomé A, García I, Dapía I, Tong HY, Díaz L, Guerra P, Frías J, Carcás Sansuan AJ, Borobia AM. Pharmacometabolomics applied to zonisamide pharmacokinetic parameter prediction. Metabolomics 2018; 14:70. [PMID: 30830352 DOI: 10.1007/s11306-018-1365-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/25/2018] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Zonisamide is a new-generation anticonvulsant antiepileptic drug metabolized primarily in the liver, with subsequent elimination via the renal route. OBJECTIVES Our objective was to evaluate the utility of pharmacometabolomics in the detection of zonisamide metabolites that could be related to its disposition and therefore, to its efficacy and toxicity. METHODS This study was nested to a bioequivalence clinical trial with 28 healthy volunteers. Each participant received a single dose of zonisamide on two separate occasions (period 1 and period 2), with a washout period between them. Blood samples of zonisamide were obtained from all patients at baseline for each period, before volunteers were administered any medication, for metabolomics analysis. RESULTS After a Lasso regression was applied, age, height, branched-chain amino acids, steroids, triacylglycerols, diacyl glycerophosphoethanolamine, glycerophospholipids susceptible to methylation, phosphatidylcholines with 20:4 FA (arachidonic acid) and cholesterol ester and lysophosphatidylcholine were obtained in both periods. CONCLUSION To our knowledge, this is the only research study to date that has attempted to link basal metabolomic status with pharmacokinetic parameters of zonisamide.
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Affiliation(s)
- J C Martínez-Ávila
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain.
| | - A García Bartolomé
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - I García
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - I Dapía
- Medical and Molecular Genetics Institute (INGEMM), La Paz University Hospital, Rare Diseases Networking Biomedical Research Center (CIBERER), ISCIII, Madrid, Spain
| | - Hoi Y Tong
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - L Díaz
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - P Guerra
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - J Frías
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - A J Carcás Sansuan
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain.
| | - A M Borobia
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
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5
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Guo Y, Yu KK, Xing LH, Liu HW, Wang W, Ji YF. Palladium-Catalyzed Divergent Regioselective Homocoupling and Hydroxylation of 3-Arylbenzo[d]isoxazoles. Adv Synth Catal 2017. [DOI: 10.1002/adsc.201600853] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ying Guo
- School of Pharmacy; East China University of Science & Technology; 130 Meilong Road Shanghai 200237 People's Republic of China
| | - Kun-Kun Yu
- School of Pharmacy; East China University of Science & Technology; 130 Meilong Road Shanghai 200237 People's Republic of China
| | - Li-Hao Xing
- School of Pharmacy; East China University of Science & Technology; 130 Meilong Road Shanghai 200237 People's Republic of China
| | - Hong-Wei Liu
- School of Pharmacy; East China University of Science & Technology; 130 Meilong Road Shanghai 200237 People's Republic of China
| | - Wei Wang
- Department of Chemistry & Chemical Biology; University of New Mexico; MSC03 2060 Albuquerque NM 87131-0001 USA
| | - Ya-Fei Ji
- School of Pharmacy; East China University of Science & Technology; 130 Meilong Road Shanghai 200237 People's Republic of China
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Guo Y, Shao LY, Yu KK, Hu YH, Liu HW, Liao DH, Ji YF. Palladium-catalyzed site-selective direct olefination of 6-electron-withdrawing group substituted 3-arylbenzo[d]isoxazoles. Org Chem Front 2017. [DOI: 10.1039/c7qo00435d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Palladium-catalyzed direct olefination of 6-electron-withdrawing group substituted 3-arylbenzo[d]isoxazoles has been developed with exclusive site-selectivity and excellent E-stereoselectivity.
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Affiliation(s)
- Ying Guo
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Ling-Yan Shao
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Kun-Kun Yu
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Ya-Hua Hu
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Hong-Wei Liu
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Dao-Hua Liao
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
| | - Ya-Fei Ji
- School of Pharmacy
- East China University of Science & Technology
- Shanghai 200237
- P. R. China
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Abstract
There are more than 12 new antiepileptic drugs approved in the last 2 decades. Even with these newer agents, seizure remission is still unachievable in around 30% of patients with partial-onset seizures (POS). Brivaracetam (BRV) is chemically related to levetiracetam (LEV) and possesses a strong binding affinity for the synaptic vesicle protein 2A tenfold above that of LEV, and other possible modes of antiepileptic actions. BRV is now under Phase III development for POS, but data from one Phase III trial also suggested its potential efficacy for primary generalized seizures. The purpose of this review is to provide updated information on the mechanisms of action of the available antiepileptic drugs, with a focus on BRV to assess its pharmacology, pharmacokinetics, clinical efficacy, safety, and tolerability in patients with uncontrolled POS. To date, six Phase IIb and III clinical trials have been performed to investigate the efficacy, safety, and tolerability of BRV as an adjunctive treatment for patients with POS. Generally, BRV was well tolerated and did not show significant difference in safety profile, compared to placebo. The efficacy outcomes of BRV, although not consistent across trials, did indicate that BRV was a promising add-on therapy for patients with POS. In conclusion, the many favorable attributes of BRV, like its high oral efficacy, good tolerability, dosing regimen, and minimal drug interaction, make it a promising antiepileptic therapy for patients with uncontrolled partial-onset epilepsy.
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Affiliation(s)
- Lan Gao
- Deakin Population Health SRC, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Shuchuen Li
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
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Could Adult European Pharmacoresistant Epilepsy Patients Be Treated With Higher Doses of Zonisamide? Clin Neuropharmacol 2016; 39:121-4. [PMID: 26818046 DOI: 10.1097/wnf.0000000000000138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the clinical effect (efficacy and tolerability) of high doses of zonisamide (ZNS) (>500 mg/d) in adult patients with pharmacoresistant epilepsy. METHODS Between 2006 and 2013, all epileptic outpatients treated with high doses of ZNS were selected. Safety and efficacy were assessed based on patient and caregiver reports. Serum levels of ZNS and other concomitant antiepileptic drugs were evaluated if available. RESULTS Nine patients (5 female): 8 focal/1 generalized pharmacoresistant epilepsy. Mean age: 34 years. Most frequent seizure type: complex partial seizures; other seizure types: generalized tonic-clonic, tonic, myoclonia. Zonisamide in polytherapy in all (100%), administered in tritherapy in 3 (33%) of 9 patients; mean dose: 633 (600-700) mg/d; efficacy (>50% seizure reduction) was observed in 5 (55%) of 9 patients. Five of 9 patients are still taking high doses of ZNS (more than 1 year). Adverse events were observed in 3 (37%) of 8 patients. Good tolerance to high doses of other antiepileptic drugs had been observed in 6 (66%) of 9 patients. Plasma levels of ZNS were only available in 2 patients; both were in the therapeutic range (34.95, 30.91) (10-40 mg/L). CONCLUSIONS High doses of ZNS are effective and safe in pharmacoresistant epileptic patients. Therapeutic drug monitoring of ZNS may be considered at therapeutic failure.
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9
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Jiao J, Jensen W, Harreby KR, Sevcencu C. The Effect of Spinal Cord Stimulation on Epileptic Seizures. Neuromodulation 2015; 19:154-60. [PMID: 26516727 DOI: 10.1111/ner.12362] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/18/2015] [Accepted: 09/15/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Spinal cord stimulation (SCS) has been applied to relieve chronic pain for decades. Recent studies suggested that SCS also might alleviate epileptic seizures, but the most effective stimulation parameters are not known. The objective of this work was to investigate the role of SCS frequency in alleviating spike-and-wave (SW) discharges induced in rats by pentylenetetrazole (PTZ) infusion. MATERIALS AND METHODS The SW discharges were induced in nine rats. An epidural electrode was placed in the spinal canal at the cervical level. SCS was delivered at four frequencies (30, 80, 130 and 180 Hz) and compared with control intervals without stimulation. The effect was evaluated by analyzing electrocorticographic and intracortical (IC) signals. The means of normalized SW spike power (mSP) and frequency (mSF) were derived from the IC recordings and used to estimate the seizure severity. RESULTS Compared with the control intervals, SCS conducted at 30 Hz significantly increased the mSP and mSF indicating an increase of the SW spiking activity; 80 Hz did not induce significant changes of the features. In contrast, 130- and 180-Hz SCS reduced both mSP and mSF significantly indicating a reduction of the SW spiking activity. CONCLUSIONS The present results showed that 130-Hz and 180-Hz SCS reduced the SWs power and frequency which may indicate an anticonvulsive effect of these SCS frequencies, whereas 30-Hz SCS induced the opposite effects and, therefore, may be proconvulsive.
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Affiliation(s)
- Jianhang Jiao
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Winnie Jensen
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Kristian R Harreby
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Cristian Sevcencu
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Kwan SY, Chuang YC, Huang CW, Chen TC, Jou SB, Dash A. Zonisamide: Review of Recent Clinical Evidence for Treatment of Epilepsy. CNS Neurosci Ther 2015. [PMID: 26205514 DOI: 10.1111/cns.12418] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Zonisamide is an orally administered antiepileptic drug that was first approved for clinical use in Japan in 1989. Since then, it has been licensed in Korea for a broad spectrum of epilepsies in adults and children, and in the USA for adjunctive therapy of adults with partial seizures, and in Europe for monotherapy of adults with newly diagnosed partial seizures and adjunctive therapy of adults and adolescents and children aged ≥6 years with partial seizures with or without secondary generalization. Zonisamide is a benzisoxazole derivative with a unique chemical structure, predictable dose-dependent pharmacokinetics, and multiple complementary mechanisms of action. Treatment with zonisamide is well tolerated and is not known to be associated with clinically significant drug-drug interactions, including with oral contraceptives or other antiepileptic drugs. There have been >2 million patient-years of experience with zonisamide for treatment of epilepsy, and this drug has International League Against Epilepsy level A evidence for efficacy/effectiveness as initial monotherapy for adults with partial-onset seizures. This review presents the evidence for zonisamide across the spectrum of epilepsy, with emphasis on real-world clinical practice and special populations of patients (children, elderly patients, and women of childbearing age) who are likely to be treated in daily clinical practice.
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Affiliation(s)
- Shang-Yeong Kwan
- Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yao-Chung Chuang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Schulze-Bonhage A. The safety and long-term efficacy of zonisamide as adjunctive therapy for focal epilepsy. Expert Rev Neurother 2015; 15:857-65. [PMID: 26144543 DOI: 10.1586/14737175.2015.1065179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epilepsy is a chronic disease which affects 1% of the population worldwide. As treatment is required for many years or decades, the long-term efficacy and tolerability of antiepileptic drugs are particularly important. Zonisamide (ZNS) is a second-generation antiepileptic drug with a unique structure and multiple mechanisms of action. Here, recently published long-term outcomes of patient cohorts with focal epilepsy undergoing ZNS treatment are discussed. Whereas ZNS monotherapy maintains similar seizure control efficacy to carbamazepine after 2 years of treatment, seizure-free rates are low in pharmacoresistant patients undergoing late adjunctive therapy. In preselected patient populations derived from double-blind studies, long-term seizure reduction and responder rates support sustained ZNS efficacy, good adherence and long-term retention. Adverse effects include somnolence and weight decrease, but data suggest that long-term treatment with ZNS is safe with only rare newly occurring adverse effects, and good long-term tolerability also regarding mood, behavior, cognition and bone maturation.
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12
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Zonisamide as a treatment for partial epileptic seizures: a systematic review. Adv Ther 2014; 31:276-88. [PMID: 24522856 DOI: 10.1007/s12325-014-0104-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Indexed: 10/25/2022]
Abstract
Although the majority of people with epilepsy have a good prognosis and their seizures can be well controlled with pharmacotherapy, up to one-third of patients can develop drug-resistant epilepsy, especially those patients with partial seizures. This unmet need has driven considerable efforts over the last few decades aimed at developing and testing newer antiepileptic agents to improve seizure control. One of the most promising antiepileptic drugs of the new generation is zonisamide, a benzisoxazole derivative chemically unrelated to other anticonvulsant agents. In this article, the authors present the results of a systematic literature review summarizing the current evidence on the efficacy and tolerability of zonisamide for the treatment of partial seizures. Of particular interest within this updated review are the recent data on the use of zonisamide as monotherapy, as they might open new therapeutic avenues.
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13
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Duan P, Yang Y, Ben R, Yan Y, Dai L, Hong M, Wu YD, Wang D, Zhang X, Zhao J. Palladium-catalyzed benzo[d]isoxazole synthesis by C–H activation/[4 + 1] annulation. Chem Sci 2014. [DOI: 10.1039/c3sc53228c] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A new protocol has been developed for the synthesis of benzo[d]isoxazole through a palladium-catalyzed C–H bond functionalization–[4 + 1] annulation pathway.
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Affiliation(s)
- Pingping Duan
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Yunfang Yang
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Rong Ben
- Institute of Chemistry and BioMedical Sciences
- State Key Laboratory of Pharmaceutical Biotechnology
- School of Life Sciences
- Nanjing University
- Nanjing, China
| | - Yiyong Yan
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Lu Dai
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Mei Hong
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Yun-Dong Wu
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Dongqi Wang
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Xinhao Zhang
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
| | - Jing Zhao
- Shenzhen Key Lab of Nano-Micro Material Research
- School of Chemical Biology and Biotechnology
- Shenzhen Graduate School of Peking University
- Shenzhen, China
- Institute of Chemistry and BioMedical Sciences
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14
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Impact of pregnancy on zonisamide pharmacokinetics in rabbits. BIOMED RESEARCH INTERNATIONAL 2013; 2013:140327. [PMID: 24455670 PMCID: PMC3878283 DOI: 10.1155/2013/140327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/22/2013] [Indexed: 11/17/2022]
Abstract
Pregnancy is associated with various physiological changes which may lead to significant alterations in the pharmacokinetics of many drugs. The present study was aimed to investigate the potential effects of pregnancy on the pharmacokinetic profile of zonisamide (ZNM) in the rabbit. Seven female rabbits were used in this study. The pregnant and nonpregnant rabbits received ZNM orally at a dose of 10 mg/kg and blood samples were collected from the animals just before receiving the drug and then serially for up to 24 h. The plasma samples were analyzed using tandem mass spectrometric method. Following a single oral dose of ZNM to the rabbits, the mean values of ZNM plasma concentrations at different times were consistently low in pregnant compared to nonpregnant rabbits. The mean values of ZNM's Cmax and AUC0-∞ were significantly (P < 0.05) decreased, whereas the CL/F exhibited substantial increase (P < 0.05) in pregnant compared to nonpregnant rabbits. Tmax, t1/2abs, t1/2el, MRT, and Vd/F showed no significant differences between the two groups. The present study demonstrates that pregnancy decreased ZNM plasma concentrations in rabbits and that the decrease could be due to decreased extent of gastrointestinal absorption, induced hepatic metabolism, or enhanced renal elimination of the drug.
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15
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Trinka E, Giorgi L, Patten A, Segieth J. Safety and tolerability of zonisamide in elderly patients with epilepsy. Acta Neurol Scand 2013; 128:422-8. [PMID: 23773051 DOI: 10.1111/ane.12162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the safety/tolerability of zonisamide in elderly patients. MATERIALS & METHODS A pooled analysis of clinical study data from elderly (≥65 years) patients receiving add-on/monotherapy zonisamide for partial seizures was compared with pooled adult (18-65 years) study data. Assessments included treatment-emergent adverse events (TEAEs), clinical laboratory parameters and weight change. RESULTS Data were analyzed from 95 elderly and 1389 adult patients. Incidence of total TEAEs was similar (elderly, 78/95 [82%] vs adult, 1165/1389 [84%]); but lower in elderly versus adult patients for treatment-related TEAEs (53/95 [56%] vs 1010/1389 [73%]), severe TEAEs (11/95 [12%] vs 289/1389 [21%]), serious TEAEs (12/95 [13%] vs 230/1389 [17%]) and TEAEs leading to withdrawal (17/95 [18%] vs 312/1389 [23%]). Most TEAEs were of mild-to-moderate intensity. TEAEs reported more frequently by elderly versus adult patients included fatigue (11/95 [12%] vs 135/1389 [10%]), nasopharyngitis (8/95 [8%] vs 100/1389 [7%]), constipation (7/95 [7%] vs 67/1389 [5%]) and pruritus (6/95 [6%] vs 29/1389 [2%]). The only serious TEAEs reported by ≥2% of elderly patients were 'convulsions' (4/95 [4%] vs 49/1389 [4%]). Three elderly patients died; one death was considered treatment-related. TEAEs leading to discontinuation of ≥2% of elderly patients were dizziness (4/95 [4%]), headache (2/95 [2%]), somnolence (2/95 [2%]) and confusional state (2/95 [2%]). For elderly patients, there were minimal changes in clinical laboratory parameters, no reports of respiratory alkalosis or metabolic acidosis and no significant weight changes. CONCLUSIONS Zonisamide demonstrated a favourable safety/tolerability profile in elderly patients. No new or unexpected safety findings were identified.
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Affiliation(s)
- E. Trinka
- Department of Neurology; Christian Doppler Klinik; Paracelsus Medical University; Salzburg Austria
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Mula M. Profile of once-daily zonisamide as monotherapy for treatment of partial seizures in adults. DRUG DESIGN DEVELOPMENT AND THERAPY 2013; 7:397-402. [PMID: 23700365 PMCID: PMC3660130 DOI: 10.2147/dddt.s43612] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Epilepsy is one of the most common neurologic disorders, affecting about 50 million people around the world. It is recognized that around 50% of patients with newly diagnosed epilepsy become seizure-free with the first drug treatment, so the choice of first antiepileptic drug is crucial. This paper provides a comprehensive overview of zonisamide as monotherapy for partial seizures, with special attention to the possibility of a once-daily regimen. The available data suggest that zonisamide is an effective and well tolerated option as monotherapy. Once-daily dosing is indicated, considering the long plasma half-life and linear pharmacokinetics of the drug. Zonisamide 300 mg was shown to be noninferior to carbamazepine 600 mg in terms of efficacy and safety, but even lower doses may be effective. Finally, the broad spectrum of efficacy in different seizure types, the low drug interaction potential, and the possibility of weight loss make zonisamide a preferred option in many epilepsy practices. Further data on monotherapy, especially in special populations, such as women of childbearing potential, are needed.
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Affiliation(s)
- Marco Mula
- Division of Neurology, Trinity Hospital, Borgomanero, Italy.
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17
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Brodie MJ, Ben-Menachem E, Chouette I, Giorgi L. Zonisamide: its pharmacology, efficacy and safety in clinical trials. Acta Neurol Scand 2012:19-28. [PMID: 23106522 DOI: 10.1111/ane.12016] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Zonisamide is a benzisoxazole derivative, chemically unrelated to other antiepileptic drugs, that appears to have multiple mechanisms of action, including inhibition of Na(+) channels and reduction of T-type Ca(2+) currents. It is currently licensed in Europe and the USA for adjunctive treatment of partial seizures in adults, and in Europe as monotherapy for treatment of partial seizures in adults with newly diagnosed epilepsy. Zonisamide displays predictable, dose-dependent pharmacokinetics and has a half-life of ~60 h, allowing once- or twice-daily administration. It has a low potential for interactions with other medications, including oral contraceptives. The clinical efficacy of adjunctive zonisamide therapy has been established in four pivotal, phase III, randomized, double-blind, placebo-controlled trials, which together included approximately 850 patients, aged 12-77 years, with refractory partial epilepsy. In all four trials, zonisamide 300-600 mg/day resulted in significant reductions in median total seizure rates vs placebo, and zonisamide was generally well tolerated; the most frequently reported adverse events being somnolence, dizziness and anorexia/weight loss. Subanalysis of the primary European trial indicated that zonisamide was effective when administered as first-line adjunctive treatment, and a long-term extension to the same trial demonstrated that the efficacy and safety/tolerability of adjunctive zonisamide was sustained for up to 36 months. Once-daily monotherapy with zonisamide (200-500 mg/day) has been shown to be non-inferior to, and as well tolerated as, twice-daily monotherapy with controlled-release carbamazepine (400-1200 mg/day) in adults with newly diagnosed partial epilepsy. Zonisamide has also been shown to have favourable long-term retention rates, an important indication of its overall effectiveness.
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Affiliation(s)
- M. J. Brodie
- Epilepsy Unit; Western Infirmary; Glasgow; Scotland
| | - E. Ben-Menachem
- Institute for Clinical Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg; Gothenburg; Sweden
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Efficacy and tolerability of zonisamide versus controlled-release carbamazepine for newly diagnosed partial epilepsy: a phase 3, randomised, double-blind, non-inferiority trial. Lancet Neurol 2012; 11:579-88. [DOI: 10.1016/s1474-4422(12)70105-9] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen CY, Andreani T, Li H. A Divergent and Selective Synthesis of Isomeric Benzoxazoles from a Single N–Cl Imine. Org Lett 2011; 13:6300-3. [DOI: 10.1021/ol202844c] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Cheng-yi Chen
- Process Chemistry, Merck Research Laboratories, P.O. Box 2000, Rahway, New Jersey 07065, United States
| | - Teresa Andreani
- Process Chemistry, Merck Research Laboratories, P.O. Box 2000, Rahway, New Jersey 07065, United States
| | - Hongmei Li
- Process Chemistry, Merck Research Laboratories, P.O. Box 2000, Rahway, New Jersey 07065, United States
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The long-term retention of zonisamide in a large cohort of people with epilepsy at a tertiary referral centre. Epilepsy Res 2011; 96:39-44. [DOI: 10.1016/j.eplepsyres.2011.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 04/19/2011] [Accepted: 04/24/2011] [Indexed: 11/18/2022]
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21
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Lasoń W, Dudra-Jastrzębska M, Rejdak K, Czuczwar SJ. Basic mechanisms of antiepileptic drugs and their pharmacokinetic/pharmacodynamic interactions: an update. Pharmacol Rep 2011; 63:271-92. [DOI: 10.1016/s1734-1140(11)70497-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 03/14/2011] [Indexed: 01/20/2023]
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