1
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Fan Z, Khizar H, Lu J, Wang A, Xun T, Zhang X, Zhao H. From pill to pain: Alendronate-induced esophageal injury-A case report and review. JGH Open 2024; 8:e13080. [PMID: 38832136 PMCID: PMC11144282 DOI: 10.1002/jgh3.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/14/2024] [Accepted: 04/21/2024] [Indexed: 06/05/2024]
Abstract
Background Alendronate is used to treat Paget's bone disease, glucocorticoid-induced osteoporosis, and postmenopausal osteoporosis because it suppresses osteoclast activity to stop bone resorption. Case report We present an exceptional case of esophagitis caused by alendronate. Blood tests and other data were normal when the patient was taken to the hospital, but an endoscopic examination revealed significant esophageal redness, erosion, and ulceration, along with pseudomembrane. The patient was given medicine after receiving a diagnosis of alendronate pill-induced esophagitis based on the pathological findings. Conclusion This case report is a timely reminder of the importance of thorough pharmacovigilance, patient education, and smart therapeutic decision-making in the context of alendronate use. To properly treat and prevent problems with the esophagus caused by alendronate, additional research is required.
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Affiliation(s)
- Zhen Fan
- Department of GastroenterologyHangzhou First People's HospitalHangzhouChina
| | - Hayat Khizar
- Department of GastroenterologyHangzhou First People's HospitalHangzhouChina
| | - Jinjiao Lu
- The Fourth School of Clinical MedicineZhejiang Chinese Medical UniversityHangzhouChina
| | - Anhua Wang
- Department of GastroenterologyWenling First People's HospitalTaizhouChina
| | - Tong Xun
- Department of PathologyHangzhou First People's HospitalHangzhouChina
| | - Xiao Zhang
- Department of GastroenterologyHangzhou First People's HospitalHangzhouChina
| | - Hongfeng Zhao
- Department of Infection ControlHangzhou First People's HospitalHangzhouChina
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2
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Mu Y, Zhao L, Shen L. Medication adherence and pharmaceutical design strategies for pediatric patients: An overview. Drug Discov Today 2023; 28:103766. [PMID: 37708932 DOI: 10.1016/j.drudis.2023.103766] [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: 08/07/2023] [Revised: 08/27/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
Medication adherence in pediatric patients is a key factor in drug development and dosage form design. High medication adherence is not only important to achieve the expected treatment effects but can also effectively reduce medical costs. It is an ongoing task to accurately identify differences in medication adherence between children and adults and analyze the factors related to pediatric medication adherence. This is necessary to guide the development of pediatric drugs. This review focuses on factors that influence pediatric medication adherence as well as pharmaceutical design strategies to improve adherence. Current new dosage forms, new technologies, and new devices are comprehensively summarized in terms of their advantages and limitations.
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Affiliation(s)
- Yingying Mu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China
| | - Lijie Zhao
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China.
| | - Lan Shen
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Pudong District, Shanghai 201203, PR China.
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3
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Psimma C, Psimma Z, Willems HC, Klüter WJ, van der Maarel‐Wierink CD. Oral bisphosphonates: Adverse effects on the oral mucosa not related to the jaw bones. A scoping review. Gerodontology 2022; 39:330-338. [PMID: 34725854 PMCID: PMC9787882 DOI: 10.1111/ger.12590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Oral bisphosphonates are widely used in the treatment of bone resorptive diseases. There is an evidence that oral bisphosphonates can exert adverse effects on the oral mucosa independently of their effects on the jaw bones. OBJECTIVE To systematically map the literature on adverse effects of oral bisphosphonates on the oral mucosa of adults with bone resorptive diseases. DESIGN Scoping review of the literature, including different study designs. METHODS Systematic searches of the PubMed, LILACS, Google Scholar and EMBASE databases were conducted. Two independent reviewers screened titles and abstracts according to predetermined criteria. RESULTS The search retrieved 26 unique articles, comprising 22 case reports, one case series and three reviews describing a total of 56 cases of oral adverse events related to oral bisphosphonates. 88% of the reported cases were female suffering from comorbidities other than metabolic bone diseases. The improper use of the oral bisphosphonate was the most suspected cause of the adverse effect on the oral mucosa. Its management mainly involved withdrawal of the medication. CONCLUSION Adverse effects on the oral mucosa can develop from using oral bisphosphonates. Standardised registration of these adverse effects in university clinics and private practises could provide additional information about their occurrence and severity.
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Affiliation(s)
- Christina Psimma
- BT‐AcademyCenter for Special Care in Dentistry AmsterdamAmsterdamThe Netherlands
| | - Zoi Psimma
- Private PracticeZoetermeerThe Netherlands
| | - Hanna C. Willems
- Department Internal Medicine, Section GeriatricsAmsterdam UMCAmsterdamThe Netherlands
| | - Wim J. Klüter
- BENECOMOFlemish‐Netherlands Geriatric Oral Research GroupNijmegenThe Netherlands,College of Dental SciencesRadboud University Medical CentreNijmegenThe Netherlands
| | - Claar D. van der Maarel‐Wierink
- BT‐AcademyCenter for Special Care in Dentistry AmsterdamAmsterdamThe Netherlands,BENECOMOFlemish‐Netherlands Geriatric Oral Research GroupNijmegenThe Netherlands,College of Dental SciencesRadboud University Medical CentreNijmegenThe Netherlands,Department of Oral MedicineAcademic Centre for Dentistry AmsterdamAmsterdamThe Netherlands
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4
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Tsuji T, Kobayashi R, Hayashi Y, Kumada S, Mizuguchi M, Okada K, Onuki Y. Determination of Hardness of a Pharmaceutical Oral Jelly by Using <i>T</i><sub>2</sub> Relaxation Behavior Measured by Time-Domain NMR. Chem Pharm Bull (Tokyo) 2022; 70:558-565. [DOI: 10.1248/cpb.c22-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Takahiro Tsuji
- Formulation Development Department, Development & Planning Division, Nichi-Iko Pharmaceutical Co., Ltd
| | - Ryosuke Kobayashi
- Laboratory of Pharmaceutical Technology, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
| | - Yoshihiro Hayashi
- Formulation Development Department, Development & Planning Division, Nichi-Iko Pharmaceutical Co., Ltd
| | - Shungo Kumada
- Formulation Development Department, Development & Planning Division, Nichi-Iko Pharmaceutical Co., Ltd
| | - Mineyuki Mizuguchi
- Laboratory of Structural Biology, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
| | - Kotaro Okada
- Laboratory of Pharmaceutical Technology, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
| | - Yoshinori Onuki
- Laboratory of Pharmaceutical Technology, School of Pharmacy and Pharmaceutical Sciences, University of Toyama
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5
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Kulkarni S, Londhe VY. Development and evaluation of extended release metformin pellets suspended in teneligliptin jelly for the treatment of diabetes mellitus. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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Fe(III)-mediated reversible catalytic activity of MoS 2 nanozymes for bisphosphonate drug sensing. Colloids Surf B Biointerfaces 2021; 206:111953. [PMID: 34218013 DOI: 10.1016/j.colsurfb.2021.111953] [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: 03/18/2021] [Revised: 06/14/2021] [Accepted: 06/27/2021] [Indexed: 11/20/2022]
Abstract
Peroxidase-like activity of MoS2 quantum dots (QDs) can be reversibly regulated by means of Fe3+/alendronate sodium (ALDS)-induced aggregation/disaggregation of the QDs in solution. Specifically, Fe3+ can selectively aggregate the MoS2 QDs and thus greatly enhance their peroxidase-like activity, while such enhancement can be inhibited in the presence of ALDS owing to the competitive coordination of ALDS with Fe3+. By regulating the enzyme-like activity of MoS2 QDs, different colorimetric signal of a typical substrate of horseradish peroxidase, 3,3΄,5,5΄-tetramethylbenzidine, can be measured in the presence of H2O2. Based on this mechanism, we develop a colorimetric approach for the determination of ALDS and further applied in quality control of pharmaceutical products, utilizing either smartphone or UV-vis spectrometer as a readout. This detection method is rapid and selective, where derivatization of ALDS before detection is not needed. Such a smartphone-based colorimetric detection platform is promising to be applied in point-of-care testing at home, small clinics, or underdeveloped regions.
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7
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Kulkarni S, Londhe V. Oral jelly of metformin hydrochloride – Formulation development using Design of Experiments and characterization. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Wiesner A, Szuta M, Galanty A, Paśko P. Optimal Dosing Regimen of Osteoporosis Drugs in Relation to Food Intake as the Key for the Enhancement of the Treatment Effectiveness-A Concise Literature Review. Foods 2021; 10:foods10040720. [PMID: 33805435 PMCID: PMC8067335 DOI: 10.3390/foods10040720] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/31/2022] Open
Abstract
Bisphosphonates and selective estrogen receptor modulators (SERMs) represent the two most important groups of medications taken orally and employed in osteoporosis treatment. Effectiveness of the therapy may be affected by poor patient adherence, in particular, due to the inconvenient dosing regimen of oral bisphosphonates. With this review we aimed to assess the effects that food, beverages, and dietary supplements consumed during treatment, along with the dosing regimens, may have on pharmacokinetics and pharmacodynamics of oral drugs employed in treating osteoporosis; we also aimed to shape the recommendations valuable for professional patients’ counseling and education, to provide appropriate dosing regimens in order to improve adherence to the therapy. Food, beverages such as coffee, juices, and mineral water, as well as dietary supplements containing multivalent cations, e.g., calcium, magnesium, aluminium, iron, showed to have a deleterious effect on the bioavailability of all the investigated oral bisphosphonates, specifically alendronate, risedronate, ibandronate, minodronate, and etidronate. For risedronate, a delayed-release (DR) tablet was designed to solve the malabsorption problem in the presence of food, hence DR risedronate can be ingested following breakfast. For other oral bisphosphonates, the proper interval between drug and food, beverages, and dietary supplements intake should be maintained to minimize the risk of interactions. The effect of food on pharmacokinetic parameters of selective estrogen receptor modulators (SERMs) was found to be clinically irrelevant.
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Affiliation(s)
- Agnieszka Wiesner
- Department of Food Chemistry and Nutrition, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Str., 30-688 Kraków, Poland;
| | - Mariusz Szuta
- Department of Oral Surgery, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich Str., 31-155 Kraków, Poland;
| | - Agnieszka Galanty
- Department of Pharmacognosy, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Str., 30-688 Kraków, Poland;
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Str., 30-688 Kraków, Poland;
- Correspondence: ; Tel.: +48-12-620-5670
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9
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Kim KH, Jun M, Lee MK. Bioavailability of the Common Cold Medicines in Jellies for Oral Administration. Pharmaceutics 2020; 12:pharmaceutics12111073. [PMID: 33182644 PMCID: PMC7697653 DOI: 10.3390/pharmaceutics12111073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 11/16/2022] Open
Abstract
Jellies for oral administration have been suggested as alternative dosage forms to conventional tablets for improved palatability and compliances for pediatric and geriatric patients. To evaluate the effect of jelly formulation on the bioavailability of cold medicines, two types of jellies were prepared for a fixed-dose combination of acetaminophen (AAP), chlorpheniramine maleate (CPM), dextromethorphan hydrobromide (DMH), and dl-methylephedrine hydrochloride (MEH). Jelly-S and Jelly-H were fabricated using carrageenan and locust bean gum in the absence and presence of xanthan gum, respectively. In vitro dissolution and in vivo absorption of the four drugs in the jellies were compared with other conventional formulations, a syrup and two types of immediate-release (IR) tablets with different hardness, Tablet-S (15 kPa) and Tablet-H (20 kPa). All the formulations exhibited more than 80% dissolution rate within 2 h even though the syrup, Jelly-S, and Tablet-S showed higher 30-min dissolution compared to Jelly-H and Tablet-H. The dissolution rates from the jellies decreased with increasing pH, which resulted in the slowest dissolution in pH 6.8 compared to the syrup and IR tablets. When administered orally to beagle dogs, all five formulations were determined not to be bioequivalent. However, Jelly-S and Jelly-H showed 0.82-1.05 of the geometric mean ratios (GMRs) of AUC0-t for all four drugs compared to the syrup suggesting comparable absorption. In two IR tablets, GMRs of AUC0-t were in a range of 0.55-0.95 indicating a tendency of lower absorption than the syrup and jellies. In conclusion, jelly can be a patient-centered formulation with comparable bioavailability to syrup.
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Affiliation(s)
- Ki Hyun Kim
- CKD Research Institute, Gyeonggi 16995, Korea; (K.H.K.); (M.J.)
| | - Minju Jun
- CKD Research Institute, Gyeonggi 16995, Korea; (K.H.K.); (M.J.)
| | - Mi-Kyung Lee
- Department of Pharmaceutical Sciences, Woosuk University, Jeonbuk 55338, Korea
- Correspondence: ; Tel.: +82-63-290-1423
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10
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Almurisi SH, Doolaanea AA, Akkawi ME, Chatterjee B, Ahmed Saeed Aljapairai K, Islam Sarker MZ. Formulation development of paracetamol instant jelly for pediatric use. Drug Dev Ind Pharm 2020; 46:1373-1383. [PMID: 32619118 DOI: 10.1080/03639045.2020.1791165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Paracetamol is a common antipyretic and analgesic medicine used in childhood illness by parents and physicians worldwide. Paracetamol has a bitter taste that is considered as a significant barrier for drug administration. This study aimed to develop an oral dosage form that is palatable and easy to swallow by pediatric patients as well as to overcome the shortcomings of liquid formulations. METHODS The paracetamol was encapsulated in beads, which were prepared mainly from alginate and chitosan through electrospray technique. The paracetamol beads were sprinkled on the instant jelly prepared from glycine, ι-carrageenan and calcium lactate gluconate. The paracetamol instant jelly characteristics, in terms of physical appearance, texture, rheology, in vitro drug release and palatability were assessed on a human volunteer. RESULTS The paracetamol instant jelly was easily reconstituted in 20 mL of water within 2 min to form jelly with acceptable consistency and texture. The jelly must be ingested within 30 min after reconstitution to avoid the bitter taste. The palatability assessment carried out on 12 human subjects established the similar palatability and texture of the paracetamol instant jelly dosage comparable to the commercial paracetamol suspension and was found to be even better in overcoming the aftertaste of paracetamol. CONCLUSION Such findings indicate that paracetamol instant jelly will compensate for the use of sweetening and flavoring agents as well as develop pediatric dosage forms with limited undesired excipients.
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Affiliation(s)
- Samah Hamed Almurisi
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Abd Almonem Doolaanea
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia.,IKOP Sdn Bhd, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Muhammad Eid Akkawi
- Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Bappaditya Chatterjee
- Department of Pharmaceutics, SPPSPTM, SVKM's NMIMS (Deemed to be University), Mumbai, India
| | - Khater Ahmed Saeed Aljapairai
- Department of Pharmaceutical Engineering, Faculty of Chemical and Process Engineering Technology, University Malaysia Pahang, Gambang, Malaysia
| | - Md Zaidul Islam Sarker
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
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11
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Harris D, Hermans E, Klein S, Wagner-Hattler L, Walsh J. Age-appropriate solid oral formulations for pediatric applications with a focus on multiparticulates and minitablets: Summary of September 2019 EuPFI workshop. Eur J Pharm Biopharm 2020; 153:222-225. [PMID: 32580052 DOI: 10.1016/j.ejpb.2020.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
Abstract
This paper presents the output of a workshop held at the 11th Annual Conference of EuPFI (European Paediatric Formulation Initiative), in September 2019 in Malmo, Sweden, on the development of multiparticulates and minitablets as pediatric formulations. The workshop focused on three specific facets of pediatric drug development, namely selection of the formulation platform, selection of the package or dosing device, and administration of minitablets/multiparticulates with soft food. The workshop discussion indicated significant interest in the use of these dosage forms, filled into stick-packs or capsules, as age-appropriate formulations for younger children, along with a growing consensus that larger sized tablets and capsules designed for adults are often also suitable for adolescents. Among the areas that were identified as technical challenges were: understanding the acceptability of multiparticulates and minitablets relative to alternate formulations; the need for a streamlined approach to compatibility testing with soft foods; the desire to avoid the need to co-administer these products with soft food; and the need for more suitable dosing devices.
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Affiliation(s)
- David Harris
- Merck & Co, Inc, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA.
| | - Esmerald Hermans
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium.
| | - Sandra Klein
- University of Greifswald, Department of Pharmacy, Felix Hausdorff Strasse 3, 17489 Greifswald, Germany.
| | | | - Jennifer Walsh
- Jenny Walsh Consulting Ltd, BioCity Nottingham NG1 1GF, UK.
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12
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Kadota K, Nogami S, Uchiyama H, Tozuka Y. Controlled release behavior of curcumin from kappa-carrageenan gels with flexible texture by the addition of metal chlorides. Food Hydrocoll 2020. [DOI: 10.1016/j.foodhyd.2019.105564] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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13
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Rycerz K, Stepien KA, Czapiewska M, Arafat BT, Habashy R, Isreb A, Peak M, Alhnan MA. Embedded 3D Printing of Novel Bespoke Soft Dosage Form Concept for Pediatrics. Pharmaceutics 2019; 11:pharmaceutics11120630. [PMID: 31779123 PMCID: PMC6956071 DOI: 10.3390/pharmaceutics11120630] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 11/16/2022] Open
Abstract
Embedded three-dimensional printing (e-3DP) is an emerging method for additive manufacturing where semi-solid materials are extruded within a solidifying liquid matrix. Here, we present the first example of employing e-3DP in the pharmaceutical field and demonstrate the fabrication of bespoke chewable dosage forms with dual drug loading for potential use in pediatrics. LegoTM-like chewable bricks made of edible soft material (gelatin-based matrix) were produced by directly extruding novel printing patterns of model drug ink (embedded phase) into a liquid gelatin-based matrix (embedding phase) at an elevated temperature (70 °C) to then solidify at room temperature. Dose titration of the two model drugs (paracetamol and ibuprofen) was possible by using specially designed printing patterns of the embedded phase to produce varying doses. A linearity [R2 = 0.9804 (paracetamol) and 0.9976 (ibuprofen)] was achieved between percentage of completion of printing patterns and achieved doses using a multi-step method. The impact of embedded phase rheological behavior, the printing speed and the needle size of the embedded phase were examined. Owning to their appearance, modular nature, ease of personalizing dose and geometry, and tailoring and potential inclusion of various materials, this new dosage form concept holds a substantial promise for novel dosage forms in pediatrics.
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Affiliation(s)
- Katarzyna Rycerz
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Krzysztof Adam Stepien
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Marta Czapiewska
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
- Faculty of Pharmacy, Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Jurasza 2 St., 85-089 Bydgoszcz, Poland
| | - Basel T. Arafat
- Faculty of Medical Sciences and Public Health, Anglia Ruskin University, Chelmsford CM1 1SQ, UK;
| | - Rober Habashy
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
| | - Abdullah Isreb
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK; (K.R.); (K.A.S.); (M.C.); (R.H.); (A.I.)
| | - Matthew Peak
- Paediatric Medicines Research Unit, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK;
| | - Mohamed A. Alhnan
- Institute of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9NH, UK
- Correspondence: ; Tel.: +44-(0)20-7848-7265
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14
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Mawazi SM, Al-Mahmood SMA, Chatterjee B, Hadi HA, Doolaanea AA. Carbamazepine Gel Formulation as a Sustained Release Epilepsy Medication for Pediatric Use. Pharmaceutics 2019; 11:pharmaceutics11100488. [PMID: 31547112 PMCID: PMC6836283 DOI: 10.3390/pharmaceutics11100488] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 11/16/2022] Open
Abstract
This study aimed to develop a carbamazepine (CBZ) sustained release formulation suitable for pediatric use with a lower risk of precipitation. The CBZ was first prepared as sustained release microparticles, and then the microparticles were embedded in alginate beads, and finally, the beads were suspended in a gel vehicle. The microparticles were prepared by a solvent evaporation method utilizing ethyl cellulose as a sustained release polymer and were evaluated for particle size, encapsulation efficiency, and release profile. The beads were fabricated by the dropwise addition of sodium alginate in calcium chloride solution and characterized for size, shape, and release properties. The gel was prepared using iota carrageenan as the gelling agent and evaluated for appearance, syneresis, drug content uniformity, rheology, release profile, and stability. The microparticles exhibited a particle size of 135.01 ± 0.61 µm with a monodisperse distribution and an encapsulation efficiency of 83.89 ± 3.98%. The beads were monodispersed with an average size of 1.4 ± 0.05 mm and a sphericity factor of less than 0.05. The gel was prepared using a 1:1 ratio (gel vehicle to beads) and exhibited no syneresis, good homogeneity, and good shear-thinning properties. The release profile from the beads and from the gel was not significantly affected, maintaining similarity to the tablet form. The gel properties were maintained for one month real time stability, but the accelerated stability showed reduced viscosity and pH with time. In conclusion, CBZ in a gel sustained release dosage form combines the advantages of the suspension form in terms of dosing flexibility, and the advantages of the tablet form in regards to the sustained release profile. This dosage form should be further investigated in vivo in animal models before being considered in clinical trials.
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Affiliation(s)
- Saeid Mezail Mawazi
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
- School of Pharmacy, PICOMS International University College, Batu Muda, Batu caves, Kuala Lumpur 68100, Malaysia.
| | | | - Bappaditya Chatterjee
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
- Department of Pharmaceutics, SPPSPTM, SVKM's NMIMS (Deemed to be University), Mumbai 400056, India.
| | - Hazrina Ab Hadi
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
| | - Abd Almonem Doolaanea
- Department of Pharmaceutical Technology, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
- IKOP Sdn Bhd, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia.
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15
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Okimoto N, Uemura Y, Yoshioka T, Arita S, Tsurukami H, Otomo H, Nishida S, Ogawa T, Hirao K, Ikeda S, Matsumoto H, Toten Y, Katae Y, Okazaki Y, Nakagawa T, Sakai A. Treatment with once-weekly alendronate oral jelly compared with once-weekly alendronate oral tablet for Japanese patients with primary osteoporosis: An open-label, prospective, observational study. Health Sci Rep 2019; 2:e107. [PMID: 30697599 PMCID: PMC6346986 DOI: 10.1002/hsr2.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Clinical data regarding alendronate jelly are limited. We compared the efficacy and safety of once-weekly alendronate oral jelly with once-weekly alendronate tablet formulations in the context of primary osteoporosis. METHODS In this 6-month, open-label, prospective, observational study, Japanese patients aged ≥60 years with primary osteoporosis were included from 14 primary care centres in Japan. The effects of once-weekly alendronate oral jelly and tablet formulations on bone mineral density (BMD), bone turnover markers, and quality of life related to gastrointestinal symptoms were assessed at baseline and 6 months. Treatment was allocated by patient preference. This potentially confounding factor was adjusted for statistically. RESULTS In total, 170 patients were enrolled (jelly, n = 97; tablet, n = 73). Mean percent changes in radius, lumbar spine, femoral neck, and hip BMD were similar in both treatment groups at 6 months. Both formulations decreased tartrate-resistant acid phosphatase 5b (TRACP-5b) and procollagen 1 N-terminal peptide (P1NP) between baseline and 6 months (by about 50% and 60%, respectively); no significant differences in mean changes were noted in these markers between groups. At 6 months, no significant differences were noted in visual analogue scale or EuroQOL five-dimension questionnaire scores between groups. The jelly group had significantly lower scores than the tablet group in the Izumo scale domains of heartburn (-0.81, P = 0.0040), epigastralgia (-0.94, P = 0.0003), and epigastric fullness (-0.49, P = 0.044). During treatment, more patients discontinued for upper gastrointestinal symptoms in the tablet group (n = 4) than the jelly group (n = 1). CONCLUSIONS Once-weekly alendronate oral jelly 35 mg may be a suitable alternative therapeutic agent for primary osteoporosis in Japan.
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Affiliation(s)
| | - Yukari Uemura
- Department of Biostatistics, Clinical Research Support CenterUniversity of Tokyo HospitalBunkyo‐kuTokyoJapan
| | - Toru Yoshioka
- Department of Orthopaedic SurgeryShimura HospitalHiroshimaJapan
| | - Shinobu Arita
- Department of Orthopaedic SurgeryObase HospitalMiyako‐gunFukuokaJapan
| | | | - Hajime Otomo
- Department of Orthopaedic SurgeryMoji Medical CenterKitakyushuJapan
| | - Satoshi Nishida
- Department of Orthopaedic SurgerySocial Insurance Nogata HospitalNogataJapan
| | - Takayuki Ogawa
- Department of Orthopaedic SurgeryKaisei General HospitalSakaideJapan
| | - Ken Hirao
- Department of Orthopaedic SurgeryHirao ClinicHiroshimaJapan
| | - Satoshi Ikeda
- Department of Orthopedic SurgeryKen‐Ai Memorial HospitalOnga‐gunFukuokaJapan
| | | | - Yoriko Toten
- Department of Orthopaedic SurgeryChugoku‐Rosai HospitalKureJapan
| | - Yuji Katae
- Department of Orthopaedic SurgeryAkaike Kyodo ClinicTagawa‐gunFukuokaJapan
| | - Yuichi Okazaki
- Department of Orthopaedic SurgeryTobata General HospitalKitakyushuJapan
| | | | - Akinori Sakai
- Department of Orthopaedic Surgery, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
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Uchiyama H, Nogami S, Katayama K, Hayashi K, Kadota K, Tozuka Y. Jelly containing composite based on α-glucosyl stevia and polyvinylpyrrolidone: Improved dissolution property of curcumin. Eur J Pharm Sci 2018; 117:48-54. [PMID: 29428541 DOI: 10.1016/j.ejps.2018.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/23/2018] [Accepted: 02/07/2018] [Indexed: 11/25/2022]
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Walsh J, Ranmal SR, Ernest TB, Liu F. Patient acceptability, safety and access: A balancing act for selecting age-appropriate oral dosage forms for paediatric and geriatric populations. Int J Pharm 2018; 536:547-562. [DOI: 10.1016/j.ijpharm.2017.07.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022]
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Ye WL, Zhao YP, Cheng Y, Liu DZ, Cui H, Liu M, Zhang BL, Mei QB, Zhou SY. Bone metastasis target redox-responsive micell for the treatment of lung cancer bone metastasis and anti-bone resorption. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2018; 46:380-391. [PMID: 29336169 DOI: 10.1080/21691401.2018.1426007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In order to inhibit the growth of lung cancer bone metastasis and reduce the bone resorption at bone metastasis sites, a bone metastasis target micelle DOX@DBMs-ALN was prepared. The size and the zeta potential of DOX@DBNs-ALN were about 60 nm and -15 mV, respectively. DOX@DBMs-ALN exhibited high binding affinity with hydroxyapatite and released DOX in redox-responsive manner. DOX@DBMs-ALN was effectively up taken by A549 cells and delivered DOX to the nucleus of A549 cells, which resulted in strong cytotoxicity on A549 cells. The in vivo experimental results indicated that DOX@DBMs-ALN specifically delivered DOX to bone metastasis site and obviously prolonged the retention time of DOX in bone metastasis site. Moreover, DOX@DBMs-ALN not only significantly inhibited the growth of bone metastasis tumour but also obviously reduced the bone resorption at bone metastasis sites without causing marked systemic toxicity. Thus, DOX@DBMs-ALN has great potential in the treatment of lung cancer bone metastasis.
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Affiliation(s)
- Wei-Liang Ye
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Yi-Pu Zhao
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Ying Cheng
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Dao-Zhou Liu
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Han Cui
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Miao Liu
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Bang-Le Zhang
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China
| | - Qi-Bing Mei
- b Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine , Fourth Military Medical University , Xi'an , China
| | - Si-Yuan Zhou
- a Department of Pharmaceutics, School of Pharmacy , Fourth Military Medical University , Xi'an , China.,b Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine , Fourth Military Medical University , Xi'an , China
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The effects of pentoxifylline adminstration on fracture healing in a postmenopausal osteoporotic rat model. Lab Anim Res 2017; 33:15-23. [PMID: 28400835 PMCID: PMC5385278 DOI: 10.5625/lar.2017.33.1.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 12/18/2022] Open
Abstract
Previous studies report positive effects of pentoxifylline (PTX) alone or in combination with other drugs on some pathologic bone diseases as well as an ability to accelerate osteogensis and fracture healing in both animal models and human patients. The aim of this present study was to evaluate the effects of PTX administration on Hounsfield unit and bone strength at catabolic response (bone resorbing) of a fracture in an experimental rat model of ovariectomy induced osteoporosis (OVX-D). Thirty adult female rats were divided into groups as follows: 1 (OVX, control, no treatment); 2 (OVX, sham: daily distilled water); 3 (OVX, daily alendronate: 3 mg/kg); 4 (OVX, twice daily 100 mg/kg PTX) and 5 (OVX, PTX+alenderonate). OVX was induced by bilateral ovariectomy in all rats. A complete standardized osteotomy of the right femur was made after 3.5 months. PTX and alendronate treatments were performed for eight weeks. Then, rats were euthanized and had its right femur subjected to computerized tomography scanning for measuring Hounsfield unit; eventually, the samples were sent for a three point bending test for evaluation of the bone strength. Administration of PTX with 200 mg/kg and alendronate alone and in combination showed no significant alteration in Hounsfield unit and biomechanical properties of repairing callus of the complete osteotomy compared with the control group. Results showed increased bending stiffness and stress high load mean values of repairing complete osteotomy in PTX-treated rats compared to the control OVX-D.
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The association between interleukin 6 -174 G/C gene polymorphism and the risk of osteoporosis: A meta-analysis. J Taibah Univ Med Sci 2016; 12:212-220. [PMID: 31435242 PMCID: PMC6694931 DOI: 10.1016/j.jtumed.2016.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/25/2016] [Accepted: 07/31/2016] [Indexed: 01/16/2023] Open
Abstract
Objectives This study aimed to investigate the association between the IL6 −174 G/C gene polymorphism and the risk of osteoporosis by performing a meta-analysis. Methods Published literature from PubMed and Embase databases was searched for eligible publications. The following information was extracted from each study: Name of first author, year of publication, country of origin, sample size of cases and controls, and size of each allele. The combined odds ratio (ORs) and 95% confidence intervals (95%CIs) for the association between the IL6 −174 G/C gene polymorphism and the risk of osteoporosis were assessed using a random or fixed effects model. A comprehensive meta-analysis (CMA) 2.0 was used to analyse the data. Results Twelve studies (4923 cases/3431 controls) were included in this meta-analysis. The results indicated that IL6 −174 G/C gene polymorphism was associated with an increased (G vs C, OR 95%CI = 1.29 [1.03–1.62], p = 0.029) and decreased risk of osteoporosis (C vs G, OR 95%CI = 0.77 [0.62–0.97], p = 0.029; CC vs GG + GC, OR 95%CI = 0.58 [0.39–0.88], p = 0.010). Conclusion The IL6 −174 G/C gene polymorphism was shown to be positively correlated with osteoporosis risk.
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Patient-centred pharmaceutical design to improve acceptability of medicines: similarities and differences in paediatric and geriatric populations. Drugs 2015; 74:1871-1889. [PMID: 25274536 PMCID: PMC4210646 DOI: 10.1007/s40265-014-0297-2] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patient acceptability of a medicinal product is a key aspect in the development and prescribing of medicines. Children and older adults differ in many aspects from the other age subsets of population and require particular considerations in medication acceptability. This review highlights the similarities and differences in these two age groups in relation to factors affecting acceptability of medicines. New and conventional formulations of medicines are considered regarding their appropriateness for use in children and older people. Aspects of a formulation that impact acceptability in these patient groups are discussed, including, for example, taste/smell/viscosity of a liquid and size/shape of a tablet. A better understanding of the acceptability of existing formulations highlights opportunities for the development of new and more acceptable medicines and facilitates safe and effective prescribing for the young and older populations.
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Citraro R, Gallelli L, Leo A, De Fazio P, Gallelli P, Russo E, De Sarro G. Effects of chronic sodium alendronate on depression and anxiety in a menopausal experimental model. Pharmacol Biochem Behav 2014; 129:65-71. [PMID: 25542587 DOI: 10.1016/j.pbb.2014.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/10/2014] [Accepted: 12/17/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE During menopause, lower levels of estrogen may induce bone resorption as well as anxiety and depression. Bisphosphonates represent the first choice in the treatment of osteoporosis and no data are available concerning their effects on comorbid behavior alterations. Therefore, in this study, we evaluated the effects of chronic alendronate (1 mg/kg/day) on depression and anxiety in an experimental animal model of menopause. METHODS Female Wistar rats were ovariectomized or sham operated at 6-7 months of age. Two weeks after surgery, rats were randomized into four treatment (24 consecutive weeks) groups: (1) vehicle-treated SHAM group, (2) alendronate-treated SHAM group, (3) vehicle-treated ovariectomized group, and (4) alendronate-treated ovariectomized group. After treatment, we evaluated both depressive- and anxiety-like behavior through forced swimming test (FST) and open-field test (OF). Finally, the inverted screen test was used to assess the incapacitating effects of ovariectomy in rats. RESULTS We documented a significant and time-related increase in immobility times and in anxiety-like behavior in rats with ovariectomy in comparison to control sham group. Alendronate at 3 months, but not at 6 months, significantly decreased both immobility time and anxiety levels, but it significantly increased motor performance. Using the Pearson's test, we documented a significant correlation between behavior and motor performance. CONCLUSION Despite the apparent effects of alendronate on animal behavior, in our experiments, such effects seem to be mediated by an increase in motor performance.
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Affiliation(s)
- Rita Citraro
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
| | - Luca Gallelli
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
| | - Antonio Leo
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
| | - Pasquale De Fazio
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
| | - Patrizia Gallelli
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
| | - Emilio Russo
- Science of Health Department, University of Catanzaro, Catanzaro 88100, Italy.
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Rizzoli R, Branco J, Brandi ML, Boonen S, Bruyère O, Cacoub P, Cooper C, Diez-Perez A, Duder J, Fielding RA, Harvey NC, Hiligsmann M, Kanis JA, Petermans J, Ringe JD, Tsouderos Y, Weinman J, Reginster JY. Management of osteoporosis of the oldest old. Osteoporos Int 2014; 25:2507-29. [PMID: 25023900 DOI: 10.1007/s00198-014-2755-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/16/2014] [Indexed: 12/25/2022]
Abstract
UNLABELLED This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional deficiencies, fall prevention strategies, pharmacological treatments and their safety considerations, the risks of sub-optimal treatment adherence and strategies for its improvement. INTRODUCTION This consensus article reviews the therapeutic strategies and management options for the treatment of osteoporosis of the oldest old. This vulnerable segment (persons over 80 years of age) stands to gain substantially from effective anti-osteoporosis treatment, but the under-prescription of these treatments is frequent. METHODS This report is the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores some of the reasons for this and presents the arguments to counter these beliefs. The risk assessment of older individuals is briefly reviewed along with the differences between some intervention guidelines. The current evidence on the impact of nutritional deficiencies (i.e. calcium, protein and vitamin D) is presented, as are strategies to prevent falls. One possible reason for the under-prescription of pharmacological treatments for osteoporosis in the oldest old is the perception that anti-fracture efficacy requires long-term treatment. However, a review of the data shows convincing anti-fracture efficacy already by 12 months. RESULTS The safety profiles of these pharmacological agents are generally satisfactory in this patient segment provided a few precautions are followed. CONCLUSION These patients should be considered for particular consultation/follow-up procedures in the effort to convince on the benefits of treatment and to allay fears of adverse drug reactions, since poor adherence is a major problem for the success of a strategy for osteoporosis and limits cost-effectiveness.
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Affiliation(s)
- R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland,
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Haraguchi T, Yoshida M, Uchida T. Evaluation of ebastine-loaded orally disintegrating tablets using new apparatus of detecting disintegration time and e-tongue system. J Drug Deliv Sci Technol 2014. [DOI: 10.1016/s1773-2247(14)50137-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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