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Akkaif MA, Daud NAA, Noor DAM, Sha'aban A, Kader MASA, Ibrahim B. The Impact of CYP2C19 Genotype on the Platelet Reactivity Index (PRI) among Chronic Coronary Syndromes (CCS) Patients Undergoing Percutaneous Coronary Intervention (PCI): Affectability of Rapid Genetic Testing. Cardiovasc Drugs Ther 2024:10.1007/s10557-024-07544-6. [PMID: 38224415 DOI: 10.1007/s10557-024-07544-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND In the Asian population, the presence of the CYP2C19 loss-of-function (LOF) allele is a known genetic variation. This allele is associated with a reduced capacity to metabolize clopidogrel into its active forms through the CYP2C19 enzyme, resulting in diminished platelet inhibition and an elevated risk of recurrent cardiovascular events. Regulatory authorities have recommended an alternative P2Y12 inhibitor, ticagrelor, for individuals carrying the LOF allele. Consequently, this study seeks to assess the impact of the CYP2C19 genotype on the Platelet reactivity index (PRI) using a rapid genetic testing approach in Asian patients with chronic coronary syndromes (CCS) who undergo percutaneous coronary intervention (PCI). METHODS This prospective study employed a parallel design, single-center design, and randomized approach. Genotyping for the CYP2C19*2 and *3 polymorphisms was conducted using the Nested Allele-Specific Multiplex PCR (NASM-PCR) technique. Patients meeting the inclusion criteria underwent genotyping for CYP2C19 polymorphisms. Following PCI, patients were randomly assigned to receive either ticagrelor or clopidogrel. PRI assessments were performed four hours after loading dose administration. The trial was registered with ClinicalTrials.gov under the identifier NCT05516784. RESULTS Among the 94 patients recruited for the study, 40 (42.55%) were identified as carriers of the LOF allele for CYP2C19*2 and *3 (*1/*2, *2/*2, *1/*3). Out of the 84 patients evaluated for PRI (44 receiving clopidogrel and 40 receiving ticagrelor), 21 (47.7%) of the clopidogrel group and 39 (97.5%) of the ticagrelor group exhibited a favorable response to antiplatelet therapy (PRI < 50). Patients treated with ticagrelor demonstrated superior antiplatelet responses compared to those receiving clopidogrel, regardless of LOF carrier status (P = 0.005 and < 0.001 for non-LOF and LOF carriers, respectively). CONCLUSION NASM-PCR as a rapid genetic test holds promise for personalizing antiplatelet therapy in Asian CCS patients.
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Affiliation(s)
- Mohammed Ahmed Akkaif
- Department of Cardiology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, 201700, People's Republic of China.
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.
| | | | | | - Abubakar Sha'aban
- School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | | | - Baharudin Ibrahim
- Faculty of Pharmacy, University of Malaya, Federal Territory Malaysia, Kuala Lumpur, 50603, Malaysia.
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Maslub MG, Radwan MA, Daud NAA, Sha'aban A. Association between CYP3A4/CYP3A5 genetic polymorphisms and treatment outcomes of atorvastatin worldwide: is there enough research on the Egyptian population? Eur J Med Res 2023; 28:381. [PMID: 37759317 PMCID: PMC10523700 DOI: 10.1186/s40001-023-01038-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/31/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Atorvastatin is regarded as the most frequently prescribed statin worldwide for dyslipidemia. However, clinical response and risk of adverse effects to statin therapy are associated with genetic variations. Numerous research linked statins pharmacokinetics (PK) variations to genetic polymorphisms in cytochromes P450 (CYPs) metabolic enzymes. OBJECTIVE This article reviews the association between CYP3A4/5 genetic variations and response to atorvastatin therapy globally, which includes atorvastatin PK, and the risk for adverse reactions, with a hint to the Egyptians. METHODS Up to March 30, 2022, electronic medical databases like PubMed, Web of Science, MEDLINE, and Egyptian Knowledge Bank (EKB) were searched. All articles that highlighted the relationship between CYP3A4/5 genetic polymorphisms and atorvastatin efficacy/safety profile were included in this review. RESULTS Initially, 492 articles were retrieved after an exhaustive search. There were 24 articles included according to the inclusion criteria. Findings of association studies of CYP3A4/5 genetic polymorphisms with response to atorvastatin varied among different ethnicities. CYP3A4*1B was associated with better therapeutic outcomes after atorvastatin therapy in Chileans and vice versa in Americans. Caucasians with myalgia while using atorvastatin were at significant risk of suffering severe muscle damage if they were carriers of CYP3A5*3/*3. As far as we can report for the Egyptian population, the impact of CYP3A4/5 genetic variations on the response to atorvastatin therapy was understudied. CONCLUSION More pharmacogenetic studies amongst diverse populations worldwide, like the Egyptian population, are necessary to detect further atorvastatin-gene interactions.
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Affiliation(s)
- Mohammed G Maslub
- Pharmacy Practice/Clinical Pharmacy Department, Faculty of Pharmacy, Egyptian Russian University, Cairo-Suez Road, Badr City, Cairo, 11829, Egypt.
| | - Mahasen A Radwan
- Pharmacy Practice/Clinical Pharmacy Department, Faculty of Pharmacy, Egyptian Russian University, Cairo-Suez Road, Badr City, Cairo, 11829, Egypt
| | - Nur Aizati Athirah Daud
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Abubakar Sha'aban
- Division of Population Medicine, Cardiff University, Cardiff, CF14 4YS, Wales, UK
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Wunrow HY, Bender RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, Gray AP, Ikuta KS, Sharara F, Wool EE, Aali A, Abd-Elsalam S, Abdollahi A, Abdul Aziz JM, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Adamu LH, Adane TD, Addo IY, Adegboye OA, Adekiya TA, Adnan M, Adnani QES, Afzal S, Aghamiri S, Aghdam ZB, Agodi A, Ahinkorah BO, Ahmad A, Ahmad S, Ahmadzade M, Ahmed A, Ahmed A, Ahmed JQ, Ahmed MS, Akinosoglou K, Aklilu A, Akonde M, Alahdab F, AL-Ahdal TMA, Alanezi FM, Albelbeisi AH, Alemayehu TBB, Alene KA, Al-Eyadhy A, Al-Gheethi AAS, Ali A, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Al-Worafi YM, Aly H, Ameyaw EK, Ancuceanu R, Ansar A, Ansari G, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Artamonov AA, Arulappan J, Aruleba RT, Asaduzzaman M, Atalell KA, Athari SS, Atlaw D, Atout MMW, Attia S, Awoke T, Ayalew MK, Ayana TM, Ayele AD, Azadnajafabad S, Azizian K, Badar M, Badiye AD, Baghcheghi N, Bagheri M, Bagherieh S, Bahadory S, Baig AA, Barac A, Barati S, Bardhan M, Basharat Z, Bashiri A, Basnyat B, Bassat Q, Basu S, Bayileyegn NS, Bedi N, Behnoush AH, Bekel AA, Belete MA, Bello OO, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhaskar S, Bhat AN, Bijani A, Bineshfar N, Boloor A, Bouaoud S, Buonsenso D, Burkart K, Cámera LA, Castañeda-Orjuela CA, Cernigliaro A, Charan J, Chattu VK, Ching PR, Chopra H, Choudhari SG, Christopher DJ, Chu DT, Couto RAS, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Das S, Dash NR, Dashti M, De la Hoz FP, Debela SA, Dejen D, Dejene H, Demeke D, Demeke FM, Demessa BH, Demetriades AK, Demissie S, Dereje D, Dervišević E, Desai HD, Dessie AM, Desta F, Dhama K, Djalalinia S, Do TC, Dodangeh M, Dodangeh M, Dominguez RMV, Dongarwar D, Dsouza HL, Durojaiye OC, Dziedzic AM, Ekat MH, Ekholuenetale M, Ekundayo TC, El Sayed Zaki M, El-Abid H, Elhadi M, El-Hajj VG, El-Huneidi W, El-Sakka AA, Esayas HL, Fagbamigbe AF, Falahi S, Fares J, Fatehizadeh A, Fatima SAF, Feasey NA, Fekadu G, Fetensa G, Feyissa D, Fischer F, Foroutan B, Gaal PA, Gadanya MA, Gaipov A, Ganesan B, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Gedef GM, Gela YY, Gerema U, Gessner BD, Getachew ME, Ghadiri K, Ghaffari K, Ghamari SH, Ghanbari R, Ghazy RMM, Ghozali G, Gizaw ABAB, Glushkova EV, Goldust M, Golechha M, Guadie HA, Guled RA, Gupta M, Gupta S, Gupta VB, Gupta VK, Gupta VK, Hadi NR, Haj-Mirzaian A, Haller S, Hamidi S, Haque S, Harapan H, Hasaballah AI, Hasan I, Hasani H, Hasanian M, Hassankhani H, Hassen MB, Hayat K, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Hezam K, Holla R, Horita N, Hossain MM, Hosseini MS, Hosseinzadeh M, Hostiuc S, Hussain S, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Iregbu KC, Ismail NE, Iwu CCD, Jaja C, Jakovljevic M, Jamshidi E, Javadi Mamaghani A, Javidnia J, Jokar M, Jomehzadeh N, Joseph N, Joshua CE, Jozwiak JJ, Kabir Z, Kalankesh LR, Kalhor R, Kamal VK, Kandel H, Karaye IM, Karch A, Karimi H, Kaur H, Kaur N, Keykhaei M, Khajuria H, Khalaji A, Khan A, Khan IA, Khan M, Khan T, Khatab K, Khatatbeh MM, Khayat Kashani HR, Khubchandani J, Kim MS, Kisa A, Kisa S, Kompani F, Koohestani HR, Kothari N, Krishan K, Krishnamoorthy Y, Kulimbet M, Kumar M, Kumaran SD, Kuttikkattu A, Kwarteng A, Laksono T, Landires I, Laryea DO, Lawal BK, Le TTT, Ledda C, Lee SW, Lee S, Lema GK, Levi M, Lim SS, Liu X, Lopes G, Lutzky Saute R, Machado Teixeira PH, Mahmoodpoor A, Mahmoud MA, Malakan Rad E, Malhotra K, Malik AA, Martinez-Guerra BA, Martorell M, Mathur V, Mayeli M, Medina JRC, Melese A, Memish ZA, Mentis AFA, Merza MA, Mestrovic T, Michalek IM, Minh LHN, Mirahmadi A, Mirmosayyeb O, Misganaw A, Misra AK, Moghadasi J, Mohamed NS, Mohammad Y, Mohammadi E, Mohammed S, Mojarrad Sani M, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Mossialos E, Mostafavi E, Motaghinejad M, Mousavi Khaneghah A, Mubarik S, Muccioli L, Muhammad JS, Mulita F, Mulugeta T, Murillo-Zamora E, Mustafa G, Muthupandian S, Nagarajan AJ, Nainu F, Nair TS, Nargus S, Nassereldine H, Natto ZS, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noroozi N, Nouraei H, Nuñez-Samudio V, Nuruzzaman KM, Nwatah VE, Nzoputam CI, Nzoputam OJ, Oancea B, Obaidur RM, Odetokun IA, Ogunsakin RE, Okonji OC, Olagunju AT, Olana LT, Olufadewa II, Oluwafemi YD, Oumer KS, Ouyahia A, P A M, Pakshir K, Palange PN, Pardhan S, Parikh RR, Patel J, Patel UK, Patil S, Paudel U, Pawar S, Pensato U, Perdigão J, Pereira M, Peres MFP, Petcu IR, Pinheiro M, Piracha ZZ, Pokhrel N, Postma MJ, Prates EJS, Qattea I, Raghav PR, Rahbarnia L, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmanian V, Rahnavard N, Ramadan H, Ramasubramani P, Rani U, Rao IR, Rapaka D, Ratan ZA, Rawaf S, Redwan EMM, Reiner Jr RC, Rezaei N, Riad A, Ribeiro da Silva TM, Roberts T, Robles Aguilar G, Rodriguez JAB, Rosenthal VD, Saddik B, Sadeghian S, Saeed U, Safary A, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahu M, Sajedi SA, Saki M, Salahi S, Salahi S, Saleh MA, Sallam M, Samadzadeh S, Samy AM, Sanjeev RK, Satpathy M, Seylani A, Sha'aban A, Shafie M, Shah PA, Shahrokhi S, Shahzamani K, Shaikh MA, Sham S, Shannawaz M, Sheikh A, Shenoy SM, Shetty PH, Shin JI, Shokri F, Shorofi SA, Shrestha S, Sibhat MM, Siddig EE, Silva LMLR, Singh H, Singh JA, Singh P, Singh S, Sinto R, Skryabina AA, Socea B, Sokhan A, Solanki R, Solomon Y, Sood P, Soshnikov S, Stergachis A, Sufiyan MB, Suliankatchi Abdulkader R, Sultana A, T Y SS, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Temsah MH, Terefa DR, Thangaraju P, Tibebu NS, Ticoalu JHV, Tillawi T, Tincho MB, Tleyjeh II, Toghroli R, Tovani-Palone MR, Tufa DG, Turner P, Ullah I, Umeokonkwo CD, Unnikrishnan B, Vahabi SM, Vaithinathan AG, Valizadeh R, Varthya SB, Vos T, Waheed Y, Walde MT, Wang C, Weerakoon KG, Wickramasinghe ND, Winkler AS, Woldemariam M, Worku NA, Wright C, Yada DY, Yaghoubi S, Yahya GATY, Yenew CYY, Yesiltepe M, Yi S, Yiğit V, You Y, Yusuf H, Zakham F, Zaman M, Zaman SB, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zhang H, Zhang J, Zhang ZJ, Zheng P, Zoladl M, Zumla A, Hay SI, Murray CJL, Naghavi M, Kyu HH. Global, regional, and national burden of meningitis and its aetiologies, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:685-711. [PMID: 37479374 PMCID: PMC10356620 DOI: 10.1016/s1474-4422(23)00195-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. METHODS We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. FINDINGS In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000-277 000) and 2·51 million (2·11-2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400-145 000) and 1·28 million incident cases (0·947-1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6-8·4) per 100 000 population in 1990 to 3·3 (2·8-3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1-19·2]), followed by N meningitidis (13·6% [12·7-14·4]) and K pneumoniae (12·2% [10·2-14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5-81·8]), followed by N meningitidis (72·3% [64·4-78·5]) and viruses (58·2% [47·1-67·3]). INTERPRETATION Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. FUNDING Bill & Melinda Gates Foundation.
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Mohammed M, Kumar N, Zawiah M, Al-Ashwal FY, Bala AA, Lawal BK, Wada AS, Halboup A, Muhammad S, Ahmad R, Sha'aban A. Psychometric Properties and Assessment of Knowledge, Attitude, and Practice Towards ChatGPT in Pharmacy Practice and Education: a Study Protocol. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01696-1. [PMID: 37428357 DOI: 10.1007/s40615-023-01696-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023]
Abstract
ChatGPT represents an advanced conversational artificial intelligence (AI), providing a powerful tool for generating human-like responses that could change pharmacy prospects. This protocol aims to describe the development, validation, and utilization of a tool to assess the knowledge, attitude, and practice towards ChatGPT (KAP-C) in pharmacy practice and education. The development and validation process of the KAP-C tool will include a comprehensive literature search to identify relevant constructs, content validation by a panel of experts for items relevancy using content validity index (CVI) and face validation by sample participants for items clarity using face validity index (FVI), readability and difficulty index using the Flesch-Kincaid Readability Test, Gunning Fog Index, or Simple Measure of Gobbledygook (SMOG), assessment of reliability using internal consistency (Cronbach's alpha), and exploratory factor analysis (EFA) to determine the underlying factor structures (eigenvalues, scree plot analysis, factor loadings, and varimax). The second phase will utilize the validated KAP-C tool to conduct KAP surveys among pharmacists and pharmacy students in selected low- and middle-income countries (LMICs) (Nigeria, Pakistan, and Yemen). The final data will be analyzed descriptively using frequencies, percentages, mean (standard deviation) or median (interquartile range), and inferential statistics like Chi-square or regression analyses using IBM SPSS version 28. A p<0.05 will be considered statistically significant. ChatGPT holds the potential to revolutionize pharmacy practice and education. This study will highlight the psychometric properties of the KAP-C tool that assesses the knowledge, attitude, and practice towards ChatGPT in pharmacy practice and education. The findings will contribute to the potential ethical integration of ChatGPT into pharmacy practice and education in LMICs, serve as a reference to other economies, and provide valuable evidence for leveraging AI advancements in pharmacy.
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Affiliation(s)
- Mustapha Mohammed
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Kaduna, Nigeria.
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
- Vice President for Medical and Health Science Office, QU Health, Qatar University, Doha, Qatar.
| | - Narendar Kumar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh Jamshoro, Sindh, Pakistan
| | - Mohammed Zawiah
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Department of Pharmacy Practice, Faculty of Clinical Pharmacy, Hodeidah University, Al Hodeidah, Yemen
| | - Fahmi Y Al-Ashwal
- Department of Pharmacy, Al-Maarif University College, Anbar, 31001, Iraq
| | - Auwal Adam Bala
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Dutse, Jigawa, Nigeria
| | - Basira Kankia Lawal
- Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Abubakar Sadiq Wada
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Abdulsalam Halboup
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana'a, Yemen
| | | | - Rabbiya Ahmad
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Abubakar Sha'aban
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, Wales, UK
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Bala AA, Mohammed M, Umar S, Ungogo MA, Al-Kassim Hassan M, Abdussalam US, Ahmad MH, Ishaq DU, Mana D, Sha'aban A, Jatau AI, Jibril M, Kurfi B, Raji I, Ringim AS, Gulma K, Malami S, Michael GC, Chedi BAZ. Pre-clinical efficacy of African medicinal plants used in the treatment of snakebite envenoming: A systematic review. Toxicon 2023; 224:107035. [PMID: 36706926 DOI: 10.1016/j.toxicon.2023.107035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
The World Health Organization has listed Snakebite Envenoming (SBE) as a priority neglected tropical disease, with a worldwide annual snakebite affecting 5.4 million people and injuring 2.7 million lives. In many parts of rural areas of Africa and Asia, medicinal plants have been used as alternatives to conventional antisnake venom (ASV) due in part to inaccessibility to hospitals. Systemic reviews (SR) of laboratory-based preclinical studies play an essential role in drug discovery. We conducted an SR to evaluate the relationship between interventional medicinal plants and their observed effects on venom-induced experiments. This SR was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Modified collaborative approach to meta-analysis and review of animal data from experimental studies (CAMARADES) and SYRCLE's risk of bias tools were used to appraise the included studies. Data were searched online in Medline via PubMed, Embase via OVID, and Scopus. Studies reporting in vivo and in vitro pharmacological activities of African medicinal plants/extracts/constituents against venom-induced pathologies were identified and included for screening. Data from the included studies were extracted and synthesized. Ten studies reported statistically significant percentage protection (40-100%) of animals against venom-induced lethality compared with control groups that received no medicinal plant intervention. Sixteen studies reported significant effects (p ≤ 0.05) against venom-induced pathologies compared with the control group; these include hemolytic, histopathologic, necrotic, and anti-enzymatic effects. The plant family Fabaceae has the highest number of studies reporting its efficacy, followed by Annonaceae, Malvaceae, Combretaceae, Sterculiaceae, and Olacaceae. Some African medicinal plants are preclinically effective against venom-induced lethality, hematotoxicity, and cytotoxicity. The evidence was extracted from three in vitro studies, nine in vivo studies, and five studies that combined both in vivo and in vitro models. The effective plants belong to the Fabaceae family, followed by Malvaceae, and Annonaceae.
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Affiliation(s)
- Auwal A Bala
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Nigeria; Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria.
| | - Mustapha Mohammed
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Pulau Pinang, Malaysia; Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Saifullahi Umar
- Department of Pharmacognosy and Herbal Medicine, Faculty of Pharmaceutical Sciences, College of Natural and Pharmaceutical Sciences, Bayero University Kano, Nigeria
| | - Marzuq A Ungogo
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, 810107, Kaduna State, Nigeria; Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, UK
| | | | - Umar S Abdussalam
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Mubarak Hussaini Ahmad
- Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Nigeria; Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Capital City University, Kano State, Nigeria
| | - Daha U Ishaq
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Health Science,Bayero University, Kano, Nigeria; Center for Mitochondrial Biology & Medicine, Xi'an Jiaotong University (XJTU), Xi'an, China
| | - Dillos Mana
- Department of Community Medicine and Primary Healthcare, Bingham University, Abuja, Nigeria
| | - Abubakar Sha'aban
- School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK
| | - Abubakar I Jatau
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | - Murtala Jibril
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Binta Kurfi
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Health Science,Bayero University, Kano, Nigeria
| | - Ismaila Raji
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Nigeria
| | - Abubakar S Ringim
- Morgan State University, Patuxent Environmental and Aquatic Research Laboratory, Maryland, USA; Department of Biological Sciences, Federal University Dutse, Jigawa State, Nigeria
| | - Kabiru Gulma
- School of Global Health and Bioethics, Euclid University, Gambia
| | - Sani Malami
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Godpower C Michael
- Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Basheer A Z Chedi
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria; Venom-Antivenom Research Project (VASP) and Nigeria- Snakebite Research and Intervention Centre(NSRIC), Nigeria
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Akkaif MA, Daud NAA, Noor DAM, Sha'aban A, Sk Abdul Kader MA, Wahab MJA, Ibrahim B. The use of ticagrelor versus clopidogrel in Malaysian patients with coronary artery disease undergoing percutaneous coronary intervention (PCI): Does the age tertile affect the platelet reactivity? Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Previous studies have shown that the prevalence of cardiovascular diseases is related to the patient's age and gender differences, but the effect of age on platelet function remains controversial. Platelet function should be tested and its efficacy correlates with the age of patients undergoing percutaneous coronary intervention (PCI) using vasodilator-associated stimulated phosphoprotein (VASP). VASP is a gold standard to assess P2Y12 receptor inhibition among patients using ticagrelor or clopidogrel.
Purpose
We sought to compare the effect of ticagrelor versus clopidogrel on the platelet function of patients undergoing PCI and the correlation of age in this effect.
Method
This study was a prospective, randomized, parallel design, an open-label investigation conducted on Malaysian patients undergoing PCI. It included 84 patients (40 patients taking ticagrelor, and 44 patients taking clopidogrel). The induced platelet reactivity was assessed by measuring total whole blood at one standardized time point after 4 hours of loading dose of ticagrelor 180 mg or clopidogrel with 600 mg and by age tertiles.
Result
The study population consisted of 23 (57.5%) patients in Tertile 1 <60 years of age, 11 (27.5%) patients in Tertile 2 between 60-70 years of age and 6 (15.0%) patients in Tertile 3 >70 years of age. The number of patients who used ticagrelor was 17 (38.64%) in Tertile 1, 21 (47.73%) in Tertile 2, and 6 (13.64%) in Tertile 3 of those who used clopidogrel. The results of platelet reactivity index was high in the patients who used clopidogrel compared to the ticagrelor group, which were 52.3% and 2.5 %, P <0.001. This effect in the clopidogrel group included all age groups without exception and at different rates (52.9%, 52.4%, and 50%, P= 0.992), respectively, but this effect was numerical and not statistically significant. In contrast to the ticagrelor group, no numerical or significant effect was observed in all age groups (4.3%, 0.0%, and 0.0%, P= 0.259), respectively (Figure 1). In addition, the results of the current cross-sectional age classification study showed no statistical differences between the clopidogrel and ticagrelor groups based on non high platelet reactivity (NHPR) (P = 0.284, P = 0.270, P = 0.796 respectively) (Figure2).
Conclusion
Our study showed that age could not be considered a risk factor in the Malaysian population, as it did not significantly affect platelet aggregation in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI).
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - A Sha'aban
- Cardiff University, School of Medicine , Cardiff , United Kingdom of Great Britain & Northern Ireland
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - M J A Wahab
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University of Malaya, Faculty of Pharmacy , Wilayah Persekutuan Kuala Lumpur , Malaysia
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7
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Akkaif MA, Daud NAA, Noor DAM, Sha'aban A, Wahab MJA, Sk Abdul Kader MA, Ibrahim B. Platelet reactivity index after treatment of clopidogrel versus ticagrelor based on CYP2C19 genotypes among patients undergoing percutaneous coronary intervention: results of a randomized study. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although clopidogrel is the basic drug for antiplatelet therapy in patients with coronary artery disease (CAD). However, loss of function (LOF) allelic variants located within the CYP2C19 gene may reduce the production of clopidogrel active metabolites and weaken the antiplatelet effect, increasing platelet rates reactivity and associated with increased rates of adverse events after percutaneous coronary intervention (PCI). Thus, drug regulatory authorities have warned of clopidogrel's reduced efficacy and suggested using alternative treatments (such as ticagrelor). However, in clinical practice, the strategy of genotype-guided selection for antiplatelet therapy has been limited by the lack of access to immediately available results.
Purpose
We sought to evaluate the effect of point-of-care genetic testing for CYP2C19 genotypes on the antiplatelet choice of therapy (i.e., clopidogrel vs ticagrelor), using platelet reactivity index (PRI) as a proxy of clinical outcome
Method
This study was a prospective, randomized, parallel design, an open-label investigation conducted among Malaysian patients with stable coronary artery disease (SCAD) undergoing PCI. Patients underwent rapid point-of-care genetic testing using the nested allele-specific multiplex PCR assay, which defines CYP2C19 genetic status within 3 hours, allowing patients to be genotyped on the same day before PCI. Patients who were carriers of at least one +LOF or -LOF (*2 or *3) allele was randomized to receive either clopidogrel [600mg loading dose (LD) - 75mg/day maintenance dose (MD)] or ticagrelor (180mg LD - 90mg MD). The induced platelet reactivity index (PRI) was assessed by Vasodilator-Associated Stimulated Phosphoprotein (VASP) Assay to whole blood at one standardized time point after 4 hours of LD. All patients were treated with aspirin. The primary endpoint of the study was the non-inferiority in platelet reactivity, measured as PRI, at 4 hours of clopidogrel vs ticagrelor in +LOF or -LOF allele carriers
Result
In 1638 SCAD patients, 94 underwent PCI and were genotyped and randomized to receive either clopidogrel (n=44) or ticagrelor (n=50). A total of 42 (44.68%) were carriers of at least one +LOF. PRI levels at 4 hours for clopidogrel vs ticagrelor 44 and 40, respectively (mean difference = 23.08; 95% CI: 17 to 30; p=<0.001); this will meet the primary endpoint of superiority in a non-inferiority. Ticagrelor significantly reduced PRI more than clopidogrel. The cross-tabulation of the response classification showed that ticagrelor is superior to clopidogrel based on the -LOF and +LOF (P= 0.005 and <0.001, respectively)
Conclusion
A rapid point-of-care genetic test using a nested allele-specific multiplex PCR assay can be used to personalize antiplatelet therapy and provides timely results for patients undergoing PCI. In addition, the results showed that ticagrelor was superior to clopidogrel in the level of platelet inhibition in both groups (+LOF or -LOF)
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - A Sha'aban
- Cardiff University, School of Medicine , Cardiff , United Kingdom of Great Britain & Northern Ireland
| | - M J A Wahab
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University of Malaya, Faculty of Pharmacy , Wilayah Persekutuan Kuala Lumpur , Malaysia
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Akkaif MA, Sha'aban A, Daud NAA, Noor DAM, Musa NF, Sk Abdul Kader MA, Ibrahim B. Fast and more affordable CYP2C19 LOF testing to personalized of clopidogrel therapy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clopidogrel is an antiplatelet drug used to treat coronary artery disease (CAD) to reduce blood clotting by inhibiting platelet activity. However, many patients experience ischemic events due to changes in clopidogrel metabolism attributed to various genetic and non-genetic factors. CYP2C19 is one of the important genes responsible for the metabolism of clopidogrel, but this gene has polymorphisms in cytochrome P450 (CYP), and this CYP2C19 Loss-of-function (LoF) polymorphisms impair clopidogrel metabolism between individuals and races. Therefore, genetic testing is an effective strategy to personalized clopidogrel and reduce the incidence of ischemic events in CAD patients.
Purpose
We sought to develop a nested allele-specific multiplex polymerase chain reaction (PCR) method for the detection of CYP2C9 LOF alleles.
Method
Genomic DNA was extracted from blood taken from 7 healthy volunteers using a commercial DNA extraction kit. A two-step PCR method was developed. First, DNA was subjected to a first PCR used to amplify exons 4 and 5 simultaneously in a single reaction tube. Second, The products of 1st PCR were then used as a template in the second PCR to detect CYP2C9 polymorphisms alleles (CYP2C19*2 and *3) using allele-specific primers. The test results were validated via sequencing.
Result
We successfully detected clinically important CYP2C19 LOF polymorphisms alleles by the nested allele-specific multiplex PCR method (Figure 1). This method is fast and doesn't require high-quality and expensive laboratory equipment. It was reproducible and specific and can reliably detect CYP2C19 variants. Direct sequencing of target variants has been used to validate this strategy further, and the amplified sequences were 100% identical to the CYP2C9 sequence.
Conclusion
The developed methods were specific to identify polymorphisms in CYP2C19 (rs4244285 and rs4986893). However, to understand ethnic differences and their potential implications for clopidogrel therapy, we highly recommend identifying relevant genetic polymorphisms before clinical manifestations arise.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia , Penang , Malaysia
| | - A Sha'aban
- Universiti Sains Malaysia , Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia , Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia , Penang , Malaysia
| | - N F Musa
- Hospital University Sains Malaysia, Human Genome Center, School of Medical Sciences , Kota Bharu , Malaysia
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University Malaya Medical Centre, Kuala Lumpur, Faculty of Pharmacy, University of Malaya , Kuala Lumpur , Malaysia
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Maslub MG, Radwan MA, Mikhail MS, Abdalla ZA, Youssef YL, Abdal Hafiz AI, Zain Eldien KM, Sha'aban A. Assessment of the latest prescribed drug-related problems. Eur Rev Med Pharmacol Sci 2022; 26:2373-2387. [PMID: 35442491 DOI: 10.26355/eurrev_202204_28467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE: Drug-related problems (DRPs) could affect patient care and lead to deleterious manifestations, therefore, this investigation aimed to review the recently published studies concerning DRPs to improve their availability to clinical pharmacists, hoping that this information will be supportive and relevant to their practice settings. MATERIALS AND METHODS: A search of Elsevier, Sage, Springer/Nature, and Wiley online libraries on Egyptian Knowledge Bank (EKB) was limited to the cumulative period from 1/1/2015 to 20/10/2020. The abstracts of 156 articles were critically reviewed and 50 articles were included based on relevance while excluding books. The selected articles reported DRPs and different strategies to reduce them. Moreover, drug-drug interactions (DDIs) in various patient populations were confirmed by many articles. Additionally, potential drug-drug interactions (pDDIs) predisposing factors were reported by others. RESULTS: 24 articles (48%) illustrated DDIs, 5 articles (10%) demonstrated ADRs, 4 articles (8%) showed medication errors (MEs), and 25 articles (50%) revealed efforts to reduce DRPs. The psychiatric population is at the utmost risk of pDDIs. Polypharmacy was the furthest recurrently reported risk factor related to DDIs. Adverse drug events (ADEs) increased healthcare costs. Different strategies to avoid DRPs were published through the stated period. CONCLUSIONS: Our findings can be supportive to healthcare professionals in enhancing their patients' quality of care by reducing the exposure to ADEs.
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Affiliation(s)
- M G Maslub
- Pharmacy Practice, Clinical Pharmacy Department, Faculty of Pharmacy, Egyptian Russian University, Badr City, Cairo, Egypt.
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Sha'aban A, Zainal H, Khalil NA, Aziz FA, Ch'ng ES, Teh C, Mohammed M, Ibrahim B. Prediction of Low-Dose Aspirin-Induced Gastric Toxicity Using Nuclear Magnetic Resonance Spectroscopy-Based Pharmacometabolomics in Rats.. [DOI: 10.20944/preprints202201.0472.v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background: Low-dose aspirin (LDA) is the backbone for secondary prevention of coronary artery disease, though limited by gastric toxicity. This study was aimed to identify novel metabolites that could predict LDA-induced gastric toxicity using pharmacometabolomics. Methods: Pre-dosed urine samples were collected from male Sprague-Dawley rats. The rats were treated with either LDA (10 mg/kg) or 1% methylcellulose (10 ml/kg) per oral for 28 days. The rats' stomachs were examined for gastric toxicity using a stereomicroscope. The urine samples were analyzed using a proton nuclear magnetic resonance spectroscopy. Metabolites were systematically identified by exploring established databases and multivariate analyses to identify the spectral pattern of metabolites related to LDA-induced gastric toxicity. Results: Treatment with LDA resulted in gastric toxicity in 20/32 rats (62.5%). The orthogonal projections to latent structures discriminant analysis (OPLS-DA) model displayed a goodness-of-fit (R2Y) value of 0.947, suggesting a near-perfect reproducibility, a goodness-of-prediction (Q2Y) of -0.185 with perfect sensitivity, specificity and accuracy (100%). Furthermore, the area under the receiver operating characteristic (AUROC) displayed was 1. The final OPLS-DA model had an R2Y value of 0.726 and Q2Y of 0.142 with sensitivity (100%), specificity (95.0%) and accuracy (96.9%). Citrate, hippurate, methylamine, trimethylamine N-oxide and alpha-keto-glutarate were identified as the possible metabolites implicated in the LDA-induced gastric toxicity. Conclusion: The study identified metabolic signatures that correlated with the development of a low dose Aspirin-induced gastric toxicity in rats. This pharmacometabolomic approach could further be validated to predict LDA-induced gastric toxicity in patients with coronary artery disease.
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Mohammed M, Zainal H, Ong SC, Abd Aziz F, Sha'aban A, Mustapha S, Looi I, Tangiisuran B. Trends in clinical prediction models of stroke outcomes research outputs: a bibliometric analysis. ASMScJ 2021; 16:1-10. [DOI: 10.32802/asmscj.2021.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Stroke is one of the leading causes of death and disability globally. Clinical models have been reported to predict stroke outcomes and thus, potentially guide clinical decisions. This study aimed to describe the global trends of research in clinical prediction models of stroke outcomes. A bibliometric analysis was conducted on clinical prediction models of stroke outcomes publications reported in Scopus from 2010 to 2019. Bibliographic data were extracted, quantitatively analysed, and visualized using VOSviewer software. A total of 6,364 publications were included in the final analysis. The number of published studies had steadily increased since 2010. “Stroke” and “Journal of Stroke and Cerebrovascular Diseases” were the journal with the most publications and citations. The most cited publications were by Lip et al. (2010) and Berkhemer et al. (2015). The United States of America (USA), China together with their institutions contributed most to the pool of publications in the field. Our study showed a steady increasing research activity in the clinical prediction of stroke outcomes since 2010, with saturation in recent years. The top articles were published in high-quality stroke-related journals and by high-income countries. There is a need to reinforce research capacities in the field by developing collaborative networks.
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Tangiisuran B, Rajendran V, Sha'aban A, Daud NAA, Nawi SNM. Physicians' perceived barriers and enablers for deprescribing among older patients at public primary care clinics: a qualitative study. Int J Clin Pharm 2021; 44:201-213. [PMID: 34642869 DOI: 10.1007/s11096-021-01336-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
Background Increased harmful effects of medication resulting from polypharmacy, especially among older patients, is a significant concern globally. Hence, continuous medication review and withdrawal of inappropriate medications are essential to improve patient safety. Objective To explore physicians' perceived barriers and enablers of deprescribing among older patients in the public primary healthcare setting. Setting Public primary care clinics in the northern states of Malaysia. Methods A semi-structured, face-to-face interview was conducted among physicians working in eight primary care clinics in northern Malaysia using a purposive sampling approach. Interviews were conducted using validated topic guides. All the responses were recorded, transcribed verbatim, validated, and analysed for the emerging themes using thematic analysis. Main outcome measure Physicians perceived barriers and enablers of deprescribing among geriatric patients. Results A total of eleven physicians were interviewed. Seven emerging themes were identified, which are categorised under barriers and enablers of deprescribing. The barriers were patient-specific, prescriber-specific, and healthcare provision and system. Prescriber deprescribing competencies, medication-specific outcomes, availability of empirical evidence, and pharmacist's role were the enablers identified. Conclusion Patient-specific barriers were identified as a significant challenge for deprescribing. Improving competencies on deprescribing was the repeatedly adduced enabler by physicians. The development of targeted educational training can help to reduce the obstacles faced by prescribers.
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Affiliation(s)
- Balamurugan Tangiisuran
- National Poison Centre, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia. .,School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia.
| | - Vijitha Rajendran
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Abubakar Sha'aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Nur Aizati Athirah Daud
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Siti Nurbaya Mohd Nawi
- School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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Akkaif MA, Ng ML, Sk Abdul Kader MA, Daud NAA, Sha'aban A, Ibrahim B. A review of the effects of ticagrelor on adenosine concentration and its clinical significance. Pharmacol Rep 2021; 73:1551-1564. [PMID: 34283374 DOI: 10.1007/s43440-021-00309-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Ticagrelor is an oral antiplatelet drug that can reversibly bind to the platelet P2Y12 receptor. Ticagrelor is metabolized mainly by CYP3A4 and produces a rapid blood concentration-dependent platelet inhibitory effect. Unlike other P2Y12 receptor antagonists, many clinical features of ticagrelor are not related to P2Y12 receptor antagonism. PURPOSE This review aims to gather existing literature on the clinical effects of ticagrelor after inhibiting adenosine uptake. METHODOLOGY The current study reviewed literature related to the effects of ticagrelor on adenosine metabolism. The review also examined the drug's biological effects and clinical characteristics to see how it could be used in a clinical setting. RESULTS Many studies have shown that ticagrelor can inhibit equilibrative nucleoside transporter 1 (ENT1). This inhibition leads to intracellular adenosine uptake, increased adenosine half-life and plasma concentration levels and an enhanced adenosine-mediated biological effect. CONCLUSIONS Based on the studies reviewed, it was found that ticagrelor essentially inhibits adenosine absorption of adenosine into cells through ENT1, which increases the concentration in the blood and subsequently increases the protection of the heart muscle by adenosine. It also prevents platelet aggregation, and extends the biological effects of coronary arteries. Moreover, it leads to a lower mortality rate in acute coronary syndrome (ACS) patients.
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Affiliation(s)
- Mohammed Ahmed Akkaif
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia
| | - Mei Li Ng
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Gelugor, Penang, Malaysia
| | | | - Nur Aizati Athirah Daud
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia
| | - Abubakar Sha'aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia
| | - Baharudin Ibrahim
- Faculty of Pharmacy, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Jatau AI, Sha'aban A, Gulma KA, Shitu Z, Khalid GM, Isa A, Wada AS, Mustapha M. The Burden of Drug Abuse in Nigeria: A Scoping Review of Epidemiological Studies and Drug Laws. Public Health Rev 2021; 42:1603960. [PMID: 33796340 PMCID: PMC7904248 DOI: 10.3389/phrs.2021.1603960] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The burden of drug abuse is becoming a public health concern in Nigeria. Preventive measures should include identifying the root causes of the burden for targeted intervention. We, therefore, aim to conduct a scoping review of the literature to summarize the findings of epidemiological studies on drug abuse and provisions of drug laws in Nigeria. The review also provides appropriate recommendations as interventions for prevention. Methods: We conducted a systematic search of the literature on PubMed to identify information on drug abuse and drug laws in Nigeria from the inception of the database to March 2020. Additional information was retrieved from Google Scholar, a manual search of included articles, discussion with experts on the subject matter, and gray literature. Study selection was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Information from gray literature was assessed for quality and accuracy using the AACODS checklist (authority, accuracy, coverage, objectively, date, significance). Results: The systematic search of the literature generated 253 studies. Nine articles were obtained from other sources. After the selection process, 23 eligible studies were included for review. A prevalence of 20-40% and 20.9% of drug abuse was reported among students and youths, respectively. Commonly abused drugs include cannabis, cocaine, amphetamine, heroin, diazepam, codeine, cough syrup and tramadol. Sources where abusers obtained drugs, were pharmacies/patent medicine shops, open drug markets, drug hawkers, fellow drug abusers, friends, and drug pushers. Drug abuse was common among undergraduates and secondary school students, youths, commercial bus drivers, farmers, and sex workers. Reason for use included to increase physical performance, stress and to derive pleasure. Poor socioeconomic factors and low educational background were the common risk factors associated with drug abuse. We identified several drug laws and policies that were established under government agencies such as the National Drug Law Enforcement Agency (NDLEA), National Agency for Foods and Drugs Administration and Control (NAFDAC), Pharmacists Council of Nigeria (PCN) and a Presidential Advisory Committee. Conclusion: Findings from epidemiological studies on drug abuse in Nigeria has demonstrated that the burden of drug abuse is still high despite the existing drug laws, policies, and strategies for prevention. Measures to reduce the burden should involve the community, government, and religious bodies. Preventive measures should target the youths, the students, identified sources of the drugs, reasons and risk factors associated with drug abuse in Nigeria.
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Affiliation(s)
| | - Abubakar Sha'aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | | | - Zayyanu Shitu
- Hospital Services Management Board, Ministry of health, Gusau, Nigeria
| | - Garba Mohammed Khalid
- Department of Pharmaceutical Sciences, Università Degli Studi di Milano, Milano, Italy
| | | | - Abubakar S Wada
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University Kano, Kano, Nigeria
| | - Mohammed Mustapha
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
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Mohammed M, Sha'aban A, Jatau AI, Yunusa I, Isa AM, Wada AS, Obamiro K, Zainal H, Ibrahim B. Assessment of COVID-19 Information Overload Among the General Public. J Racial Ethn Health Disparities 2021; 9:184-192. [PMID: 33469869 PMCID: PMC7815186 DOI: 10.1007/s40615-020-00942-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/17/2022]
Abstract
Background A relentless flood of information accompanied the novel coronavirus 2019 (COVID-19) pandemic. False news, conspiracy theories, and magical cures were shared with the general public at an alarming rate, which may lead to increased anxiety and stress levels and associated debilitating consequences. Objectives To measure the level of COVID-19 information overload (COVIO) and assess the association between COVIO and sociodemographic characteristics among the general public. Methods A cross-sectional online survey was conducted between April and May 2020 using a modified Cancer Information Overload scale. The survey was developed and posted on four social media platforms. The data were only collected from those who consented to participate. COVIO score was classified into high vs. low using the asymmetrical distribution as a guide and conducted a binary logistic regression to examine the factors associated with COVIO. Results A total number of 584 respondents participated in this study. The mean COVIO score of the respondents was 19.4 (± 4.0). Sources and frequency of receiving COVID-19 information were found to be significant predictors of COVIO. Participants who received information via the broadcast media were more likely to have high COVIO than those who received information via the social media (adjusted odds ratio ([aOR],14.599; 95% confidence interval [CI], 1.608–132.559; p = 0.017). Also, participants who received COVID-19 information every minute (aOR, 3.892; 95% CI, 1.124–13.480; p = 0.032) were more likely to have high COVIO than those who received information every week. Conclusion The source of information and the frequency of receiving COVID-19 information were significantly associated with COVIO. The COVID-19 information is often conflicting, leading to confusion and overload of information in the general population. This can have unfavorable effects on the measures taken to control the transmission and management of COVID-19 infection. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-020-00942-0.
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Affiliation(s)
- Mustapha Mohammed
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria
| | - Abubakar Sha'aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia. .,Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria.
| | - Abubakar Ibrahim Jatau
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA.,Harvard School of Public Health, Boston, MA, USA
| | | | - Abubakar Sadiq Wada
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Kehinde Obamiro
- Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Hadzliana Zainal
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Baharudin Ibrahim
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
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Mohammed M, Muhammad S, Mohammed FZ, Mustapha S, Sha'aban A, Sani NY, Ahmad MH, Bala AA, Ungogo MA, Alotaibi NM, Zainal H. Risk Factors Associated with Mortality Among Patients with Novel Coronavirus Disease (COVID-19) in Africa. J Racial Ethn Health Disparities 2020; 8:1267-1272. [PMID: 33051749 PMCID: PMC7553376 DOI: 10.1007/s40615-020-00888-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China and later spread rapidly to other parts of the world, including Africa. Africa was projected to be devastated by COVID-19. There is currently limited data regarding regional predictors of mortality among patients with COVID-19. This study aimed to evaluate the independent risk factors associated with mortality among patients with COVID-19 in Africa. METHODS A total of 1028 confirmed cases of COVID-19 from Africa with definite survival outcomes were identified retrospectively from an open-access individual-level worldwide COVID-19 database. The live version of the dataset is available at https://github.com/beoutbreakprepared/nCoV2019 . Multivariable logistic regression was conducted to determine the risk factors that independently predict mortality among patients with COVID-19 in Africa. RESULTS Of the 1028 cases included in study, 432 (42.0%) were females with a median (interquartile range, IQR) age of 50 (24) years. Older age (adjusted odds ratio {aOR} 1.06; [95% confidence intervals {95% CI}, 1.04-1.08]), presence of chronic disease (aOR 9.63; [95% CI, 3.84-24.15]), travel history (aOR 2.44; [95% CI, 1.26-4.72]), as well as locations of Central Africa (aOR 0.14; [95% CI, 0.03-0.72]) and West Africa (aOR 0.12; [95% CI, 0.04-0.32]) were identified as the independent risk factors significantly associated with increased mortality among the patients with COVID-19. CONCLUSIONS The COVID-19 pandemic is evolving gradually in Africa. Among patients with COVID-19 in Africa, older age, presence of chronic disease, travel history, and the locations of Central Africa and West Africa were associated with increased mortality. A regional response should prioritize strategies that will protect these populations. Also, conducting a further in-depth study could provide more insights into additional factors predictive of mortality in COVID-19 patients.
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Affiliation(s)
- Mustapha Mohammed
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Pulau Pinang, Malaysia. .,Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Kaduna, Nigeria.
| | | | - Fatima Zaji Mohammed
- School of Dental Health Sciences, Shehu Idris College of Health Sciences and Technology, Makarfi, Kaduna, Nigeria
| | - Sagir Mustapha
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Abubakar Sha'aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Pulau Pinang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Najib Yahaya Sani
- Center for Drug Research, Universiti Sains Malaysia, Penang, Pulau Pinang, Malaysia.,Department of Pharmaceutical and Medicinal Chemistry, Bayero University Kano, Kano, Nigeria
| | - Mubarak Hussaini Ahmad
- Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Kaduna, Nigeria.,School of Pharmacy Technician, Aminu Dabo College of Health Sciences and Technology, Kano, Nigeria
| | - Auwal Adam Bala
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Jigawa, Nigeria.,Department of Pharmacology and Therapeutics, Bayero University Kano, Kano, Nigeria
| | - Marzuq Abubakar Ungogo
- Department of Veterinary Pharmacology and Toxicology, Ahmadu Bello University, Zaria, Nigeria.,Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nawaf M Alotaibi
- College of Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia
| | - Hadzliana Zainal
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Pulau Pinang, Malaysia
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Jatau AI, Aung MMT, Kamauzaman THT, Chedi BAZ, Sha'aban A, Rahman AFA. Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review. J Intercult Ethnopharmacol 2016; 5:191-7. [PMID: 27104042 PMCID: PMC4835996 DOI: 10.5455/jice.20160223105521] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/09/2016] [Indexed: 11/23/2022]
Abstract
Many studies have been conducted in health-care settings with regards to complementary and alternative medicine (CAM) use among patients. However, information regarding CAM use among patients in the emergency department (ED) is scarce. The aim of this article was to conduct a systematic review of published studies with regards to CAM use among the ED patients. A literature search of published studies from inception to September 2015 was conducted using PubMed, Scopus, and manual search of the reference list. 18 studies that met the inclusion criteria were reviewed. The prevalence rate of CAM use among ED patients across the studies ranged of 1.4-68.1%. Herbal therapy was the sub-modality of CAM most commonly used and frequently implicated in CAM-related ED visits. Higher education, age, female gender, religious affiliation, and chronic diseases were the most frequent factors associated with CAM use among the ED patients. Over 80% of the ED physicians did not ask the patients about the CAM therapy. Similarly, 80% of the ED patients were ready to disclose CAM therapy to the ED physician. The prevalence rate of CAM use among patients at ED is high and is growing with the current increasing popularity, and it has been a reason for some of the ED visits. There is a need for the health-care professionals to receive training and always ask patients about CAM therapy to enable them provide appropriate medical care and prevent CAM-related adverse events.
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Affiliation(s)
- Abubakar Ibrahim Jatau
- Department of Health Sciences, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak, Kuala Terengganu, Malaysia
| | - Myat Moe Thwe Aung
- Department of Community Medicine, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kampus Kota, Kuala Terengganu, Malaysia
| | | | - Basheer A Z Chedi
- Department of Pharmacology, College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Abubakar Sha'aban
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Ab Fatah Ab Rahman
- Department of Health Sciences, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak, Kuala Terengganu, Malaysia
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