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Ju SH, Lim JY, Song M, Kim JM, Kang YE, Yi HS, Joung KH, Lee JH, Kim HJ, Ku BJ. Distinct effects of rosuvastatin and rosuvastatin/ezetimibe on senescence markers of CD8+ T cells in patients with type 2 diabetes mellitus: a randomized controlled trial. Front Endocrinol (Lausanne) 2024; 15:1336357. [PMID: 38586464 PMCID: PMC10996898 DOI: 10.3389/fendo.2024.1336357] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/04/2024] [Indexed: 04/09/2024] Open
Abstract
Objectives Chronic low-grade inflammation is widely recognized as a pathophysiological defect contributing to β-cell failure in type 2 diabetes mellitus (T2DM). Statin therapy is known to ameliorate CD8+ T cell senescence, a mediator of chronic inflammation. However, the additional immunomodulatory roles of ezetimibe are not fully understood. Therefore, we investigated the effect of statin or statin/ezetimibe combination treatment on T cell senescence markers. Methods In this two-group parallel and randomized controlled trial, we enrolled 149 patients with T2DM whose low-density lipoprotein cholesterol (LDL-C) was 100 mg/dL or higher. Patients were randomly assigned to either the rosuvastatin group (N=74) or the rosuvastatin/ezetimibe group (N=75). The immunophenotype of peripheral blood mononuclear cells and metabolic profiles were analyzed using samples from baseline and post-12 weeks of medication. Results The fractions of CD8+CD57+ (senescent CD8+ T cells) and CD4+FoxP3+ (Treg) significantly decreased after intervention in the rosuvastatin/ezetimibe group (-4.5 ± 14.1% and -1.2 ± 2.3%, respectively), while these fractions showed minimal change in the rosuvastatin group (2.8 ± 9.4% and 1.4 ± 1.5%, respectively). The degree of LDL-C reduction was correlated with an improvement in HbA1c (R=0.193, p=0.021). Changes in the CD8+CD57+ fraction positively correlated with patient age (R=0.538, p=0.026). Notably, the fraction change in senescent CD8+ T cells showed no significant relationship with changes in either HbA1c (p=0.314) or LDL-C (p=0.592). Finally, the ratio of naïve to memory CD8+ T cells increased in the rosuvastatin/ezetimibe group (p=0.011), but not in the rosuvastatin group (p=0.339). Conclusions We observed a reduction in senescent CD8+ T cells and an increase in the ratio of naive to memory CD8+ T cells with rosuvastatin/ezetimibe treatment. Our results demonstrate the immunomodulatory roles of ezetimibe in combination with statins, independent of improvements in lipid or HbA1c levels.
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Affiliation(s)
- Sang-Hyeon Ju
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Joung Youl Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Minchul Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ji Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Yea Eun Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyon-Seung Yi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Kyong Hye Joung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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Dautović E, Rustemović-Čorbić M, Srabović N, Softić A, Smajlović A, Husejnović MŠ, Hatkić A, Halilčević D. Some pleiotropic effects of statins on hepatocellular carcinoma cells: Comparative study on atorvastatin, rosuvastatin and simvastatin. Adv Med Sci 2023; 68:258-264. [PMID: 37478516 DOI: 10.1016/j.advms.2023.07.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE For many years, statins have been the most commonly used drugs in cholesterol-lowering therapy. In addition to these therapeutic effects, statins exhibit other, pleiotropic effects that can be beneficial, but also harmful to cells and tissues. The aim of this research was to determine and compare the pleiotropic effects of structurally different statins: atorvastatin, simvastatin and rosuvastatin at different concentrations on hepatocellular carcinoma (HepG2) cells. MATERIALS AND METHODS The MTT assay was used to determine the cytotoxic effects of statins. The influence of statins on the production of reactive oxygen species (ROS) was determined by measuring fluorescent response of 2,7-dichlorofluorescein diacetate (DCFH-DA). The effect of statins on glucose production and excretion was determined with glucose production assay. RESULTS The obtained results confirmed that all tested statins exhibit cytotoxic effects, increase the production of ROS as well as the production and excretion of glucose from HepG2 cells. It was observed that all the mentioned effects are more pronounced with lipophilic statins, atorvastatin and simvastatin compared to hydrophilic rosuvastatin. CONCLUSION The less pronounced pleiotropic effects of rosuvastatin on HepG2 cells are probably due to differences in structure and solubility compared to atorvastatin and simvastatin. Transporter-dependent and a slower influx of rosuvastatin into cells compared to the tested lipophilic statins probably lead to a weaker accumulation of rosuvastatin in HepG2 cells, which results in less pronounced pleiotropic effects compared to lipophilic atorvastatin and simvastatin.
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Affiliation(s)
- Esmeralda Dautović
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina.
| | | | - Nahida Srabović
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Adaleta Softić
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Aida Smajlović
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Maida Šljivić Husejnović
- Department of Pharmaceutical Analytics, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Alen Hatkić
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Dalila Halilčević
- Department of Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina
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Niu HL, Liu YN, Xue DQ, Dong LY, Liu HJ, Wang J, Zheng YL, Zou AR, Shao LM, Wang K. Inhibition of Nav1.7 channel by a novel blocker QLS-81 for alleviation of neuropathic pain. Acta Pharmacol Sin 2021; 42:1235-1247. [PMID: 34103689 PMCID: PMC8285378 DOI: 10.1038/s41401-021-00682-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/14/2021] [Indexed: 02/02/2023] Open
Abstract
Voltage-gated sodium channel Nav1.7 robustly expressed in peripheral nociceptive neurons has been considered as a therapeutic target for chronic pain, but there is no selective Nav1.7 inhibitor available for therapy of chronic pain. Ralfinamide has shown anti-nociceptive activity in animal models of inflammatory and neuropathic pain and is currently under phase III clinical trial for neuropathic pain. Based on ralfinamide, a novel small molecule (S)-2-((3-(4-((2-fluorobenzyl) oxy) phenyl) propyl) amino) propanamide (QLS-81) was synthesized. Here, we report the electrophysiological and pharmacodynamic characterization of QLS-81 as a Nav1.7 channel inhibitor with promising anti-nociceptive activity. In whole-cell recordings of HEK293 cells stably expressing Nav1.7, QLS-81 (IC50 at 3.5 ± 1.5 μM) was ten-fold more potent than its parent compound ralfinamide (37.1 ± 2.9 μM) in inhibiting Nav1.7 current. QLS-81 inhibition on Nav1.7 current was use-dependent. Application of QLS-81 (10 μM) caused a hyperpolarizing shift of the fast and slow inactivation of Nav1.7 channel about 7.9 mV and 26.6 mV, respectively, and also slowed down the channel fast and slow inactivation recovery. In dissociated mouse DRG neurons, QLS-81 (10 μM) inhibited native Nav current and suppressed depolarizing current pulse-elicited neuronal firing. Administration of QLS-81 (2, 5, 10 mg· kg-1· d-1, i.p.) in mice for 10 days dose-dependently alleviated spinal nerve injury-induced neuropathic pain and formalin-induced inflammatory pain. In addition, QLS-81 (10 μM) did not significantly affect ECG in guinea pig heart ex vivo; and administration of QLS-81 (10, 20 mg/kg, i.p.) in mice had no significant effect on spontaneous locomotor activity. Taken together, our results demonstrate that QLS-81, as a novel Nav1.7 inhibitor, is efficacious on chronic pain in mice, and it may hold developmental potential for pain therapy.
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Affiliation(s)
- He-Ling Niu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China
| | - Ya-Ni Liu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China.
| | - Deng-Qi Xue
- School of Pharmacy, Fudan University, Shanghai, 201203, China
| | - Li-Ying Dong
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China
| | - Hui-Jie Liu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China
| | - Jing Wang
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China
| | - Yi-Lin Zheng
- School of Pharmacy, Fudan University, Shanghai, 201203, China
| | - An-Ruo Zou
- Institute of Innovative Drug, Qingdao University, Qingdao, 266021, China
| | - Li-Ming Shao
- School of Pharmacy, Fudan University, Shanghai, 201203, China.
| | - KeWei Wang
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, 266073, China.
- Institute of Innovative Drug, Qingdao University, Qingdao, 266021, China.
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Tamar, Hong Kong, China.
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Courlet P, Guidi M, Alves Saldanha S, Stader F, Traytel A, Cavassini M, Stoeckle M, Buclin T, Marzolini C, Decosterd LA, Csajka C. Pharmacokinetic/Pharmacodynamic Modelling to Describe the Cholesterol Lowering Effect of Rosuvastatin in People Living with HIV. Clin Pharmacokinet 2021; 60:379-390. [PMID: 33124006 PMCID: PMC7932937 DOI: 10.1007/s40262-020-00946-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Rosuvastatin is a lipid-lowering agent widely prescribed in people living with HIV, which is actively transported into the liver, making it a potential victim of drug-drug interactions with antiretroviral agents. OBJECTIVES The aims of this study were to characterise the pharmacokinetic profile of rosuvastatin and to describe the relationship between rosuvastatin concentrations and non-high-density lipoprotein (HDL)-cholesterol levels in people living with HIV. METHODS A population pharmacokinetic model (NONMEM) was developed to quantify the influence of demographics, clinical characteristics and comedications on rosuvastatin pharmacokinetics. This model was combined with an indirect effect model to describe non-HDL-cholesterol measurements. RESULTS A two-compartment model with sequential zero- and first-order absorption best fitted the 154 rosuvastatin concentrations provided by 65 people living with HIV. None of the tested covariates significantly influenced rosuvastatin pharmacokinetics. A total of 403 non-HDL cholesterol values were available for pharmacokinetic-pharmacodynamic modelling. Baseline non-HDL cholesterol decreased by 14% and increased by 12% with etravirine and antiretroviral drugs with a known impact on the lipid profile (i.e. protease inhibitors, efavirenz, cobicistat), respectively. The baseline value was surprisingly 43% lower in people living with HIV aged 80 years compared with those aged 40 years. Simulations based on the covariate-free model predicted that, under standard rosuvastatin dosages of 5 mg and 20 mg once daily, 31% and 64% of people living with HIV would achieve non-HDL-cholesterol targets, respectively. CONCLUSIONS The high between-subject variability that characterises both rosuvastatin pharmacokinetic and pharmacodynamic profiles remained unexplained after the inclusion of usual covariates. Considering its limited potential for drug-drug interactions with antiretroviral agents and its potent lipid-lowering effect, rosuvastatin prescription appears safe and effective in people living with HIV with hypercholesterolaemia. CLINICAL TRIAL REGISTRATION NO NCT03515772.
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Affiliation(s)
- Perrine Courlet
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005, 1011, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Susana Alves Saldanha
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Felix Stader
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Traytel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Cavassini
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
| | - Thierry Buclin
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Catia Marzolini
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Laurent A Decosterd
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chantal Csajka
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005, 1011, Lausanne, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.
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Saengjaroentham C, Strother LC, Dripps I, Sultan Jabir MR, Pradhan A, Goadsby PJ, Holland PR. Differential medication overuse risk of novel anti-migraine therapeutics. Brain 2020; 143:2681-2688. [PMID: 32810212 PMCID: PMC7523700 DOI: 10.1093/brain/awaa211] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 12/20/2019] [Revised: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 01/16/2023] Open
Abstract
Medication overuse headache is estimated to affect 2% of the population, and is ranked in the top 20 most disabling disorders due to its high level of disability. Several therapies used in the treatment of acute migraine are thought to be associated with medication overuse headache, including opioids and triptans. With limited treatment options, it is critical to determine the risk profile of novel therapies prior to their widespread use. The current study explores the potential medication overuse risk of two novel therapeutic drug classes, namely the ditans: 5-HT1F receptor agonists, and the gepants: calcitonin gene-related peptide receptor antagonists, in a preclinical model of medication overuse. Persistent exposure of mice to the 5-HT1F agonist LY344864, but not olcegepant produced a significant reduction in hind paw and orofacial mechanical withdrawal thresholds as a surrogate readout of allodynia. In agreement, only LY344864 induced neuroplastic changes in trigeminal sensory afferents, increasing calcitonin gene-related peptide expression and basal trigeminal nociception. Our data highlight a differential medication overuse headache risk profile for the ditan and gepant classes of drugs that has important implications for their clinical use and patient education to help reduce the burden of medication overuse headache.
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Affiliation(s)
- Chonlawan Saengjaroentham
- Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Lauren C Strother
- Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Isaac Dripps
- Department of Psychiatry, University of Illinois at Chicago, Chicago, USA
| | - Mohammad Rayhan Sultan Jabir
- Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Amynah Pradhan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, USA
| | - Peter J Goadsby
- Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Philip R Holland
- Headache Group, Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Abstract
Targeting RNA drastically expands our target space to therapeutically modulate numerous cellular processes implicated in human diseases. Of particular interest, drugging pre-mRNA splicing appears a very viable strategy; to control levels of splicing product by promoting the inclusion or exclusion of exons. After describing the concept of "splicing modulation", this chapter will cover the outstanding progress achieved in this field, by highlighting the breakthrough accomplished recently for the treatment of spinal muscular atrophy using two therapeutic modalities: splice switching oligonucleotides and small molecules. This review discusses the vital but feasible requirement for such drugs to deliver selectivity, and critical safety aspects are highlighted. Transformational medicines such as those developed to treat SMA are likely just the beginning of this story.
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Affiliation(s)
- Hasane Ratni
- F. Hoffmann-La Roche Ltd., pRED, Pharma Research & Early Development, Roche Innovation Center Basel, Basel, Switzerland.
| | - Lutz Mueller
- F. Hoffmann-La Roche Ltd., pRED, Pharma Research & Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Martin Ebeling
- F. Hoffmann-La Roche Ltd., pRED, Pharma Research & Early Development, Roche Innovation Center Basel, Basel, Switzerland
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Scholpa NE, Lynn MK, Corum D, Boger HA, Schnellmann RG. 5-HT 1F receptor-mediated mitochondrial biogenesis for the treatment of Parkinson's disease. Br J Pharmacol 2018; 175:348-358. [PMID: 29057453 PMCID: PMC5758398 DOI: 10.1111/bph.14076] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/25/2017] [Accepted: 10/18/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND PURPOSE Parkinson's disease is characterized by progressive decline in motor function due to degeneration of nigrostriatal dopaminergic neurons, as well as other deficits including cognitive impairment and behavioural abnormalities. Mitochondrial dysfunction, leading to loss of ATP-dependent cellular functions, calcium overload, excitotoxicity and oxidative stress, is implicated in the pathophysiology of Parkinson's disease. Using the 5-HT1F receptor agonist LY344864, a known inducer of mitochondrial biogenesis (MB), we investigated the therapeutic efficacy of stimulating MB on dopaminergic neuron loss in a mouse model of Parkinson's disease. EXPERIMENTAL APPROACH Male C57BL/6 mice underwent bilateral intrastriatal 6-hydroxydopamine or saline injections and daily treatment with 2 mg·kg-1 LY344864 or vehicle for 14 days beginning 7 days post-lesion. Tyrosine hydroxylase immunoreactivity (TH-ir) and MB were assessed in the brains of all groups following treatment, and locomotor activity was evaluated prior to lesioning, 7 days post-lesion and after treatment. KEY RESULTS Increased mitochondrial DNA content and nuclear- and mitochondrial-encoded mRNA and protein expression was observed in specific brain regions of LY344864-treated naïve and lesioned mice, indicating augmented MB. LY344864 attenuated TH-ir loss in the striatum and substantia nigra compared to vehicle-treated lesioned animals. LY344864 treatment also increased locomotor activity in 6-hydroxydopamine lesioned mice, while vehicle treatment had no effect. CONCLUSIONS AND IMPLICATIONS These data revealed that LY344864-induced MB attenuates dopaminergic neuron loss and improves behavioural endpoints in this model. We suggest that stimulating MB may be beneficial for the treatment of Parkinson's disease and that the 5-HT1F receptor may be an effective therapeutic target.
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Affiliation(s)
- Natalie E Scholpa
- Department of Pharmacology and Toxicology, College of PharmacyUniversity of ArizonaTucsonAZUSA
| | - Mary K Lynn
- Department of NeuroscienceMedical University of South CarolinaCharlestonSCUSA
| | - Daniel Corum
- Department of Drug Discovery and Biomedical SciencesMedical University of South CarolinaCharlestonSCUSA
| | - Heather A Boger
- Department of NeuroscienceMedical University of South CarolinaCharlestonSCUSA
| | - Rick G Schnellmann
- Department of Pharmacology and Toxicology, College of PharmacyUniversity of ArizonaTucsonAZUSA
- Southern Arizona VA Health Care SystemTucsonAZUSA
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Milionis HJ, Gazi IF, Filippatos TD, Tzovaras V, Chasiotis G, Goudevenos J, Seferiadis K, Elisaf MS. Starting with Rosuvastatin in Primary Hyperlipidemia—. Angiology 2016; 56:585-92. [PMID: 16193198 DOI: 10.1177/000331970505600510] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors investigated the effects of rosuvastatin, beyond its lipid-lowering activity, on several nonlipid metabolic variables, along with its safety and tolerability, in patients treated for primary hyperlipidemia. Patients (n=55) with primary hyperlipidemia were open-label assigned to the recommended starting dose of rosuvastatin 10 mg/day, and serum metabolic variables were measured at baseline and after 8 and 20 weeks. Treatment with rosuvastatin produced significant reductions in total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B, nonhigh-density lipoprotein cholesterol (non HDL-C), and triglyceride concentrations, whereas HDL-C, apolipoprotein A-I, and lipoprotein(a) levels did not change significantly from baseline. The LDL-C treatment target was achieved in 71% of patients. No significant variations in renal function parameters (serum creatinine and creatinine clearance), insulin resistance estimates, and serum concentrations of uric acid, total homocysteine, vitamin B12, and folic acid were observed during the period of treatment. High-sensitivity C-reactive protein levels were significantly lowered by rosuvastatin therapy (median values, 3.1 vs 2.0 vs 1.9 mg/L, at 0, 8, and 20 weeks, respectively; p<0.0001). In conclusion, rosuvastatin at 10 mg/day is a highly effective, safe, and well-tolerated monotherapy option for patients with primary hyperlipidemia, with a favorable antiinflammatory potential and nondeteriorating effects on renal function.
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Affiliation(s)
- Haralampos J Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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Dyer C. GP admits to falsifying clinical trial of insomnia drug. BMJ 2016; 353:i2441. [PMID: 27122294 DOI: 10.1136/bmj.i2441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yang Y, Wu YX, Hu YZ. Rosuvastatin Treatment for Preventing Contrast-Induced Acute Kidney Injury After Cardiac Catheterization: A Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore) 2015; 94:e1226. [PMID: 26222855 PMCID: PMC4554112 DOI: 10.1097/md.0000000000001226] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the protective effects of rosuvastatin on contrast-induced acute kidney injury (CI-AKI) and major adverse cardiovascular events (MACEs) in patients undergoing cardiac catherization.PubMed, MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central RCTs were searched for RCTs from inception to May 2015, to compare rosuvastatin for preventing CI-AKI with placebo treatment in patients undergoing cardiac catherization.Five RCTs with a total of 4045 patients involving 2020 patients pretreated with rosuvastatin and 2025 control patients were identified and analyzed. Patients treated with rosuvastatin had a 51% lower risk of CI-AKI compared with the control group based on a fixed-effect model (OR = 0.49, 95% CI = 0.37-0.66, P < 0.001), and showed a trend toward a reduced risk of MACEs (OR = 0.62, 95% CI = 0.36-1.07, P = 0.08). A subgroup analysis showed that studies with Jadad score ≥3 showed a significant reduction of CI-AKI (OR = 0.53, 95% CI, 0.38-0.73, P < 0.001). However, the risk of CI-AKI did not significantly differ in the studies with Jadad score <3 (OR = 0.54, 95% CI, 0.13-2.24, P = 0.40). In addition, the rosuvastatin treatment showed no effect for preventing CI-AKI in patients with chronic kidney disease (CKD) undergoing elective cardiac catherization (I = 0%, OR = 0.81, 95% CI = 0.41-1.61, P = 0.55).This updated meta-analysis demonstrated that preprocedural rosuvastatin treatment could significantly reduce the incidence of CI-AKI, with a trend toward a reduced risk of MACEs in patients undergoing cardiac catheterization. However, rosuvastatin treatment did not seem to be effective for preventing CI-AKI in CKD patients undergoing elective cardiac catheterization.
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Affiliation(s)
- You Yang
- From the Department of Cardiology, the First People's Hospital of Shunde, Foshan, China (YY, Y-xW, Y-zH)
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Ng TWK, Ooi EMM, Watts GF, Chan DC, Meikle PJ, Barrett PHR. Association of Plasma Ceramides and Sphingomyelin With VLDL apoB-100 Fractional Catabolic Rate Before and After Rosuvastatin Treatment. J Clin Endocrinol Metab 2015; 100:2497-501. [PMID: 25816050 DOI: 10.1210/jc.2014-4348] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The objective of the study was to examine post hoc associations between plasma sphingolipids and lipoprotein kinetics in men with the metabolic syndrome after rosuvastatin treatment. MATERIALS AND METHODS Plasma sphingolipid profiling, determined by tandem mass spectrometry, was performed in a randomized, double-blind, triple-crossover trial (n = 12) of 5-week treatment periods with placebo or rosuvastatin (10 or 40 mg/d) with 2-week washouts between treatments. RESULTS AND DISCUSSION Baseline plasma ceramides were associated with very low-density lipoprotein (VLDL) apolipoprotein (apo)-B-100 concentration (r = 0.58, P < .05) and inversely with VLDL apoB-100 fractional catabolic rate (FCR; r = -0.67, P = .02). Posttreatment changes with rosuvastatin (40 mg/d) in plasma ceramides were inversely associated with VLDL apoB-100 FCR (r = -0.62, P = .03) independent of changes in plasma triglycerides, cholesterol, and low-density lipoprotein-cholesterol. By contrast, baseline and postrosuvastatin treatment plasma sphingomyelin levels were not associated with apoB-100 kinetics. Plasma ceramides and sphingomyelin were not associated with the kinetics or concentrations of high-density lipoprotein apoA-I, and low-density lipoprotein apoB. In the metabolic syndrome, the ability of rosuvastatin to increase VLDL apoB-100 FCR may reflect ceramide-specific mechanistic actions and/or sphingolipid exchange.
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Affiliation(s)
- Theodore W K Ng
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Esther M M Ooi
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Gerald F Watts
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Dick C Chan
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Peter J Meikle
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - P Hugh R Barrett
- Metabolic Research Centre (T.W.K.N., E.M.M.O., G.F.W., D.C.C., P.H.R.B.), School of Medicine and Pharmacology, University of Western Australia and Lipid Disorders Clinic (G.F.W.), Department of Cardiovascular Medicine, Royal Perth Hospital, Faculty of Engineering, Computing, and Mathematics (P.H.R.B.), University of Western Australia, Perth, Western Australia 6847, Australia; and Metabolomics Laboratory (T.W.K.N., P.J.M.), Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
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Abaci O, Arat Ozkan A, Kocas C, Cetinkal G, Sukru Karaca O, Baydar O, Kaya A, Gurmen T. Impact of Rosuvastatin on contrast-induced acute kidney injury in patients at high risk for nephropathy undergoing elective angiography. Am J Cardiol 2015; 115:867-71. [PMID: 25670636 DOI: 10.1016/j.amjcard.2015.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/03/2015] [Accepted: 01/03/2015] [Indexed: 11/27/2022]
Abstract
Although statins have been shown to prevent contrast-induced acute kidney injury in patients with acute coronary syndromes, the benefit of statins is not known for patients at high risk for nephropathy who undergo elective coronary angiography. Two hundred twenty consecutive statin-naive patients with chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73 m(2)) who underwent elective coronary or peripheral angiography were randomly assigned to receive rosuvastatin (40 mg on admission, followed by 20 mg/day; n = 110) or no statin treatment (control group, n = 110). Contrast-induced acute kidney injury was defined by an absolute increase in serum creatinine of ≥0.5 mg/dl or a relative increase of ≥25% measured 48 or 72 hours after the procedure. Contrast-induced acute kidney injury occurred in 15 patients (7.2%), 9 (8.5%) in the control group and 6 (5.8%) in the rosuvastatin group (p = 0.44). The incidences of adverse cardiovascular and renal events (death, dialysis, myocardial infarction, stroke, or persistent renal damage) were similar between the two groups at follow-up. In conclusion, rosuvastatin did not reduce the risk for contrast-induced acute kidney injury or other clinically relevant outcomes in at-risk patients who underwent coronary and peripheral vascular angiography.
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Affiliation(s)
- Okay Abaci
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey.
| | - Alev Arat Ozkan
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Cuneyt Kocas
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Gokhan Cetinkal
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Osman Sukru Karaca
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Onur Baydar
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Aysem Kaya
- Department of Biochemistry, Istanbul University Cardiology Institute, Istanbul, Turkey
| | - Tevfik Gurmen
- Department of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey
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Cho Y, Choe E, Lee YH, Seo JW, Choi Y, Yun Y, Wang HJ, Ahn CW, Cha BS, Lee HC, Kang ES. Risk of diabetes in patients treated with HMG-CoA reductase inhibitors. Metabolism 2015; 64:482-8. [PMID: 25312577 DOI: 10.1016/j.metabol.2014.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 09/17/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are used to control blood cholesterol levels and reduce cardiovascular disease. It has been repeatedly reported that statins may cause new-onset diabetes mellitus (DM). However, limited evidence exists from direct head to head comparisons of statins on whether the risk of DM differs among statins. We investigated the risk of development of new-onset diabetes in subjects treated with different statins. METHODS We retrospectively enrolled consecutive 3680 patients without DM or impaired fasting glucose who started receiving statin treatment for cholesterol control. We evaluated the incidence of new-onset diabetes according to the type of statin. RESULTS The mean duration of follow-up was 62.6±15.3 months. The incidence of DM was significantly higher in the pitavastatin group (49 of 628; 7.8%) compared to that in the other statin groups [atorvastatin (68 of 1327; 5.1%), rosuvastatin (77 of 1191; 6.5%), simvastatin (11 of 326; 3.4%), and pravastatin (12 of 298; 5.8%); p=0.041]. The risk of diabetes was the highest in the pitavastatin group compared with that in the simvastatin group [hazard ratio (HR)=2.68, p=0.011]. Other statins showed no significant risk differences compared to that for simvastatin. Fasting blood glucose (FBG) level at baseline and body-mass index (BMI) were associated with the development of diabetes [FBG, HR=1.11, p<0.001; BMI, HR=1.02, p=0.005]. CONCLUSIONS Among the five statins, pitavastatin showed the strongest effect on the development of new-onset diabetes.
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Affiliation(s)
- Yongin Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - EunYeong Choe
- Endocrinology and Metabolism Clinic, International St. Mary's Hospital Internal Medicine, Incheon, South Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Won Seo
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Younjeong Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yujung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jin Wang
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Woo Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Bong Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Chul Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea.
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Lewicki M, Ng I, Schneider AG. HMG CoA reductase inhibitors (statins) for preventing acute kidney injury after surgical procedures requiring cardiac bypass. Cochrane Database Syst Rev 2015; 2015:CD010480. [PMID: 25758322 PMCID: PMC10788137 DOI: 10.1002/14651858.cd010480.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is common in patients undergoing cardiac surgery among whom it is associated with poor outcomes, prolonged hospital stays and increased mortality. Statin drugs can produce more than one effect independent of their lipid lowering effect, and may improve kidney injury through inhibition of postoperative inflammatory responses. OBJECTIVES This review aimed to look at the evidence supporting the benefits of perioperative statins for AKI prevention in hospitalised adults after surgery who require cardiac bypass. The main objectives were to 1) determine whether use of statins was associated with preventing AKI development; 2) determine whether use of statins was associated with reductions in in-hospital mortality; 3) determine whether use of statins was associated with reduced need for RRT; and 4) determine any adverse effects associated with the use of statins. SEARCH METHODS We searched the Cochrane Renal Group's Specialised Register to 13 January 2015 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared administration of statin therapy with placebo or standard clinical care in adult patients undergoing surgery requiring cardiopulmonary bypass and reporting AKI, serum creatinine (SCr) or need for renal replacement therapy (RRT) as an outcome were eligible for inclusion. All forms and dosages of statins in conjunction with any duration of pre-operative therapy were considered for inclusion in this review. DATA COLLECTION AND ANALYSIS All authors extracted data independently and assessments were cross-checked by a second author. Likewise, assessment of study risk of bias was initially conducted by one author and then by a second author to ensure accuracy. Disagreements were arbitrated among authors until consensus was reached. Authors from two of the included studies provided additional data surrounding post-operative SCr as well as need for RRT. Meta-analyses were used to assess the outcomes of AKI, SCr and mortality rate. Data for the outcomes of RRT and adverse effects were not pooled. Adverse effects taken into account were those reported by the authors of included studies. MAIN RESULTS We included seven studies (662 participants) in this review. All except one study was assessed as being at high risk of bias. Three studies assessed atorvastatin, three assessed simvastatin and one investigated rosuvastatin. All studies collected data during the immediate perioperative period only; data collection to hospital discharge and postoperative biochemical data collection ranged from 24 hours to 7 days. Overall, pre-operative statin treatment was not associated with a reduction in postoperative AKI, need for RRT, or mortality. Only two studies (195 participants) reported postoperative SCr level. In those studies, patients allocated to receive statins had lower postoperative SCr concentrations compared with those allocated to no drug treatment/placebo (MD 21.2 µmol/L, 95% CI -31.1 to -11.1). Adverse effects were adequately reported in only one study; no difference was found between the statin group compared to placebo. AUTHORS' CONCLUSIONS Analysis of currently available data did not suggest that preoperative statin use is associated with decreased incidence of AKI in adults after surgery who required cardiac bypass. Although a significant reduction in SCr was seen postoperatively in people treated with statins, this result was driven by results from a single study, where SCr was considered as a secondary outcome. The results of the meta-analysis should be interpreted with caution; few studies were included in subgroup analyses, and significant differences in methodology exist among the included studies. Large high quality RCTs are required to establish the safety and efficacy of statins to prevent AKI after cardiac surgery.
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Affiliation(s)
- Michelle Lewicki
- Monash Medical CentreDepartment of Nephrology246 Clayton RoadClaytonVICAustralia3168
- Monash UniversityDepartment of MedicineClaytonVICAustralia
- Monash UniversityDepartment of Epidemiology and Preventative MedicineClaytonVICAustralia
| | - Irene Ng
- Monash UniversityDepartment of Epidemiology and Preventative MedicineClaytonVICAustralia
- Royal Melbourne HospitalDepartment of AnaesthesiaParkvilleVICAustralia
| | - Antoine G Schneider
- Monash UniversityDepartment of Epidemiology and Preventative MedicineClaytonVICAustralia
- Hospitalo‐Universitaire Vaudois (CHUV)Intensive Care UnitLausanneSwitzerland
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Affiliation(s)
- Peter Vestergaard
- Departments of Clinical Medicine and Endocrinology, Aalborg University Hospital, Mølleparkvej 4, DK-9100 Aalborg, Denmark
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Affiliation(s)
- Vito M Campese
- Division of Nephrology and Hypertension Center, Keck School of Medicine, USC, 1200 North State Street, Los Angeles, CA 90033, USA.
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de Zeeuw D, Anzalone DA, Cain VA, Cressman MD, Heerspink HJL, Molitoris BA, Monyak JT, Parving HH, Remuzzi G, Sowers JR, Vidt DG. Renal effects of atorvastatin and rosuvastatin in patients with diabetes who have progressive renal disease (PLANET I): a randomised clinical trial. Lancet Diabetes Endocrinol 2015; 3:181-90. [PMID: 25660356 DOI: 10.1016/s2213-8587(14)70246-3] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of lipid-lowering treatments in renoprotection for patients with diabetes is debated. We studied the renal effects of two statins in patients with diabetes who had proteinuria. METHODS PLANET I was a randomised, double-blind, parallel-group trial done in 147 research centres in Argentina, Brazil, Bulgaria, Canada, Denmark, France, Hungary, Italy, Mexico, Romania, and the USA. We enrolled patients with type 1 or type 2 diabetes aged 18 years or older with proteinuria (urine protein:creatinine ratio [UPCR] 500-5000 mg/g) and taking stable angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or both. We randomly assigned participants to atorvastatin 80 mg, rosuvastatin 10 mg, or rosuvastatin 40 mg for 52 weeks. The primary endpoint was change from baseline to week 52 of mean UPCR in each treatment group. The study is registered with ClinicalTrials.gov, number NCT00296374. FINDINGS We enrolled 353 patients: 118 were assigned to rosuvastatin 10 mg, 124 to rosuvastatin 40 mg, and 111 to atorvastatin 80 mg; of these, 325 were included in the intention-to-treat population. UPCR baseline:week 52 ratio was 0·87 (95% CI 0·77-0·99; p=0·033) with atorvastatin 80 mg, 1·02 (0·88-1·18; p=0·83) with rosuvastatin 10 mg, and 0·96 (0·83-1·11; p=0·53) with rosuvastatin 40 mg. In a post-hoc analysis to compare statins, we combined data from PLANET I with those from PLANET II (a similar randomised parallel study of 237 patients with proteinuria but without diabetes; registered with ClinicalTrials.gov, NCT00296400). In this analysis, atorvastatin 80 mg lowered UPCR significantly more than did rosuvastatin 10 mg (-15·6%, 95% CI -28·3 to -0·5; p=0·043) and rosuvastatin 40 mg (-18·2%, -30·2 to -4·2; p=0·013). Adverse events occurred in 69 (60%) of 116 patients in the rosuvastatin 10 mg group versus 79 (64%) of 123 patients in the rosuvastatin 40 mg group versus 63 (57%) of 110 patients in the atorvastatin 80 mg group; renal events occurred in nine (7·8%) versus 12 (9·8%) versus five (4·5%). INTERPRETATION Despite high-dose rosuvastatin lowering plasma lipid concentrations to a greater extent than did high-dose atorvastatin, atorvastatin seems to have more renoprotective effects for the studied chronic kidney disease population. FUNDING AstraZeneca.
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Affiliation(s)
- Dick de Zeeuw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | | | | | - Michael D Cressman
- Cardiovascular/Metabolic Unit, Covance, Princeton, NJ, USA (formerly AstraZeneca, Wilmington, DE, USA)
| | - Hiddo J Lambers Heerspink
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Bruce A Molitoris
- Department of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Hans-Henrik Parving
- Department of Medical Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Science, Aarhus University, Aarhus, Denmark
| | - Giuseppe Remuzzi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy
| | - James R Sowers
- Diabetes and Cardiovascular Center, University of Missouri, Columbia, MO, USA
| | - Donald G Vidt
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH, USA
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Kouvelos GN, Arnaoutoglou EM, Milionis HJ, Raikou VD, Papa N, Matsagkas MI. The effect of adding ezetimibe to rosuvastatin on renal function in patients undergoing elective vascular surgery. Angiology 2015; 66:128-35. [PMID: 24458801 DOI: 10.1177/0003319713519492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We compared the effects of lipid lowering with rosuvastatin (RSV) monotherapy versus intensified treatment by combining RSV with ezetimibe (EZT) on kidney function in patients undergoing vascular surgery. Patients were randomly assigned to either 10 mg/d RSV (n = 136) or RSV 10 mg/d plus EZT 10 mg/d (RSV/EZT, n = 126). At 12 months, a similar decrease in estimated glomerular filtration rate (eGFR) was noted. Patients who achieved a low-density lipoprotein cholesterol (LDL-C) of <100 mg/dL had less eGFR decrease than those patients having an LDL-C limit of more than 100 mg/dL. There were no significant changes in the urinary total protein to creatinine ratio in either group. Significant microalbuminuria was evident in both the groups. Patients undergoing vascular surgery show deterioration in their renal function during the first year, despite statin therapy. Intensified lipid-lowering therapy by adding EZT does not appear to have any renoprotective effect.
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Affiliation(s)
- George N Kouvelos
- Department of Surgery-Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Eleni M Arnaoutoglou
- Department of Anesthesiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Haralampos J Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Vaia D Raikou
- First Department of Internal Medicine, School of Medicine, University of Athens, Athens, Greece
| | - Nektario Papa
- Department of Surgery-Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Miltiadis I Matsagkas
- Department of Surgery-Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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Tungsubutra W, Phongtuntakul B. Achievement of LDL-cholesterol goal with statins after an st segment elevation myocardial infarction. J Med Assoc Thai 2015; 98:129-136. [PMID: 25842792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In patients with very high cardiovascular risk, low-density lipoprotein cholesterol (LDL-C) less than 70 mg/dL or at least 50% reduction of LDL-C are recommended targets. High-dose atorvastatin has been shown to reduce death and ischemic events among patients with acute coronary syndrome. OBJECTIVE To evaluate the proportion of STEMl patients that achieve LDL-C goal after hospital discharge from a real-world setting in Thailand To determine if the formulation of statin prescribed affected the LDL-C goal achievement. MATERIAL AND METHOD The authors analyzed data from a cohort of patients with STEMI enrolled from June 1, 2008 through May 31, 2011. Patients who survived, were prescribed astatin on discharge and had LDL-C data at follow-up were analyzed. The formulation of statin was categorized as simvastatin or other statins (atorvastatin or rosuvastatin) group. RESULTS Ninety-seven percent (n = 265 of 272) of patients were prescribed a statin at discharge. Of these, 216 patients had LDL-C data during a 3-month follow-up period, 75% were men, the mean age was 60.5 ± 12.2 years old and the mean baseline LDL-C was 118.1 ± 41.2 mg/dL. 73% (n = 157) of patients received simvastatin and 27% (n = 59) received other statins. At discharge, the median daily dose of simvastatin, atorvastatin and rosuvastatin were 20, 20 and 10 mg respectively. At follow-up, target LDL-C < 70 mg/dL or LDL-C reduction ≥ 50% was achieved in 30.1% (n = 65) of patients, 27.4% (n = 43) on simvastatin and 37.3% (n = 22) on other statins, (p = 0.158, simvastatin versus other statins). When stratified by the dose intensity of statin, a significantly greater proportion of patients on moderate to high intensity statin attained LDL-C goals than those on low intensity statin: (36.3% versus 24.3%, p = 0.038). CONCLUSION Most patients with STEMI are prescribed statin therapy at discharge. Despite this, the target LDL-C is attained in a minority of the patients due to suboptimal statin dosing. The formulation of statin did not affect LDL-C goal attainment. High-dose statin therapy is underused in real-world clinical practice. These findings emphasize the opportunities to improve outcomes of STEMI patients with evidence-based therapies.
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Drapkina OM, Eliashevich SO. [Efficacy and Safety of Rosuvastatin in Patients of Different Risk Groups of Developing Cardiovascular Diseases]. Kardiologiia 2015; 55:72-81. [PMID: 26164992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of the review - analysis of randomized clinical trials to evaluate the efficacy and safety of rosuvastatin in respect of primary and secondary prevention of cardiovascular events, as well as in patients with acute coronary syndrome. As a primary pathogenetic therapy aimed at reducing the risk of cardiovascular disease and death from cardiovascular disease ischemic nature, used statins, which have both lipid-lowering and pleiotropic other positive properties. When analyzing the results of the comparative evaluation of different statins best performance indicators in primary and secondary prevention of cardiovascular events were at the rosuvastatin. The first drug is bioequivalent to the original rosuvastatin in Russia became mertenil company "Gedeon Richter". The therapeutic equivalence of mertenil is comparable with that of the original drug in patients of different groups at risk of developing cardiovascular complications (from low to very high). Mertenil can be regarded as an effective and safe drug from the group of statins for primary and secondary prevention of cardiovascular complications in patients of all risk groups.
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Muntoni S, Pisciotta L, Muntoni S, Bertolini S. Pharmacological treatment of a Sardinian patient affected by Autosomal Recessive Hypercholesterolemia (ARH). J Clin Lipidol 2015; 9:103-6. [PMID: 25670367 DOI: 10.1016/j.jacl.2014.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 05/24/2014] [Accepted: 08/26/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIM Previous studies have shown that patients with autosomal recessive hypercholesterolemia (ARH) resulting from mutations in LDLRAP1 gene have a less severe cardiovascular involvement than familial hypercholesterolemia homozygotes, lower levels of low-density lipoprotein cholesterol (LDL-C), and higher levels of high-density lipoprotein cholesterol (HDL-C). In addition, ARH patients seem to be more responsive to the lipid-lowering drugs. The aim was to test the effect of a combined drug treatment in an ARH patient in the absence of plasmapheresis. METHODS AND RESULTS Here we report the lipid-lowering effect of rosuvastatin (60 mg/day) associated with ezetimibe (10 mg/day) in a single ARH patient. The sequencing of LDLRAP1 gene showed that the patient was homozygous for the c.432insA mutation. During a 6-month treatment, we observed an 80% reduction of LDL-C and a significant increase of HDL-C and ApoA-I. Some sequence variations in PCSK9 and NPC1L1 genes found in this patient may have contributed to the success of drug treatment. CONCLUSIONS Our findings, although limited to a single case, suggest that in many ARH patients the LDL-C goal may be reached with the more potent statins associated with ezetimibe in the absence of extracorporeal procedures.
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Affiliation(s)
- Sandro Muntoni
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Italy; Centre for Metabolic Diseases and Atherosclerosis, The ME.DI.CO. Association, Cagliari, Italy.
| | - Livia Pisciotta
- Department of Internal Medicine, University of Genova, Italy
| | - Sergio Muntoni
- Centre for Metabolic Diseases and Atherosclerosis, The ME.DI.CO. Association, Cagliari, Italy
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Willemsen AECAB, Bredie SJHB, Lobo CM, van der Vlugt MJ, Kramers C. [Choosing wisely when prescribing statins]. Ned Tijdschr Geneeskd 2015; 159:A8695. [PMID: 25990330] [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: 06/04/2023]
Abstract
The Dutch campaign 'Verstandig kiezen', based on the American programme 'Choosing wisely', aims to improve quality in healthcare, with attention to cost control. The 'Choosing wisely'-based programme can be applied in the choice of a statin. Atorvastatin and rosuvastatin are regarded as equal choices in various guidelines regarding cardiovascular risk management. Generic atorvastatin is available, and is approximately 25 times cheaper than rosuvastatin in almost equipotent doses. Rosuvastatin provides a greater LDL reduction than atorvastatin. Patient LDL targets can usually be achieved with atorvastatin, and rosuvastatin is not needed. At group level, there are no relevant differences in adverse-events profile between both statins. Atorvastatin and rosuvastatin do have different pharmacokinetic interactions. When changing medication, good provision of information is a prerequisite for patient satisfaction and compliance. We advise use of atorvastatin instead of rosuvastatin as drug of choice when the LDL target is not reached using simvastatin. However, under specific conditions, rosuvastatin should be the treatment of choice. Efficacy and adverse effects should then be evaluated at individual patient level.
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Switching from high-efficacy lipid-lowering therapies [atorvastatin or rosuvastatin] to simvastatin and the results on low-density lipoprotein cholesterol level. J Med Assoc Thai 2015; 98:21-5. [PMID: 25775727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In Thai National List of Essential Drugs in 2010, simvastatin is the only medication on the list for the statin group. Patients who previously prescribed other groups of statin were recommended to switch to simvastatin. OBJECTIVE Comparison of lipid low-density lipoprotein cholesterol (LDL) levels before and after switching from rosuvastatin or atorvastatin to simvastatin. MATERIAL AND METHOD The study was a retrospective observational study performed in patients older than 18 year-old who were enrolled as an outpatient at Siriraj Hospital during October 2009 and October 2010. From these patients who were switched from atorvastatin or rosuvastatin to simvastatin, LDL level was compared between before and after switching to simvastatin. RESULTS Of 276 patients who were switched from atorvastatin to equivalent dose simvastatin, LDL levels increased from 106.20 ± 33.47 mg/dl to 109.61 ± 39.62 mg/dl (p = 0.089). Of 228 patients who were switched from rosuvastatin to a less than equivalent dose simvastatin, LDL levels increased from 112.73 ± 45.94 mg/dl to 114.49 ± 42.70 mg/dl (p = 0.437). CONCLUSION In the patients who were switched from atorvastatin and rosuvastatin to simvastatin, LDL levels before and after being switched was not significantly different. Moreover patients who had switched from rosuvastatin to a less than equivalent dose ofsimvastatin still had no significant increases in LDL levels after switching.
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Abstract
BACKGROUND Venous thromboembolism (VTE) is common in clinical practice. The efficacy of statins in the primary prevention of VTE remains unproven. This is an update of the review first published in 2011. OBJECTIVES To assess the efficacy of statins in the primary prevention of VTE. SEARCH METHODS For this update the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Search Co-ordinator searched the Specialised Register (last searched February 2014) and CENTRAL (2014, Issue 1). SELECTION CRITERIA Randomised controlled trials (RCTs) that assessed statins in the primary prevention of VTE were considered. The outcomes we evaluated were the rates of VTE, cardiovascular and cerebrovascular events, death and adverse events. Two authors (L Li, JH Tian) independently selected RCTs against the inclusion criteria. Disagreements were resolved by discussion with a third author (KH Yang). DATA COLLECTION AND ANALYSIS Data extraction was independently carried out by two authors (L Li, JH Tian). Disagreements were resolved by discussion with a third author (PZ Zhang). Two authors (L Li, JH Tian) independently assessed the risk of bias according to a standard quality checklist provided by the PVD Group. MAIN RESULTS For this update we included one RCT with 17,802 participants that assessed rosuvastatin compared with placebo for the prevention of VTE. The quality of the evidence was moderate because of imprecision, as the required sample size for the outcomes of this review was not achieved. Analysis showed that when compared with placebo rosuvastatin reduced the incidence of VTE (odds ratio (OR) 0.57, 95% confidence interval (CI) 0.37 to 0.86) and deep vein thrombosis (DVT) (OR 0.45, 95% CI 0.25 to 0.79), the risk of any (fatal and non-fatal) myocardial infarction (MI) (OR 0.45, 95% CI 0.30 to 0.69), and any (fatal and non-fatal) stroke (OR 0.51, 95% CI 0.34 to 0.78). There was no difference in the incidence of pulmonary embolism (PE) (OR 0.77, 95% CI 0.41 to 1.46), fatal MI (OR 1.50, 95% CI 0.53 to 4.22), fatal stroke (OR 0.30, 95% CI 0.08 to 1.09) or death after VTE (OR 0.50, 95% CI 0.20 to 1.24). The incidence of any serious adverse events was no different between the rosuvastatin and placebo groups (OR 1.07, 95% CI 0.95 to 1.20). AUTHORS' CONCLUSIONS Available evidence showed that rosuvastatin was associated with a reduced incidence of VTE, but the evidence was limited to a single RCT and any firm conclusions and suggestions could be not drawn. Randomised controlled trials of statins (including rosuvastatin) are needed to evaluate their efficacy in the prevention of VTE.
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Affiliation(s)
- Lun Li
- The First Clinical College of Lanzhou University; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, China
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Everett BM, Mora S, Glynn RJ, MacFadyen J, Ridker PM. Safety profile of subjects treated to very low low-density lipoprotein cholesterol levels (<30 mg/dl) with rosuvastatin 20 mg daily (from JUPITER). Am J Cardiol 2014; 114:1682-9. [PMID: 25439449 DOI: 10.1016/j.amjcard.2014.08.041] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/15/2014] [Accepted: 08/15/2014] [Indexed: 11/27/2022]
Abstract
Recent US guidelines expand the indications for high-intensity statin therapy, yet data on the safety of attaining very low-density lipoprotein cholesterol (LDL-C) levels are scarce. Among 16,304 participants in the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) with on-treatment LDL-C levels, we identified 767 who did and 7,387 who did not achieve LDL-C <30 mg/dl on rosuvastatin 20 mg daily and 718 participants who did and 7,436 who did not achieve LDL-C reductions of ≥70% on rosuvastatin, and 8,150 allocated to placebo. In participants with an LDL-C <30 mg/dl, we observed an increase in the risk of physician-reported type 2 diabetes with an adjusted hazard ratio (95% confidence interval) of 1.56 (1.09 to 2.23, p = 0.01) and physician-reported hematuria (hazard ratio 2.10 [1.39 to 3.19], p <0.001) compared with rosuvastatin-treated participants with LDL-C ≥30 mg/dl. There was also an increased risk of certain musculoskeletal, hepatobiliary, and psychiatric disorders. No difference in renal failure, cancer, memory impairment, or hemorrhagic stroke was observed, although there were few events in these categories. In rosuvastatin-treated participants, achieving LDL-C reduction ≥70% versus <70% did not appear to be associated with increased risk of hepatobiliary, renal, or urinary disorders. In conclusion, in this post hoc analysis in the JUPITER, achieving LDL-C levels <30 mg/dl with high-intensity statin therapy appeared to be generally well tolerated but associated with certain adverse events, including more physician-reported diabetes, hematuria, hepatobiliary disorders, and insomnia. These data may guide the monitoring of patients on intensive statin therapy and adverse events in trials of therapies that lead to very low LDL-C levels.
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Affiliation(s)
- Brendan M Everett
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
| | - Samia Mora
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert J Glynn
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jean MacFadyen
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Paul M Ridker
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Barabanchyk OV, Svintsits'kyĭ AS, Kozak NP. [CORRECTION OF BILE FLOW CHARACTERISTICS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN COMBINATION WITH HYPERURICEMIA]. Lik Sprava 2014:48-53. [PMID: 25528832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Basis on study through integrated comparative assessment of clinical, biochemical survey data revealed that in patients with impaired metabolism of uric acid in a greater percentage of common biliary sludge, a violation of the rheological properties of bile, a violation of cholate-cholesterol ratio index, which indicates an increased risk of bile stones. The study found that despite the high levels of uric acid there is a violation of the spectrum of bile acids, cholic and deoxycholic growth acid reduction taurocholic acid. Thus, application of ursodeoxycholic acid, rosuvastatin and allopurinol in these study patients with NAFLD dosages in combination with hyperuricemia improves the clinical symptoms and normalization of biochemical parameters and normalizes the spectrum of biliary acids.
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Chen Y, Jiang C, Liu M, Liu F, Fan Y. [Efficacy and safety comparison of different statins in elderly patients]. Zhonghua Xin Xue Guan Bing Za Zhi 2014; 42:910-915. [PMID: 25620252] [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: 06/04/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of atorvastatin, rosuvastatin and xuezhikang capsule in elderly. METHODS A total of 314 60-to-94-year-old (average (73.6 ± 7.9) years old) patients who were given different doses and types of statins were divided into three groups: the atorvastatin group (108 patients), the rosuvastatin group (104 patients) and the xuezhikang capsule group (102 patients). The serum TG, TC, LDL-C, HDL-C,ALT and CK were examined before and after the treatment which lasted for at least 4 weeks. All patients were divided into moderate risk group (13, 12 and 21 patients respectively in 3 groups); high risk group (40, 44 and 48 patients respectively in 3 groups) and very high risk group (55, 48 and 33 patients respectively in 3 groups ) according to guidelines on prevention and treatment of dyslipidemia in chinese adults (2007 version). The rate of reaching target goal and the dose when reaching target levels in different risk stratification groups were calculated and compared. RESULTS Serum TC, LDL-C and non-HDL-C were significantly reduced after the 4-week-treatment in all the three groups (P < 0.01). Serum LDL-C level before and after treatment were (3.14 ± 0.78)mmol/L vs. (2.14 ± 0.65)mmol/L in atorvastatin group (the arevage dose was (16.4 ± 4.8)mg/d), (2.92 ± 0.77)mmol/L vs. (1.96 ± 0.55)mmol/L in rosuvastatin group (the arevage dose was (8.7 ± 3.0) mg/d), and (2.70 ± 0.62)mmol/L vs. (2.16 ± 0.61) mmol/L in xuezhikang capsule group (the arevage dose was (0.9 ± 0.3) g/d ). Among all the three groups of patients, the cases of reaching target levels of LDL-C were 13, 11 and 20 in patients at moderate risk, were 38(95.0%), 38(86.4%) and 40 (83.3%) in patients at high risk, and were 22(40.0%), 30(62.5%) and 17(51.5%) in patients at very high risk. There were no statistical differences in the rate of reaching target levels of LDL-C, non-HDL-C and TC in the three groups and at different risks (P > 0.05). One patient in the atorvastatin group showed ALT level elevation >3 times of the upper limit of normal value, there was no patient with CK level elevation >5 times of the upper limit of normal value. CONCLUSION Atorvastatin, rosuvastatin and xuezhikang capsule at low dose and/or standard dose are effective and safety in elderly patients.
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Affiliation(s)
- Yahong Chen
- Department of Geriatrics, First Hospital, Peking University, Beijing 100034, China
| | - Chenggong Jiang
- Department of Geriatrics, First Hospital, Peking University, Beijing 100034, China
| | - Meilin Liu
- Department of Geriatrics, First Hospital, Peking University, Beijing 100034, China.
| | - Fang Liu
- Department of Geriatrics, First Hospital, Peking University, Beijing 100034, China
| | - Yan Fan
- Department of Geriatrics, First Hospital, Peking University, Beijing 100034, China
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Schwartz GG, Bessac L, Berdan LG, Bhatt DL, Bittner V, Diaz R, Goodman SG, Hanotin C, Harrington RA, Jukema JW, Mahaffey KW, Moryusef A, Pordy R, Roe MT, Rorick T, Sasiela WJ, Shirodaria C, Szarek M, Tamby JF, Tricoci P, White H, Zeiher A, Steg PG. Effect of alirocumab, a monoclonal antibody to PCSK9, on long-term cardiovascular outcomes following acute coronary syndromes: rationale and design of the ODYSSEY outcomes trial. Am Heart J 2014; 168:682-9. [PMID: 25440796 DOI: 10.1016/j.ahj.2014.07.028] [Citation(s) in RCA: 326] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/31/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Following acute coronary syndrome (ACS), the risk for future cardiovascular events is high and is related to levels of low-density lipoprotein cholesterol (LDL-C) even within the setting of intensive statin treatment. Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates LDL receptor expression and circulating levels of LDL-C. Antibodies to PCSK9 can produce substantial and sustained reductions of LDL-C. The ODYSSEY Outcomes trial tests the hypothesis that treatment with alirocumab, a fully human monoclonal antibody to PCSK9, improves cardiovascular outcomes after ACS. DESIGN This Phase 3 study will randomize approximately 18,000 patients to receive biweekly injections of alirocumab (75-150 mg) or matching placebo beginning 1 to 12 months after an index hospitalization for acute myocardial infarction or unstable angina. Qualifying patients are treated with atorvastatin 40 or 80 mg daily, rosuvastatin 20 or 40 mg daily, or the maximum tolerated and approved dose of one of these agents and fulfill one of the following criteria: LDL-C ≥ 70 mg/dL, non-high-density lipoprotein cholesterol ≥ 100 mg/dL, or apolipoprotein B ≥ 80 mg/dL. The primary efficacy measure is time to first occurrence of coronary heart disease death, acute myocardial infarction, hospitalization for unstable angina, or ischemic stroke. The trial is expected to continue until 1613 primary end point events have occurred with minimum follow-up of at least 2 years, providing 90% power to detect a 15% hazard reduction. Adverse events of special interest include allergic events and injection site reactions. Interim analyses are planned when approximately 50% and 75% of the targeted number of primary end points have occurred. SUMMARY ODYSSEY Outcomes will determine whether the addition of the PCSK9 antibody alirocumab to intensive statin therapy reduces cardiovascular morbidity and mortality after ACS.
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Affiliation(s)
| | - Laurence Bessac
- Sanofi-Aventis Recherche et Développement S.A., Paris, France; Sanofi-Aventis Recherche et Développement S.A., Bridgewater, NJ
| | | | - Deepak L Bhatt
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Vera Bittner
- University of Alabama at Birmingham, Birmingham, AL
| | - Rafael Diaz
- Estudios Cardiológicos Latinoamérica, Rosario, Argentina
| | - Shaun G Goodman
- Canadian VIGOUR Centre, University of Alberta, Toronto, Canada
| | - Corinne Hanotin
- Sanofi-Aventis Recherche et Développement S.A., Paris, France; Sanofi-Aventis Recherche et Développement S.A., Bridgewater, NJ
| | | | | | | | - Angèle Moryusef
- Sanofi-Aventis Recherche et Développement S.A., Paris, France; Sanofi-Aventis Recherche et Développement S.A., Bridgewater, NJ
| | | | | | | | | | - Cheerag Shirodaria
- Covance, Inc.,Maidenhead, and Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Michael Szarek
- State University of New York Downstate Medical Center, Brooklyn, NY
| | - Jean-François Tamby
- Sanofi-Aventis Recherche et Développement S.A., Paris, France; Sanofi-Aventis Recherche et Développement S.A., Bridgewater, NJ
| | | | - Harvey White
- Auckland City Hospital and University of Auckland, Auckland, New Zealand
| | | | - Philippe Gabriel Steg
- Assistance Publique-Hôpitaux de Paris, INSERM U-1148, Université Paris Diderot, Paris, France
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Skrypnyk IM, Dubrovins'ka TV. [Negative effects of termination statinotherapy in patients after acute coronary event with concominent non-alcoholic steatohepatitis]. Lik Sprava 2014:106-111. [PMID: 25528845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
140 patients with myocardial infarction in combination with non-alcoholic steatohepatitis, 58 patients took medium theraupeutic doses of rosuvastatin of 10 mg/day and 82 patients--torvastatin of 40 mg/day, have been examined. The study found significant progression of dyslipidemia, when the statins (improving blood total cholesterol and TG by 34% and LDL cholesterol by 38%). In patients who continued receiving statins, noted the positive dynamics of lipidohramy: in patients receiving rosuvastatin 10 mg levels of total cholesterol and LDL cholesterol decreased by 36% and 43%, respectively, with atorvastatin 40 mg level indicators fell by 34% and 40% respectively. Therapy rosuvastatin 10 mg had an advantage over the use of atorvastatin 40 mg in raising HDL cholesterol by 21%, and reduction of TG level by 37%. It is proved that the method furthers statins improves disease in patients with acute myocardial infarction, prevents the development of coronary artery disease resistant and recurrent acute coronary events, reduces the incidence of hospitalizations for heart failure progression.
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Yamashita A, Morioka M, Kishi H, Kimura T, Yahara Y, Okada M, Fujita K, Sawai H, Ikegawa S, Tsumaki N. Statin treatment rescues FGFR3 skeletal dysplasia phenotypes. Nature 2014; 513:507-11. [PMID: 25231866 DOI: 10.1038/nature13775] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 08/19/2014] [Indexed: 12/16/2022]
Abstract
Gain-of-function mutations in the fibroblast growth factor receptor 3 gene (FGFR3) result in skeletal dysplasias, such as thanatophoric dysplasia and achondroplasia (ACH). The lack of disease models using human cells has hampered the identification of a clinically effective treatment for these diseases. Here we show that statin treatment can rescue patient-specific induced pluripotent stem cell (iPSC) models and a mouse model of FGFR3 skeletal dysplasia. We converted fibroblasts from thanatophoric dysplasia type I (TD1) and ACH patients into iPSCs. The chondrogenic differentiation of TD1 iPSCs and ACH iPSCs resulted in the formation of degraded cartilage. We found that statins could correct the degraded cartilage in both chondrogenically differentiated TD1 and ACH iPSCs. Treatment of ACH model mice with statin led to a significant recovery of bone growth. These results suggest that statins could represent a medical treatment for infants and children with TD1 and ACH.
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Affiliation(s)
- Akihiro Yamashita
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Miho Morioka
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Hiromi Kishi
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Takeshi Kimura
- 1] Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan [2] Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Yasuhito Yahara
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Minoru Okada
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Kaori Fujita
- Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan
| | - Hideaki Sawai
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrated Medical Sciences, RIKEN, Tokyo 108-8639, Japan
| | - Noriyuki Tsumaki
- 1] Cell Induction and Regulation Field, Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto 606-8507, Japan [2] Japan Science and Technology Agency, CREST, Tokyo 102-0075, Japan
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Capoulade R, Côté N, Mathieu P, Chan KL, Clavel MA, Dumesnil JG, Teo KK, Tam JW, Fournier D, Després JP, Pibarot P. Circulating levels of matrix gla protein and progression of aortic stenosis: a substudy of the Aortic Stenosis Progression Observation: Measuring Effects of rosuvastatin (ASTRONOMER) trial. Can J Cardiol 2014; 30:1088-95. [PMID: 25015689 DOI: 10.1016/j.cjca.2014.03.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/03/2014] [Accepted: 03/16/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Matrix γ-carboxyglutamate protein is an inhibitor of cardiovascular calcification. The objective of this substudy of the Aortic Stenosis Progression Observation: Measuring Effects of Rosuvastatin (ASTRONOMER) trial was to examine the relationship between total (ie, carboxylated [active] form + uncarboxylated [inactive] form) circulating desphosphorylated matrix γ-carboxyglutamate protein (dpMGP) level and the progression rate of aortic stenosis (AS). METHODS Among the patients included in the ASTRONOMER trial, 215 patients had measures of baseline circulating total dpMGP level and an echocardiographic follow-up (mean follow-up: 3.5 ± 1.3 years). Progression of AS was assessed according to the measurement of the annualized increase in peak aortic jet velocity. RESULTS In the whole cohort, baseline dpMGP level was associated with faster progression rate of peak aortic jet velocity (r = 0.16; P = 0.02) in individual analysis but not in multivariable analysis (P = 0.40). However, there was a significant interaction (P = 0.03) between dpMGP level and age, with respect to the effect on AS progression. After dichotomization according to median value of age (ie, 57 years old), total dpMGP level was associated with faster AS progression rate (r = 0.24; P = 0.008) in the younger patients, and this association remained significant in multivariable analysis (P = 0.04), but not in the older ones. The independent correlates of dpMGP level were fasting glucose (P = 0.009) and oxidized low-density lipoprotein (P = 0.01). CONCLUSIONS This is the first prospective study to demonstrate a relationship between increased circulating levels of total dpMGP and faster progression rate of AS in younger individuals. Future studies are needed to determine if dpMGP is simply a marker or a contributing factor to ectopic mineralization of aortic valve.
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Affiliation(s)
- Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Kwan L Chan
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Koon K Teo
- McMaster University, Hamilton, Ontario, Canada
| | - James W Tam
- St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | - Dominique Fournier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jean-Pierre Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
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Han Y. Reply: Intravenous hydration (with or without rosuvastatin) should remain the cornerstone of the prevention of contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease. J Am Coll Cardiol 2014; 64:332-3. [PMID: 25034073 DOI: 10.1016/j.jacc.2014.04.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 11/30/2022]
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Affiliation(s)
- Jeffrey M Drazen
- From the Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York (A.C.G.)
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Truwit JD, Bernard GR, Steingrub J, Matthay MA, Liu KD, Albertson TE, Brower RG, Shanholtz C, Rock P, Douglas IS, deBoisblanc BP, Hough CL, Hite RD, Thompson BT. Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med 2014; 370:2191-200. [PMID: 24835849 PMCID: PMC4241052 DOI: 10.1056/nejmoa1401520] [Citation(s) in RCA: 380] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the acute respiratory distress syndrome (ARDS), inflammation in the lungs and other organs can cause life-threatening organ failure. Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase (statins) can modulate inflammatory responses. Previous observational studies suggested that statins improved clinical outcomes in patients with sepsis. We hypothesized that rosuvastatin therapy would improve clinical outcomes in critically ill patients with sepsis-associated ARDS. METHODS We conducted a multicenter trial in which patients with sepsis-associated ARDS were randomly assigned to receive either enteral rosuvastatin or placebo in a double-blind manner. The primary outcome was mortality before hospital discharge home or until study day 60 if the patient was still in a health care facility. Secondary outcomes included the number of ventilator-free days (days that patients were alive and breathing spontaneously) to day 28 and organ-failure-free days to day 14. RESULTS The study was stopped because of futility after 745 of an estimated 1000 patients had been enrolled. There was no significant difference between study groups in 60-day in-hospital mortality (28.5% with rosuvastatin and 24.9% with placebo, P=0.21) or in mean (±SD) ventilator-free days (15.1±10.8 with rosuvastatin and 15.1±11.0 with placebo, P=0.96). The groups were well matched with respect to demographic and key physiological variables. Rosuvastatin therapy, as compared with placebo, was associated with fewer days free of renal failure to day 14 (10.1±5.3 vs. 11.0±4.7, P=0.01) and fewer days free of hepatic failure to day 14 (10.8±5.0 vs. 11.8±4.3, P=0.003). Rosuvastatin was not associated with an increased incidence of serum creatine kinase levels that were more than 10 times the upper limit of the normal range. CONCLUSIONS Rosuvastatin therapy did not improve clinical outcomes in patients with sepsis-associated ARDS and may have contributed to hepatic and renal organ dysfunction. (Funded by the National Heart, Lung, and Blood Institute and the Investigator-Sponsored Study Program of AstraZeneca; ClinicalTrials.gov number, NCT00979121.).
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Hill N, Zhou HN, Wang P, Guo X, Carneiro I, Moore SJ. A household randomized, controlled trial of the efficacy of 0.03% transfluthrin coils alone and in combination with long-lasting insecticidal nets on the incidence of Plasmodium falciparum and Plasmodium vivax malaria in Western Yunnan Province, China. Malar J 2014; 13:208. [PMID: 24885993 PMCID: PMC4057598 DOI: 10.1186/1475-2875-13-208] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 05/27/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mosquito coils are the most commonly used household insecticidal product in the world with sales exceeding 50 billion coils, used by two billion people worldwide annually. Despite strong evidence that coils prevent mosquito bites a systematic review concluded that there is no evidence that burning mosquito coils prevents malaria acquisition. Therefore, the current trial was designed to measure and compare prevention of malaria infection by mosquito coils or long-lasting insecticidal net (LLIN) or a combination of the two in Yunnan, China in the Greater Mekong sub-region. METHODS A four-arm single blind household-randomized design was chosen as coils emanate insecticide throughout the household. Households enrolled at baseline were randomly allocated by the lottery method to one of the four intervention arms: (i) nothing, (ii) 0.03% transfluthrin coils alone, (iii) deltamethrin long-lasting insecticide treated nets, (LLINs) alone or (iv) a combination of transfluthrin coils and deltamethrin LLINs. All household members were recruited to the study, with only those households excluded with pregnant or breastfeeding mothers, members with chest complaints or allergies or members that regularly slept away from home. The main outcome of interest was Plasmodium falciparum malaria prevalence detected by rapid diagnostic tests (RDTs) during six repeated monthly cross-sectional surveys. The secondary outcome of interest was the effect on Plasmodium vivax prevalence detected in the same way. RESULTS A total of 2,052 households were recruited into the study, comprising 7,341 individuals The odds ratios of testing positive by RDT with P. falciparum or P. vivax were >75% lower for all intervention arms compared with the control arm. Coils alone provided 77% protection (95% CI: 50%-89%), LLINs provided 91% protection (95% CI: 72%-97%) and the combination of coils and LLINs provided 94% protection (95% CI: 77%-99%) against P. falciparum compared with the control arm. There was no statistically significant difference between the protective efficacies of the different interventions. CONCLUSIONS This is the first robust clinical evaluation of transfluthrin mosquito coils as a means to reduce malaria and the high degree of infection prevented would indicate they represent a potentially highly effective tool, which could be integrated into larger vector control programmes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00442442, March 2007.
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Affiliation(s)
- Nigel Hill
- London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Hong Ning Zhou
- London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
- Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao, Puer, Yunnan, People’s Republic of China
| | - Piyu Wang
- Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao, Puer, Yunnan, People’s Republic of China
| | - Xiaofang Guo
- Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao, Puer, Yunnan, People’s Republic of China
| | - Ilona Carneiro
- London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Sarah J Moore
- Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
- Swiss Tropical and Public Health Institute, Socinstr. 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
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Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, Medical School, University of Ioannina, St. Niarchou Avenue, 45110, Ioannina, Greece
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Skrypnyk IM, Dubrovins'ka TV. [Optimization of long-term treatment with rosuvastatin of patients with myocardial infarction in combination with non-alcoholic steatohepatitis]. Lik Sprava 2014:113-121. [PMID: 25906659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Dynamics of indices of lipidograma, functional state of liver and level C-reactive of protein (CRP) was investigated in 36 patients with heart attack of myocardium diseases in combination with non-alcoholic steatohepatitis, who received 9-months treatment by rosuvastatin of 20 mg dose and rosuvastatin of 10 mg dose in combination with ursodeoxycholic acid (UDCA), in a comparative aspect. The equivalence of hypolipidemia effect of both conditions reliable advantage in decline of triglycerides level and CRP normalization under the influence of combined therapy was discovered. The treatment by combination of rosuvastatin of 10 mg dose with UDCA has shown the advantages in comparison with the treatment by rosuvastatin of 20 mg dose in decline and normalization of transaminases and gamma-glutamiltranspeptidase activity. The data obtained resulted in optimization of standard treatment by statins of patients with heart attack of myocardium diseases in combination with non-alcoholic steatohepatitis by means of combination the initial rosuvastatin dose with UDCA.
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[Optimization of long-term hypolipidemia treatment of patients with myocardial infarction in combination with non-alcoholic steatohepatitis]. Georgian Med News 2014;:53-8. [PMID: 24850606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In a comparative aspect, the dynamics of indices of lipidogram, functional state of liver and level of C-reactive of protein have been analyzed in 79 patients with myocardial infarction in combination with non-alcoholic steatohepatitis, who received a 9-months treatment by rosuvastatin of 20 mg, atorvastatin of 80 mg, as well as rosuvastatin of 10 mg, atorvastatin of 40 mg in combination with ursodeoxycholic acid (UDCA). The obtained results show the equivalent of hypolipidemia effectiveness of all investigated courses of statinotherapy with the benefit of rosuvastatin of 20 mg in increase of level of HDL cholesterol and combined statinotherapy with UDCA in decrease of level of triglycerides. It was confirmed the significant advantages of combined statinotherapy with UDCA as for the influence on functional state of liver and CRP level, and advantages of rosuvastatin of 10 mg in combination with UDCA. Thus, the combination of rosuvastatin of 10 mg with UDCA should be preferable in the treatment of patients with myocardial infarction in combination with non-alcoholic steatohepatitis from the positions of the effectiveness and safety. Besides, taking into account positive correlation between the CRP level in blood and activity of transaminases in the dynamics of observation it can be concluded that high activity of transaminases is the prognostic marker of the severity and procession of polymorbid pathology - myocardial infarction in combination with non-alcoholic steatohepatitis.
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Dias PCS, Sena-Evangelista KCM, Paiva MSMDO, Ferreira DQC, Ururahy MAG, Rezende AA, Abdalla DSP, Pedrosa LFC. The beneficial effects of rosuvastatin are independent of zinc supplementation in patients with atherosclerosis. J Trace Elem Med Biol 2014; 28:194-199. [PMID: 24560278 DOI: 10.1016/j.jtemb.2014.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/05/2013] [Accepted: 01/15/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Statins have multiple antiatherosclerotic effects, but can reduce blood plasma concentrations of minerals, including zinc. As zinc possesses antiinflammatory and antioxidant effects, low zinc status can promote injuries or inadequate tissue repair in endothelial cells. Metallothionein (MT) expression might modulate responses induced by statins in patients with atherosclerosis. However, research regarding mineral status and the use of statins is scarce. This study evaluated the effects of zinc supplementation on zinc status and expression of the zinc-dependent MT1F and MT2A genes in patients with atherosclerosis treated with rosuvastatin. METHODS A double-blind, randomized clinical trial was performed with 54 participants treated with 10mg rosuvastatin for 4 months with or without zinc supplementation (30mg/day). Diet, lipid profile, high-sensitivity reactive protein C (hs-CRP), plasma and erythrocyte zinc concentrations, erythrocyte superoxide dismutase (SOD) activity, and MT1F and MT2A genes expression were analyzed before and after intervention. RESULTS Rosuvastatin therapy was effective in reducing low- and non-high-density lipoprotein, total cholesterol, triglycerides, and hs-CRP levels, independent of zinc supplementation. Additionally, zinc treatment had no effect on SOD enzyme activity (P=0.201), plasma (P>0.671) and erythrocyte (P>0.123) zinc concentrations, or the pattern of MT1F and MT2A genes expression (P=0.088 and P=0.229, respectively). CONCLUSIONS The effectiveness of rosuvastatin treatment is independent of the effects of zinc supplementation. Moreover, rosuvastatin treatment did not have a significant impact on zinc status or MT1F and MT2A genes expression in patients with atherosclerosis.
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Affiliation(s)
| | | | | | | | | | - Adriana Augusto Rezende
- Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Dulcinéia Saes Parra Abdalla
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
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Müller-Nordhorn J, Muckelbauer R, Englert H, Grittner U, Berger H, Sonntag F, Völler H, Prugger C, Wegscheider K, Katus HA, Willich SN. Longitudinal association between body mass index and health-related quality of life. PLoS One 2014; 9:e93071. [PMID: 24671104 PMCID: PMC3966840 DOI: 10.1371/journal.pone.0093071] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 02/28/2014] [Indexed: 11/29/2022] Open
Abstract
Objective Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity. Design Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy. Methods HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time. Results Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (β [95% CI] per 1 kg/m2: −0.36 [−0.41; −0.30] and −0.05 [−0.11; −0.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (−0.18 [−0.27; −0.09]) and only in obese participants (−0.19 [−0.29; −0.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population. Conclusion Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status. Trial Registration ClinicalTrials.gov NCT00379249
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Affiliation(s)
- Jacqueline Müller-Nordhorn
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| | - Rebecca Muckelbauer
- Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ulrike Grittner
- Department of Biostatistics and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Heinz Völler
- Centre of Rehabilitation Research, University of Potsdam, Potsdam, Germany
| | - Christof Prugger
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University of Hamburg, Hamburg, Germany
| | - Hugo A. Katus
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Feng X, Zhang J, Liu M, Li X. [Impact on the carotid intima-medial thickness and safety of rosuvastatin in Chinese patients with carotid atherosclerosis: a meta-analysis]. Zhonghua Xin Xue Guan Bing Za Zhi 2014; 42:247-253. [PMID: 24831484] [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: 06/03/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of rosuvastatin in Chinese patients with carotid atherosclerosis. METHOD A systematic search of Pubmed, EMBase, CENTRAL, CBMdisc, CNKI and WANFANG databases up to January 2013 was performed to identify studies comparing rosuvastatin with a placebo or other statins on carotid intima-medial thickness (IMT) with a minimum follow-up of 6 months in Chinese patients. Meta-analysis was performed by using RevMan 5.0 software after the strict evaluation of the methodological quality of the included studies independently by two reviewers. RESULTS Twenty-eight studies involving 1 392 individuals were included in this review. The pooled weighted mean difference (WMD) between rosuvastatin and placebo or control on IMT was 0.28 mm (95%CI 0.14-0.42, P < 0.01), with 0.31 mm (95%CI 0.14-0.49, P < 0.01) on 6-8 months and 0.16 mm (95%CI 0.05-0.27, P = 0.005) on 12 months, respectively. Analysis on studies in core journals showed the WMD between rosuvastatin and placebo or control on IMT was 0.18 mm (95%CI 0.09-0.27, P < 0.01). The WMD between rosuvastatin and other statins on IMT was 0.06 mm (95%CI 0.04-0.08, P < 0.01). The WMD between rosuvastatin and placebo or control on plaque score was 0.89 (95%CI 0.78-0.99, P < 0.01). The WMD between rosuvastatin and placebo or control on plaque area was 1.46 (95%CI 0.67-2.25, P < 0.01).Reports of adverse effect were elevated liver enzyme (2.30%, 19/825), elevated muscle enzyme (0.73%, 6/825), muscle aches (0.61%, 5/825). CONCLUSIONS Rosuvastatin therapy is effective and safe to decrease IMT in Chinese patients with carotid atherosclerosis.
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Affiliation(s)
- Xueru Feng
- Department of Geriatrics, Peking University First Hospital, Beijing 100034, China
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Broch K, Askevold ET, Gjertsen E, Ueland T, Yndestad A, Godang K, Stueflotten W, Andreassen J, Svendsmark R, Smith HJ, Aakhus S, Aukrust P, Gullestad L. The effect of rosuvastatin on inflammation, matrix turnover and left ventricular remodeling in dilated cardiomyopathy: a randomized, controlled trial. PLoS One 2014; 9:e89732. [PMID: 24586994 PMCID: PMC3934914 DOI: 10.1371/journal.pone.0089732] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 01/21/2014] [Indexed: 11/25/2022] Open
Abstract
Background Dilated cardiomyopathy is characterized by left ventricular dilatation and dysfunction. Inflammation and adverse remodeling of the extracellular matrix may be involved in the pathogenesis. Statins reduce levels of low density lipoprotein cholesterol, but may also attenuate inflammation and affect matrix remodeling. We hypothesized that treatment with rosuvastatin would reduce or even reverse left ventricular remodeling in dilated cardiomyopathy. Materials and Methods In this multicenter, randomized, double blind, placebo-controlled study, 71 patients were randomized to 10 mg of rosuvastatin or matching placebo. Physical examination, blood sampling, echocardiography and cardiac magnetic resonance imaging were performed at baseline and at six months’ follow-up. The pre-specified primary end point was the change in left ventricular ejection fraction from baseline to six months. Results Over all, left ventricular ejection fraction improved 5 percentage points over the duration of the study, but there was no difference in the change in left ventricular ejection fraction between patients allocated to rosuvastatin and those allocated to placebo. Whereas serum low density lipoprotein cholesterol concentration fell significantly in the treatment arm, rosuvastatin did not affect plasma or serum levels of a wide range of inflammatory variables, including C-reactive protein. The effect on markers of extracellular matrix remodeling was modest. Conclusion Treatment with rosuvastatin does not improve left ventricular ejection fraction in patients with dilated cardiomyopathy. Trial Registration ClinicalTrials.gov NCT00505154
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Affiliation(s)
- Kaspar Broch
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Erik T. Askevold
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Erik Gjertsen
- Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust; Drammen, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Kristin Godang
- Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Wenche Stueflotten
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Johanna Andreassen
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Rolf Svendsmark
- Department of Radiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Hans-Jørgen Smith
- Department of Radiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Svend Aakhus
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Gullestad
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- K. G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
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Takase B, Hattori H, Tanaka Y, Nagata M, Ishihara M. Anti-sympathetic action enhances statin's pleiotropic effects: the combined effect of rosuvastatin and atenolol on endothelial function. INT ANGIOL 2014; 33:27-34. [PMID: 24452083] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Assessment of flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery by a new device (UNEXEF18G) has been reported to be excellent for evaluating endothelial function, and sympathetic overdrive can accelerate the atherosclerotic process. The purpose of this study was to investigate and confirm whether anti-sympathetic beta-blocking action can enhance the pleiotropic effects of statins. METHODS FMD and NMD were measured using the UNEXEF18G before and after 4-week treatment of rosuvastatin (5 mg/day) with or without atenolol (25 mg/day) in 44 hypercholesterolemic patients (70±8 years old, LDL-C >140 mg/dL) with hypertension. Patients were randomly allocated to two treatment arms: rosuvastatin alone (R-group, N.=22) and rosuvastatin with atenolol (RA-group, N.=22). RESULTS Baseline FMD was not different between the two treatment arms, and both groups showed improvement in FMD (R-group, 3.48±1.9% to 4.65±2.41%, P<0.05; RA-group, 3.42±1.48% to 5.46±1.79%, P<0.05), while there were no differences in NMD. The effects on lipid profiles were identical in the two groups. In addition, FMD improvement was greater in the RA-group than in the R-group (Δchange 2.15±1.29% vs. 1.16±1.15%, P<0.05). CONCLUSION Beta-blockade enhances the pleiotropic effects of statins on endothelial function. The mechanism should be confirmed by further studies.
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Affiliation(s)
- B Takase
- Department of Intensive Care Medicine, National Defense Medical College, Saitama, Japan -
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Moreira FT, Ramos SC, Monteiro AM, Helfenstein T, Gidlund M, Damasceno NRT, Neto AMF, Izar MC, Fonseca FAH. Effects of two lipid lowering therapies on immune responses in hyperlipidemic subjects. Life Sci 2014; 98:83-7. [PMID: 24447629 DOI: 10.1016/j.lfs.2014.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 11/23/2013] [Accepted: 01/06/2014] [Indexed: 01/05/2023]
Abstract
AIMS To compare the effects of two of the most effective lipid-lowering therapies with similar LDL-cholesterol reduction capacity on the innate and adaptive immune responses through the evaluation of autoantibodies anti-oxidized LDL (anti-oxLDL Abs) and electronegative LDL [LDL(-)] levels. MAIN METHODS We performed a prospective, randomized, open label study, with parallel arms and blinded endpoints. One hundred and twelve subjects completed the study protocol and received rosuvastatin 40 mg or ezetimibe/simvastatin 10/40 mg for 12 weeks. Lipids, apolipoproteins, LDL(-), and anti-oxLDL Abs (IgG) were assayed at baseline and end of study. KEY FINDINGS Main clinical and laboratory characteristics were comparable at baseline. Lipid modifications were similar in both treatment arms, however, a significant raise in anti-oxLDL Abs levels was observed in subjects treated with rosuvastatin (p=0.026 vs. baseline), but not in those receiving simvastatin/ezetimibe. (p=0.233 vs. baseline), thus suggesting modulation of adaptive immunity by a potent statin. Titers of LDL(-) were not modified by the treatments. SIGNIFICANCE Considering atherosclerosis as an immune disease, this study adds new information, showing that under similar LDL-cholesterol reduction, the choice of lipid-lowering therapy can differently modulate adaptive immune responses.
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Affiliation(s)
| | | | - Andrea Moreira Monteiro
- Complex Fluids Laboratory, Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Tatiana Helfenstein
- Department of Medicine, Federal University of São Paulo, Sao Paulo, SP, Brazil
| | - Magnus Gidlund
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Maria Cristina Izar
- Department of Medicine, Federal University of São Paulo, Sao Paulo, SP, Brazil
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Abstract
The GALAXY Program is a series of clinical studies investigating the efficacy and tolerability of rosuvastatin in line with the hypothesis that the statin with the greatest efficacy for improving the atherogenic lipid profile and beneficially modifying inflammatory markers will also slow progression of atherosclerosis and improve cardiovascular outcomes. Completed studies report that rosuvastatin is more effective than comparator statins in reducing low-density lipoprotein cholesterol, improving the lipid profile and enabling patients to achieve lipid goals, including revised, more stringent goals, even in high-risk patients. Studies have also reported that rosuvastatin can arrest and even regress atherosclerosis. Ongoing outcomes studies will determine whether these beneficial effects of rosuvastatin translate into reduced morbidity and mortality.
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Abstract
Since the identification of a fungal metabolite that inhibits HMG-CoA reductase in 1976, statins have emerged rapidly as the global leader in pharmacotherapeutics designed to lower low-density lipoprotein cholesterol (LDL-C). In conjunction, practice guidelines have recommended increasingly aggressive measures to improve coronary heart disease (CHD) outcomes by lowering LDL-C. By virtue of unique chemical characteristics, enhanced binding thermodynamics and limited cytochrome P450 3A4 metabolism, rosuvastatin calcium has a safety profile in line with currently marketed statins, but a different efficacy profile. Mirroring this chemical profile, the GALAXY program represents a comprehensive evaluation of the efficacy, safety and cost-effectiveness of rosuvastatin in individuals representing various clinical diagnoses, pathophysiological states and ethnicities. Also results from the Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) study could provide further evidence for the use of rosuvastatin in individuals with traditional and emerging CHD risk factors, such as an elevated high sensitivity C-reactive protein level. This review will provide a comprehensive evaluation of the chemistry, clinical efficacy, safety and tolerability of rosuvastatin, and discuss the future role in the management of CHD and atherosclerosis.
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Affiliation(s)
- Navin K Kapur
- Johns Hopkins University School of Medicine, 600 North Wolfe Street, Carnegie Bldg, Room #568, Baltimore, MD 21287, USA.
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Chen SY, Shah SN, Lee YC, Boulanger L, Mardekian J, Kuznik A. Moving branded statins to lowest copay tier improves patient adherence. J Manag Care Pharm 2014; 20:34-42. [PMID: 24372458 PMCID: PMC10437520 DOI: 10.18553/jmcp.2014.20.1.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Statins are efficacious in reducing the risk of major cardiovascular events for both primary and secondary prevention, yet long-term adherence is poor. Their effectiveness could be compromised in actual practice when patients are not adherent to the treatments. Higher copayments have been shown to be associated with lower adherence to statins. OBJECTIVE To assess the effect on patient adherence of moving branded atorvastatin and rosuvastatin from the second to the first tier by a Medicare Part D plan sponsor. METHODS Pharmacy claims and eligibility records between July 1, 2009, and July 31, 2011, of Medicare Part D members not receiving the low-income subsidy were analyzed. New atorvastatin and rosuvastatin users in January 2010 (2010 cohort) were compared with those in January 2011 (2011 cohort) after this formulary tier change (tier-reduction group). Adherence was defined by the proportion of days covered (PDC) over 6 months. The impact of tier reduction on adherence was evaluated via logistic regression for binary outcome (PDC≥0.8) and generalized linear regression for continuous PDC by comparing the 2011 cohort with the 2010 cohort, adjusting for demographic and clinical characteristics. Other statin users (97% on generic statins) were also analyzed, serving as a nontier-reduction comparator group. RESULTS We identified 12,437 members in the tier-reduction group. Between the 2010 and 2011 cohorts, mean PDC increased from 0.77 to 0.83, and the proportion of members with high adherence increased from 62.0% to 72.9% (both P < 0.001). After regression adjustment, members in the 2011 cohort were more likely to be adherent (OR=1.68; 95% CI=1.55-1.82) and had a 5.9% increase in PDC (P < 0.05). There was no significant increase in adherence observed in the comparator nontier-reduction group. CONCLUSION Findings from this study suggest that financial incentives may improve medication adherence. Future studies should evaluate whether such formulary strategies improve long-term adherence and patient outcomes.
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